Santos v. Metro. Prop. & Cas. Ins. Co.
Santos v. Metro. Prop. & Cas. Ins. Co.
Opinion of the Court
*1246The defendant, Metropolitan Property and Casualty Insurance Company (Metropolitan), appeals an order of the Superior Court (Schulman, J.) partially granting and partially denying its summary judgment motion as well as a cross-motion filed by the plaintiff, Joseph A. Santos. Santos held a personal excess liability policy with Metropolitan that included excess underinsured motorist (UIM) coverage. After Metropolitan denied a claim made by Santos for excess UIM benefits, he brought this declaratory judgment action. The trial court ruled that Metropolitan was liable to Santos for excess UIM benefits. Metropolitan argues that the trial court erred in so holding because Santos's policy requires, as a precondition to receiving excess UIM benefits, that he carry a certain amount of underlying insurance coverage, and Santos did not do so. Santos argues that his lack of sufficient underlying coverage allows Metropolitan to reduce its excess UIM liability but not escape it altogether. We affirm.
The trial court determined that the following material facts are undisputed. Santos alleges that he was driving his motorcycle when he was struck by an SUV. He claims that the collision was the result of the other driver's negligence and that he suffered debilitating injuries in the accident. Santos further claims that, although the other driver carried insurance, his damages exceed the other driver's policy limits. Santos insured his motorcycle with a policy from Allstate Insurance Company. That policy insured Santos's motorcycle for $25,000 per person and $50,000 per accident. He claims that the Allstate policy also is insufficient to fully compensate him for the injuries he suffered in the accident.
Santos also held the policy with Metropolitan that is at issue. It provided Santos with excess personal liability coverage as well as excess UIM coverage. Santos submitted a claim to Metropolitan for excess UIM benefits pursuant to this policy. Metropolitan denied his claim, asserting that the endorsement in the policy that grants excess UIM coverage contains a precondition requiring Santos to maintain a certain amount of underlying insurance on his motorcycle, which Santos did not maintain.
Santos then filed this declaratory judgment action to determine his coverage under the Metropolitan policy. The parties filed cross-motions for summary judgment. The trial court ruled that, notwithstanding Santos's failure to maintain the underlying insurance coverage specified in the excess UIM endorsement, Metropolitan was required to provide Santos with excess UIM benefits for the alleged injuries he suffered as a result of the accident. The trial court further ruled that Metropolitan was liable to Santos for excess UIM benefits only to the extent and in the amount it would have been liable had he maintained the amount of underlying coverage specified in the excess UIM endorsement. This appeal followed.
In an appeal from the disposition of cross-motions for summary judgment, we consider the evidence in the light most favorable to each party in its capacity as the nonmoving party and, if no genuine issue of material fact exists, we determine whether the moving party is entitled to judgment as a matter of law. Newell v. Markel Corp.,
In a declaratory judgment action to determine the coverage of an insurance policy, the burden of proof is always on the insurer, regardless of which party brings *1247the petition. Exeter Hosp. v. Steadfast Ins. Co.,
Insurers are free to contractually limit the extent of their liability provided that they violate no statutory provision by doing so. Russell v. NGM Ins. Co.,
We turn to an examination of the policy itself. The Metropolitan policy issued to Santos may be broken into three parts for the sake of analysis. The first part consists of declarations. The declarations state the amount of excess personal liability coverage as well as excess UIM coverage available under the policy, in addition to the required amounts of underlying insurance. Automobile insurance is listed as a type of required underlying insurance. The declarations further state that the policy was "issued and rated" based in part on the respective years, manufacturers, models, and body types of Santos's vehicles. (Capitalization omitted.) The second part of the policy consists of the policy form itself. Section I of the policy form is the grant of excess personal liability coverage. Section II contains exclusions from coverage. Section III establishes conditions of coverage. Section IV provides definitions of certain terms used elsewhere in the policy. Of importance to this case is Section III, paragraph 7 of the policy form, which provides:
This policy requires you to have the types and amounts of insurance shown in the declarations pages. If you fail to maintain the required underlying policies for any reason, or if no insurance is available because an insured has breached a term or condition of any underlying policy , we will be liable only for the amount that we would have been liable for had you maintained the required insurance. You will be liable for the amount that would have been covered by the underlying policy .
