Robert W. DAUN, Plaintiff and Appellant,
v.
USAA CASUALTY INSURANCE COMPANY, Defendant and Respondent.
Court of Appeal, Fourth District, Division 1.
*45 O'Mara & Padilla, San Diego, and Michael Padilla, for Plaintiff and Appellant.
Shifflet, Kane & Konoske, Gregory P. Konoske, San Diego, and D. Amy Akiyama, for Defendant and Respondent.
McINTYRE, J.
In this appeal we address the question of whether the California uninsured motorist statute (Ins.Code, § 11580.2) allows an insurer to properly exclude uninsured or underinsured motorist coverage where the insured is injured by an uninsured motorist or underinsured motorist while the insured operated a motor vehicle with less than four wheels. (All undesignated statutory references are to the Insurance Code.) We conclude this exclusion contravenes public policy because it impermissibly narrows the scope of UM and UIM coverage and we therefore reverse the judgment in favor of the insurer.
FACTUAL AND PROCEDURAL BACKGROUND
The following facts are undisputed: A vehicle driven by an UIM struck Robert W. Daun while he was riding a two-wheeled motorcycle owned by the City of San Diego and furnished to him for his regular use as a police officer. Daun did not own or lease the motorcycle and he was acting within the course and scope of his employment at the time of the accident. USAA Casualty Insurance Company (USAA) had issued Daun an automobile insurance policy that included UM and UIM сoverage; however, Daun did not include the motorcycle as an insured vehicle under the policy.
Daun's USAA policy contained UM and UIM limits of $30,000; however, the motorist who struck Daun had a liability limit of only $15,000 per person and this sum has been paid to Daun and his employer, which had a subrogation claim fоr workers' compensation benefits. Daun's policy contained an exclusion denying UM and UIM coverage where "you or any family member is the operator of any self-propelled vehicle with less than four wheels that is not insured for this coverage under *46 this policy." USAA relied on this exclusion when it denied Daun's claim for coverage under his policy.
Daun filed this action alleging a violation of Business and Professions Code section 17200 and the parties agreed to submit the matter for trial on stipulated facts. The trial court entered judgment in favor of USAA after it concluded there was no сoverage under the policy and hence, no violation of Business and Professions Code section 17200. Daun timely appealed.
DISCUSSION
General Legal Principles and Standard of Review
This action presents an issue of law regarding interpretation of section 11580.2 as applied to undisputed facts. Our review is de novo (Murphy v. Padilla (1996)
With these general principles in mind, we must evaluate whether section 11580.2 permits the exclusion contained in the USAA policy.
Analysis
California law requires owners and operators of automobiles "to be `financially responsible' (usually by means of insurance) for аny" bodily injury or property damage that they may cause. (King v. Meese (1987)
Unless the insurer and named insured execute a written waiver in the statutory form (§ 11580.2, subd. (a)(2), (3)), section 11580.2 becomes part of every motor vehicle liability insurance policy (Kincer v. Reserve Ins. Co. (1970)
Section 11580.2 mandates two separate tyрes of coverage UM and UIM coverage. UM coverage requires the insurer to *47 pay its insured, up to specified limits, damages for bodily injury or wrongful death the insured would be entitled to recover from the owner or operator of an uninsured motor vehicle. (§ 11580.2, subd. (a)(1).) UIM coverage allows an insured to recover from his or her own insurer the difference between the amount of the insured's own underinsured motorist policy limits and whatever is available from the negligent driver's liability insurance. (§ 11580.2, subd. (p)(2); Viking Ins. Co. v. State Farm Mut. Auto. Ins. Co. (1993)
UM and UIM coverage, if not waived, protects "the insured, the insured's heirs or legal representative ...." (§ 11580.2, subd. (a)(1).) Thus, section 11580.2 defines coverage in terms of the "insured" and not the insured's occupancy of any particular type of motor vehicle. The statute then defines who is an "insured" entitled to coverage.
Where the named insured is an individual, section 11580.2, subdivision (b) provides different definitions of an "insured" for рurposes of this subdivision, depending on the relationship of the person seeking coverage to the named insured. Specifically, the named insured and his or her family members living in the same household are covered "while [they are] occupants of a motor vehicle or otherwise," whereas the coverage afforded "any other person" is limited to when he or she is "in or upon or entering into or alighting from an insured motor vehicle...." (§ 11580.2, subd. (b).) Thus, section 11580.2 creates two distinct classes of insured individuals. The phrase "or otherwise" gives broad coverage to members of the first class of insureds when they are injured by an uninsured or underinsured motorist's neglect without reference to an insured motor vehicle or possibly, any motor vehicle. (Lopez v. State Farm Fire & Cas. Co. (1967)
Daun falls into this class of insureds and USAA's reliancе on the definition of "insured motor vehicle" contained within subdivision (b) of section 11580.2 as a basis for denying coverage is clearly erroneous. Stated differently, the definition of "insured motor vehicle" only becomes relevant when an UM or UIM injures any person other than the named insured and his or her family members living in the same household.
