Lead Opinion
The principal issue in this appeal is whether, under the facts of this case, the plaintiff is entitled to underinsured motorist benefits, as a “family member” of the insured, pursuant to the business automobile insurance policy issued by the defendant to the plaintiffs corporate employer.
“At issue in this case are the provisions of the insurance policy that dealt with uninsured motorist coverage. According to these provisions, the defendant would pay for damages caused by an uninsured vehicle. Individuals covered by this provision included: ‘(1) you or any family member (2) anyone else occupying a covered auto or a temporary substitute for covered auto.’ The policy defined ‘ “Family member” ’ as ‘a person related to you by blood, marriage or adoption who is a resident of your household, including a ward or foster child.’ The policy defined ‘occupying’ as ‘in, upon, getting in, on or off.’
“The plaintiff submitted his claim for uninsured motorist benefits to an arbitration panel. The arbitrators denied the plaintiff’s claim for coverage, finding that because the plaintiff was neither a family member of the named insured nor occupying any of the insured vehicles, he was not an insured under the policy. The plaintiff filed an application to vacate the arbitration award. The defendant asserted a counterclaim seeking to confirm the decision of the arbitration panel.
The Appellate Court agreed with the defendant that “[b]ecause it is clear that the plaintiff could not be related to the corporation, there was no ambiguity that would еntitle him to coverage based on the presumption favoring an insured where an insurance policy is ambiguous.” Id., 665. The Appellate Court accepted the defendant’s argument that a plain reading of the entire policy leads to the conclusion that a corporation could not have family members related by blood, marriage or adoption, and conсluded that no reasonable interpretation of the family member provision would entitle the plaintiff to recover under this policy. Id., 665-66. We disagree.
The provisions of the policy issued by the defendant cannot be construed in a vacuum. Chmielewski v. Aetna Casualty & Surety Co.,
This policy was prepared for the defendant by underwriter Nancy Belliveau, who used only one underinsured motorist coverage endorsement in all automobile liability policies: the one appended to the Victor Ceci Refuse, Inc. policy. Belliveau had considerable information about the insured when she prepared the policy. Belliveau knew that Victor Ceci Refuse, Inc., was a smаll, family operated business, and that the plaintiff is the brother of Victor Ceci, the corporation’s sole shareholder. The plaintiff was an employee of the insured corporation and was listed as one of the three drivers on the schedule of drivers section of the application submitted to the defendant. The other drivers were family members Victor Ceci and Louis Ceci, who ran the business. Victor Ceci advised Belliveau that the drivers of the vehicles were not covered by the Workers’ Compensation Act because the business was owner operated.
The policy in effect at the time of the plaintiffs accident provided the following:
“PART I - WORDS AND PHRASES WITH SPECIAL MEANING - READ THEM CAREFULLY
“A. ‘You’ and ‘your’ mean the pеrson or organization shown as the named insured in ITEM ONE of the declarations. . . .
“F. ‘Insured’ means any person or organization qualifying as an insured in the WHO IS INSURED section of the applicable insurance. Except with respect to our limit of liability, the insurance afforded applies separately to each insured who is seeking coverage or against whom a claim is made or suit is brought. . . .
“PART IV - LIABILITY INSURANCE. . . .
“D. WHO IS INSURED.
“1. You are an insured for any covered auto.
“2. Anyone else is an insured while using with your permission a covered auto you own, hire or borrow except . . . .”
The uninsured motorists insurance endorsement to the policy provided the following:
“THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
“UNINSURED MOTORISTS INSURANCE
“A. WORDS AND PHRASES WITH SPECIAL MEANING. . . .
*171 “1. ‘Family member’ means a person related to you by blood, marriage or adoption who is a resident of your household, including a ward or foster child. . . .
“D. WHO IS INSURED
“1. You or any family member.
“2. Anyone else occupying a covered autо or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown, repair, servicing, loss or destruction. ...” (Emphasis added.)
According to well established principles governing the construction of insurance polices, an ambiguous provision in an insurance policy will be construed to favor the insured. S & S Tobacco & Candy Co. v. Greater New York Mutual Ins. Co.,
The defendant, on the other hand, maintains that the language in the policy is clear and unambiguous because a corporation cannot have “family members.” Because it is a distinct legal entity, a corporation can act only through its agents. Lieberman v. Reliable Refuse Co.,
Before we can construe the terms of the policy in the plaintiff’s favor as he suggests, we must first determine whether the policy provision is ambiguous. Hammer v. Lumberman’s Mutual Casualty Co.,
“Under Connecticut law, the named insured refers only to the name actually appearing on the insurance policy. Testone v. Allstate Ins. Co.,
The endorsemеnt adding uninsured motorist insurance specifically included terms not previously used,
The parties agree that the plaintiff did not fаll within section D.2. of the uninsured motorists endorsement because he was not occupying any vehicle at the time of the accident. Moreover, the plaintiff did not fall within that portion of section D.l. of that endorsement referring to “You” because he was not the named insured or a designated insured. Thus, the plaintiff could not recover underinsured benefits unless he was a “family member” of thе corporation.
