Fidelity & Casualty Co. v. Merridew

Case Date: 12/17/2001
Court: 1st District Appellate
Docket No: 1-00-2849 Rel

FIRST DIVISION
December 17, 2001



No. 1-00-2849


FIDELITY AND CASUALTY COMPANY,

          Plaintiff-Appellee,

                   v.

DORIS MERRIDEW, as Adm'r
of the Estate of Reginald Merridew,
and DORIS MERRIDEW, Indiv.,

          Defendants-Appellants.

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Appeal from the
Circuit Court of
Cook County


No. 99 CR 7541


The Honorable
Stephen A. Schiller,
Judge Presiding.

JUSTICE COUSINS delivered the opinion of the court:

In June 1997, Reginald Merridew was involved in anautomobile accident with a vehicle driven by Jack Torcolese. Reginald Merridew filed an action against Torcolese seekingdamages for his bodily injuries. His wife, Doris Merridew,brought an action against Torcolese alleging loss of consortium. Torcolese was insured for automobile liability by UnitrinProperty & Casualty Company (Unitrin). The Merridews wereinsured by Fidelity & Casualty Company (Fidelity). After thesuits were settled, Doris Merridew made a claim against Fidelityfor underinsured motorist coverage. Fidelity sought adeclaration that it did not owe underinsured motorist coverage toDoris Merridew or to Reginald Merridew's estate. Fidelitysubsequently filed a motion for summary judgment. Doris Merridewfiled a cross-motion for summary judgment against Fidelity. OnJuly 19, 2000, the trial court granted Fidelity's motion forsummary judgment and denied Doris' cross-motion for summaryjudgment.

Doris Merridew, individually and as special administrator ofReginald's estate, now appeals the trial court's July 19, 2000,order. Doris Merridew presents the following issue upon appeal: whether Torcolese was an underinsured motorist pursuant to theterms of the Fidelity policy.

BACKGROUND

On June 11, 1997, 81-year-old Reginald Merridew was involvedin an automobile collision with Jack Torcolese. Merridew washospitalized for over 90 days and his medical expenses exceeded$300,000. Merridew filed a personal injury suit against thedriver. His wife, Doris Merridew, brought a loss of consortiumsuit. In July 1998, Reginald Merridew died after undergoinggallstone surgery that was unrelated to the accident. On August10, 1998, Doris Merridew was appointed special administrator ofReginald Merridew's estate.

At the time of the accident, Torcolese was insured byUnitrin. The policy issued by Unitrin contained a singleliability limit of $500,000. Reginald Merridew and DorisMerridew were named insureds on a motor vehicle insurance policyissued by Fidelity for the period covering September 9, 1996,through September 9, 1997. The Fidelity policy included anunderinsured motorist coverage endorsement with a $500,000 limitfor underinsured motorist liability coverage. The underinsuredmotorist coverage endorsement provides:

"DEFINITIONS

***

1. Covered Person means:

a. You for the ownership, maintenance or use of anyvehicle;

* * *

5. Underinsured Motor Vehicle means a land motor vehicleor trailer of any type to which a bodily injury liabilitybond or policy applies at the time of the accident but itslimit for bodily injury liability:

a. Is less than the limit of liability for UnderinsuredMotorists coverage.

b. Has been reduced by payments to other p[e]rsonsinjured in the accident to an amount less than the limit ofliability for this coverage.

* * *

INSURING AGREEMENT

We will pay compensatory damages which any covered personis legally entitled to recover from the owner or operator ofan underinsured motor vehicle because of bodily injury:

1. Sustained by any covered person; and

2. Caused by an accident arising out of the ownership,maintenance or use of an underinsured motor vehicle.

* * *

LIMIT OF LIABILITY

1. The limit of liability shown in the Coverage Summaryfor this coverage is our maximum limit of liability for alldamages, resulting from any one motor vehicle accident.

This is the most we will pay regardless of the number of:

a. Covered persons;

b. Claims or suits made;

c. Vehicles involved in an accident or shown in theCoverage Summary;

d. Persons who sustain injury or damage ***.