This paragraph establishes that, should Santos fail to maintain the amount of underlying insurance specified in the declarations pages, Metropolitan will only be liable for the amount it would have had to pay had Santos maintained the correct amount of underlying coverage.
*1248The third part of the policy consists of endorsements attached to the policy form. Of importance to this case is an endorsement titled "EXCESS UNINSURED/UNDERINSURED MOTORISTS COVERAGE ENDORSEMENT." (Bolding omitted.) This endorsement states, "The Personal Excess Liability Policy to which this endorsement applies, is extended to provide Excess Uninsured/Underinsured Motorists Coverage up to the limits shown in the declarations of the policy." This language grants excess UIM coverage. The endorsement also states, "As a precondition to receiving the benefits under this endorsement, you shall maintain the underlying policy of automobile insurance having uninsured/underinsured motorists coverage with split limits equal to or greater than $100,000/$300,000 bodily injury or with a single limit of $300,000 bodily injury."
The parties agree that the Allstate policy Santos had for his motorcycle is the only underlying insurance policy relevant to this case. Santos concedes that the Allstate policy did not provide the amount of underlying insurance specified by the excess UIM endorsement. He argues that he is nevertheless entitled to excess UIM benefits because the policy read as a whole allows Metropolitan to offset its excess UIM liability by the underlying insurance limits specified in the UIM endorsement, but it does not allow Metropolitan to escape liability altogether. In the alternative, Santos argues that the difference between Section III, paragraph 7 and the excess UIM endorsement with respect to the consequences for his failure to maintain the required amount of underlying insurance renders the policy ambiguous, and that the ambiguity must be construed in his favor. See U.S. Automobile Assoc. v. Wilkinson,
By contrast, Metropolitan argues that the excess UIM endorsement makes Santos's maintenance of the specified amount of underlying insurance a condition precedent to the availability of any excess UIM benefits.
As an initial matter, we conclude that the excess UIM endorsement contains a condition precedent to excess UIM coverage that conflicts with Section III, paragraph 7. A condition precedent is a provision that makes an act or event contingent upon the performance or occurrence of another act or event.
*1249Appeal of City of Manchester,
So construed, the excess UIM endorsement is in direct conflict with Section III, paragraph 7. These provisions provide incompatible remedies to Metropolitan in the event of Santos's failure to maintain sufficient underlying coverage: the excess UIM endorsement purports to allow Metropolitan to entirely deny excess UIM benefits should Santos fail to maintain sufficient underlying coverage; Section III, paragraph 7, by contrast, does not allow Metropolitan to entirely deny benefits for such a failure. See Israel v. State Farm Mut. Auto. Ins. Co.,
Santos argues, and the trial court concluded, that the conflict between the excess UIM endorsement and Section III, paragraph 7 renders the policy ambiguous, requiring a construction in his favor. Santos is correct to note that, when an ambiguity arises from conflicting provisions of a policy, we resolve the inconsistency in favor of the insured. See Kelly v. Prudential Prop. & Cas. Ins. Co.,
This does not end our inquiry, however. As the trial court noted, whether this construction of the policy complies *1250with RSA 264:15, I, must still be determined. This requires us to engage in statutory interpretation. In matters of statutory interpretation, we are the final arbiters of the legislature's intent as expressed in the words of a statute considered as a whole. STIHL, Inc. v. State of N.H.,
The trial court correctly noted that construing the policy to include a limitation on the availability of excess UIM benefits that was not also placed on the availability of excess liability benefits would be in tension with RSA 264:15, I. At the time of the accident in this case, that statute provided in pertinent part that:
No policy shall be issued under the provisions of RSA 264:14, with respect to a vehicle registered or principally garaged in this state, unless coverage is provided therein or supplemental thereto at least in amounts or limits prescribed for bodily injury or death for a liability policy under this chapter, for the protection of persons insured thereunder who are legally entitled to recover damages from owners or drivers of uninsured motor vehicles, and hit-and-run vehicles because of bodily injury, sickness, or disease, including death resulting therefrom. When an insured elects to purchase liability insurance in an amount greater than the minimum coverage required by RSA 259:61, the insured's uninsured motorist coverage shall automatically be equal to the liability coverage elected. For the purposes of this paragraph umbrella or excess policies that provide excess limits to [motor vehicle liability policies] shall also provide uninsured motorist coverage equal to the limits of liability purchased unless the named insured rejects such coverage in writing.
