Miller v. Ho Kun Yun
400 S.W.3d 779
| Mo. Ct. App. | 2013Background
- Miller, a passenger in a vehicle insured by AmFam, sought $100,000 UIM benefits after Geico paid $100,000 to Miller from the at-fault driver.
- The at-fault driver’s vehicle was insured for $100,000 per person, making the UIM limits appear potentially duplicative of the tortfeasor’s liability.
- AmFam denied UIM benefits, arguing the tortfeasor’s vehicle was not an “underinsured motor vehicle” and that set-off provisions reduced or eliminated recovery.
- The UIM endorsement defined ‘underinsured motor vehicle’ as a vehicle insured for less than the UIM limits, and included limits-of-liability and other-offset provisions.
- The trial court granted Miller summary judgment for $100,000, holding the policy’s language created ambiguity in favor of the insured.
- On appeal, the court reviewed the entire policy for ambiguity and affirmed, concluding there was ambiguity that should be resolved in Miller’s favor.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Is there ambiguity in the policy’s UIM terms when read as a whole? | Miller: endorser pays excess over tortfeasor; conflict with declarations causes ambiguity. | AmFam: definition is unambiguous; set-off limits align with declaration and off-set provisions. | Yes, ambiguity exists; resolved in Miller’s favor. |
| Does the ‘underinsured motor vehicle’ definition, by itself, determine coverage? | Miller: definition precludes any coverage only if tortfeasor’s limits exceed UIM, but policy language elsewhere creates ambiguity. | AmFam: definition is clear; no coverage if tortfeasor is not underinsured. | Definition alone not dispositive; policy read as a whole creates ambiguity. |
| Does the ‘Limits of Liability’/off-set provision conflict with the UIM promise to pay excess amounts? | Miller: off-set could apply to excess of $100,000, creating ambiguity about total available coverage. | AmFam: off-set reduces the stated UIM limit; intended to cap payments. | Ambiguity persists; off-set read with other clauses creates uncertainty about coverage. |
| Should the Declarations Page influence interpretation given ‘gap’ vs. ‘excess’ coverage? | Miller: declarations imply coverage beyond tortfeasor payment; not clearly marked as gap coverage. | AmFam: declarations reflect limits; endorsement defines mechanics, not misleading. | Declarations page planning contributes to ambiguity; must be considered with endorsement. |
| May bolded terms and structure influence whether coverage is excess or gap? | Miller: bolded terms should signal definitional scope; failure to bold clearly obscures coverage intent. | AmFam: bolding is insufficient to negate unambiguous terms. | Policy ambiguity remains when bolding is inconclusive; interpretation in insured’s favor. |
Key Cases Cited
- Rodriguez v. Gen. Accident Ins. Co. of Am., 808 S.W.2d 379 (Mo. banc 1991) (definition alone not controlling; consider policy as a whole)
- Seeck v. Geico Gen. Ins. Co., 212 S.W.3d 129 (Mo. banc 2007) (ambiguous when whole policy contradicts clear definition)
- Jones v. Mid-Century Ins. Co., 287 S.W.3d 687 (Mo. banc 2009) (set-off language may create ambiguity; endorse interpretation to preserve coverage)
- Ritchie v. Allied Prop. & Cas. Ins. Co., 307 S.W.3d 132 (Mo. banc 2009) (ambiguity when other-insurance clause conflicts with stated limit)
- Wasson v. Shelter Mut. Ins. Co., 358 S.W.3d 113 (Mo. App. 2011) (uncompensated damages vs. declared limits; set-off context)
- Long v. Shelter Insurance Cos., 351 S.W.3d 692 (Mo. App. 2011) (ambiguous excess vs. gap coverage when terms promise excess over payments)