Gedeon v. State Farm Mutual Automobile Insurance
Gedeon v. State Farm Mutual Automobile Insurance
Opinion of the Court
Opinion by
An automobile liability insurance policy was issued to appellant by appellee-insurance company on May 18, 1955, insuring Mm against liability for bodily injury to one person in the amount of $10,000. On August 11, 1955, wMle the said automobile was being driven by appellant, it was involved in an accident in which appellant’s wife, a passenger in the car, was Mlled. Appellant subsequently qualified as administrator of his wife’s estate and, in such representative capacity, instituted suit under the Wrongful Death Act naming himself as defendant-tortfeasor.
Appellant in his individual capacity then instituted the present action of assumpsit claiming the $51,318.90 judgment as the damages resulting from appellee’s breach of its covenant to defend him. The case was heard by a judge sitting without a jury and judgment entered for the appellee. After argument before the court en banc, this judgment was affirmed by a divided court with the majority setting forth three separate reasons for its decision: (1) that the policy was not in force on the day of the accident because of a failure to pay premiums; (2) that even if the policy were in force, obligations to members of the insured’s household were specifically excluded from coverage; (3) that even if there were a breach of appellee’s contractual
Under a typical automobile liability insurance policy, such as the one before us, the insurer undertakes three distinct types of obligations, each of which involves different elements of proof to establish breach thereof, and from the breach of which different measures of recovery result.
Secondly, the insurer agrees to defend the insured against any suits arising under the policy “even if such suit is groundless, false, or fraudulent.” Since the insurer thus agrees to relieve the insured of the burden of defending even those suits which have no basis in fact, our cases have held that the obligation to defend arises whenever the complaint filed by the injured party may potentially come within the coverage of the policy. See Cadwallader v. New Amsterdam Cas. Co., 396 Pa. 582, 152 A. 2d 484 (1959).
Thirdly, by asserting in the policy the right to handle all claims against the insured, including the right to make a binding settlement, the insurer assumes a fiduciary position towards the insured and becomes obligated to act in good faith and with due care in representing the interests of the insured. If the insurer is derelict in this duty, as where it negligently investigates the claim or unreasonably refuses an offer of settlement, it may be liable regardless of the limits of the policy for the entire amount of the judgment secured against the insured. See Cowden v. Aetna Casualty and Surety Company, 389 Pa. 459, 134 A. 2d 223
The complaint of appellant-insured evidences his confusion as to the nature of these different obligations of appellee-insurer. The sole basis of the complaint is appellee’s refusal to defend the wrongful death action. Appellant does not seek to recover $10,000 under the indemnity clause,
Judgment affirmed.
Appellant disclaimed any benefit that might accrue to himself from the wrongful death action and thus the only beneficiaries of the action were the children.
Of course, these obligations arise only if the insured can show that the policy was in force on the day of the accident in question.
The insurance company may defend the action with the express understanding that it is not admitting coverage by so doing. See Laroche v. Farm Bureau Mutual Automobile Insurance Co., 335 Pa. 478, 7 A. 2d 361 (1939).
“Good cause” as used in this connection should not be confused with “good faith.” Where, as in Epstein v. Erie Indemnity Company, 39 Pa. D. & C. 117 (1940), aff’d per curiam, 340 Pa. 417, 16 A. 2d 47 (1940), the insured refuses to cooperate with the insurer in the preparation of the litigation, the latter has good cause for its refusal to defend. However, the good faith of the insurer’s belief that it had no contractual duty to defend a particular action is not a defense.
The general rule is to award damages which will place the injured party in the position which he would have been in had the obligation in question been performed. Restatement, Contracts §329(a) (1932).
For a comprehensive analysis of this fiduciary obligation, see Keeton, Liability Insurance and Responsibility for Settlement, 67 Harv. L. Rev. 1136 (1954).
Such a suit in this situation would properly be brought by appellant in his representative capacity for the benefit of the children.
In fact, appellant conducted the defense of the wrongful death action himself.
Concurring Opinion
The cogent opinion of Mr. Justice Cohen does much to clarify the real obligations of an insurance company under the provisions of an automobile liability insurance policy as here involved. However, I think one area should be further clarified.
The majority opinion provides for recovery in excess of the policy limits where the insurer “negligently investigates the claim or unreasonably refuses an offer of settlement . . In Cowden v. Aetna Casualty and Surety Company, 389 Pa. 459, 134 A. 2d 223 (1957), the following rules were laid down in this area of the duty to settle:
(1) The interests of insured and the insurer are balanced by requiring the insurer to treat the claim as if he alone were liable for the entire amount.
(2) When there is little possibility of.a verdict or settlement within the policy limits, the decision to expose the insured to' personal pecuniary loss must be based on a bona fide belief by the insurer, predicated on all of the circumstances of the case, that it has a good possibility of winning the suit.
(3) The insurer cannot hazard the well-being of the insured.
(4) Good faith requires that the. chance of a finding of nonliability be real and substantial and that the decision to litigate be made honestly.
The foregoing rules, I believe, establish a standard by which it can be determined whether the insurer exercised due care in a particular case. I would base the liability of the insurer for a breach of the duty to settle on the theory of negligence using the above rules as a standard and in that way eliminate the dichotomy between bad faith and negligence with regard to the duty to settle and the duty of handling the case with ordinary care.
Reference
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