Opinion · Wisconsin Supreme Court
Danbeck v. American Family Mutual Insurance
245 Wis. 2d 186
- Type
- Opinion
- Court
- Wisconsin Supreme Court
- Jurisdiction
- Wisconsin
- Date
- 2001-07-06
- Topic
- general
stating the foundational principle that “[t]he words of an insurance pol- icy are given their common and ordinary meaning” | stating the foundational principle that “[t]he words of an insurance pol- icy are given their common and ordinary meaning” | Courts enforce plain policy language as written- “to avoid rewriting the contract by construction and imposing contract obligations that the parties did not undertake.” | Courts enforce plain policy language as written “to avoid rewriting the contract by construction and imposing contract obligations that the parties did not undertake.” | "[t]he interpretation of an insurance contract is a question of law"; "[t]he words of an insurance policy are given their common and ordinary meaning" | first citing Henderson v. State Farm Mut. Auto. Ins. Co., 208 N.W.2d 423, 426 (Wis. 1973); and then citing Hull v. State Farm Mut. Auto. Ins. Co., 586 N.W.2d 863, 867 (Wis. 1998) | "Obviously, Chilberg can only `occupy' one car at a time."
Citator
- Cited by
- 56 opinions
[EDITORS' NOTE: THIS PAGE CONTAINS HEADNOTES. HEADNOTES ARE NOT AN OFFICIAL PRODUCT OF THE COURT, THEREFORE THEY ARE NOT DISPLAYED.]Page 189
For the defendant-appellant there was a brief byWard I. Richter,John M. ChristensonandBell, Gierhart Moore, S.C., Madison, and oral argument byAnn E. Curtiss.
An amicus curiae brief was filed byMichael RileyandAtterburyRiley, S.C., Madison, on behalf of the Wisconsin Academy of Trial Lawyers.
ABRAHAMSON, C.J., joins dissent.
¶ 3. Danbeck was insured by American Family Mutual Insurance Company and had $100,000 of UIM coverage.1The UIM policy issued by American Family specified the circumstances under which it would pay UIM benefits:
[American Family] will pay compensatory damages forbodily injurywhich aninsured personis legally entitled to recover from the owner or operator of anunderinsured motor vehicle. Thebodily injurymust be sustained by aninsured personand must be caused by accident and arise out of theuseof theunderinsuredmotor vehicle.
Youmust notifyusof any suit brought to determine legal liability or damages. Withoutourwritten consentweare not bound by any resulting judgment.
Wewill pay under this coverage only after the limits of liability under anybodily injuryliability bonds or policies have been exhausted by payment of judgements or settlements.
¶ 4. Danbeck settled with Country and Horne for $48,000 ($47,500 for bodily injury and $500 for the damage to his bicycle). Pursuant to
¶ 5. American Family refused to pay Danbeck's claim. The company took the position that UIM coverage was not available under its policy because Danbeck had settled for less than Horne's liability limit and therefore had not "exhausted" that limit within the meaning of the policy language. Danbeck sued.
¶ 6. American Family moved for summary judgment. The Circuit Court for Dane County, Paul B. Higginbotham, Judge, denied the motion on several grounds. First, the circuit court applied
¶ 7. Accordingly, the circuit court interpreted the exhaustion clause to allow recovery of UIM benefits when the UIM policyholder settles his or her claim with the tortfeasor's insurer and credits the UIM carrier for the difference between the settlement amount and the tortfeasor's liability limits. The court then ordered mediation, and the parties agreed that Danbeck was entitled to $20,000.
¶ 8. American Family appealed the denial of summary judgment, and the court of appeals reversed. The court focused on the policy language and concluded that the exhaustion clause unambiguously required the insured to exhaust the underinsured motorist's limits of liability by payment of full policy limits-in this case, $50,000. The court held that the partial settlement and credit endorsed by the circuit court did not satisfy the policy's requirements for coverage.
¶ 10. The interpretation of an insurance contract is a question of law subject to de novo review.
¶ 12. The parties dispute whether the language of the exhaustion clause is ambiguous. American Family says the language unambiguously requires full payment of the tortfeasor's liability policy limits as a prerequisite to payment of UIM benefits. Danbeck argues that the exhaustion clause is ambiguous because a reasonable insured might understand it to mean that a settlement that barred further claims and gave credit for full payment of liability limits would effectively "exhaust" those limits.
¶ 13. We agree with American Family and the court of appeals that while the "settlement plus credit" approach to exhaustion has the same practical effect as payment of full policy limits, it is not consistent with the plain language of the policy, which unambiguously requires exhaustion "by payment of judgements or settlements," not "settlement plus credit."3Page 195
¶ 14. The exhaustion clause in the insurance policy sets forth these requirements for UIM coverage: thelimitsof the tortfeasor's bodily injuryliabilitypolicymust beexhaustedbypayment of judgments orsettlements. The phrase "limits of liability" clearly refers to the total amount of liability coverage available under the tortfeasor's bodily injury liability insurance policy. In this case, Horne carried $50,000 of liability insurance.
