The second and current Boyle County Courthouse. Located in Danville and completed in 1862 at a cost of $15,000. It was built at the of the first courthouse .which was destroyed by fire in 1860.. Italianate style with two-story clock tower. The structure held only one session of court before the U.S. Army took it over as a hospital following the Battle of Perryville in October 1862. Damage caused by the soldiers required renovations and repairs 1873-1875. The design, construction, and repairs were by local architect James Carrigan. It was listed in the National Registry or Historical Places in 1973.
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Published Court of Appeals appellate cases for this week – March 18, 2016:
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224. immunity under the Health Care Quality Improvement Act, 42 United States Code (U.S.C.) §§ 11101et seq.
Benjamin Reid, Jr. M.D. vs. KentuckyOne Health, Inc
Court of Appeals Published Opinion Reversing and Remanding Jefferson Cir. Ct.’s judgment on the pleadings dismissing Reid’s tort and contractual claims.
Dr. Reid was a general surgeon on the staff of Jewish Hospital and St. Mary’s Healthcare for forty years when the hospital’s medical executive committee votes to cancel his surgical and endoscopy privileges and that he could no longer perform any further surgical procedures unless he was accompanied by an actively practicing and board certified general surgeon or endoscopist. Dr. Reid later filed suit seeking compensatory and punitive damages for breach of contract, intentional infliction of emotional distress, tortious interference with business and contractual relations, and slander. On September 12, 2014, KentuckyOne filed a Kentucky Rules of Civil Procedure (CR) 12.03 motion for judgment on the pleadings. Therein, KentuckyOne argued that it was entitled to immunity under the Health Care Quality Improvement Act, 42 United States Code (U.S.C.) §§ 11101et seq. (“HCQIA”), because the Hospital’s conduct with respect to Dr. Reid was related to its professional review activities. KentuckyOne further argued that, notwithstanding immunity, all of the claims asserted by Dr. Reid failed as a matter of law. The trial court (Judge Audra Eckerle) granted KentuckyOne Health’s motion and dismissing Dr. Reid’s claims. Dr. Reid argues that the trial court erred in concluding that he could not overcome the rebuttable presumption that KentuckyOne was entitled to immunity. Dr. Reid points out that professional review actions are afforded a rebuttable presumption of immunity under the HCQIA only if certain conditions are met by the healthcare entity, including notice and a hearing, which Dr. Reid claims did not occur herein.
The trial court herein, because it concluded that the Hospital’s conduct was a professional review activity, never considered the standards set forth in 42 U.S.C. § 11112(a). Dr. Reid alleged in his pleadings, and the Hospital did not dispute, that he was never afforded any notice or opportunity for a hearing prior to his privileges being restricted. Certainly, 42 U.S.C. § 11112(b) does provide that the failure to meet the notice and hearing requirements does not, in and of itself, constitute a failure to meet the required standards in 42 U.S.C. § 11112(a). Nevertheless, we are of the opinion that the trial court must consider whether the Hospital met all of the standards in 42 U.S.C. § 11112(a) before the Hospital’s immunity can be determined. Accordingly, a judgment on the pleadings was inappropriate and further consideration of the pertinent provisions of the HCQIA is required.
As such, we necessarily do not reach the substance of Dr. Reid’s underlying claims.
Not to be published tort, insurance and civil procedure decisions:
226. Appeal. Substantial compliance doctrine. Fee
Carlos Jones a/k/a Carlos Gresham vs. Brenda Clark
COA Not to Be Published Opinion reversing and remanding Jefferson Cir. Ct. dismissal or district court appeal holding the circuit court violated the substantial compliance doctrine when it dismissed an otherwise timely filed district court appeal on the basis that the entire filing fee was not paid until after expiration of the appeal time. For the reasons more fully explained below, we REVERSE and REMAND.
246.
General Hale Contracting, Inc. vs. Motorist Mutual Ins. Co.