* * *

2. Except in the event of a settlement agreement, thelimit of liability shall be reduced by all sums paid becauseof the bodily injury by or on behalf of persons ororganizations who may be legally responsible." (Emphasisoriginal and added.)

Reginald Merridew's underlying personal injury action wassettled on behalf of his estate in the amount of $350,000. Theloss of consortium action on behalf of Doris Merridew was settledfor $150,000.

Doris Merridew and the estate of Reginald Merridewsubsequently filed a claim against Fidelity for underinsuredmotorist coverage. On May 19, 1999, Fidelity filed a complaintfor declaratory judgment seeking the following determinations:

"A. That the accident of June 11, 1997 involving ReginaldMerridew and Jack Torcolese did not involve an underinsuredmotor vehicle as defined by the Fidelity & Casualty policy.

B. That the Unitrin policy issued to Jack Torcolesecontained a single limit of liability coverage in the amountof $500,000, which Unitrin paid for the bodily injurysustained by Reginald Merridew.

C. That Fidelity & Casualty Company owes no UnderinsuredMotor Vehicle Coverage to the Estate of Reginald Merridewand/or Doris Merridew."

Doris Merridew, individually and as administrator ofReginald Merridew's estate, filed an answer to Fidelity'scomplaint for declaratory judgment. Fidelity filed a motion forsummary judgment, asserting that no underinsured motoristcoverage was owed under its policy. Doris Merridew filed across-motion for summary judgment asserting that because theestate of Reginald Merridew only received $350,000, the estatewas entitled to an additional $150,000 of coverage and sinceDoris Merridew received only $150,000, she was entitled to anadditional $350,000. On July 19, 2000, the trial court enteredan order granting Fidelity's motion for summary judgment anddenying Doris Merridew's cross-motion for summary judgment. Doris Merridew now appeals.

We affirm.

ANALYSIS  

Where there are no genuine issues of material fact, summaryjudgment is a proper method of disposing of a cause. Bailey v.Allstate Development Corp., 316 Ill. App. 3d 949, 953, 738 N.E.2d189 (2000). Accordingly, appellate review of an order grantingsummary judgment is de novo. Zekman v. Direct AmericanMarketers, Inc., 182 Ill. 2d 359, 374, 695 N.E.2d 853 (1998).

Principally, we must determine whether Torcolese's vehiclewas considered an underinsured motor vehicle, enabling Doris tostate a claim against Fidelity for underinsured motoristbenefits. In examining whether the vehicle was underinsured, wewill review the underinsured motor vehicle provision of theIllinois Insurance Code (215 ILCS 5/143a-2(4) (West 1996)) andFidelity's underinsured motor vehicle endorsement. Section 143a-2(4) of the Illinois Insurance Code defines an underinsured motorvehicle as follows:

"For the purpose of this Code the term 'underinsuredmotor vehicle' means a motor vehicle whose ownership,maintenance or use has resulted in bodily injury or death ofthe insured, as defined in the policy, and for which the sumof the limits of liability under all bodily injury liabilityinsurance policies or under bonds or other security requiredto be maintained under Illinois law applicable to the driveror to the person or organization legally responsible forsuch vehicle and applicable to the vehicle, is less than thelimits for underinsured coverage provided the insured asdefined in the policy at the time of the accident. Thelimits of liability for an insurer providing underinsuredmotorist coverage shall be the limits of such coverage, lessthose amounts actually recovered under the applicable bodilyinjury insurance policies, bonds or other securitymaintained on the underinsured motor vehicle. However, themaximum amount payable by the underinsured motorist coveragecarrier shall not exceed the amount by which the limits ofthe underinsured motorist coverage exceeds the limits of thebodily injury liability insurance of the owner or operatorof the underinsured motor vehicle." (Emphasis added.) 215ILCS 5/143a-2(4) (West 1996).

