ERIE INSURANCE EXCHANGE, Appellee v. Linda J. BAKER, Administratrix of the Estate of Eugene Baker, Appellant.
Supreme Court of Pennsylvania.
Argued Sept. 10, 2008. Decided June 22, 2009.
972 A.2d 507
(2) HSP‘s Application for Summary Relief in the form of a judgment is dismissed as moot.
Justice SAYLOR, EAKIN, BAER and Justice TODD join the opinion.
Justice McCAFFERY joins the majority opinion, with the exception of Part III. and Parts IV.(3) and (4) (respecting the state legislators’ Petition for Review); Justice McCAFFERY concurs in the result as to the latter.
Richard E. Freeburn, Freeburn & Hamilton, Harrisburg, for Pennsylvania State Troopers Ass‘n, appellant amicus curiae.
Michael J. Foley, John Thomas McLane, Jr., Thomas J. Foley, Foley, McLane, Foley, McDonald & McGregor, P.C., Scranton; James Richard Ronca, Anapol Schwartz, Philadelphia; Lee C. Swartz, Tucker Arensberg, P.C., Harrisburg, for Pennsylvania Ass‘n for Justice, appellant amicus curiae.
Timothy Allen Shollenberger, Adam Todd Wolfe, Shollenberger & Januzzi, L.L.P., Enola, for Alliance of Bikers Aimed Toward Educ. of Pennsylvania, appellant amicus curiae.
Mark William Tanner, Feldman, Shepherd, Wohlgelernter, Tanner, Weinstock & Dodig, Philadelphia, for AFSCME Counsil 13 and SEIU Local 668, appellant amici curiae.
Craig R.F. Murphey, MacDonald, Illig, Jones & Britton, L.L.P., Erie; Arthur J. Leonard, Pittsburgh, for Erie Insurance Exchange, appellee.
James C. Haggerty, Swartz Campbell, L.L.C., Philadelphia, for PA Defense Inst. and the Ins. Federation of PA, appellee amici curiae.
Teresa Ficken Sachs, Post & Schell, P.C., Philadelphia, for Philadelphia Ass‘n of Defense Counsel, appellee amicus curiae.
BEFORE: CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, McCAFFERY and GREENSPAN, JJ.
OPINION ANNOUNCING THE JUDGMENT OF THE COURT
Justice GREENSPAN.
We decide whether the so-called “household exclusion” in a motor vehicle insurance policy is valid and enforceable to preclude the payment of underinsured motorist benefits under the circumstances of this case. We hold the exclusion is valid, and accordingly affirm the order of the Superior Court.
Appellee Erie Insurance Exchange (Erie) filed this action seeking a declaration of rights and obligations regarding a motor vehicle insurance policy it issued to appellant Eugene Baker, covering three vehicles he owned.1 The Erie policy included $100,000/$300,000 in underinsured motorist (UIM) coverage on each of these vehicles. Baker did not sign a waiver of his rights to “stack” the coverages of these three vehicles.2
In June 1999, Baker was in an accident while operating his motorcycle. The motorcycle was not insured by Erie, but rather by Universal Underwriters Insurance Company (Universal). The Universal motorcycle policy included $15,000 in UIM coverage. Because the tortfeasor‘s insurance was insufficient to cover Baker‘s injuries, Baker sought UIM coverage under his own policies with Erie and Universal.
Universal paid its UIM limits to Baker. Baker then sought additional UIM benefits from the Erie policy. Erie denied coverage, relying on the following exclusion language in its policy:
This insurance does not apply to ... damages sustained by anyone we protect while occupying or being struck by a motor vehicle owned by you or a relative, but not insured for Uninsured or Underinsured Motorists Coverage under this policy.3
In the instant declaratory judgment action, Erie filed a motion for judgment on the pleadings. Erie argued the plain language of its household exclusion denies coverage to Baker because, at the time of the accident, he was driving a vehicle owned by him but not insured under the Erie policy, i.e., his Universal-insured motorcycle. The trial court agreed with Erie and entered judgment in its favor. The Superior Court affirmed in an unpublished memorandum opinion.