Hence, Daun is entitled to UM or UIM coverage under the plain language of the statute unless one of eight statutory exemptions from the required primary or excess coverage applies. (§ 11580.2, subd. (c).) One such exemption excludes coverage for injuries suffered by the named insured or family members while occupying a car owned by the named insured, but not covered under the policy. (§ 11580.2, subd. (c)(6).) This exclusion prevents the owner of two motor vehicles from paying for insurance on only one of them and recovering benefits for injuries sustained while operating the оther. (Interinsurance Exchange v. Velji (1975)
Another exemptiоn that is potentially relevant to the instant facts specifically exempts from coverage "bodily injury of the insured while in or upon or while entering into or alighting from a motor vehicle other than the described motor vehicle if the owner thereof has insurance similar to that provided in this seсtion." (§ 11580.2, subd. (c)(2), italics added.) This provision is designed, in part, to prevent double recovery where more than one policy's UM or UIM protection is involved. (California State Auto. Assn. Inter-Ins. Bureau v. Huddleston (1977)
Having established that Daun is entitled to UM or UIM coverage under the plain language of the statute and that none of the eight statutory exemptions applies, we turn to the exclusion contained within his policy eliminating UM and UIM coverage where he "or any family member is the operator of any self-propelled vehicle with less than four wheels that is not insured for this coverage under this policy." Daun claims this exclusion is against public policy because it impermissibly narrows the scoрe of UM and UIM coverage required by statute. We agree.
"The purpose of [section 11580.2] is `to protect one lawfully using the highway by assuring him of payment of a minimum amount ... for bodily injury caused by the actionable fault of another driver.' [Citation.]" (Hartford Fire Ins. Co. v. Macri (1992)
Freedom to contract should not be unduly restricted and agreements will not be declared void as against public policy unless they clearly contravene public policy as declared by statutory enactment or judicial decisions. (Jensen v. Traders & General Ins. Co. (1959)
For example, in Aetna Ins. Co. v. Hurst, supra,
USAA contends it permissibly excluded UM and UIM coverage to a particular class of motor vehicles, i.e., any self-propelled vehicle with less than four wheels. In support of this argument, USAA cites section 11580.1, governing the mandatory provisions for every automobile liability policy issued or delivered in California (§ 11580.1, subd. (a)), arguing that subdivision (c)(8) of this section allows an automobile insurance policy to exclude "[a]ny motor vehicle or class of motor vehicles" from liability coverage. We reject this argument as USAA is attempting to graft an exclusion contained in section 11580.1 governing liability coverage to third parties onto section 11580.2 concerning "first party" coverage (i.e. coverage owed by an insurer to cover losses suffered by its own insured). (Farmers Ins. Exchange v. Hurley (1999)
At oral argument, USAA argued that the court in Canadian Ins. Co. v. Ehrlich (1991)
USAA's reliance on Canadian is misplaced. The court in Canadian recognized the general rule that exclusions not expressly authorized by or broader than, those stated in section 11580.1 are impermissible and invalid. (Canadian, supra,
In summary, section 11580.2 mandates UM and UIM coverage to the named insured regardless of whether the individual is in a motor vehicle or on a horse, *50 motorcycle, bicycle or stilts when injured by an uninsured or underinsured motorist, so long as one of the statutory exclusions does not apply. As such, the uninsured motorist statute unambiguously covers Daun, the named insured, because none оf the statutory exclusions apply and he suffered bodily injury caused by the negligence of an uninsured motorist "while [he was an] occupant[] of a motor vehicle or otherwise ...." (§ 11580.2, subd. (b), italics added.) The fact Daun was in a nonowned motor vehicle at the time of the accident and not in the insured motor vehicle does not vitiate coverage where none of the statutory exclusions apply.
The exemption USAA seeks to enforce is void as against public policy because it imposes a limitation upon UM and UIM coverage required by section 11580.2. The Legislature did not require insurers to prоvide such coverage to their "insured," only to allow them to take part of that coverage away through exclusions and exceptions not contained in the statute.
Since the trial court concluded there was no coverage, it did not reach USAA's remaining arguments regarding the merits оf this action. Accordingly, we decline to reach these issues in the first instance on appeal and remand to the trial court for that purpose.
DISPOSITION
The judgment is reversed and this matter is remanded for further proceedings consistent with this opinion. Appellant is entitled to his costs on appeal.
WE CONCUR: HUFFMAN, Acting P.J., and McDONALD, J.
NOTES
Notes
[*] Brown, J., did not participate therein.