In construing a statutory provision, the primary goal is toascertain and give effect to the legislature's intent. StateFarm Fire & Casualty Co. v. Yapejian, 152 Ill. 2d 533, 540-41,605 N.E.2d 539 (1992). If the language of the statute is clear,it is unnecessary for the court to resort to other tools ofstatutory interpretation. Nottage v. Jeka, 172 Ill. 2d 386, 392,667 N.E.2d 91 (1996). The Illinois legislature enacted itsprovision for underinsured motorist coverage in order to placethe insured in the same position he would have occupied if thetortfeasor had carried adequate insurance. Sulser v. CountryMutual Insurance Co., 147 Ill. 2d 548, 555, 591 N.E.2d 427(1992). Section 143a-2 (215 ILCS 5/143a-2 (West 1996)) isdesigned to offer insurance to "fill the gap" between the claimand the tortfeasor's insurance. Sulser, 147 Ill. 2d at 556. The provision was intended to assure compensation for aninsured's injuries in an amount equal to, but not exceeding, thelimit of underinsured motorist coverage specified in theinsured's policy. Koperski v. Amica Mutual Insurance Co., 287Ill. App. 3d 494, 498, 678 N.E.2d 734 (1997).

We now turn to the pertinent provisions of the Fidelityinsurance policy. Fidelity's underinsured motorist endorsementdefines an underinsured motor vehicle as "a land motor vehicle ortrailer of any type to which a bodily injury liability bond orpolicy applies at the time of the accident but its limit forbodily injury liability *** [h]as been reduced by payments toother p[e]rsons injured in the accident to an amount less thanthe limit of liability for this coverage." (Emphasis original.)

The limit of liability provision of Fidelity's underinsuredmotorist endorsement provides:

"Except in the event of a settlement agreement, the limitof liability shall be reduced by all sums paid because of the bodily injury by or on behalf of persons ororganizations who may be legally responsible." (Emphasisoriginal.)

Where the facts are not contested, the construction of aninsurance policy is a question of law, and a court of review mayexamine such policy de novo. Smith v. Allstate Insurance Co.,312 Ill. App. 3d 246, 251, 726 N.E.2d 1 (1999). In construinginsurance policies, the court's primary objective is to ascertainand give effect to the intent of the parties to the contract. Outboard Marine Corp. v. Liberty Mutual Insurance Co., 154 Ill.2d 90, 108, 607 N.E.2d 1204 (1992). A court must construe thepolicy as a whole and take into account the type of insurancepurchased, the nature of the risks involved, and the overallpurpose of the contract. Crum & Forster Managers Corp. v.Resolution Trust Corp., 156 Ill. 2d 384, 391, 620 N.E.2d 1073(1993). When the language of an insurance policy is clear andunambiguous, the court must construe the policy according to theplain and ordinary meaning of its provisions. Allstate InsuranceCo. v. Gonzalez-Loya, 226 Ill. App. 3d 446, 449, 589 N.E.2d 882(1992). Provisions that limit or exclude coverage will beinterpreted liberally in favor of the insured. American StatesInsurance Co. v. Koloms, 177 Ill. 2d 473, 479, 687 N.E.2d 72(1997).

Doris Merridew asserts that the term "other persons" inFidelity's definition of an "underinsured motorist" does notexclude another covered person. Doris Merridew further contendsthat the term "other persons" is not defined in the Fidelitypolicy and "[i]f Fidelity had intended that the reduction made inthe definition of an 'underinsured motor vehicle' include amountspaid to any covered person by the tortfeasor's insurance,Fidelity should have included such language in the instantpolicy."

"All the provisions of the insurance contract, rather thanan isolated part, should be read together to interpret it and todetermine whether an ambiguity exists." United States FireInsurance Co. v. Schnackenberg, 88 Ill. 2d 1, 5, 429 N.E.2d 1203(1981). The court must also not read an ambiguity into a policyjust to find in favor of the insured. See Lapham-Hickey SteelCorp. v. Protection Mutual Insurance Co., 166 Ill. 2d 520, 530,655 N.E.2d 842 (1995).