This Court granted Baker‘s petition for allowance of appeal, limited to the following issue:
Whether Section 1738(a) of the [Motor Vehicle Financial Responsibility Law] precludes application of the so-called “household exclusion” to prevent inter-policy stacking of UIM benefits when there has been no valid stacking waiver by the insured.
In his argument to this Court, Baker concedes that the unambiguous terms of Erie‘s household exclusion apply to preclude UIM coverage under the circumstances of this case. But Baker claims that Erie‘s household exclusion violates the Motor Vehicle Financial Responsibility Law (MVFRL), specifically the provisions regarding stacking contained in
§ 1738. Stacking of uninsured and underinsured benefits and option to waive
(a) Limit for each vehicle. ----When more than one vehicle is insured under one or more policies providing uninsured or
Baker asserts he is entitled to the “sum of limits for each motor vehicle as to which [he] is an insured” under Section 1738(a) because he did not execute the stacking rejection form authorized by that statute.4 He argues further that, because the plain language of Erie‘s exclusion prevents the payment of the “sum of limits” in the absence of a valid stacking waiver,
Erie counters that the policy exclusion involved here is valid and enforceable, and has been upheld by this Court time and time again. See, e.g., Prudential Prop. & Cas. Ins. Co. v. Colbert, 572 Pa. 82, 813 A.2d 747 (2002); Eichelman v. Nationwide Ins. Co., 551 Pa. 558, 711 A.2d 1006 (1998). See also Paylor v. Hartford Ins. Co., 536 Pa. 583, 640 A.2d 1234 (1994) (upholding similar “family car exclusion“). There is no dispute that the exclusion‘s unambiguous language precludes coverage in this case, where the insured was injured while riding his non-Erie-insured motorcycle. If its exclusion is invalidated, Erie will be paying on a risk it did not knowingly insure, or collect a premium to underwrite: in this case, the substantially higher risk associated with motorcycles. Furthermore, Erie argues, Section 1738‘s stacking provisions do not apply here. Those provisions refer to stacking UIM benefits in policies that provide UIM coverage. There is no UIM coverage under the circumstances of this case because the household exclusion applies to preclude it in the first instance. Ultimately, this case is not about stacking. It is about an applicable, unambiguous exclusion designed to preclude unpaid coverage of unknown risks.6
We begin our analysis by noting that “the interpretation of a contract of insurance is a matter of law for the courts to decide. In interpreting an insurance contract, we must ascertain the intent of the parties as manifested by the language of the written agreement. When the policy language is clear and unambiguous, we will give effect to the language of the contract.” Paylor, 640 A.2d at 1235. We further note that an insured‘s failure to read carefully the clear and unambiguous terms of his insurance policy has never furnished grounds to invalidate those terms or otherwise nullify them. See, e.g., Standard Venetian Blind Co. v. American Empire Ins. Co., 503 Pa. 300, 469 A.2d 563, 566 (1983) (holding failure to read an insurance contract is an unavailing excuse and cannot justify avoidance of its terms). There is no dispute in this case that the terms of the exclusion are clear, unambiguous and directly applicable. Baker‘s claim that the exclusion was somehow “buried” in his insurance policy is not persuasive.
Baker, however, was injured in a collision while driving a fourth vehicle from his household, his Universal-insured motorcycle. The third-party tortfeasor‘s insurance was insufficient to cover his damages. Baker therefore sought UIM benefits from the Universal policy on his motorcycle, and received the policy limits of $15,000, which still did not adequately compensate him.9 Next in priority was the other
Likewise, in Eichelman v. Nationwide Ins. Co., supra, this Court rejected the insured‘s claims that the household exclusion was void as against public policy. Eichelman was struck and injured while riding his motorcycle, insured by Aegis Security Insurance Company (Aegis). The tortfeasor‘s insurer paid out its limits ($100,000), but apparently this did not cover Eichelman‘s injuries. 711 A.2d at 1007. Eichelman did not carry UIM coverage on his Aegis policy. Instead, he sought recovery of UIM benefits under his parents’ two
This Court‘s decisions in Colbert and Eichelman direct our result here.11 We thus conclude that the Erie exclusion is valid as applied in this case. Accordingly, we affirm the Superior Court‘s decision upholding judgment on the pleadings in favor of Erie.12
Order affirmed.
