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Ahrenholtz v. Time Ins. Co.

Ahrenholtz v. Time Ins. Co.

Supreme Court of Wyoming

December 11, 1998, Decided

No. 98-10

Opinion

 [*947]  Golden, Justice.

John and Pam Ahrenholtz (Ahrenholtz) purchased a health insurance policy from Time Insurance Company (Time) with an effective date of May 1, 1994. By its terms the policy excluded coverage for treatment or removal of tonsils or adenoids during the first six months of coverage, except on an emergency basis. In June or July, 1994, Ahrenholtz' daughter began experiencing medical problems related to her tonsils and adenoids. Ahrenholtz' doctor recommended surgery in August, 1994, on a non-emergency basis. Ahrenholtz sought health benefits for the surgery, but Time rejected the claims because of the policy's above-referenced exclusion. Ahrenholtz sued Time, alleging [**2]  breach of contract, fraud, bad faith, and violation of reasonable expectations. They also sought attorneys' fees and interest because of alleged violations of WYO. STAT. § 25-14-124, which addresses a forty-five day period in which an insurer is to accept and pay or reject claims. The district court granted Time's motion for summary judgment against Ahrenholtz. We affirm that judgment.

ISSUES

Appellant Ahrenholtz submits the following statement of issues presented for review: 2

1. Did Time Insurance prove -- when the evidence is construed against it and in favor of its policyholder -- that all reasonable persons would conclude that Time exercised good faith and dealt fairly in all respects with John and Pam Ahrenholtz in the drafting and sale of its insurance coverage and in the investigation, handling and refusal to pay all claims under it?

2. Did Time prove that no reasonable person would find any merit in any of the causes of action asserted by John and Pam Ahrenholtz?

 [*948]  3. Do the Insurance Department regulations constitute standards of fair insurance practice so as to allow the jury to be instructed that they may consider violations as acts of bad faith?

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968 P.2d 946 *; 1998 Wyo. LEXIS 177 **

JOHN D. AHRENHOLTZ and PAM D. AHRENHOLTZ, Appellants (Plaintiffs), v. TIME INSURANCE COMPANY, a Wisconsin Corporation, Appellee (Defendant).

Prior History:  [**1]  Appeal from the District Court of Albany County Honorable Jeffrey A. Donnell, Judge.

Disposition: We affirm the district court.

CORE TERMS

surgery, insurer, coverage, district court, terms, summary judgment, unambiguous, insurance policy, bad faith, reasonable expectation, good faith, benefits, matter of law, attorney's fees, telegram, parties

Civil Procedure, Summary Judgment, Entitlement as Matter of Law, General Overview, Appeals, Summary Judgment Review, Opposing Materials, Supporting Materials, Contracts Law, Contract Interpretation, Ambiguities & Contra Proferentem, Insurance Law, Claim, Contract & Practice Issues, Policy Interpretation, Labor & Employment Law, Wrongful Termination, Breach of Contract, Express Contracts, Contract Formation, Ambiguous Terms, Construction Against Insurers, Ordinary & Usual Meanings, Unambiguous Terms, Business Insurance, Commercial General Liability Insurance, Coverage, Reasonable Expectations, Contract Conditions & Provisions, Remedies, Reformation, Business & Corporate Compliance, Contracts Law, Types of Contracts, Covenants, Liability & Performance Standards, Bad Faith & Extracontractual Liability, Breach, Breach of Contract Actions, Good Faith & Fair Dealing, Good Faith & Fair Dealing, Bad Faith & Extracontractual Liability, Payment Delays & Denials, Torts, Standards of Care, Appropriate Standard, Objectivity, Business Torts, Bad Faith Breach of Contract, Payments, Settlements, Releases From Liability, Costs & Attorney Fees, Costs