Young v. Metro. Prop. Cas. Ins. Co., No. Cv95-0380614 (Mar. 5, 1998)
Opinion of the Court
On September 12, 1991, the plaintiff, Leroy Young, was involved in an auto accident, while operating a non-owned motor vehicle. The vehicle was owned by the plaintiff's employer1 and insured by Continental under a policy providing $1,000,000 in underinsured/uninsured motorist ("UM/UIM") benefits. Pi.'s Mem. Supp. Summ. J., Ex. A. The plaintiff's own policy with Metropolitan was also in force at the time of The accident. The plaintiff's policy insured two vehicles and provided UM/UIM coverage of $100,000 per person, a separate premium having been paid for each of the two vehicles. Id., Ex. B. The total UM/UIM coverage under the Metropolitan policy, after intra-policy stacking, was $200,000. Continental's $1,000,000 policy is primary and Metropolitan's $200,000 is excess pursuant to the insurance contracts and the existing underinsured/uninsured law.2 The tortfeasor had $100,000 in liability insurance coverage which was paid to the plaintiff. Pl.'s Mem. Supp. Summ. J., Ex. C.
The plaintiff filed a complaint against Metropolitan on November 5, 1995, alleging that as his damages "greatly exceed[ed] the policy limits recovered from the [tortfeasor] . . . and greatly exceed[ed] the underinsured motorist coverage available under the Continental policy"; Complaint, ¶ 16; he was "entitled to recover his full damages by the aggregation of uninsured policy coverage on each of [two] automobiles from . . . Metropolitan." Id., ¶ 17. Subsequently, the plaintiff moved to stay his action against Metropolitan, pending the outcome of his arbitration proceeding against Continental. This motion was denied on July 8, 1996. By orders dated October 20, 1996 and April 18, 1997, however, the plaintiff's subsequent Motions for Exemption from Dormancy were granted, pending the outcome of the arbitration proceedings against Continental: "if the arbitration proceedings result in exhaustion of the UM limits of the Continental policy, then this [present action against Metropolitan] may go forward to determine what, if any, additional UM benefits should be awarded to plaintiff." Pl.'s Motion for Exemption from Dormancy, dated October 20, 1996 and April 18, 1997, ¶ 5.
Pursuant to the terms of the Continental policy, the plaintiff also initiated arbitration proceedings against Continental to recover [UM] benefits.3 By letters dated CT Page 2615 November 20, 1995, December 19, 1995, and March 12, 1996, the plaintiff invited Metropolitan to join in its arbitration. Id., Ex. E. Metropolitan declined. Its policy with the plaintiff did not have an arbitration provision; by contrast, section four of its policy specifically provided that "[Metropolitan would not be] bound by any judgment against any person or organization obtained without [its] written consent. . . ." Pl.'s Mem. Supp. Summ. J., Ex. B, p. 4.
On September 9, 1997, the arbitrators issued a finding and award of damages in the amount of $1,150,000, from which the arbitrators made the following deductions or credits to Continental:
Continental Coverage Limit $1,000,000 Payment by Tortfeasor $ 100,000 BRB4 Payments by Continental $ 4,486 SSDI Benefits $ 132,664 __________ Total Set Offs/Credits $ 237,150
Net Damage Award $ 762,850
See id., Ex. C., p. 16. The arbitrators reduced Continental's responsibility by the total set offs and credit amount and found that Continental owed the plaintiff $762,850. Pl.'s Mem. Supp. Summ. J., Ex. C, p. 16. The arbitrators did not make findings with respect to Metropolitan's excess policy. Id.
The plaintiff filed his motion for summary judgment against Metropolitan on October 3, 1997, on the ground that there is no genuine issue as to any material fact and that he is therefore entitled to judgment as a matter of law. He argues in support of his motion that (1) intra-policy stacking requires Metropolitan, as an excess carrier, to provide him with UM coverage; and that (2) the arbitration panel correctly allocated the total set offs and credit amounts to Continental as the primary insurer; and that (3) Metropolitan, is collaterally estopped from contesting the arbitration award as to damages.
The defendant filed a memorandum in opposition and cross motion for summary judgment on October 29, 1997, on the ground that there is no genuine issue as to any material fact and it is therefore entitled to judgment as a matter of law. In support of its motion, it argues that (1) the plaintiff has failed to CT Page 2616 exhaust Continental's primary coverage based on the proper application of available set offs and credits; and that (2) it may not be collaterally estopped from "litigating matters decided by [the] arbitration entered into pursuant to Continental's insurance policy."