¶ 15. The term "exhaust" is also plain and unambiguous and has a readily ascertainable common and ordinary meaning. The dictionary defines "exhaust" as: "to use up or consume completely; expend the whole of. . . ."
¶ 16. Finally, the exhaustion clause specifies that only one manner of exhaustion will trigger the obligation to pay UIM benefits: exhaustion "by payment of judgements or settlements." Danbeck argues that the term "payment" can be understood in more than one way: payment of full policy limits, or payment of less than full policy limits plus a credit in favor of the UIM carrier for the difference.
¶ 17. However, a "settlement plus credit" does not constitute "payment" of liability limits as that term is commonly and ordinarily understood. It is true that a settlement of this nature bars further claim against the tortfeasor's insurer and protects the UIM carrier against liability for the difference between the settlement amount and the tortfeasor's full policy limits. ButPage 196it plainly does not exhaust the tortfeasor's policy limitsby paymentof those limits, as required by the UIM policy.
¶ 18. A "payment" is "1. something that is paid; an amount paid; compensation; recompense.2. the act of paying. . . ."
¶ 19. Danbeck's argument that the exhaustion clause is ambiguous arises primarily out of his reading of
¶ 20.
¶ 21. It is unquestionably true that partial settlements, and
The desirability ofLoytype agreements lies in the encouragement of partial settlements in future cases, thereby fostering effective and expeditious resolution of lawsuits. Partial settlements not only benefit the parties involved, but the justice system as a whole. Further, we reemphasize that "public interest requires that a plaintiff be permitted to settle claims against some of the exposed parties without releasing others." [Loy, 107 Wis.2d] at 425,320 N.W.2d 175.Accord,Pierringer v. Hoger,21 Wis.2d 182,124 N.W.2d 106(1963), andSwanigan v. State Farm Ins. Co.,99 Wis.2d 179,299 N.W.2d 234(1980).
¶ 22. As this contract is written, UIM benefits are owed only when the tortfeasor's liability insurance is insufficient to cover the UIM policyholder's damages. According to the plain language of the policy, that insufficiency does not arise unless and until the full limits of the tortfeasor's policy are paid out. In other words, the tortfeasor "motorist" is not "underinsured" as a definitional matter until his or her policy limits are fully-not partially-paid. Thus, although the public policy supporting partial settlements still figures prominently in our jurisprudence, it does not supplant the plain language of the insurance contract. To choose an interpretation that furthers the public policy of encouraging settlements but contradicts the clear language of the contract would be to substitute our policy preferences regarding UIM insurance for the agreement of the parties.5Page 199
¶ 23. Danbeck also argues pursuant to
¶ 24. By contrast, the insurance policy in this case contains explicit, unambiguous language specifying that the UIM carrier's duty to pay does not arise until exhaustion within the meaning of the policy has occurred. Therefore, and once again, we are not at libertyPage 200to rewrite the insurance contract to achieve the public policy invoked in
¶ 25. In summary, we conclude that the unambiguous language of the exhaustion clause in the UIM policy in this case requires the insured to exhaust the tortfeasor's liability limits by payment of full policy limits in order to trigger the duty to pay UIM benefits. Accordingly, because Danbeck's settlement with Horne's insurer was not for full policy limits, he is not eligible for UIM benefits under his policy with American Family.By the Court. — The decision of the court of appeals is affirmed.
¶ 27. Yet, sixteen years ago this court examined that exact language — word for word — and interpreted the phrase to mean the opposite of what the majority espouses today.
¶ 28. Nevertheless, the majority persists in its conclusion. Its decision begins and ends with the policy language, concluding that the exhaustion clause unambiguously requires full payment of the at-fault driver'sPage 201liability limits in order to trigger the UIM insurer's obligations. The majority concludes that a settlement plus credit cannot constitute a "payment" under the exhaustion clause.
¶ 29. I would instead acknowledge that the language is ambiguous and apply the principles of insurance policy construction which require it to be construed against the insurer. Additionally, I would acknowledge both our case law and public policy require a construction of the exhaustion clause that allows an insured to "settle and credit."
¶ 30. This court's interpretation of the same language in
¶ 31. Today the majority, emphasizing the word "payment" in the same phrase, concludes that there may be no exhaustion under the same language where an insured settles and credits under a
¶ 32. We do not need more than the ambiguity inherent in these competing interpretations to resolvePage 202this case. This case should be simply a matter of applying the rule that the ambiguous language should be construed against the insurer and in favor of coverage.
¶ 33. As the majority notes, the settle and credit arrangement entered into by Danbeck and the at-fault driver's liability insurer is similar to a
¶ 34. The majority asserts that "
¶ 35. Moreover, the
If the issue of the existence of a true primary/excess insurance situation had been fundamental to our reasoning behind theLoyprinciple, then our holding inLoywould not control in the present suit. However, that is not the case. The rationale behind our affirmance of the "Loy Release/Covenant Not To Sue" is not anchored to the issue of whether a true primary/excess insurance situation exists. The desirability ofLoy— type agreements lies in the encouragement of partial settlements in future cases, thereby fostering effective and expeditious resolution of lawsuits.
