Wilshire Ins. Co. v. Yager
Opinion of the Court
Pending before the Court are motions for summary judgment filed by Wilshire Insurance Company ("Wilshire"), Girard *934Insurance Services, Ira Girard and Mary Ann Girard (collectively referred to as "Girard"), and Patrick Yager and Javier Lopez (collectively referred to as "Yager"
STANDARD OF REVIEW
Summary judgment is appropriate where "there is no genuine dispute as to any material fact." Fed. R. Civ. P. 56(a). A genuine issue exists if "the evidence is such that a reasonable jury could return a verdict for the nonmoving party," and material facts are those "that might affect the outcome of the suit under the governing law." Anderson v. Liberty Lobby, Inc. ,
BACKGROUND
This case involves an insurance dispute that arises from an automobile accident in Tucson, Arizona. On November 12, 2014, Javier Lopez was driving his 2004 Econoline Van ("Van"). The Van was involved in an accident with a motorcycle driven by Patrick Yager. Yager suffered various physical injuries in the accident. It is disputed as to who was at fault in the accident. Yager argues that Lopez made an unsafe lane change and collided with Yager. Wilshire argues that Yager had been in three other accidents, had been required to go to driving school twice for speeding, that he has driven his motorcycles at speeds of 190 miles an hour, that Yager lacks any memory of the accident, and that the three eye witnesses to the accident indicated that Yager caused the accident.
After the accident, Yager filed a lawsuit in Pima County Superior Court against Lopez alleging that he was at fault in the accident; in addition, Alonso Pastor was also named in the lawsuit ("State Lawsuit"). Pastor was named in the State Lawsuit as he was the named insured under a commercial auto liability policy with Wilshire; the Van that Lopez owned was added as a covered auto under Pastor's previously existing policy with Wilshire, but Lopez was not listed as a named insured under that policy (the "Policy").
Lopez tendered his defense to Wilshire pursuant to the Policy issued to Pastor. In March of 2015, Wilshire retained counsel to defend Lopez in the State Lawsuit. However, by August of 2015, Wilshire sent Lopez a reservation of rights letter informing him that while Wilshire would continue to provide counsel to Lopez in the State Lawsuit, it was doing so under a reservation of rights because although Lopez's Van was listed as a covered auto under Pastor's Policy, Lopez was not an insured under the Policy (i.e., one has to be both an "insured" driving a "covered auto" for liability coverage to apply).
Yager's claims in the State Lawsuit against Pastor were dismissed at summary judgment, and that dismissal was affirmed on appeal. The State Lawsuit against Lopez ended when Lopez entered into a Morris agreement with Yager whereby Lopez assigned all of his rights against Wilshire and Girard to Yager; pursuant to the Morris agreement, the parties stipulated to a judgment of $1.5 million, and Yager agreed not to seek recovery of the judgment, or any other form of damages, against Lopez. Thereafter, Wilshire filed the instant declaratory judgment action against Yager and Lopez in this Court seeking a declaration that Wilshire owed no duty to indemnify. Thereafter, Yager asserted claims for breach of contract and bad faith against Wilshire, and claims against Girard stemming from its failure to properly procure insurance coverage for Lopez.
DISCUSSION
The Insurance Policy and Reasonable Expectations
Wilshire and Yager have both moved for summary judgment as to the issue of whether Lopez was covered by the Policy. The Court agrees with Wilshire's position that the Policy is unambiguous and does not cover Lopez.
Contract interpretation is a matter of law, and whether the terms of the contract are ambiguous is also a matter of law. United States v. King Features Entm't, Inc. ,
*936and applied as written. Nat'l Fire Ins. Co. of Hartford ,
As pertinent to the dispute at bar, the Policy states in relevant part:
SECTION II - LIABILITY COVERAGE
We will pay all sums an 'insured' legally must pay as damages because of 'bodily injury' or 'property damage' to which this insurance applies, caused by an 'accident' and resulting from the ownership, maintenance or use of a covered 'auto.' ...
1. Who Is An Insured
The following are 'insureds':
a. You for any covered 'auto.'
b. Anyone else while using with your permission a covered 'auto' you own, hire or borrow except:
(1) The owner or anyone else from whom you hire or borrow a covered 'auto'. This exception does not apply if the covered 'auto' is a trailer connected to a covered 'auto' you own.
(2) Your 'employee' if the covered 'auto' is owned by that 'employee' or a member of his or her household.
(3) Someone using a covered 'auto' while he or she is working in a business of selling, servicing, repairing, parking or storing 'autos' unless that business is yours.
(4) Anyone other than your 'employees', partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their 'employees', while moving property to or from a covered 'auto.'