Legal Discussion
I. Collateral Estoppel
The plaintiff argues that Metropolitan is estopped from contesting the arbitration panel's award of damages. The plaintiff argues that privity exists between Metropolitan and Continental as the amount of their respective UM motorist payments is determined, within contractual limits, by the arbitration panel's determination of tort damages. In addition, the plaintiff argues that Metropolitan's interests were adequately represented by Continental's counsel of Morris, Mahoney Miller as well as by arbiter, Jon Berk, the co-author of the text, Connecticut Law of Insured and Underinsured Motorist Coverage.5 The plaintiff argues that through Continental's full and fair opportunity to cross examine each witness over the course of the several days of testimony and to produce evidence contesting the plaintiff tortfeasor's claim, Metropolitan was afforded the same opportunity. The defendant argues that it may not be estopped from contesting the arbitration panel's award of damages as it was not a party to the arbitration proceeding, thus the panel's decision cannot bind it. The defendant argues, in the alternative, that even if the panel's decision is a "final judgment" as to Metropolitan, it cannot be estopped from litigating the proper application of set offs as this issue was never litigated from its perspective, a perspective that is necessary for full and fair litigation as it is at odds with Continental's perspective.
"Collateral estoppel, or issue preclusion, is that aspect of res judicata which prohibits the relitigation of an issue when that issue was actually litigated and necessarily determined in a prior action between the same parties upon a different claim."Jackson v. R.G. Whipple. Inc.,
Collateral estoppel may also be invoked against those in privity with parties to a prior proceeding. See Aetna Casualty Surety Co. v. Jones, supra,
In Mazziotti v. Allstate Ins. Co., supra,
In reversing the trial court on the collateral estoppel issue, the Supreme Court reasoned that as the "[tortfeasor] and Allstate did not share the same legal right, they were not in privity." (Emphasis in original.) Mazziotti v. Allstate Ins. Co., supra,
The Mazziotti court went on to explain the connection between privity of "legal right" and "full and fair litigation": "the interest of the party to be precluded must have been suffficiently represented in the prior action so that the application of collateral estoppel is not inequitable." Id., 818. The Mazziotti court found that the uninsured motorist insurer's interests were not sufficiently represented in the prior negligence action against the tortfeasor defendant driver. Id. Because the tortfeasor's liability was limited to $20,000 under its policy, "there was little or no incentive in [the underlying action] to litigate against a recovery in excess of that amount. . . . Allstate [the UM/UIM insurer] . . . with five times the risk, was in a different position with a far greater incentive to litigate [in the present action] . . . The relationship between the party to be estopped (Allstate) and the [tortfeasor] [was] not sufficiently close so as to justify the application of the principles of preclusion." Id. See also AetnaCasualty Surety Co. v. Jones, supra,
In State v. Fritz,
The plaintiff's argument in support of his motion for summary judgment is unavailing as privity does not exist between Continental and Metropolitan; thus, Metropolitan may not be estopped from contesting the arbitration decision. Continental and Metropolitan do not share the same legal right as their separate rights arise from their separate contracts. Continental's contractual obligation to provide underinsured motorist payments is triggered when the insured proves that a third party is underinsured and legally liable. Williams v. StateFarm Mutual Automobile Ins. Co.,
It is because Continental and Metropolitan have disparate legal rights that Continental can not fully and fairly litigate Metropolitan's legal interests. That Metropolitan presently disputes the arbitration panel's allocations of set offs and credits in Continental's favor, exemplifies their disparate foci and calls into question whether Metropolitan's interest was "adequately served in the [arbitration] proceeding." State v.Fritz, supra,
The defendant is correct in its argument in cross motion that it may contest the arbitration panel's decision as it was not a party to the Metropolitan insurance contract's arbitration provision. "Contracts of insurance are to be construed in the same manner as other contracts, such that they are given a reasonable interpretation and the words used [are to] to be given CT Page 2621 their common, ordinary and customary meaning." Candido v.Worcester Ins. Co., Superior Court, judicial district of New Haven at New Haven, Docket No. 343978, (July 22, 1997, Hodgson,J.) citing Aetna Casualty Surety Co. v. CNA Ins. Co., supra,
By express terms, the plaintiff insured, Young,8 and the insurer, Continental, agreed to submit disagreements as to whether the insured was entitled to UM damages or the amount of those damages to arbitration9 and that agreement is binding on them. See M L Building Corp. v. Housing Authority,
The defendant's alternative argument is that even were the court to decide that it is bound by the arbitration decision, it may not be estopped from contesting the panel's application of CT Page 2622 set offs and credits as this matter was not litigated with respect to it. Although the defendant may litigate matters decided by the arbitration panel, as detailed in part two of this opinion, the arbitration panel's allocation of full credit for the set offs to the primary insurer, was correct as a matter of law.