Justice SAYLOR files a concurring opinion.
Justice BAER files a dissenting opinion in which Justice TODD and Justice McCAFFERY join.
Justice SAYLOR concurring.
I concur in the result only, as I believe Appellant‘s argumentation is stronger than the lead opinion portrays. As Appellant ably explains, the Colbert and Eichelman decisions, upon which the lead Justices rely, are readily distinguishable. For example, in those cases, this Court did not examine the express requirements of the stacking provisions of the Motor Vehicle Financial Responsibility Law, see
Nevertheless, I am persuaded that the amendments to the MVFRL codified at Section 1738 do not invalidate longstanding policy exclusions (including regularly-used non-owned car, household, and territorial exclusions) rooted in ensuring the collection of reasonable premiums (with reasonableness being monitored by the Insurance Department). Had the Legislature intended to invalidate these, I believe, it would have done so more directly. Instead, to the extent the General Assembly even considered the matter, it seems most
My position also incorporates thoughts I previously developed concerning the many difficulties presented by the MVFRL, including the question of what the Legislature meant in the requirement to offer “uninsured or underinsured motorist coverage,” and specifically, the degree of portability the General Assembly intended to be associated with these concepts. See, e.g., Burstein, 570 Pa. at 219-23, 809 A.2d at 230-32 (Saylor, J., dissenting).
Justice BAER dissenting.
I respectfully dissent from the decision of the Majority based upon my conclusion that the “household exclusion”
Initially, I agree with Justice Saylor‘s concurring opinion that the Majority‘s reliance on the analysis allowing for the enforcement of household exclusions in Prudential Insurance v. Colbert, supra, and Eichelman v. Nationwide Insurance, supra, is misplaced because those cases considered whether a household exclusion violated general public policy and did not address the interaction between the household exclusion and the specific language of § 1738. However, I differ with the concurring opinion because I conclude that the household exclusion violates § 1738, and thus is unenforceable. See Colbert, 813 A.2d at 751 (“[S]tipulations in a contract of insurance in conflict with, or repugnant to, statutory provisions which are applicable to, and consequently form a part of, the contract, must yield to the statute, and are invalid, since contracts cannot change existing statutory laws“) (citations omitted).
Under § 1738 of the MVFRL, stacked coverage is the default coverage: “The limits of coverages available under this subchapter for an insured shall be the sum of the limits for each motor vehicle as to which the injured person is an insured.”1
In this case, Appellant did not waive stacking on his automobile policy covering three automobiles with $100,000 of underinsured motorist (UIM) coverage on each automobile. Instead, he paid increased premiums to purchase UIM coverage and to obtain stacked coverage of up to $300,000. Additionally, he paid increased premiums to obtain stacked UIM coverage on the policy covering his motorcycle.2 Under the
(1) The named insured shall be informed that he may exercise the waiver of the stacked limits of uninsured motorist coverage by signing the following written rejection form:
UNINSURED COVERAGE LIMITS
By signing this waiver, I am rejecting stacked limits of uninsured motorist coverage under the policy for myself and members of my household under which the limits of coverage available would be the sum of limits for each motor vehicle insured under the policy. Instead, the limits of coverage that I am purchasing shall be reduced to the limits stated in the policy. I knowingly and voluntarily reject the stacked limits of coverage. I understand that my premiums will be reduced if I reject this coverage.
