Sсott BRUNSON, Plaintiff-Appellant, v. Robert L. WARD, Debra Czaplewski, State Farm Mutual and Continental Casualty Company, Defendants, PROGRESSIVE NORTHERN INSURANCE COMPANY, Defendant-Respondent.
Nos. 98-3002, 98-3300
Supreme Court of Wisconsin
Oral argument January 4, 2001. Decided July 6, 2001.
2001 WI 89 | 629 N.W.2d 140 | 245 Wis. 2d 163
For the defendant-respondent there was a brief by Rick E. Hills, Michelle M. Stoeck and Hills & Hicks, S.C., Brookfield, and oral argument by Rick E. Hills.
¶ 1. DIANE S. SYKES, J. In Wisconsin, underinsured motorist policies written in the amount of $25,000 have been held to be illusory contracts, and case law has required insurers to pay damagеs, up to the $25,000 limit of any such policy, as a remedy for the issuance of an illusory contract. Meyer v. Classified Ins. Co., 192 Wis. 2d 463, 468, 531 N.W.2d 416 (Ct. App. 1995); see also Kaun v. Indust. Fire & Cas. Ins. Co., 148 Wis. 2d 662, 670, 436 N.W.2d 321 (1989); Hoglund v. Secura Ins., 176 Wis. 2d 265, 270-71, 500 N.W.2d 354 (Ct. App. 1993). The question in this case is the continued viability of this judicially-created remedy in light of a subsequent legislative one—a statute requiring underinsured motorist (UIM) policies to provide at least $50,000 in coverage—where the policy in question contains a clause conforming the policy to the requirements of state statute.
¶ 2. More specifically, the court of appeals in this case certified the following question to this court: “Does
I
¶ 3. Plaintiff Scott Brunson was seriously injured in an automobile accident in January 1996. The other driver, defendant Robert Ward, had $100,000 in automobile liability coverage, and his insurer offered full policy limits to Brunson.
¶ 4. Brunson had UIM insurance through his automobile liability insurer, Progressive Northern Insurance Company (Progressive), which he purchased on November 19, 1995, for a premium of $23. The declarations page of the policy stated that it provided UIM coverage in the amount of $25,000 per person and $50,000 per accident. The policy provided that Progressive would pay “damages . . . which an insured person is legally entitled to recover from the owner or operator of an underinsured motor vehicle up to the limit of liability as defined in this Endorsement . . .” and defined an “underinsured motor vehicle” as
¶ 5. Prior to Brunson‘s purchase of UIM coverage from Progressive, several appellate decisions had concluded that $25,000 UIM policies were illusory beсause of their interaction with
¶ 6. In Meyer, the court of appeals established a remedy for an insurer‘s issuance of this type of illusory UIM policy, requiring the insurer to compensate the insured for damages not covered by the third-party liability policy up to the $25,000 limit of the UIM policy. Meyer, 192 Wis. 2d at 468. Subsequent to Meyer, but before Brunson purchased his UIM coverage from Progressive, the Wisconsin legislature enacted 1995 Wis. Act 21. The act eliminated the illusory contract problem identified in Kaun and Hoglund, and remedied in Meyer, by creating
If an insured [on a policy that goes into effect after October 1, 1995] accepts underinsured motorist coverage, the insurer shall include the covеrage under the policy just delivered to the insured in limits of at least $50,000 per person and $100,000 per accident. For any insured who accepts the coverage after notification [on a policy in effect on October 1, 1995], the insurer shall include the coverage under the renewed policy in limits of at least $50,000 per person and $100,000 per accident.
¶ 7. Because it was issued after the effective date of this change in the law, Brunson‘s policy was required to provide at least $50,000 of UIM coverage. On June 25, 1996, Progressive notified Brunson by lеtter that although the declarations page of the policy specified $25,000 of UIM coverage, the policy actually provided $50,000 of UIM coverage because it was required to do so by state law. The letter also explained that Ward was not “underinsured” as defined in the policy, because his $100,000 liability limits exceeded Brunson‘s $50,000 UIM limits. Accordingly, Progressive declined to pay UIM benefits.
¶ 8. On June 6, 1997, Brunson filed a negligence action against Ward. Brunson amended his complaint three times, eventually adding a UIM claim against Progressive. Progressive sought a declaratory judgment, asking the circuit court to: (1) reform the policy to comply with the requirement in
¶ 9.