Accordingly, the court will deny the plaintiff's motion for summary judgment on the issue of whether the defendant is collaterally estopped from contesting the arbitration panel's award of damages as no privity exists between Continental and Metropolitan and therefore Metropolitan was not afforded a full and fair opportunity to litigate its claims.
In addition, the court will grant the defendant's cross motion for summary judgment on the issue of whether the defendant is collaterally estopped from contesting the arbitration panel's decision as it neither signed the Continental arbitration contract nor assented to the arbitration hearings. Thus, it can neither be compelled to arbitrate nor be held bound by the arbitration panel's decision.
II. The Proper Allocation of Credits and Set Offs Between Primary and Excess Underinsurance Carriers
The plaintiff further argues (1) that intra-policy stacking requires Metropolitan to provide UM motorist benefits to the plaintiff in the amount of $200,000; and (2) that the arbitration panel properly "gave Continental [the primary underinsurance carrier] full credit for payment by the tortfeasor and other set offs and reductions." Pl.'s Mem. Supp. Summ. J., P. 7.
The defendant further argues that "the plaintiff can not sustain an action against Metropolitan [as he] has failed to exhaust the primary coverage by Continental based upon proper application of available set offs and credits." Def.'s Mem. Opp. and Cross, p. 3.
"The public policy established by the underinsured motorist statute is that every is entitled to recover for the damages he or she would have been able to recover if the underinsured motorist had maintained an adequate policy of liability insurance." (Brackets omitted; internal quotation marks omitted.)Haynes v. Yale-New Haven Hospital,
In Aetna Casualty and Surety Co. v. CNA Ins. Co., supra,
Pursuant to the policies' terms, the claims went to arbitration and the panel determined that the plaintiff suffered total damages in the amount of $400,000; that the total UM coverage available under the Aetna policy was $300,000; and that the total UM coverage available under the CNA policy after stacking was $600,000. Id. The panel also decided that the CT Page 2624 insurer of the vehicle involved in the accident, Aetna, was the primary insurer and that the other insurer was excess. Id. "The panel, therefore, concluded that Aetna's coverage should be exhausted before CNA should be obligated to pay underinsured motorist benefits." Id., 782. The panel awarded Aetna full credit for the $100,000 tortfeasor payment; it ordered Aetna to pay the first $200,000 and CNA to pay the additional $100,000. Id.
On Aetna's motion to vacate and CNA's motion to confirm, the trial court held that the parties' respective "other insurance" provisions were in conflict and it declared both policies primary and prorated the tortfeasor's payment between them. Id., 783-84.
On appeal, the Supreme Court reversed the trial court proration judgment and reinstated the arbitrator's decision, reasoning that although each policy contained an other insurance/excess clause, the Aetna policy, by its own terms, did not envision being excess under the facts. "The policies themselves . . . dictate that we hold that the Aetna underinsured motorist coverage be primary and the CNA underinsured motorist coverage be excess." Id., 787. The court reinstated the arbitration panel's award, thus giving full credit for the tortfeasor payment to the primary insurer, Aetna. Id., 788. SeeLoika v. Aetna Casualty Surety Co.,
The plaintiff's first argument in support of its motion for summary judgment is incorrect. As a matter of law, it is not intra-policy stacking per se which would require Metropolitan to pay UM benefits to the plaintiff in the amount of $200,000. "Stacking [of underinsured motorist coverage] is available when the insured has paid separate premiums for the underinsured motorist coverage afforded to each vehicle. . . . This is particularly true when each of the insured vehicles is separately described, the coverage granted under the policy is separately listed for each vehicle, and a separate premium is charged for the coverage afforded to each of the described vehicles." (Citations omitted; internal quotation marks omitted.) Kent v.Middlesex Mutual Assurance Co.,
The plaintiff's second argument is correct as a matter of law as the arbitration panel properly awarded full credit for the available set offs to Continental. Neither party disputes that Continental is the primary carrier and that Metropolitan is the excess carrier. Pl.'s Mem. Supp. Summ. J., p. 2; Def.'s Mem. Opp. CT Page 2626 And Cross, p. 5. Thus, Continental was properly awarded credit for the (1) the tortfeasor's insurer's payment; (2) its own BRB payment; and (3) SSDI benefits.11 Under the reasoning employed by the arbitration panel in Aetna Casualty and Surety Co.v. CNA Ins. Co., supra,