(5) A partner (if you are a partnership) or a member (if you are a limited liability company) for a covered 'auto' owned by him or her or a member of his or her household.
c. Anyone liable for the conduct of an 'insured' described above but only to the extent of that liability.
See Doc. 178-1
Yager primarily argues that Lopez was covered by the Policy because *937Lopez's Van (which was involved in the accident in this case) was specifically listed as a covered auto under the Policy. While the Van was indeed listed as a covered auto under the Policy, it does not change the fact that the Policy clearly states that liability coverage only applies if you are also an insured under the Policy (i.e., liability coverage only applies if one is an insured who is driving a covered auto). There are three categories of insureds under the Policy. Under section "a", the Policy states that "You" refers to the named insured listed in the Declaration. Lopez is not listed as a named insured; only Pastor is listed as a named insured. Under section "b", one is considered an insured if the named insured (i.e., Pastor) gives permission to drive a "covered 'auto' you own, hire or borrow." Lopez owned the Van involved in the accident; as such, Pastor did not give Lopez permission to drive a Van that Lopez actually owned. As to section "c", Lopez was driving the subject vehicle (not Pastor) at the time of the accident; thus, Lopez could not be liable for Pastor's conduct under the circumstances at bar. Although Lopez was driving a covered auto under the Policy, Lopez was not an insured under the Policy such that liability coverage did not attach. See Ogden v. U.S. Fid. & Guar. Co. ,
Wilshire also argues that the reasonable expectations doctrine does not apply under the circumstances of this case, and therefore it is entitled to summary judgment as to this issue. The Court agrees.
Insurance provisions that are facially valid may be invalidated if they subvert the insured's reasonable expectations. See Gordinier v. Aetna Cas. & Sur. Co. ,
"[M]ost insureds develop a reasonable expectation that every loss will be covered by their policy, ... the reasonable expectation concept must be limited by something more than the fervent hope usually engendered by a loss." Lincoln Tech. Inst. of Arizona, Inc. v. Fed. Ins. Co. ,
As a threshold matter, as discussed above, Lopez was not a named insured under the Policy. Pastor was the named insured under the Policy and had the contract of insurance with Wilshire. Lopez was not a party to the insurance contract with Wilshire, and therefore Lopez's reasonable expectations have little impact on the enforceability of the Policy in this case. See Ogden ,
Waiver and Estoppel
Wilshire and Yager have both moved for summary judgment as to the issues of waiver and estoppel. The Court agrees with Wilshire's position as to these issues; Wilshire is entitled to summary judgment.
As a general matter, "waiver, either express or implied, has been defined as the voluntary and intentional relinquishment *939or abandonment of a known right. It is unilateral in that it arises out of either action or non-action on the part of the insurer or its duly authorized agents and rests upon circumstances indicating or inferring that the relinquishment of the right was voluntarily intended by the insurer with full knowledge of all of the facts pertaining thereto ... Estoppel ... refers to a preclusion from asserting a right by an insurer where it would be inequitable to permit the assertion. It arises by operation of law, and rests upon acts, statements or conduct on the part of the insurer or its agents which lead or induce the insured, in justifiable reliance thereupon, to act or forbear to act to his prejudice. Abatement of the right or privilege involved by way of estoppel need not be intentionally, voluntarily or purposely effected by or on the part of the insurer." McCollum v. Continental Cas. Co.,
The Arizona cases most relevant to the specific circumstances in this case (i.e., alleged harm stemming from an insurance company's delayed reservation of rights) are Penn-Am. Ins. Co. v. Sanchez ,
Penn-Am involved an auto accident that occurred while a delivery was being made on behalf of a warehouse company ("Inside Arizona") responsible for transporting commercial goods; the auto accident occurred on June 30, 2000 and resulted in the death of three people. See Penn-Am at 218 Ariz. at 8,
The Penn-Am policy provided for coverage in the amount of $1,000,000 per occurrence, but the policy contained "an exclusion for any coverage for '[b]odily injury' or 'property damage' arising out of the 'ownership, maintenance, use or entrustment to others' of an automobile."
By the time Penn-Am had reserved its rights and notified National of the lawsuit in mid-October of 2002, the discovery deadline in the wrongful death lawsuit had already expired on September 30, 2002, and cross-motions for summary judgment were already pending in the trial court.
Because of Penn-Am's unreasonable delay in reserving its rights, Inside Arizona's business auto insurer (National) was not notified of the wrongful death lawsuit until discovery had already closed and cross-motions for summary judgment were pending.