¶ 10. Subsequently, Progressive notified the Office of the Commissioner of Insurance (OCI) by letter that the declarations page issued to Brunson mistakenly stated that he had $25,000 of UIM coverage instead of the statutorily required $50,000. Based upon this letter, Brunson moved the court pursuant to
¶ 11. Brunson appealed from both the declaratory judgment and the denial of his motion for reconsideration and the award of costs and attorney‘s fees against him. The appeals were consolidated. The court of appeals certified the case to this court to con-
II
¶ 12. This case involves the interpretation of an insurance contract, which is a question of law that the court reviews de novo. Katze v. Randolph & Scott Mut. Fire Ins. Co., 116 Wis. 2d 206, 212, 341 N.W.2d 689 (1984). We construe an insurance policy to give effect to the intent of the parties, as expressed in the language of the policy. Stanhope v. Brown County, 90 Wis. 2d 823, 848, 280 N.W.2d 711 (1979); Garriguenc v. Love, 67 Wis. 2d 130, 134, 226 N.W.2d 414 (1975). If the policy language is unambiguous, we apply it as written. However, if the words of the policy are reasonably or fairly susceptible to more than one construсtion, it is ambiguous and we construe such ambiguities against the insurer. Id. at 135.
III
¶ 13. To resolve the certified question of the applicability of the Meyer remedy, we must first decide whether Progressive‘s policy should have been reformed to reflect the statutorily required $50,000 of UIM coverage instead of $25,000. If reformation was proper, the policy is not illusory and the Meyer remedy does not come into play.
¶ 14. Progressive‘s policy provides that any of its terms that conflict with state statute are conformed to the requirements of state statute. The insurance code itself also requires that any policy that violates state statute or rule be conformed to the requirements of the statutes and rules. See
¶ 15.
¶ 16. Upgrading the policy to the higher level of coverage was appropriate for reasons separate and apart from the “conformance to law” clause in the policy. The insurance code provides that insuranсe policy provisions inconsistent with insurance statutes or rules are enforceable to the extent of the requirements contained in the statutes and rules. Specifically,
¶ 17. The circuit court‘s “reformation” of the policy, therefore, was not so much a reformation at common law as a recognition that, pursuant to
¶ 18.
¶ 19. St. Mary‘s concerned a hospital‘s failure to comрly with the requirements necessary to become a self-insurer under
¶ 20. Because of their conflicting results, these cases do not provide much guidance here. In one, the court of appeals invoked
¶ 21. The most that can be said about the applicability of St. Mary‘s here is that it is distinguishablе and therefore limited to its own facts insofar as its interpretation of
¶ 22. Appleton Papers is closer to this case, at least to the extent that the case applied
¶ 23. This case is analogous, although not perfectly so, to Smith v. National Indemnity Co., 57 Wis. 2d 706, 710, 205 N.W.2d 365 (1973). In Smith, an insurer issued a policy providing $100,000 per person and $300,000 per accident to the named insured and $10,000 per person and $20,000 per accident to renters of the insured‘s vehicles. However, the omnibus coverage statute,
Contrary to its written terms, the policy by operation of law must be deemed to afford the renters protection to the extent of the higher limits. This view is not remaking the policy. We are aware the parties were not mistaken when they wrote the policy and it was written as they intended, but [the insurer] should know or be chargeable with knowledge of the effect of the omnibus сoverage statute and that it cannot issue a policy in conflict there-
Id. at 714 (citations omitted).
¶ 24. We reach a similar conclusion here. Brunson and Progressive contracted for $25,000 of UIM insurance, and Brunson paid a premium for that amount of coverage. However,
¶ 25. At either $25,000 or $50,000, Brunson‘s UIM coverage limits were less than Ward‘s $100,000 liability policy limits. Progressive‘s policy defined an underinsured motor vehicle as a vehicle insured for less than the UIM coverage limits in Progressive‘s policy. Since Ward‘s liability limits exceeded Brunson‘s UIM coverage limits, Ward was not an underinsured motorist under the policy. Therefore, UIM benefits were not recoverable, and Progressive was properly dismissed from this aсtion.
IV
¶ 26. Although we agree with that portion of the circuit court‘s order which dismissed Progressive from this case, we do not agree with the award of costs and attorney‘s fees for the filing of a frivolous motion for
¶ 27. The inquiry into whether a claim is frivolous involves a mixed question of fact and law. Stern v. Thompson & Coates, Ltd., 185 Wis. 2d 220, 241, 517 N.W.2d 658 (1994). The determination of “what was known or should have been known” is a question of fact that is not disturbed “unless [it is] against the great weight and clear preponderance of the evidence,” in other words, clearly erroneous. Id. However, “the ultimate conclusion about whether what was known or should have been known supports a finding of frivolousness” is a question of law, which we review independently of the circuit court. Id.
¶ 28. From the outset we note that frivolous claims are an especially delicate area of the law. Radlein v. Indus. Fire & Cas. Ins. Co., 117 Wis. 2d 605, 613, 345 N.W.2d 874 (1984). A claim, action, or defense is frivolous if it was brought without any reasonable
¶ 29. Here, the circuit court found Brunson‘s motion for reconsideration to be frivolous. The motion centered on the issue of the reformation of the insurance policy. Yet, the issues of the applicability of the Meyer remedy after the enactment of
V
¶ 30. In sum, we conclude that the circuit court‘s reformation of the UIM policy to provide $50,000 in UIM coverage was proper pursuant to the “conformance to law” clause in the policy and
By the Court.—The order of the Waukesha County Circuit Court is affirmed in part and reversed in part.