The defendant argues that the inclusion of family members in a business policy did not make the policy ambiguous. We disagree. An endorsement that specifically added coverage for “family members,” as did this one, would reasonably be understood as providing uninsured motorist insurance for members of the Ceci family independent of whether they were occupying а covered automobile at the time of injury. “It is a basic principle of insurance law that policy language will be construed as laymen would understand it and not according to the interpretation of sophisticated underwriters, and that ambiguities in contract documents are resolved against the party responsible for its drafting; the policyholder’s expectations should bе protected as long as they are objectively reasonable from the layman’s point of view.” Cody v. Remington Electric Shavers, supra, 497.
The premise behind the rule is simple. “ ‘The party who actually does the writing of an instrument will presumably be guided by his own interests and goals in the transaction. He may choose shadings of expression,
The language relating to “family members” in a policy insuring a corporation wаs not required. The defendant could have omitted section D.l. of the uninsured motorists endorsement of this corporate auto policy.
Because corporations do not have families, uninsured motorist endorsements containing family member lan
By inserting a family member provision in a business policy, the defendant has left the Cecis in the unenviable position of having to divine the meaning and purpose of the family member language in the context of the policy. This is precisely the problem that the rules of insurance pоlicy construction were designed to avoid. See General Statutes §§ 38a-297 through 38a-299 (insurance coverage shall be “readily understandable”). The position proposed by the defendant and adopted by the Appellate Court, that only those persons covered by section D.2. of the endorsement are entitled to underinsured benefits, renders section D.l. of the endorsement meaningless. Although some jurisdictions, as cited by the defendant,
The endorsement attached to the policy issued to Victor Ceci Refuse, Inc., is used by the defendant in all of its business policies. The defendant could have clarified or omitted the problematic language to provide notice to the Cecis of the precise nature of the coverage that was being purchased. It failеd to do so, and instead highlighted these significant changes to the insured, thereby creating the ambiguity in the policy. “This is the kind of case that has been described as ‘one where no principle of law is involved, but only the meaning of careless and slovenly documents.’ ” Robinhorne Construction Corporation v. Snyder,
The judgment is reversed and the case is remanded to the Aрpellate Court with direction to remand the case to the trial court with direction to render judgment (1) granting the plaintiff’s application to vacate the arbitration award, and (2) denying the defendant’s application to confirm the award.
In this opinion Peters, C. J., Berdon and Norcott, Js., concurred.
Notes
Uninsured and underinsured motorist coverage is governed by General Statutes § 38-175c, now recodified as General Statutes § 38a-336. “[Statutory provisions relating expressly to uninsured motorist coverage apply also to underinsured motorists.” American Motorists Ins. Co. v. Gould,
Certification was granted limited to the following issue: “Did the Appellate Court properly determine that, under the facts of this case, the plain
Issues of uninsured motorist coverage are required to be arbitrated. Bodner v. United Services Automobile Assn.,
Victor Ceci believed that his owner operated business was not eligible for workers’ compensation coverage. At the time оf the plaintiffs accident, the relevant workers’ compensation provision stated: “(5) ‘Employee’ . . . shall not be construed to include . . . (c) a member of the employer’s family dwelling in his house; but, if in any contract of insurance the wages or salary of a member of the employer’s family dwelling in his house is included in the payroll on which the premium is based, then such person shall, in the event of his sustaining an injury arising out of and in the course of his employment, be deemed an employee and compensated accordingly. . . General Statutes (Rev. to 1985) § 31-275 (5) (C), now recodified and reorganized as General Statutes § 31-275 (9) (B) (iii). Because it is only Victor Ceci’s communication to Belliveau that is relevant to this analysis, we need not address the accuracy of his belief.
The plaintiff аlso argues that it would be a violation of public policy for an insurer to collect a premium for coverage that is nonexistent. A separate uninsured motorist premium of $58 per vehicle had been paid by Victor Ceci Refuse, Inc. The uninsured motorist benefits, however, were provided through section D.2. of the policy endorsement; therefore, even were we to find thе “family member” provision of section D.l a nullity, this interpretation would not render the coverage for each vehicle illusory.
When construing an ambiguous provision of an insurance policy, we look to the expectations of the purchaser of the policy. Travelers Inc. Co. v. Kulla,
See, e.g., Hogan v. Mayor & Aldermen of Savannah,
Concurrence Opinion
concurring. I view this case somewhat differently from and more narrowly than does the majority. In my view, this case involves the clash of two competing and, in the context of this case, inconsistent canons of construction of insurance policies: (1) unambiguous language must be given its plain meaning; and (2) a policy should not be interpreted so as to render any part of it superfluous.
Thus, if we follow canon (1) above, the defendant would prevail; if we follow canon (2), the plaintiff would prevail. In order to decide this case, therefore, we have to violate one of the two canons. Because the defendant is charged with having “drafted” the policy language in question, by virtue of the underwriter having appended the inapt endorsement, I would opt to follow canon (2) and violate canon (1). I therefore join in the judgment of the court.
