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Quirk v. Delaware County

Court of Appeals of Indiana

January 8, 2018

Michael P. Quirk, Appellant-Plaintiff,
v.
Delaware County, Indiana and The Board of Commissioners of Delaware County, Indiana, Appellee-Defendants

         Appeal from the Delaware Circuit Court The Honorable Peter Haviza, Special Judge Trial Court Cause No. 18C01-1210-PL-28

          ATTORNEY FOR APPELLANT Jason R. Delk Delk McNally LLP Muncie, Indiana.

          ATTORNEYS FOR APPELLEES John M. Stevens John H. Brooke Brooke Stevens, P.C. Muncie, Indiana.

          MAY, JUDGE.

         [¶1] Michael P. Quirk ("Quirk") appeals the trial court's grant of summary judgment in favor of Delaware County, Indiana, and the Board of Commissioners of Delaware County, Indiana (collectively, "Delaware"). He asserts that because Delaware did not respond to his motion for summary judgment within the thirty days allowed in Indiana Trial Rule 56(C), the trial court erred when it allowed Delaware to submit a brief after the summary judgment hearing that raised new arguments regarding affirmative defenses and when it thereafter relied on Delaware's affirmative defenses to grant summary judgment to Delaware.[1] Because Delaware's motion for summary judgment, which was filed before Quirk's motion for summary judgment, had asserted the argument and designated the evidence on which Delaware was entitled to summary judgment, we affirm.

         Facts and Procedural History[2]

         [¶2] Quirk was a public defender in Delaware County. Starting in 2005, he was enrolled in their health benefits plan. On July 1, 2011, Quirk was in a single-vehicle accident. According to the vehicle's Event Data Recorder, [3] Quirk was speeding, was not using his seatbelt, and did not apply the brakes until he crashed. Quirk's blood alcohol level was .363%. Quirk was charged with and convicted of Class A misdemeanor operating while intoxicated and Class A misdemeanor criminal recklessness.[4]

         [¶3] When Quirk submitted his medical bills from the accident to the administrator of the Delaware County health insurance plan, they were denied due to the "Illegal Acts Exclusion" found in the policy's description of the coverage provided. (See, e.g., Appellee's App. Vol. II at 128.)[5] This Illegal Acts Exclusion provides, in pertinent part:

The Plan does not cover charges for any of the following services:
* * * * *
(7) To the extent permitted by applicable law, services and supplies rendered for any condition, Disability or expense resulting from or sustained as a result of being engaged in an illegal occupation, commission of or attempted commission of an assault or an illegal act unless resulting from an act of domestic violence or a physical or mental medical condition as would be prohibited under the Health Insurance Portability and Accountability Act of 1996.

(Appellant's App. Vol. II at 83.)

         [¶4] On October 12, 2011, Quirk appealed the denial of his claim through the insurance plan's internal appeal procedure. Again, this claim was denied due to the Illegal Acts Exclusion. In the appeal denial, Quirk was notified that the

plan administrator has not been provided any information that would suggest that your illegal act . . . is the result of a physical or mental condition, such that the plan's exclusion for expenses resulting from or sustained as a result of the commission of your illegal act would be prohibited under the Health Insurance Portability and Accountability Act of 1996.

(Appellee's App. Vol. II at 129.)

         [¶5] Quirk had further medical procedures resulting from the injuries acquired during the car accident, the claims for which were also denied under the Illegal Acts Exclusion. He again appealed, but his appeal was denied. He was again informed the medical bills would not be paid by the insurance company unless the illegal act was the result of a mental or physical medical condition. The record contains no evidence or argument that Quirk asserted, at any time during those insurance company proceedings, that he had a mental or physical medical condition that made the Illegal Acts Exclusion inapplicable.

         [¶6] In October 2012, Quirk filed suit against Delaware for the unpaid medical bills, stating Delaware had breached the insurance contract and acted in bad faith. In Delaware's answer to the complaint, it asserted the affirmative defenses of estoppel, laches, accord and satisfaction, doctrine of unclean hands, and Statute of Frauds.

         [¶7] On April 18, 2016, Delaware filed a motion for summary judgment based on the Illegal Acts Exclusion and designated in support thereof all "pleadings, answers to Discovery, policy of insurance, and attached affidavits and exhibits."[6] (Id. at 7.) Delaware offered exhibits in support of its motion, including: (1) proof of the car accident; (2) proof of Quirk's blood alcohol level of .363%; (3) proof Quirk was convicted of operating while intoxicated and criminal recklessness; (4) the insurance plan; (5) Quirk's enrollment in the insurance plan; (6) Quirk's appeal letters regarding the denial of benefits; and (7) the insurance plan's denial of claims wherein the reason for denial was explained.

         [¶8] Quirk responded to Delaware's motion within his own motion for summary judgment. Therein, Quirk argued, for the first time, the mental medical condition exception ("Mental Medical Condition Exception") to the Illegal Acts Exclusion required Delaware to pay his claims. In the alternative, he also argued Delaware did not designate any evidence he was involved in an illegal act ...


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