American United Life Insurance Co. v. Restaurant Hospitality Ass'n of Indiana

BROWN, Judge

dissenting.

I respectfully dissent from the majority’s reversal of the grant of summary judgment to the associations. I conclude that a meeting of minds did not occur and that the trial court properly granted the associations’ motion for summary judgment.

“To create a contract of insurance there must be an agreement between the insurer and the insured. There must be a meeting of the minds.” Celina Mut. Cas. Co. v. Baldridge, 218 Ind. 198, 203-204, 10 N.E.2d 904, 906 (1937), reh’g denied. A contract of insurance requires a meeting of the minds of the parties upon the following essential elements of a contract: (1) the subject of the insurance; (2) the risk or peril insured against; (3) the amount of coverage; (4) the limit and duration of the risk; and (5) the amount of the premium to be paid. Stockberger v. Meridian Mut. Ins. Co., 182 Ind.App. 566, 577, 395 N.E.2d 1272, 1279 (1979).

Here, the three associations were made up of individual member employers that had established their own self-funded health insurance plans and maintained their own single employer trust accounts. The associations sought stop-loss insurance, which typically reimburses the employers for claims paid by self-funded plans in excess of a certain deductible. The insurers initially believed the associations to be multiple employer welfare arrangements. At some point, however, the insurers became aware that each member employer had its own trust account. The associations themselves had no employees, no health plans, and no risk to be insured. The insurers then issued the stop-loss policies to the associations, not the individual employers.

The majority holds that the parties had a meeting of minds regarding the risk insured against because the insurers were provided with information regarding the member employers’ employees. I disagree. In effect, the insurers contractually committed to cover a risk that did not exist, which was clearly not what the associations intended.

On appeal, the insurers claim that there was a meeting of minds regarding the risk and that the member employers were covered by the stop-loss insurance. However, this assertion conflicts with claims made in the insurers’ earlier filings to the trial court. “Judicial estoppel ‘prevents a party from asserting a position in a legal pro*429ceeding inconsistent with one previously asserted.’ ” Meridian Ins. Co. v. Zepeda, 734 N.E.2d 1126, 1133 (Ind.Ct.App.2000) (quoting Wabash Grain, Inc. v. Smith, 700 N.E.2d 234, 237 (Ind.Ct.App.1998), reh’g denied, trans. denied), trans. denied. A party may properly plead alternative and contradictory theories, but judicial estop-pel precludes a party from repudiating assertions in the party’s own pleadings. Marquez v. Mayer, 727 N.E.2d 768, 773 (Ind.Ct.App.2000), trans. denied.

The insurers earlier claimed that one of the associations, Hospitality, was not entitled to reimbursement of medical expenses incurred when a member employer’s employee was seriously injured in an accident. The insurers argued that the association was the insured and that the association itself had not made payments for the medical expenses. Rather, the payments were made by the member employer, which, the insurers argued, were not the insured. Consequently, the insurers argued that the association was not entitled to reimbursement.

The insurers should not be allowed now to take an inconsistent position that the member employers were covered by the stop-loss policies. Given the judicial estop-pel and the designated evidence, the associations and insurers clearly had different expectations regarding the risk to be insured by the stop-loss policies. I conclude that there was no meeting of the minds as to the risk to be insured, and the trial court properly granted summary judgment to the associations.