¶ 36. Unfortunately, by invoking the supposed lack of ambiguity to avoid consideration of the policy of encouraging settlement, the majority not only fails to promote that policy, but indeed frustrates it. The loss of all potential UIM recovery is a strong disincentive to settlement. In cases where an injured party is represented by counsel, who after today's decision will be expected to know the harsh consequences of such aPage 204settlement, we should have no reason to anticipate settlement where there is the potential for UIM recovery.
¶ 37. The most unfortunate aspect of the majority opinion is the harsh result unwitting Wisconsin insureds will bear. While we can expect to see settlement deterred where an injured party is represented by counsel, those individuals without the advice of counsel will most certainly be unaware of today's decision. These injured parties may unwarily agree to settle and credit at the expense of any potential UIM recovery. Additionally, such an insured may unknowingly be the subject of agreements between the UIM and liability carriers. To facilitate settlement, the UIM insurer may offer to underwrite a portion of the settlement costs in order to avoid a larger payout under the UIM endorsement. The suggestion of such agreements has been brought before the court this very term.
¶ 38. As a result of today's decision, we can now add the UIM exhaustion clause to the growing list of inequitable UIM endorsement provisions that persist under the current state of UIM. In my dissent in
¶ 39. I would conclude that not only is the exhaustion clause ambiguous and subject to constructionPage 205against the insurer but also that our precedent and public policy require a construction under which a settle and credit agreement is deemed to exhaust the at-fault driver's liability limits. Accordingly, I respectfully dissent.
¶ 40. I am authorized to state that Chief Justice SHIRLEY S. ABRAHAMSON joins this dissent.Page 206
- In Wisconsin, UIM coverage is not mandatory. Rather, Wisconsin law only requires that insurers notify policyholders of the availability of such coverage.
SeeWis. Stat. §632.32(4m) (1997-98). Once an insured opts for UIM coverage, §632.32(4m) sets the minimum amount of coverage at $50,000. ↩
- This type of settlement is similar to what is typically known as a
Loyagreement. InLoy v. Bunderson,107 Wis.2d 400,320 N.W.2d 175(1982), this court approved the use of such agreements, in which a primary insurer is allowed to settle for less than its policy limits and then is released from liability, while the excess insurer remains liable.Loyapproved the agreements in the context of primary/excess insurance in order to promote partial settlements. We affirmed the use of these types of agreements inTeigen v. Jelco of Wisconsin, Inc.,124 Wis.2d 1,367 N.W.2d 806(1985). ↩
- Our conclusion that the language of the UIM exhaustion clause is unambiguous is consistent with cases from other jurisdictions that have construed nearly identical language, either in the context of a UIM policy, a UIM statute, or both.
SeeRobinette v. Am. Liberty Ins. Co.,720 F. Supp. 577,580(S.D.Miss. 1989);Birchfield v. Nationwide Ins.,875 S.W.2d 502,503(Ark. 1994);Farmers Ins. Exch. v. Hurley,90 Cal.Rptr.2d 697,701(Cal.Ct.App. 1999);Cont'l Ins. Co. v.Cebe-Habersky,571 A.2d 104,106(Conn. 1990);Lewis v. State Farm Mut.Auto. Ins. Co.,857 S.W.2d 465,466-67(Mo.Ct.App. 1993);Fed. Ins. Co.v. Watnick,607 N.E.2d 771,774(N.Y.Ct.App. 1992). ↩
- The dissent is concerned that "an insured may unknowingly be the subject of agreements between the UIM and liability carriers" in that "the UIM insurer may offer to underwrite a portion of the settlement costs in order to avoid a larger payout under the UIM endorsement," and refers another case heard this term in which this fact pattern occurred. Dissent at ¶ 37. However, in
Danner v. Auto Owners Insurance,2001 WI 90,245 Wis.2d 49,629 N.W.2d 159, also issued today, we hold, among other things, that such collusive conduct on the part of a UIM carrier, undertaken to defeat a UIM insured's otherwise available UIM coverage, may give rise to a bad faith claim underAnderson v. ContinentalInsurance Co.,85 Wis.2d 675,271 N.W.2d 368(1978). ↩
- The dissent argues that the exhaustion clause in this case is inherently ambiguous because we have interpreted it differently than the exhaustion clause in
Teigen. But as we have noted, the policies and the exhaustion clauses in each case are actually quite different, despite the similarity in language.Teigenconcerned an exhaustion clause in a primary insurance policy that specified when the insurer's duty to defend its insured was satisfied and at an end. This case, in contrast, concerns an exhaustion clause in a UIM policy (in a sense, an excess policy, as the dissent notes) that specifies when the UIM insurer's duty to pay is triggered, or, stated differently, when the tortfeasor motorist is "underinsured" according to the terms of the policy. This distinction makesTeigeninapplicable; it does not create ambiguity in this contract. IfTeigenhad concerned the interpretation of language in the excess carrier's policy that specified when excess coverage was triggered, it might well be applicable here. But it did not. ↩