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(2) The named insured shall be informed that he may exercise the waiver of the stacked limits of underinsured motorist coverage by signing the following written rejection form:
UNDERINSURED COVERAGE LIMITS
By signing this waiver, I am rejecting stacked limits of underinsured motorist coverage under the policy for myself and members of my household under which the limits of coverage available would be the sum of limits for each motor vehicle insured under the policy. Instead, the limits of coverage that I am purchasing shall be reduced to the limits stated in the policy. I knowingly and voluntarily reject the stacked limits of coverage. I understand that my premiums will be reduced if I reject this coverage.
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(e) Signature and date.—The forms described in subsection (d) must be signed by the first named insured and dated to be valid. Any rejection form that does not comply with this section is void.
75 Pa.C.S. § 1738 (emphasis added).
The Majority and the Concurrence conclude that the household exclusion does not operate as a waiver of stacking, but instead precludes underinsured motorist (UIM) coverage prior to any consideration of stacking. The concurrence determines that, to the extent that the General Assembly actually considered the matter, the Legislature likely regarded exclusions and stacking as separate issues. It therefore concludes that the exclusions frame the scope of UIM coverage, and thus do not effect the application of the stacking provisions because stacking does not apply when an accident does not come within the scope of the UIM coverage of the policy in question. The proverbial bottom line deriving from this analysis is the employment of the household exclusion to deny an insured the benefits of stacking, for which he paid, without complying with the statutorily mandated waiver provisions, in violation of the clear language of the legislature. Rather than requiring an overt act of waiver by the named insured pursuant to the specific form as specified in § 1738(d), the household exclusion does not even require the insurer to demonstrate that the insured was aware of the exclusion.
As noted by the concurrence, Concurring Op. at 367-68, n. 2, 972 A.2d at 515, n. 2, the MVFRL fails to provide specifically for many circumstances including this one, and arguably, the legislature did not consider the interaction of these two scenarios. More significantly, I have no doubt that most consumers of stacked coverage have not considered that their
I acknowledge that the Majority correctly asserts the general law that “an insured‘s failure to read carefully the clear and unambiguous terms of his insurance policy has never furnished grounds to invalidate those terms or otherwise nullify them.” Maj. Op. at 362, 972 A.2d at 511. However, we have distinguished the case relied upon by the Majority, Standard Venetian Blind v. American Empire Insurance Co., 503 Pa. 300, 469 A.2d 563 (1983), and refused to apply it to cases where the insured receives a policy that differs from the policy requested:
We find a crucial distinction between cases where one applies for a specific type of coverage and the insurer unilaterally limits that coverage, resulting in a policy quite different from what the insured requested, and cases where the insured received precisely the coverage that he requested but failed to read the policy to discover clauses that are the usual incident of the coverage applied for. When the insurer elects to issue a policy differing from what the insured requested and paid for, there is clearly a duty to advise the insured of the changes so made. The burden is not on the insured to read the policy to discover such changes, or not read it at his peril.
Tonkovic v. State Farm Mutual Auto. Ins. Co., 513 Pa. 445, 521 A.2d 920, 925 (1987). While my esteemed colleagues may contend that the household exclusion is one of the “clauses that are a usual incident of the coverage,” I would suggest that the consumer who does not waive stacking and agrees to pay the increased premiums associated with stacking is requesting a policy that actually provides stacking. The insured would not expect the decision to pay an increased premium for stacking to be undercut by a household exclusion buried in the fine print of the policy, without the insurer advising the insured of this restriction.
Moreover, if the allegation is true that consumers cannot add motorcycles to their automobile policies and cannot obtain higher UIM coverage for their motorcycles, then insurers are
In short, I believe this Court should consider itself bound by the affirmative statements of the MVFRL that require an explicit waiver of stacking on a specific waiver form. Rather than interpreting legislative silence as approving of the household exclusion, I conclude that the household exclusion violates the stated requirements that the waiver of stacking occur through a clear affirmative act, and accordingly, dissent from the decision to enforce the exclusion.
