Secura Supreme Insurance Company v. The Estate of Daniel Keith Huck
986 N.W.2d 810
Wis.2023Background
- Daniel Huck was killed in the scope of his employment; his Estate first received $35,798.04 in worker's compensation (WC) benefits and later a $25,000 tortfeasor settlement.
- Under Wis. Stat. §102.29 the Estate had to reimburse the WC insurer $9,718.73 of the tort settlement, leaving the Estate with net WC of $26,079.31.
- Huck's Secura UIM policy had a $250,000 per-person limit and a reducing clause allowing setoffs for (a) amounts paid by tortfeasors and (b) amounts paid or payable under workers' compensation law.
- Secura reduced its UIM payment by $25,000 (tort settlement) and by the full $35,798.04 WC payment and tendered $189,201.96; the Estate sought the $9,718.73 reimbursement back.
- The circuit court and court of appeals ruled for the Estate; the Wisconsin Supreme Court affirmed, holding Secura must pay the $9,718.73 because reductions are calculated based on the insured's recovery after statutory WC reimbursements.
Issues
| Issue | Plaintiff's Argument (Secura) | Defendant's Argument (Estate) | Held |
|---|---|---|---|
| Whether Secura's policy permits reducing UIM limits by the gross WC payment even though part was statutorily reimbursed | "Paid" means the WC carrier and tortfeasor discharged obligations when they paid the Estate, so Secura may deduct the full amounts initially paid | The policy contemplates WC payments made "in accordance with" WC law; reductions must account for statutorily required reimbursements, i.e., the insured's net recovery | Court: Policy requires Secura to calculate reductions after final resolution (including §102.29 reimbursements); Secura may not deduct the reimbursed $9,718.73. |
| Whether Wis. Stat. §632.32(5)(i) authorizes reducing UIM limits by amounts initially paid even if later reimbursed under WC law | The statute permits reduction by "amounts paid" (or "paid or payable") without regard to subsequent reimbursements | The statute contemplates WC law (including §102.29); "amounts paid" refers to the insured's final/outstanding recovery when the insurer enforces the reducing clause | Court: §632.32(5)(i) is read to allow reduction by amounts paid/payable as measured at the time the insurer enforces the clause (i.e., the insured's final recovery); Secura may not reduce by sums the insured was obligated to repay. |
Key Cases Cited
- Teschendorf v. State Farm Ins. Cos., 293 Wis. 2d 123, 717 N.W.2d 258 (Wis. 2006) (addressed limits on reducing clauses; central precedent discussed)
- State ex rel. Kalal v. Circuit Court for Dane County, 271 Wis. 2d 633, 681 N.W.2d 110 (Wis. 2004) (statutory interpretation principles)
- Smith v. Atlantic Mutual Ins. Co., 155 Wis. 2d 808, 456 N.W.2d 597 (Wis. 1990) (insurance-policy interpretation follows contract principles)
- Welin v. American Family Mutual Ins. Co., 292 Wis. 2d 73, 717 N.W.2d 690 (Wis. 2006) (describing UIM coverage as a predetermined, fixed level combined from multiple sources)
- Dowhower ex rel. Rosenberg v. Western Bend Mutual Ins. Co., 236 Wis. 2d 113, 613 N.W.2d 557 (Wis. 2000) (explaining reducing-clause mechanics)