Pueblo involved a lawsuit by a homeowners' association (Pueblo Santa Fe Townhomes Owners' Association - "Pueblo") against several general contractors and subcontractors that were involved in constructing homes in the Pueblo community. Pueblo , 218 Ariz. at 16,
In August of 1999, Palo Verde notified its insurance company ("Transcontinental") that it was named as a defendant in the Pueblo lawsuit, and Transcontinental retained a law firm to represent Palo Verde in the suit.
*941Palo Verde's insurance policy contained a "your work" exclusion whereby there was no liability coverage for repairing or replacing Palo Verde's work (i.e., stucco damages over a million dollars); rather, relevant coverage only applied to incidental damage caused by Palo Verde's work (such as water seepage into homes through cracks in the stucco).
Although Transcontinental retained defense counsel to defend Palo Verde in the Pueblo lawsuit in August of 1999, Transcontinental did not issue a reservation of rights letter to Palo Verde until February of 2001.
Counsel retained by Transcontinental never took any action to engage in destructive testing prior to October of 2000, and did not even obtain an expert for Palo Verde until seven months after the deadline expired.
The Pueblo court observed that "[i]n view of the many cracks in the stucco and the Pueblo laboratory report critical of the stucco mix, [Palo Verde's] best chance to avoid an adverse jury verdict ... was to prove that its stucco had cracked not because of anything [Palo Verde] had done but because of mistakes in how the buildings were designed or built that permitted the walls or foundations to shift, causing the stucco to crack as a result. The most powerful evidence of those factors was to be found beneath the stucco on the buildings, obtainable only through destructive *942testing."
Unlike the insureds in Penn-Am and Pueblo , there is no evidence that Lopez suffered any prejudice as a result of Wilshire's delay in issuing a reservation of rights letter to Lopez. Wilshire retained counsel to defend Lopez in the State Lawsuit in March of 2015. By August of 2015, Wilshire had issued its reservation of rights letter to Lopez. There is no evidence that the defense provided to Lopez (via counsel retained by Wilshire on Lopez's behalf) was in any way improper. There is no evidence that had the reservation of rights been issued earlier, counsel for Lopez would have done anything differently, or that Lopez could have and would have done anything differently, to avoid any purported prejudice stemming from the delay in the reservation of rights. Yager argues, for example, that he was prejudiced because he testified at a deposition and responded to discovery, that a policy limit settlement offer of $750,000 expired prior to the issuance of the reservation of rights, and that Wilshire's refusal to indemnify him exposed him to the risk of losing his license to operate his van to transport customers. However, there is no evidence that Lopez was prejudiced by participating in discovery or being deposed, or that he lost his license due to the delay in the reservation of rights. Likewise, unlike the insured in Penn-Am who could have satisfied the $925,000 settlement demand via a second insurance policy with a separate insurer, there is no evidence that Lopez could have satisfied the $725,000 settlement demand made in this case. The evidence before the Court does not support waiver or estoppel in this case. There is no evidence supporting detrimental reliance and prejudice stemming from Wilshire's delay in sending the reservation of rights letter to Lopez.
As the Court has found that Lopez was not entitled to any liability coverage under the Policy, and that all of Plaintiff's alternative grounds for liability coverage are without basis, Wilshire's motion for summary judgment is granted, and Plaintiff's motion for summary judgment or in the alternative for partial summary adjudication is denied.
Girard's Motion for Summary Judgment
Girard's motion for summary judgment only warrants a brief discussion as it is primarily premised on accepting Girard's position that there is no evidence showing that Girard was aware of Lopez's existence prior to the accident. Girard argues, for example, that as of the time period prior to the accident: Girard employees have stated that they never had any contact with Lopez and were not aware of Lopez; there are no receipts showing that Lopez made any payments at Girard's office regarding Pastor's Policy; there are no phone records showing any contact between Girard and *943Lopez; and there is no physical documentation to substantiate any claim that Girard was aware of Lopez. Therefore, according to Girard, as it was completely unaware of Lopez's existence prior to the accident, it cannot be held liable for Yager's claims of negligence, breach of good faith and fair dealing, reasonable expectations of coverage, and punitive damages stemming from any failure to properly procure insurance for Lopez.
There is evidence, however, reflecting that Girard was aware of Lopez prior to the accident. For example, according to Lopez's deposition testimony, during the time period prior to the accident: Lopez personally met with and spoke to Girard employee Francine Dortch seven times in Girard's office; Lopez only dealt with Dortch at Girard; Lopez made in-person payments on the Policy at Girard's office; Dortch was told that Lopez owned the Van; Lopez was told that he was covered under the Policy; when Lopez noticed that his name did not appear on some documents related to the insurance, and he pointed this concern out to Dortch, Dortch told Lopez that it was fine and there was no problem.