RSA 264:15, I (emphasis added).
The policy in this case is a "personal excess liability policy" that provides coverage similar to an umbrella policy. We held in Wilkinson that a prior version of this statute did not apply to such policies. See Wilkinson,
Two years after Wilkinson, the legislature amended the statute. See Laws 1991, *1251330:2. In 1991, the legislature added a third sentence to the statute, which stated that "umbrella or excess policies that provide excess limits to [motor vehicle policies], shall also provide [UIM] coverage equal to the limits of liability purchased, unless the named insured rejects such coverage."
We proceed to analyze whether the policy, as we have construed it, violates RSA 264:15.
In Gisonni, we determined whether, when an insured purchased motor vehicle liability coverage with a territorial scope broader than statutorily required, the insurer was required to issue UIM coverage with an identical territorial scope. See Gisonni,
*1252We re-affirmed this understanding of RSA 264:15, I, in Swain. Swain,
The foregoing demonstrates that the word "limits" as used in RSA 264:15, I, has a different meaning than the words "amount" or "amounts." See Gisonni,
Unlike the first two sentences of the statute, however, the third sentence of RSA 264:15, I, requires providers of "umbrella or excess policies that provide excess limits" to motor vehicle policies to "provide [UIM] coverage equal to the limits of liability purchased." RSA 264:15, I (emphasis added). Based on the meaning we have ascribed to the word "limits" as used in the statute, this sentence means an insurer that issues an umbrella or excess policy that provides excess coverage to motor vehicle liability policies must provide excess UIM coverage with the same scope. See *1253Swain,
The precondition contained in the excess UIM endorsement attached to Santos's policy violates this sentence of the statute. Section III, paragraph 7 of the policy establishes that excess liability coverage is available to the insured even when he does not maintain sufficient underlying coverage. The precondition in the excess UIM endorsement, however, purports to allow the insurer to entirely deny coverage when the insured maintains insufficient underlying coverage. Thus, the precondition attempts to make excess UIM coverage unavailable in the same circumstances in which the policy provides excess motor vehicle liability coverage.
The parties to an insurance contract may not by agreement limit the required coverage in contravention of RSA chapter 264. Wegner v. Prudential Prop. & Cas. Ins. Co.,
Affirmed.
LYNN, C.J., and BASSETT and DONOVAN, JJ., concurred.
Metropolitan also argues that the excess UIM endorsement contains a second precondition. The excess UIM endorsement provides, "the benefits of this [endorsement] shall apply only after the underlying policy 's uninsured/underinsured motorists coverage limits and all other collectible uninsured/underinsured motorists benefits have been paid in full." Metropolitan asserts that the underlying policy limits will never be paid in full because Santos did not maintain the required amount of underlying insurance, thus "this pre-condition can never be satisfied under the circumstances of this case." Metropolitan has failed to develop this argument sufficiently for our review. Thus we do not consider it. See Lennartz v. Oak Point Associates, P.A.,
Metropolitan, in its brief, does not contest the statute's applicability to Santos's policy. At oral argument, Metropolitan agreed that Santos's policy provided "excess liability coverage for use of automobiles and the like."
We note that the elective coverage provision was amended in 2015, after the accident in this case occurred. See Laws 2015, 237:1. The elective coverage provision now provides, "[w]hen an insured elects to purchase liability insurance in an amount greater than the minimum coverage required [for motor vehicle liability policies], the insured's uninsured motorist coverage shall automatically be equal in amounts and limits to the liability coverage elected." RSA 264:15, I (2014) (Supp. 2017) (emphasis added). Because the accident in this case occurred prior to this amendment, and because this case does not directly concern the elective coverage provision, we express no view on the effect of this amendment. See Appeal of White Mountain Regional Sch. Dist.,
Reference
- Full Case Name
- Joseph A. SANTOS v. METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY
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- 3 cases
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- Published