Fidelity argues that the phrase in the subject policy is notambiguous. We agree. The policy refers to "other p[e]rsonsinjured in the accident." (Emphasis original.) No payments weremade to "other persons injured in the accident." Torcolese'sinsurance carrier made payments to Doris Merridew for herderivative loss of consortium. Doris Merridew was entitled torecover for loss of consortium because of the injury to herhusband.

Doris Merridew also contends that because Torcolese's policylimit ($500,000) less the amount that she received ($150,000) isless than the amount that Reginald Merridew would be entitled toreceive under his underinsured motorist coverage with Fidelity($500,000), Torcolese is an underinsured motorist with regard tothe Merridew estate underinsured motorist claim. Fidelityresponds that Torcolese was not an underinsured motorist and thathis insurer paid the Merridew estate an amount equal to theFidelity insurance policy limits.

Though factually dissimilar, we find Cummins v. CountryMutual Insurance Co., 178 Ill. 2d 474, 687 N.E.2d 1021 (1997),instructive. In Cummins, the plaintiff, Craig Cummins, was thepassenger in a car insured by Country Mutual Insurance Company(Country Mutual) when the vehicle was involved in an accident. At the time of the accident, Cummins was covered by the CountryMutual policy, which provided both uninsured and underinsuredmotorist benefits in the amount of $50,000 per person and$100,000 per accident. The other motorist, who was at fault, hadinsurance with identical limits. Cummins received $35,000 in acourt-approved settlement from the at-fault driver's liabilityinsurance company with the balance of the liability proceedsgoing to injured passengers in the at-fault driver's vehicle. Cummins, 178 Ill. 2d at 477. He later filed suit against CountryMutual seeking the $15,000 difference between the $35,000 that hereceived as settlement from the at-fault driver's liabilityinsurance and the $50,000 limit of Country Mutual's underinsuredmotorist coverage. Country Mutual filed a motion to dismissplaintiff's complaint contending that the liable driver's vehiclewas not underinsured, as defined by the Illinois Insurance Code(215 ILCS 5/143 et seq. (West 1992)), because the driver carriedliability limits that were equal to the limits of plaintiff'sunderinsured motorist coverage. Cummins, 178 Ill. 2d at 476. The trial court granted defendant's motion to dismiss andplaintiff appealed. The appellate court reversed, holding thatplaintiff could state a claim for the underinsured motoristcoverage provided by Country Mutual, and remanded for furtherproceedings. Cummins, 178 Ill. 2d at 476.

The issue before the Illinois Supreme Court was whetherplaintiff could state a claim to recover the shortfall betweenhis underinsured motorist policy limits and the amount heactually recovered from the liable driver's insurance, when theliable driver's policy had limits equal to plaintiff'sunderinsured motorist coverage, but the coverage was exhausted bypayments to other injured claimants. Cummins, 178 Ill. 2d at476. The Illinois Supreme Court, in a plurality opinion,affirmed the judgment of the appellate court, holding that theat-fault driver was underinsured and the plaintiff was entitledto underinsured motorist coverage. Cummins, 178 Ill. 2d at 486. The court reasoned that under the Sulser case, plaintiff needed$15,000 to "fill the gap" between his underinsured coveragelimits and the amount of liability insurance actually recovered. Cummins, 178 Ill. 2d at 486. The at-fault driver's insurancecompany made payments to other persons injured in the accident.Two justices specially concurred in Cummins because theydisagreed with the analysis by the plurality, but agreed that thevehicle of the at-fault driver should be considered an"underinsured motor vehicle" with respect to Cummins. Cummins,178 Ill. 2d at 492. In Cummins, the court wrote: "[M]otorists[are] considered 'underinsured' when the amount of liabilityinsurance they actually pay out is less than the amount ofunderinsured-motorist coverage a policyholder obtains." Cummins,178 Ill. 2d at 485.

Another instructive case is Gober v. State Farm MutualAutomobile Insurance Co., 263 Ill. App. 3d 846, 636 N.E.2d 1016(1994). In Gober, Charles Gober was involved in a collisioncaused by Dean Galvin. Gober, 263 Ill. App. 3d at 847. In anaction against Galvin, Charles sued for bodily injury and Helensued for loss of consortium. Galvin's insurer, AllstateInsurance Company (Allstate), settled Charles' claim for $10,000and Helen's claim for $10,000. Together the settlement amountsrepresented Galvin's total liability policy limit of $20,000.

Charles then made a claim for underinsured motorist benefitsfor his personal injuries under four different State FarmInsurance Company policies. Gober, 263 Ill. App. 3d at 847. Allfour polices contained underinsured motorist coverage limits inthe amount of $100,000 per person and $300,000 per accident. Charles sought $90,000 in benefits under the State Farm firepolicy and an additional $20,000 of benefits under any one of theState Farm auto policies. State Farm Fire paid Charles $80,000under its policy, representing the difference between the singleper-person limits of $100,000 and the $20,000 that Allstate paidto Charles and Helen. The defendants denied Charles' additionalclaims. Charles and Helen brought a declaratory judgment actionseeking to recover additional underinsured motorist benefitsunder the State Farm insurance policies. Gober, 263 Ill. App. 3dat 847.

The appellate court held that, "Since Allstate's payment toHelen was made as part of a larger, overall payment for thebodily injury caused to Charles, State Farm Fire properly reducedits benefit by the $10,000 paid to Helen in addition to the$10,000 paid to Charles." Gober, 263 Ill. App. 3d at 850. Thecourt reasoned that "[t]he thrust of the policy language is toallow a setoff for any amount previously paid for bodily injurysustained by an insured at the hands of an underinsuredmotorist." Gober, 263 Ill. App. 3d at 850.

Berutti v. State Farm Mutual Automobile Insurance Co., 288Ill. App. 3d 997, 682 N.E.2d 216 (1997), is also an instructivecase. In Berutti, Clifford Berutti was involved in a automobileaccident. He received the $100,000 per-person limit of the otherdriver's policy to cover his personal injuries. Berutti's policyprovided underinsured motorist coverage with limits of $100,000per person and $300,000 per occurrence. He and his wife, Helga,sought a declaration that defendant was required to pay benefitsfor Helga's loss of consortium claim under their underinsuredmotorist coverage. Berutti, 288 Ill. App. 3d at 998. The trialcourt held that the policy did not provide separate coverage forHelga's loss of consortium claim. Berutti, 288 Ill. App. 3d at998.

The appellate court affirmed, reasoning that, "Becauseplaintiffs do not claim that anyone other than Clifford Beruttiwas physically injured, these provisions unambiguously limitdefendant's liability to the per-person limitation rather thanthe per-occurrence limitation." Berutti, 288 Ill. App. 3d at1001. Further, "[b]ecause the per-person liability refers to oneperson injured, if the injured person receives the maximum per-person liability, the coverage is deemed exhausted." Berutti,288 Ill. App. 3d at 1002.

In the instant case, Torcolese was at fault in the accidentwith Reginald Merridew. The Unitrin insurance policy issued toTorcolese contained a single liability limit of $500,000. Theinsurance policy that Reginald and Doris Merridew carried withFidelity included an underinsured motorist coverage endorsementwith a $500,000 limit. The limit of liability provision forunderinsurance coverage in the Fidelity policy provides that thelimit of liability shall be reduced by all sums paid because ofbodily injury by persons legally responsible. The insurancecarrier for Torcolese, the person legally responsible for theaccident and injury to Charles Merridew, paid $350,000 to CharlesMerridew for his injury and $150,000 to Doris Merridew for lossof consortium because of the injury to Charles Merridew.

In our view, the total $500,000 paid by Torcolese'sinsurance carrier was paid because of injuries to CharlesMerridew and not because of injuries to other persons. Accordingly, we hold that Torcolese was not an underinsuredmotorist and that his insurance carrier has paid the Merridewestate an amount equal to the Fidelity insurance policy limits.

For the foregoing reasons, we affirm the judgment of thecircuit court.

Affirmed.

COHEN, P.J., and TULLY, JJ., concur.