COA Not to Be Published Opinion affirming Warren Cir. Ct. entry of judgment in conformity with a jury verdict dismissing, with prejudice, Terry Hale’s claim of bad faith against the appellee, Motorist Mutual Insurance Company (“Motorist”) claiming trial court committed error in admitting evidence
Bad faith claim was bifurcated and underlying tort claim for personal injuries in car collision went to jury and awarded Hale a the net sum of his recovery was $286,838. No appeal by Motorists.
Hale’s bad faith claim against Motorist proceeded to trial. The circuit court ultimately dismissed this claim with prejudice after a jury made the following findings: (1) Motorist had not failed to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies; (2) Motorist had not refused to pay Hale’s claims without conducting a reasonable investigation based upon all available information; (3) Motorist had not violated its duty to attempt in good faith to effectuate a prompt, fair and equitable settlement of a claim in which liability had become reasonably clear; and (4) Motorist had not compelled Hale to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amount Hale ultimately recovered in his lawsuit.
Hale’s arguments on appeal are two-fold. First, he contends the circuit court committed reversible error by allowing Motorist to introduce evidence regarding its negotiations with Hale and the parties’ settlement positions during and after the January 10, 2012 mediation. This, he asserts, is because Kentucky Rule of Evidence (KRE) 4082 provides that settlement negotiations are always inadmissible. Second, Hale argues the circuit court committed reversible error by also allowing Motorist to introduce expert opinion evidence that tended to prove he had exaggerated his estimate of economic damages resulting from the May 24, 2008 accident, and that he had also been comparatively negligent in causing the accident and a large extent of his own injuries by failing to avoid or lessen the severity of the accident by keeping a proper lookout, and by admittedly failing to wear a seatbelt. Hale asserts this expert evidence became irrelevant for all purposes after the jury in the September, 2012 trial found in his favor.
Both of Hale’s arguments have no merit because they are predicated upon a misapprehension of the issues presented in the January 2015 trial. To reemphasize, the overarching issue was whether Motorist committed the tort of bad faith by denying coverage and otherwise failing to offer Hale an adequate settlement prior to the September 2012 trial date.
The elements of bad faith from Wittmer v. Jones, 864 S.W.2d 885 (Ky. 1993) are as follows:
[A]n insured must prove three elements in order to prevail against an insurance company for alleged refusal in bad faith to pay the insured’s claim: (1) the insurer must be obligated to pay the claim under the terms of the policy; (2) the insurer must lack a reasonable basis in law or fact for denying the claim; and (3) it must be shown that the insurer either knew there was no reasonable basis for denying the claim or acted with reckless disregard for whether such a basis existed . . . [A]n insurer is . . . entitled to challenge a claim and litigate it if the claim is debatable on the law or facts.
As to Hale’s first argument, Motorist did not introduce evidence of its settlement negotiations with Hale to prove either its liability for or the invalidity of Hale’s UM/UIM claim or its amount. KRE 408 prohibits such a use for this type of evidence. Moreover, doing so would have been pointless because the prior jury verdict following the September 2012 trial (which Motorist never appealed) had already resolved the matter of Motorist’s liability.
Instead, it is readily apparent from the record that Motorist introduced this evidence for “another purpose” that the language of KRE 408 does not prohibit. Specifically, Motorist used this evidence to establish that any failure on its part to offer a settlement with Hale between the January 10, 2012 mediation and September, 2012 trial did not injure Hale in any cognizable way. It demonstrated (1) all of Hale’s multiple settlement demands, which ranged between $1.3 million and $400,000, were well in excess of what he eventually recovered in his UM/UIM judgment; and (2) Hale admitted, over the course of his deposition testimony, that he never would have settled for the amount he was awarded in his UM/UIM judgment.
Hale’s second argument similarly misses the mark. To begin, Hale cites no rule of law standing for the proposition that evidence, once disbelieved by a jury at some point in time, ceases to be evidence for any and all purposes thereafter. This is because no such rule of law exists. Furthermore, by reintroducing the expert evidence it had previously introduced in the September, 2015 UM/UIM trial, Motorist was not attempting, as Hale repeatedly insists throughout his brief, to retry the UM/UIM action.
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