Justice TODD and Justice McCAFFERY join this dissenting opinion.
Notes
1738. Stacking of uninsured and underinsured benefits and option to waive
(a) Limit for each vehicle.—When more than one vehicle is insured under one or more policies providing uninsured or underinsured motorist coverage, the stated limit for uninsured or underinsured coverage shall apply separately to each vehicle so insured. The limits of coverages available under this subchapter for an insured shall be the sum of the limits for each motor vehicle as to which the injured person is an insured.
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(d) Forms.—
Section 1738 further provides:
(b) Waiver.—Notwithstanding the provisions of subsection (a), a named insured may waive coverage providing stacking of uninsured or underinsured coverages in which case the limits of coverage available under the policy for an insured shall be the stated limits for the motor vehicle as to which the injured person is an insured.
(c) More than one vehicle.—Each named insured purchasing uninsured or under insured motorist coverage for more than one vehicle under a policy shall be provided the opportunity to waive the stacked limits of coverage and instead purchase coverage as described in subsection (b). The premiums for an insured who exercises such waiver shall be reduced to reflect the different cost of such coverage. For drivers who wish to waive the right to stack coverages in return for a lower premium, Section 1738 of the MVFRL mandates the specific language to be used by insurers for stacking rejection forms. See
This Court has recently confirmed that inter-policy stacking may be waived in accordance with the MVFRL. Craley v. State Farm Fire & Cas. Co., 586 Pa. 484, 895 A.2d 530 (2006). In Craley, the insured was killed by an uninsured driver while driving her State Farm-insured vehicle. The insured‘s estate received the limits of her uninsured motorist coverage from State Farm, then sought additional coverage under her husband‘s vehicle, also insured by State Farm but on a separate policy. 895 A.2d at 533. State Farm denied coverage based on an express written waiver of inter-policy stacking signed by the insured pursuant to
We are not unaware of, or unsympathetic to, the difficulty encountered by motorcyclists who seek adequate motor vehicle insurance coverage. Amicus ABATE asserts that Baker should be entitled to coverage here because the MVFRL does not provide sufficient protection to motorcyclists. For example, ABATE states:
- Motorcyclists cannot recover first party benefits (
75 Pa.C.S. § 1714 ); - Many insurers will not write a motorcycle on the same policy as a car;
- Motorcyclists typically sustain serious injuries because of the nature of the vehicle they are occupying; and
- Motorcycles are becoming more and more prevalent as a primary mode of transportation particularly in light of the ever increasing cost of gasoline.
ABATE Amicus Brief at 7-8. However, we do not necessarily see these circumstances—which apparently are tied to the increased risk of serious injury associated with motorcycles—as a proper basis to invalidate an otherwise legal and valid insurance policy exclusion. In this
case, Baker insured his motorcycle with $15,000 of UIM coverage, which was inadequate to compensate him for his injuries. ABATE indicates that $15,000 is the best he could do because insurers simply do not provide higher UIM limits for motorcycles. ABATE states that:Motorcycle policies are often issued with low bodily injury liability limits because motorcycles typically do not cause a great deal of bodily injury [to others] when involved in collisions. Because the provisions of the Motor Vehicle Financial Responsibility Law mandate that an individual may not purchase underinsured motorist coverage in excess of the amount of her bodily injury liability limits [
75 Pa.C.S. § 1734 ], the underinsured motorist coverage on a motorcycle policy is often inadequate. Thus, many seriously injured motorcyclists are not “made whole” and are often left grossly undercompensated.
ABATE Amicus Brief at 1-2. Assuming ABATE‘s description of the situation is accurate, it clearly reflects the higher risks and dangers of motorcycles. The practical problem of insuring motorcycles may be compared to the problems of insuring drivers with bad driving records, or pedestrians who do not own and insure a vehicle, or who do not otherwise have access to motor vehicle insurance. Our legislature has demonstrated in the past that it can structure alternative insurance programs to provide coverage in special risk situations. See, e.g.,
