Citations
- 69 Ohio App. 3d 249
Full opinion text
Brogan, Judge.
Appellant, Leonard Johnson, appeals from the summary judgment granted by the trial court in favor of appellee, Lincoln National Life Insurance Company (“Lincoln”).
The facts may be summarized as follows. On October 1, 1981, Lincoln issued a flexible income protection policy and rider to Johnson. It was Johnson’s intent to purchase an insurance policy that provided benefits in the event that he suffered any physical disability.
The terms of the policy obligated Lincoln to pay Johnson a monthly benefit of $500, reduced by certain other income, for each month that Johnson was totally disabled. The policy sets forth the following pertinent language beneath the boldface caption of “Benefits”:
“We will * * * make the first payment, equal to the Monthly Benefit Shown on page 3 [$500] less any Current Monthly Income (Total Disability Benefit), after you have been Totally Disabled for one month following the Waiting Period (and for a period of less than one month, Vm of the Total Disability Benefit for each day) and monthly thereafter.” (Emphasis added.)
In order to determine the amount of current monthly income to be subtracted from the monthly benefit of $500, one must successfully navigate the labyrinth of definitions as explained by Lincoln in its brief at p. 5:
“Pages 4 and 5 contain the ‘Definitions’ portion of the policy. On page 5, the term ‘Total Disability Benefit’ is defined as: ‘The Monthly Benefit shown on page 3 reduced by any Current Monthly Income.’ ‘Current Monthly Income’ is defined on page 5 as: ‘Your Monthly Income for the month that a benefit is claimed.’ ‘Monthly Income’ is defined on page 4 as follows: ‘During the Initial Benefit Period of any continuance Total Disability, Monthly Income is the sum of your Social Insurance Benefits.’ ‘Social Insurance Benefit’ is defined on page 4 as: ‘The initial amount of benefit which you receive or are entitled to receive from a Social Insurance Program.’ ‘Social Insurance Programs’ is defined on page 4 as, inter alia: ‘1. The Social Security Act (Social Security) * * V ”
From November 1,1982 through May 31,1988, Johnson experienced several periods of disability during which he received a total of $8,666.66 pursuant to the insurance policy at issue. However, after May 1988, Johnson began receiving Social Security benefits in excess of the $500 monthly benefit and Lincoln ceased payment under its policy.
In his amended complaint, Johnson asserted three causes of action. The first two, asserted against Lincoln, are at issue on appeal; the third, asserted against Lincoln’s agent, Phillip Stanze, is not. In his first cause of action, Johnson alleges that Lincoln’s policy is ambiguous and violates R.C. 3923.-03(E), which reads:
“No policy of sickness and accident insurance shall be delivered, issued for delivery, or used in this state unless all the following requirements are complied with: