Bell v. Progressive Direct Insurance
407 S.C. 565
| S.C. | 2014Background
- Bell was injured in a 2006 car accident and sought UIM benefits under Progressive, which insured Severn; there was no UIM coverage on the at-fault vehicle.
- Bell resided with Severn, who was the named insured, and both names appeared on the Declarations Page as drivers/household residents; Severn was listed as the named insured.
- Policy defines You/Your as the named insured and their spouse in the same household; Relative means a person residing in the same household and related by blood, marriage, or adoption.
- Part III provides UIM coverage to an insured person defined as you or a relative; Progressive denied UIM benefits because Bell was not named insured or a resident relative.
- Circuit court granted summary judgment for Progressive; held no common-law marriage existed and denied reasonable expectations; court of appeals affirmed; certiorari granted by this Court.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Is the Policy ambiguous regarding UIM coverage? | Bell contends the term household resident creates ambiguity favorable to coverage. | Progressive argues the policy is unambiguous, relying on Ex parte USAA. | Policy not ambiguous; Ex parte USAA controls. |
| May the doctrine of reasonable expectations apply to extend UIM coverage? | Bell asserts reasonable expectations should extend coverage for a household resident. | Progressive argues the doctrine is not recognized or applicable to enlarge unambiguous terms. | Reasonable expectations may be used as an interpretive tool but cannot alter unambiguous policy terms. |
| Did Bell prove a common-law marriage with Severn to qualify as a relative? | Bell argues cohabitation and engagement create a common-law marriage. | Progressive contends no common-law marriage existed, so Bell is not a 'relative'. | No common-law marriage; Bell not a relative under the policy. |
Key Cases Cited
- Ex parte USAA, 365 S.C. 50 (Ct.App. 2005) (driver vs. named insured; no ambiguity in operator term; stacking denied)
- Gambrell v. Travelers Ins. Cos., 280 S.C. 69 (1983) (insurance policy language construed by plain meaning; avoid defeating coverage)
- USAA Prop. & Cas. Ins. Co. v. Clegg, 377 S.C. 643 (2008) (policy language construed; reaffirmation of rules of contract interpretation for policies)
- Mangum, 299 S.C. 226 ( Ct. App. 1989) (discussion of reasonable expectations in dicta; not controlling law)
- Crossmann Cmtys. of N.C., Inc. v. Harleysville Mut. Ins. Co., 395 S.C. 40 (2011) (coverage existence; contract interpretation framework for insurance disputes)