In light of the foregoing, there are material issues of fact precluding summary judgment in favor of Girard; Girard's motion for summary judgment is denied.
MOTIONS IN LIMINE
As the Court has granted summary judgment in favor of Wilshire, Wilshire's motions in limine
As to Girard's "motion to strike expert opinion of Daniel Fink" (Doc. 145)
CONCLUSION
Accordingly, IT IS HEREBY ORDERED as follows:
(1) Girard's motion for summary judgment (Doc. 186), Yager's motion for summary judgment or in the alternative for partial summary adjudication (Doc. 180), and the motions in limine (Docs. 141, 145, 146, 147, 148, 156, 169) are denied.
(2) Wilshire's motion for summary judgment (Doc. 177) is granted; the Clerk of the Court shall enter judgment in favor of Wilshire Insurance Company.
(3) Yager and Girard shall file their Proposed Joint Pretrial Order within 30 days of the filing date of this Order. See Doc. 19 (Scheduling Order at p. 4).
Yager is the real party in interest in this case inasmuch as Lopez assigned all of his rights against Wilshire and Girard to Yager.
In addition to considering the parties' respective personal characterizations of the evidence as reflected in their briefs, statements of fact, oppositions thereto and supplemental facts, the Court has likewise considered the underlying evidence specifically cited by the parties in relation to all of those filings.
Because the briefing is adequate and oral argument will not help in resolving this matter, oral argument is denied. See Mahon v. Credit Bureau of Placer County, Inc. ,
Unless otherwise noted by the Court, internal quotes and citations have been omitted when quoting and citing cases throughout this Order.
Pastor had a commercial shuttle business; although Lopez did not work for Pastor in any capacity, and Lopez owned the Van that Lopez himself used to shuttle passengers, Pastor added Lopez's Van to his preexisting Policy.
The evidence reflects that Pastor and Lopez exclusively communicated with only Girard in relation to the Policy. To the extent that Girard later communicated with Statewide Insurance Company ("Statewide" - an agent of Wilshire) to procure Wilshire insurance coverage, there also is no evidence that Statewide was aware of Lopez's existence prior to the accident. There is no evidence that Girard is Wilshire's agent, and there is no evidence that Girard informed Wilshire or Statewide of Lopez's existence prior to the accident. Yager's separate claims against Girard are discussed later in this Order.
The policy also states: "throughout this policy the words 'you' and 'your' refer to the Named Insured shown in the Declarations. The words 'we', 'us', and 'our' refer to the Company providing this insurance." The only named insured listed in the policy is Alonso Pastor.
When citing to docket entries, page references are to the CM/ECF computer generated page numbers appearing in the upper right hand corner of the page.
To the extent that Yager generally argues that public policy somehow establishes liability coverage, Yager's position is not supported by the pertinent authority applicable to the circumstances of this case. For example, Yager argues that Arizona law generally requires insurance coverage where an insured grants a third party permission to drive the insured's vehicle. While this is true, it is irrelevant in this case. Lopez was driving the vehicle he owned which was involved in the accident with Yager. Pastor (the insured) did not give Lopez permission to drive the vehicle that Lopez actually owned. See Ogden ,
Prejudice to the insured is evaluated prior to the date of the Morris agreement. Id. at 15,
Moreover, the record does not reflect that Wilshire intended to waive its right to deny coverage, engaged in any action or inaction that would support waiver, and never communicated any waiver to Lopez or Pastor.
In reliance on a separately filed motion in limine to exclude the testimony of expert Carmine Cornelio (Doc. 156), Girard summarily argues that Yager cannot prove any damages to support any of his claims, and therefore summary judgment must be granted in its favor. However, as discussed herein, the motion in limine in question has been denied, and therefore there is no basis for Girard's position.
Although some of these documents were titled "motions to strike", they are motions in limine seeking to exclude evidence at trial.
To the extent that Girard filed joinders summarily relying on Wilshire's motions in limine appearing at Docs. 146, 147, and 148, those motions have now been denied. If the issues in those denied motions are still pertinent to the remaining case against Girard, Girard may file its own motions in limine arguing why such evidence is inadmissible at trial as it relates to the claims remaining against Girard.
Although Doc. 145 is titled as a joinder in Wilshire's motion, it is a substantive motion in limine that discusses pertinent facts and authority applicable to the claims against Girard, and it stands on its own apart from Wilshire's motion.
As Girard's motion for summary judgment has been denied, Yager's motion to strike (Doc. 209) (pertaining to Girard's summary judgment motion) is denied as moot.
Any party may file a motion seeking to stay the remaining deadlines in the case pending a settlement conference. In addition, the Court notes that it can set up a settlement conference with a Magistrate Judge at no cost to the parties.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.