De Leon v. Western Reserve Mut. Cas. Co., Unpublished Decision (2-1-1999)
De Leon v. Western Reserve Mut. Cas. Co., Unpublished Decision (2-1-1999)
Opinion of the Court
Western Reserve Mutual Casualty Company ("Western Reserve"), appeals from the judgment of the Putnam County Court of Common Pleas which granted declaratory judgment in favor of Elidia DeLeon and Simona Rodriguez on their motion for partial summary judgment and denied Western Reserve's motion for summary judgment.
On April 7, 1997, George Rodriguez, while operating a motor vehicle on State Route 281 in Henry County, was killed when another vehicle, negligently driven by Paul Grey, struck Rodriguez's vehicle. Simona Rodriguez, riding as a passenger with her husband George Rodriguez, was severely injured in this collision. The tortfeasor, Paul Grey, is not a party to this appeal.
Simona Rodriguez and Elidia DeLeon, the administratrix of the estate of George Rodriguez, were tendered separate payments of the per person limit of the tortfeasor's liability insurance of $100,000 each. The Appellees then requested that Western Reserve make available to them underinsurance collectively, to the extent of Western Reserve's single occurrence policy limit, $300,000. Western Reserve declined and instead offered both Appellees collectively $100,000 of underinsurance coverage. The Appellees, unable to agree with Western Reserve as to the amount of underinsurance available to them because of this occurrence, filed a complaint for declaratory judgment.
Appellees sought a judgment declaring that the separate amounts tendered by the tortfeasor's liability insurance carrier should be setoff separately, and not collectively, against Western Reserve's underinsurance policy limits. Under Appellees' interpretation of the policy, the $100,000 tendered by the tortfeasor to Elidia DeLeon would be setoff against Western Reserve's $300,000 policy limits, leaving $200,000 from which her wrongful death claim in excess of the tortfeasor's tender might be paid when determined. Likewise, the separate $100,000 tendered to Simona Rodriguez by the tortfeasor would also be setoff against Western Reserve's $300,000 policy limits, leaving $200,000 available to pay her separate underinsured personal injury claim when determined. The Appellees concede that because of the policy's single limit of liability, $300,000 is the most Western Reserve could owe to them collectively.
Western Reserve answered the Appellees' complaint and filed a counterclaim for declaratory judgment urging that the policy should be interpreted to mean that all sums paid by the tortfeasor to all the insureds collectively should be setoff against the single occurrence policy limit. Under such a construction, the $200,000 received collectively by Elidia DeLeon and Simona Rodriguez would be offset against the $300,000 policy limit, leaving only $100,000 available to both Appellees. The trial court rejected Western Reserve's interpretation of the insurance agreement and determined that the policy required setoff to be done separately. Appellees' motion for partial summary judgment was then granted and the remaining claims were dismissed upon agreement of the parties.
1. The Trial Court (sic) Ruling Holding Appellees Entitled To Recover The Full Single Limit Of Appellant's Underinsured Coverage, In Addition To The Coverage Already Provided Under The Tort Feasor's Liability Policy, Was Contrary To R.C. §
2. The Court Erred In Applying Radenbaugh and Derr Given The Contract For Underinsurance Coverage Was Entered Into Following The Amendments to R.C. §
3. The Trial Court Erred In Ignoring The Clear And Unambiguous Language In Appellant's Policy Which Entitled It To A Set Off In The Amount Of $200,000.
Western Reserve's first three assignments of error are interrelated and essentially are separate arguments explaining why Western Reserve believes the trial court erred when granting partial summary judgment to the Appellees. Accordingly, these three assignments of error will be discussed together.
When reviewing a determination on a motion for summary judgment, an appellate court's review is independent of the trial court's judgment. Midwest Specialties, Inc. v. FirestoneTire Rubber Co. (1988),
Here, the facts of this case are undisputed. Western Reserve admits that each Appellee is an insured under its policy and each is entitled to underinsured benefits thereunder. The issue, however, is how much coverage must be afforded to the Appellees based on the setoff provision within the insurance agreement.
With respect to uninsured and underinsured motorist law, Justice Douglas has recognized:
* * * that un insured-motorist cases are different from under insured-motorist cases; that multiple-claimant cases are different from single-claimant cases; that cases involving wrongful death are different from those where no death is involved; and that cases where there is a tortfeasor liability policy are different from those where there is no liability policy.
Thus, we have cases (1) where the tortfeasor is insured and there is only one injured claimant; (2) where the tortfeasor is insured and there are more than one injured claimant; (3) where the tortfeasor is insured and there is a single wrongful death; (4) where the tortfeasor is insured and there are injured claimants and a wrongful death claimant or claimants; (5) where a tortfeasor is uninsured and there are single or multiple injured claimants and single or multiple wrongful death claimants and any or all of such claimants have uninsured-motorist coverage and under insured-motorist coverage.
