You Only Get What You Pay For

Trial Court May Not Torture Policy Language to Compel Payment of More than Is Owed

People buy a multi-car auto policy to save money on premium. In such a situation the Uninsured Motorist/Underinsured Motorist (UM/UIM) coverages apply to each injured person and are not intended to stack coverage for both policies when the policy clearly states stacking is not available.

In Government Employees Insurance Company v. Steve Sayre, as Administrator of the Estate of Robert Sayre, Supreme Court of Appeals of West Virginia, 2017 WL 2417112, No. 16-0750 (May 31, 2017) it was contended that West Virginia statutes, that do not forbid the inclusion and application of an anti-stacking provision in an automobile insurance policy, where a single insurance policy is issued by a single insurer and contains an UIM endorsement even though the policy covers two or more vehicles.

The petitioner, Government Employees Insurance Company (“GEICO”), appealed from the order of the Circuit Court of Jackson County granting summary judgment to the respondent, Steve Sayre, in connection with determining the amount of underinsured motorist insurance (“UIM”) that is owed by GEICO to Mr. Sayre. Finding an ambiguity in the GEICO policy language, the trial court ruled that, because there were two underinsured motorists involved in this case, the UIM coverage was triggered separately by each of those motorists.

FACTUAL AND PROCEDURAL BACKGROUND

The decedent, Robert Keith Sayre, died from injuries sustained in a car accident in Jackson County. At the time of the accident, the decedent was a guest passenger in a vehicle operated by Richard Ryan Smith. A second vehicle was involved in the accident, which was operated by Kurtis Barnett. The accident was determined to be proximately caused by the independent negligence of both drivers of the two vehicles.

GEICO filed the underlying declaratory judgment action to resolve the issue of UIM coverage. Both GEICO and Mr. Sayre filed motions for summary judgment on the issue of whether the respondent was entitled to an additional $20,000 of UIM insurance coverage rather than the $20,000 policy limits that GEICO had already tendered.

DISCUSSION

Because this case revolves around the interpretation of the UIM endorsement language, the analysis is necessarily controlled by the policy language. Where the provisions of an insurance policy contract are clear and unambiguous they are not subject to judicial construction or interpretation, but full effect will be given to the plain meaning intended. UIM coverage comes into play “only after the limits of liability under any applicable liability policies or bonds have been exhausted by payment of judgments or settlements.”

The dispute presented concerns the meaning of the section of the Underinsured Motorists Amendment that sets forth “LIMITS OF LIABILITY.” That section provides, in pertinent part, the following conditions: “Regardless of the number of autos or trailers to which this policy applies: ¶ 1. The Underinsured Motorists Bodily Injury Liability limit for “each person” less any liability coverage available to the insured from the tortfeasor or tortfeasors is the maximum we will pay for damages for bodily injury, including all derivative claims and any claim for damages for care and loss of services, to one person in one accident; … ¶ 4. When coverage is afforded to two or more autos, the limits of liability shall apply separately to each auto as stated in the Declarations.”

Beginning with this Court’s decision in Shamblin v. Nationwide Mutual Insurance Company, 175 W.Va. 337, 332 S.E.2d 639 (1985), the validity of anti-stacking language in an insurance policy has been settled. The statute does not forbid the inclusion and application of an anti-stacking provision in an automobile insurance policy where a single insurance policy is issued by a single insurer and contains an underinsured endorsement even though the policy covers two or more vehicles. “Under the terms of such a policy, the insured is not entitled to stack the coverages of the multiple vehicles and may only recover up to the policy limits set forth in the single policy endorsement.” [emphasis in the original]

Anti-stacking language in an automobile insurance policy is valid and enforceable as to uninsured and underinsured motorist coverage where the insured purchases a single insurance policy to cover two or more vehicles and receives a multi-car discount on the total policy premium.  There is no dispute that the GEICO policy purchased by Mr. Sayre contained a multi-car premium discount and, as a result, accepted the anti-stacking language.

Of critical import is the language prominently set forth in the introductory language to the Limits on Liability of the UIM endorsement that applies to each condition–“regardless of the number of vehicles subject to this policy”–which is then followed by the unmistakable limiting of the amount of UIM liability to the UIM “per person” limit of $20,000 as the “maximum we will pay for bodily injury.” This language states in no uncertain terms that the “per person” limit of UIM coverage is the maximum amount of UIM coverage available in this circumstance.

The trial court reasoned that there was nothing in the GEICO policy “which prevents each of the two underinsured motorists from activating a per person limit on separate insured motor vehicles.” What constitutes effective limiting language and the language included in the GEICO policy is consistent with prior cases in which we have upheld similar limiting language for anti-stacking purposes. The circuit court, in awarding the respondent an additional $20,000 of UIM coverage, tortured the language of the policy and granted Mr. Sayre benefits for which he had neither contracted or paid.

In choosing to purchase a singular insurance policy from GEICO to insure his two vehicles, Mr. Sayre purchased just one UIM amendment to be added to his policy. He did not purchase two UIM amendments with two separate sets of liability limits from GEICO. Thus, when the circuit court doubled his UIM coverage from the $20,000 “per person” limit that he paid for, it improperly awarded him $20,000 more UIM coverage than he had purchased.

An insured, such as Mr. Sayre, who purchases a multi-car insurance policy that contains enforceable anti-stacking language is only entitled to recover up to the policy limits set forth in the single policy endorsement. Accordingly, an insured is not entitled to stack underinsured motorist coverage for every vehicle covered by a single policy where the insured received a multi-car premium discount and the policy contains language expressly limiting the insurer’s liability regardless of the number of vehicles insured under the policy.

ZALMA OPINION

When an insured seeks to save money on premium he or she is counting on a belief that the insurance coverage will not be needed. Sayre bought inexpensive UM/UIM insurance with minimum limits that had language limiting coverage to a single accident applying a single limit. Just because he was killed by the negligence of two underinsured motorists does not change the single limit he purchased.

ZALMA-INS-CONSULT                      © 2017 – Barry Zalma

This article and all of the blog posts on this site digests 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 and expert witness 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 49 years in the insurance business.

Mr. Zalma is the first recipient of theLEGEND-TROPHY-2 first annual Claims Magazine/ACE Legend Award.

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About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.

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