Win Some – Lose Some
Insurance contracts need to be written in clear and unambiguous language that can be understood by anyone with a Fourth Grad education. Preparing an insurance contract is often difficult and by not being absolutely clear can cost an insurance company money.
In Georgia Farm Bureau Mutual Insurance Company v. Claxton et al., A18A0737, Court of Appeals of Georgia (April 2, 2018) Georgia Farm Bureau Mutual Insurance Company (“Georgia Farm Bureau”) appealed from the trial court’s denial of its motions for summary judgment in a declaratory judgment action it filed against Dena Claxton and Carl Lowery. Claxton and Lowery, both of whom hold insurance policies issued by Georgia Farm Bureau and were involved in a motor vehicle accident. They each sought coverage under their respective policies.
The largely undisputed record before the court reflects that Lowery was operating a mule-drawn carriage in a Christmas parade organized by the City of McRae. Claxton was riding in the carriage. After the parade had ended, Lowery and Claxton were riding the carriage back to Lowery’s motor vehicle when the carriage was struck in the rear by a motor vehicle operated by a third party, resulting in injuries to Claxton.
Lowery testified at deposition that the carriage he was driving was designed to be pulled by one horse or mule. He further stated that the carriage was designed to only be pulled by an animal and could not be hooked up to a motor vehicle. The carriage was being pulled by a mule during the parade and at the time of the accident. Lowery did not charge Claxton a fee to ride in the carriage.
Following the accident, Claxton filed suit against Lowery. In that action, which is separate from this case, she sought damages from Lowery arising out of the accident.
Lowery, an insured of Georgia Farm Bureau, claimed the policy covers any liability he may have for Claxton’s injuries. In the same action, Claxton also claims that two uninsured motorist (“UM”) policies she holds with Georgia Farm Bureau also provide coverage for her injuries arising from the accident.
The liability policy issued to Lowery contains an exclusion that Georgia Farm Bureau claims shields it from liability under the insurance contract. The exclusion provides that the policy “does not apply to . . . [t]he use of any livestock or other animal, with or without an accessory vehicle, for providing rides to any person for a fee or in connection with or during a fair, charitable function, or similar type of event[.]” The policy defines “livestock” to include mules.
The UM policies issued to Claxton define “uninsured motor vehicle” to mean a “land motor vehicle or trailer of any type.” The policy defines “trailer” to mean a “vehicle designed to be pulled by a . . . [p]rivate passenger auto [or] [p]ickup or van.”
Georgia Farm Bureau first argues that the trial court erred by denying its motion for summary judgment with regard to its claim that the exclusion for livestock in Lowery’s policy applies and that Georgia Farm Bureau has no liability to him under his policy.
The trial court’s order focused specifically on the phrase “for a fee,” determining that because neither Claxton nor any other party had paid Lowery a fee to drive the carriage the exclusion did not apply. The actual terms of the policy provide an exclusion where the insured provides rides “for a fee or in connection with or during a fair, charitable function or similar type of event.” (emphasis supplied by the court) The trial court’s omission of this small but critical word caused it to err in denying summary judgment on these grounds. However, that does not end the issue.
The Mule Drawn Cart
It is undisputed that Claxton was utilizing a mule to draw the carriage at all relevant times, including during the parade and as he and Claxton were returning to Lowery’s vehicle at the time of the accident. However, it remains disputed whether the parade constitutes a “fair, charitable function, or similar type of event.”
The construction of an insurance contract is a matter of law for the court. When an exclusion is unambiguous and capable of but one reasonable construction, the trial court must expound the contract as made by the parties. A word or phrase is ambiguous when it is of uncertain meaning and may be fairly understood in more ways than one.
The Merriam-Webster Dictionary defines “similar” variously to mean “having characteristics in common” and “alike in substance or essentials.” Whether one thing is similar to another thing is necessarily a multi-faceted, qualitative, and subjective determination, and it is no less so in determining whether the parade at issue here is similar to a fair or charitable function. In brief, whether something is similar to something else is almost inherently ambiguous.
Because any ambiguities in the contract are strictly construed against the insurer as drafter of the document and any exclusion from coverage sought to be invoked by the insurer is likewise strictly construed. The court of appeal was unable to conclude that, as a matter of law, the Christmas parade was an event similar to a fair or charitable function.
Whether Lowery was providing a ride in connection with the event at the time of the accident is also a question of fact. The record reflects that the parade had ended at the time of the accident and that Lowery and Claxton were riding the carriage back to Lowery’s vehicle. As with the determination of whether the parade constitutes a “similar type of event” contemplated by the insurance policy, whether Lowery’s act of driving back to his vehicle was taken in connection with the parade is a question of fact for a jury to resolve.
In light of the foregoing, summary adjudication of Georgia Farm Bureau’s claim in regard to Lowery’s policy is not appropriate.
The UM/UIM Claim
Georgia Farm Bureau next argues that the trial court erred in denying its motion for summary judgment in regard to its coverage obligations under Claxton’s UM policies. Here, the record before us makes clear that the carriage Claxton was riding in was not a motor vehicle under the terms of her UM policy. She claimed the cart was a “trailer” as defined in her UM policy.
However, the definition of the term “trailer” in the UM policies sets a clear outer boundary relevant to the issues in this case: in order to qualify as a trailer that can be considered an uninsured motor vehicle, the vehicle must be designed in such a way that it can be pulled by private passenger autos, pickups, or vans.
The undisputed testimony in the record shows that the carriage Claxton was riding in was designed only to be drawn by an animal and that it specifically could not be attached to or pulled by a motor vehicle. Thus, there is no genuine issue of fact as to whether the carriage constituted a trailer under the terms of Claxton’s UM policies, and summary judgment was improperly denied by the trial court as to Georgia Farm Bureau’s coverage obligations under those policies.
If Georgia Farm Bureau wished to avoid liability for a mule draw cart in a parade would have been to add the word “parade” to the exclusion’s limitation to an animal drawn action in a “fair or charitable function” and not rely on the statement: “or similar type of event” language that was vague and ambiguous on its face.
© 2018 – Barry Zalma
This article, and all of the blog posts on this site, digest and summarize cases published by courts of the various states and the United States. The court decisions have been modified from the actual language of the court decisions, were condensed for ease of reading, and convey the opinions of the author regarding each case.
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 50 years in the insurance business. He is available at http://www.zalma.com and email@example.com.
Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.
Mr. Zalma’s books available as Kindle books or paperbacks at Amazon.com can be reached at http://zalma.com/zalma-books/
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