¶ 31. ANN WALSH BRADLEY, J. (dissenting).
“against the insurer”
What happened to those words? The majority opinion in essence rewrites
¶ 32. How can this happen? Not easily. To reach this conclusion the majority must ignore the plain meaning of the statute, delete the problematic phrase “against the insurer,” discard the stated clear and specific legislative intent, and misconstrue case law interpreting the statute. Because I disagree with this approach and believe that the majority‘s conclusion effectively transforms the insurance code into a safety net for those insurers who issue illegal policies, I respectfully dissent.
¶ 33. The majority opinion rests to a large degree on its misreading and misapplication of
(3m) Enforcement of statute and rule requirements. A policy that violates a statute or rule is enforceable against the insurer as if it conformed to the statute or rule.
¶ 34. The statutory language signifies that conformance of policies to the statutes under
¶ 35. While this is made clear from the express language of the statute, legislative statements of intent remove all doubt as to the intended effects of
First, insured persons should always be able to enforce rights given them under the contract as issued . . . .
Second, cоntracts issued with terms deviating in favor of the insurer from those prescribed by a specific statute should be, in effect, reformed to accord with the statute and then be enforced against the insurer. This is standard common law doctrine.
Comment to § 41, ch. 375, Laws of 1975,
¶ 36. Today‘s majority contravenes not only the language of the statute, but also the express intent of the legislature. The majority does not enforce the stat-
¶ 37. There is no question that unless the policy is reformed to comply with
¶ 38. To rectify the wrong committed upon Wisconsin insureds by the issuance of such policies, the court of аppeals crafted the remedy that is at the center of this case. In Meyer, the court explained that an insurer issuing such an illusory policy was required to compensate the insured for damages exceeding the at-fault driver‘s liability limits up to the $25,000 limit of UIM coverage purchased by the insured. Meyer, 192 Wis. 2d at 469. Thus, Brunson would be entitled to have his reasonable expectations fulfilled. Progressive would be liable for the full amount of the $25,000 of worthless UIM coverage it issued. Today‘s majority lets Progressive off this hook.
¶ 39. The majority curiously asserts that the application of thе statute actually operates to the insurer‘s detriment in this case because operation of
¶ 40. In this case, higher coverage limits operate to the benefit of the insurer by relieving the insurer of its liability and allowing the insurer to hide behind the very statute which it violated. By conveniently ignoring that the benefits of statutory conformance are always to inure to the benefit of the insured, the majority has effectively read the words “against the insurer” out of
¶ 41. Its misreading of
¶ 42. In Appleton Papers the court of appeals required statutory conformance over the insurer‘s objections, where the insured sought enforcement of the statutory provisions to avoid an arbitration clause included in the policy by the insurer in contravention of the statutes. 2000 WI App 104, ¶ 42. In doing so, the court of appeals simply followed the legislative man-
¶ 43. Finally, I note that the majority also rests its decision on the “conformance to law” clause contained in the policy. While we have enforced such provisions in the past, I have yet to find a case where we hаve enforced such a provision in a manner that allows an insurer to avoid the consequences of issuing an illusory and illegal policy. The facts before us do not suggest that we should begin to do so with this case.
¶ 44. Wisconsin courts had established that UIM coverage of $25,000 was illusory as far back as 1989.5 On July 15, 1995, the legislature amended the statutes to require an insurer to issue minimum UIM coverage of $50,000. Yet, in November 1995, six years after the courts identified UIM coverage of $25,000 as illusory, and well after the statutory change was effective, Progressive sold Brunson an illegal six-mоnth $25,000 UIM policy.
¶ 45. Brunson was severely and permanently injured in January 1996. It was not until June of 1996, after the accident and even after the policy had already expired, that Progressive eventually notified Brunson that it was of the opinion that his former policy actually
¶ 46. Public policy requires that we not allow insurers to accept the premium for a policy that is illusory as written and then fall back on the “conformance to law” clause of their policy when the deceptive nature of the policy they have drafted comes to light. Doing so transforms the insurance code into a safety net for insurers who issue illegal policies. The majority‘s decision provides no consequences for insurers that draft policies in advantageous cоntravention of the statutes.
¶ 47. Insurers now know that the conformance to law clause will remedy their statutory violation and save them from a judicially created penalty, such as the Meyer remedy, crafted to prevent such illegal policies. Thus, today‘s majority opinion not only fails to provide consequences for issuing a policy that violates the law, but instead confers a benefit for doing so. In arriving at this anomalous conclusion, the majority ignores the mandate of
¶ 48. I am authorized to state that Chief Justice SHIRLEY S. ABRAHAMSON joins this dissent.