Savoie v. Grange Mut. Ins. Co. (1993),
Here, we have an underinsured tortfeasor, one wrongful death claimant, one injured claimant and a provider of underinsurance coverage with a single occurrence limit of $300,000. This court, in an action arising out of the same county, has dealt with circumstances nearly identical. Radenbaugh v. MotoristIns. Co. (1993),
Western Reserve contends our decision in Radenbaugh, and the Ohio Supreme Court's decision in Derr v. Westfield Cos. (1992),
Nevertheless, Appellees agree that the amended version of R.C. §
That version of R.C. §
Mandatory offering of uninsured and underinsured motorist coverage.
(A) No automobile liability or motor vehicle liability policy of insurance insuring against loss resulting from liability imposed by law for bodily injury or death suffered by any person arising out of the ownership, maintenance, or use of a motor vehicle shall be delivered or issued for delivery in this state with respect to any motor vehicle registered or principally garaged in this state unless both of the following coverages are provided to persons insured under the policy for loss due to bodily injury or death suffered by such persons:
* * *
(2) Underinsured motorist coverage, which shall be in an amount of coverage equivalent to the automobile liability or motor vehicle liability coverage and shall provide protection for an insured against loss for bodily injury, sickness, or disease, including death, suffered by any person insured under the policy, where the limits of coverage available for payment to the insured under all bodily injury liability bonds and insurance policies covering persons liable to the insured are less than the limits for the insured's uninsured motorist coverage. Underinsured motorist coverage is not and shall not be excess insurance to other applicable liability coverages, and shall be provided only to afford the insured an amount of protection not greater than that which would be available under the insured's uninsured motorist coverage if the person or persons liable were uninsured at the time of the accident. The policy limits of the underinsured motorist coverage shall be reduced by those amounts available for payment under all applicable bodily injury liability bonds and insurance policies covering persons liable to the insured.
R.C. §
This amended statute continues to mandate underinsurance coverage. However, as is apparent from the underlined text, the amendment also appears to limit the scope of that mandatory coverage. R.C. §
Western Reserve's insuring agreement states:
We will pay compensatory damages which an "insured" is legally entitled to recover from the owner or operator of an "uninsured motor vehicle" because of "bodily injury" caused by an accident.
Further, under its LIMIT OF LIABILITY provision, the policy states in part:
1. "Insureds"; 2. Claims made;The Limit of Liability shown in the Declarations [$300,000] for this coverage is our maximum limit of liability for all damages resulting from any one accident. This is the most we will pay regardless of the number of:
4. Vehicles involved in the accident.3. Vehicles or premiums shown in the Declarations; or
* * *
Finally, the policy's setoff provision states:
With respect to coverage under Section 2. [underinsured motorist coverage] . . . the limit of liability shall be reduced by all sums paid because of "bodily injury" by or on behalf of persons or organizations who may be legally responsible such that the total amount owed by [sic]2 under this provision of policy is no greater than what could be recovered from the owner or operator of a vehicle carrying liability limits equal to the limits specified in this portion of your policy.
(Western Reserve Replacement policy p. 2)
The setoff provision in Western Reserve's policy states that "the limit of liability shall be reduced by all sums paid [by the tortfeasor] because of 'bodily injury.' " However, this provision does not sufficiently describe the manner setoff is to be computed. For instance, the contract does not state whether Western Reserve may aggregate amounts received by all claimants against their policy limits or whether the setoff should be done separately for each claimant.
In Derr v. Westfield Cos. (1992),
We, likewise, are unable to discern from Western Reserve's setoff provision a "clear and unambiguous" manner for calculating setoff when multiple claimants seek coverage under this single limit policy. Id. Accordingly, as noted in Derr,
"language in a contract of insurance reasonably susceptible of more than one meaning will be construed liberally in favor of the insured and strictly against the insurer." Id. at 542,
Further, this method of computing setoff does not offend the only restriction in Western Reserve's policy with respect to setoff. If separate and successive setoff is done, neither Elidia DeLeon or Simona Rodriguez will obtain more from Western Reserve "than what could be recovered from the owner oroperator of a vehicle carrying liability limits equal to thelimits specified in this portion of your policy." (Western Reserve Replacement policy p. 2).
As noted, Western Reserve also contends that separate and successive setoff would not comply with the amended version of the underinsured motorist statute, R.C. §
The Supreme Court has recognized that one purpose of theSavoie amendment was to permit insurance companies to setoff amounts available for payment to the insured from the tortfeasor against the insured's policy's limits, rather than their total damages. Cole,
Further, the amount available to each insured after separate and successive setoff, is a maximum of $200,000. Western Reserve's single occurrence limit is $300,000. Accordingly, because the maximum amount each insured could recover is less than $300,000, neither insured will individually recover more than they could have recovered had the tortfeasor been uninsured. R.C. §
Because summary judgment was properly granted to the Appellees, Western Reserve's first, second and third assignments of error are without merit and are overruled.
Even If The Trial Court Were Correct In Applying The Former Version Of R.C. §
3937.18 , Plaintiffs [sic] Claims Against Western Reserve Were Not Ripe Given All Other Available Coverage Had Not Been Exhausted.
As noted above, pursuant to Ross, supra, the amended version of R.C. §
Judgment Affirmed.
SHAW, P.J., and HADLEY, J., concur.
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