The defendant's argument in support of its motion for summary judgment is incorrect. While there are no issues of material fact in dispute, the defendant is incorrect as a matter of law in its argument that the plaintiff can not sustain an action against Metropolitan to collect UM benefits as it "has failed to exhaust the primary coverage by Continental based upon proper application of available set offs and credits." Def.'s Mem. Opp., p. 3. The substance of the defendant's argument is that the arbitration panel incorrectly awarded full credit for the available set offs to Continental. The defendant cites Allstate Ins. Co. v. Link,
Thus, when the Link court declared that the plaintiff "was entitled to have available a total of $600,000 . . . [instead of $400,000] under the two Allstate policies . . . [from which] Allstate should have been credited with only the $100,000 actually paid by the tortfeasor"; id., 349; the court revealed that its chief concern was to avoid compromising coverage for the insured. It was not, as the defendant argues, declaring that the rule for the application of set offs and credits when the plaintiff's damages exceed coverage is to first determine the total available UM coverage and then reduce the credits from the total coverage of both policies. Even were that the case, the defendant's case presents the converse situation: the plaintiff's damages do not exceed coverage. Thus, the defendant's derivation of the rule which it presumes is appropriate for the converse case — that where the damages do not exceed coverage, the set off and credit amounts are to be reduced from the damage award — is nonetheless without authority. As no agreement exists between Metropolitan and Continental to prorate the arbitration award between them; Stephen v. Pennsylvania General Ins. Co., supra,
Therefore, the court will deny the plaintiff's motion for summary judgment on the issue of whether stacking requires Metropolitan to pay UM benefits in the amount of $200,000 as the excess carrier's liability is triggered when the claimant's loss exceeds the policy limits of the primary insurer. The court will grant the plaintiff s motion for summary judgment on the issue of whether the arbitration panel properly awarded full credit for the available set offs to the primary insurer, Continental. As a matter of law, the primary insurer's coverage should be exhausted before the excess carrier should be obligated to pay UM benefits; the primary insurer's coverage is exhausted when it is required to pay benefits up to its policy limits less full credit for available set offs. CT Page 2628
The court will deny the defendant's motion for summary judgment on the issue of whether the plaintiff has failed to exhaust the primary insurer's coverage "based upon proper application of available set offs and credits." The substance of this argument is that the arbitration panel incorrectly allocated full credit for the available set offs to Continental, but the court finds that the arbitration panel's allocation of set offs and credits was correct as a matter of law.
Conclusion
Based on the foregoing, the plaintiff's motion for summary judgment (#111) is denied on the issue of whether the defendant is collaterally estopped from contesting the arbitration panel's award of damages as no privity exists between Continental and Metropolitan and therefore Metropolitan was not afforded a full and fair opportunity to litigate its claims.
Additionally, the court will deny the plaintiff's motion for summary judgment on the issue of whether stacking alone requires the excess carrier, Metropolitan, to pay UM benefits in the amount of $200,000 as the excess carrier's liability is triggered when the claimant's loss exceeds the policy limits of the primary insurer. However, the court will grant the plaintiff's motion for summary judgment on the issue of whether the arbitration panel properly awarded full credit for the available set offs to the primary insurer, Continental. As a matter of law, the primary insurer's coverage should be exhausted before the excess carrier should be obligated to pay UM benefits.
The defendant's cross motion for summary judgment on the issue of whether the defendant is collaterally estopped from contesting the arbitration panel's decision is granted. The defendant was not a party to the Continental arbitration contract and thus, can neither be compelled to arbitrate nor be held bound by the arbitration panel's decision.
Finally, the court will deny the defendant's cross motion for summary judgment on the issue of whether the plaintiff has failed to exhaust the primary insurer's coverage "based upon proper application of available set offs and credits." The substance of this argument is that the arbitration panel incorrectly allocated full credit for the available set offs to Continental, but the court finds that the arbitration panel's allocation of set offs and credits was correct as a matter of law. CT Page 2629
So ordered.
Michael Hartmere Judge of the Superior Court.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.