909 N.W.2d 402
Wis.2018Background
- On Oct. 11, 2010 Robert Shugarts (a deputy sheriff) was injured when Dennis Mohr struck his squad car; Mohr was insured by Progressive and the county vehicle by WMMIC; the Shugarts also had personal UIM coverage with Allstate.
- Progressive initially denied coverage (Jan. 2012) as to Mohr based on an intentional-act exclusion, later offered $10,000, and eventually (Oct. 13, 2014) offered to pay Mohr’s $50,000 policy limit to settle.
- The Shugarts sued Progressive in June 2013 and later amended to add WMMIC and, after Progressive’s $50,000 offer, added Allstate in March 2015.
- Allstate moved for summary judgment, arguing the Shugarts failed to give timely notice of a UIM claim under the Allstate policy; circuit court and court of appeals granted summary judgment for Allstate.
- Wisconsin Supreme Court granted review and reversed, holding the UIM proof-of-claim notice was triggered by tender of the tortfeasor’s policy limit and the Shugarts’ notices (Oct. 28, 2014 retainer notice; Feb. 9, 2015 Vogt notice) were timely.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| When does the Allstate UIM policy’s proof-of-claim notice requirement trigger? | Trigger is tender/exhaustion of tortfeasor’s liability limits (not the accident). | Trigger is the accident or as soon as possible after injury; timely notice was long overdue. | Trigger is tender of tortfeasor’s policy limit; notice after Progressive’s $50,000 offer was timely. |
| Does the liability-section “notice of accident” clause apply to UIM claims? | No — liability and UIM sections are separate; UIM section controls. | Yes — the policy’s general notice language applies across sections. | No — reasonable insured would read the UIM section as governing UIM notice; liability clause does not apply. |
| Does Wis. Stat. § 631.81(1) (proof of loss within 1 year) control here? | § 631.81(1) does not apply because the UIM policy requires proof of “claim,” not “loss.” | § 631.81(1) applies to all insurance and makes the notice untimely. | § 631.81(1) does not apply; its text refers back to policy provisions that require notice/proof of loss. |
| If notice were untimely, did insured rebut presumption of prejudice? | N/A (court resolved on timeliness) | Allstate argued insured failed to rebut prejudice. | Court did not reach prejudice because notice was held timely. |
Key Cases Cited
- Vogt v. Schroeder, 129 Wis. 2d 3 (UIM insurer’s subrogation rights and right to notice of tentative settlements)
- Danbeck v. Am. Family Mut. Ins. Co., 245 Wis. 2d 186 (UIM exhaustion clause: UIM triggered only after tortfeasor’s liability limits are exhausted)
- Martinson v. Am. Family Mut. Ins. Co., 63 Wis. 2d 14 (distinguishable UM case: proof-of-claim must be filed as soon as practicable after incident)
- Yocherer v. Farmers Ins. Exch., 252 Wis. 2d 114 (policy language can show when a presentable claim exists)
- Ranes v. Am. Family Mut. Ins. Co., 219 Wis. 2d 49 (failure to give notice of settlement bars UIM coverage only if insurer prejudiced)
- Pitts v. Revocable Trust of Knueppel, 282 Wis. 2d 550 (discussing substitution of payment and preservation of subrogation rights)
- Acuity v. Chartis Specialty Ins. Co., 361 Wis. 2d 396 (policy interpretation against insurer when ambiguous)
