Farmers Insurance Exchange v. HurleyFarmers Insurance Exchange v. Hurley
Lead Opinion
Opinion
Insurance Code section 11580.2, subdivision (PX3),
I
Factual and Procedural Background
In April 1991, Farmers Insurance Exchange issued a policy of automobile liability insurance to Luzestela Hurley. The policy provided underinsured motorist coverage in the amount of $250,000 per person, but stated Farmers would pay under that coverage “only after the limits of liability under any applicable bodily injury liability bonds or policies have been exhausted by payment of judgments or settlements.”
Hurley sustained damages in an automobile accident in May 1991. The other driver, Sunjeon Datta, was driving a car rented from Dollar Rent-a-Car. Hurley sued Datta and Dollar and obtained a default judgment against Datta. However, Datta apparently had no assets or insurance, and Hurley collected no payment from him.
Hurley made a claim for underinsured motorist benefits under her policy with Farmers. In October 1997, Farmers brought the present action, seeking a declaration that, because Hurley had failed to exhaust Dollar’s liability limits as required by her policy with Farmers and section 11580.2(p)(3), she was not entitled to coverage under that policy.
Farmers moved for summary judgment, and the court granted the motion, ruling that section 11580.2(p)(3) required Hurley to obtain full payment of Dollar’s liability limits before she could recover underinsurance benefits. Hurley appealed from the resulting judgment of dismissal.
II
Discussion
Unless the parties otherwise agree, an automobile bodily injury liability insurance policy issued in California must include underinsured motorist coverage. (§ 11580.2(a)(1), (b), (p)(7).) This “first-party” coverage provides the insured with a source of compensation for injuries caused by an under-insured motor vehicle. A vehicle is underinsured if it is insured for less than the injured party’s underinsured motorist coverage limits. (§ 11580.2(p)(2).)
The most an underinsured motorist carrier may be liable for is the amount of its coverage limits, “less the amount paid to the insured by or for any person or organization that may be held legally liable for the injury.” (§ 11580.2(p)(4).) A carrier paying an underinsurance claim is entitled to “reimbursement or credit in the amount received by the insured from the owner or operator of the underinsured motor vehicle or the insurer of the owner or operator.” (§ 11580.2(p)(5).) Thus, “‘. . . a carrier providing underinsured motorist benefits never pays the full amount, only the difference between the policy limits and all contributions by all tortfeasors to all insureds.’ ” (Hartford Fire Ins. Co. v. Maori (1992)
The provision at issue in this case, section 11580.2(p)(3), provides that underinsurance coverage “does not apply to any bodily injury until the
The question is whether section 11580.2(p)(3) and the corresponding exhaustion clause in the Farmers policy prohibit the insured from settling with the underinsured for less than the full policy limits, even if the insured agrees to credit the full policy limits against any benefits paid by his or her underinsurance carrier. Hurley contends that in such a case the carrier is in the same position it would have been in had the policy limits been paid. Therefore, she argues, a discounted settlement should not preclude the insured from seeking underinsurance benefits. Farmers contends the plain language of section 11580.2(p)(3) requires actual payment of the full limits before any underinsurance benefits may be sought.
We are aware of no California authority on point. Hurley cites numerous decisions of other jurisdictions holding that exhaustion clauses of the kind included in the Farmers policy do not require the insured to collect the underinsured’s full policy limits, as long as the carrier receives credit for the full limits. (See, e.g., Boyle v. Erie Ins. Co. (1995)
The view expressed in these cases is not unanimous, and other jurisdictions have held exhaustion clauses to be enforceable notwithstanding their potential undesirable consequences. (See, e.g., Robinette by McMahon v. American Liberty Ins. Co. (S.D.Miss. 1989)
Unlike the present case, the decisions declining to require exhaustion on public policy grounds did not involve exhaustion provisions contained in statutes such as section 11580.2(p)(3), but only provisions contained in the insurance policies themselves. In several of the decisions, in fact, the courts expressly noted that the applicable statutes did not require the insured to obtain actual payment of the underinsured’s full policy limits. (See, e.g., State Farm Mut. Auto. Ins. Co. v. Bencomo, supra,
While a contractual provision may be declared void if it is contrary to public policy (Civ. Code, § 1667), a statute may not be invalidated except on constitutional grounds. (Smith v. Fair Employment & Housing Com. (1996)
Because a statute necessarily reflects public policy “[w]hen a clause in an insurance policy is authorized by statute, it is deemed consistent with public policy as established by the Legislature.” (Prudential-LMI Com. Insurance v. Superior Court (1990)
“[I]n determining the meaning of a statute, we look to its words and give them their usual and ordinary meaning. [Citations.] ‘[I]f statutory language is “clear and unambiguous there is no need for construction, and courts should not indulge in it.” [Citation.]’ [Citation.]” (Birbrower, Montalbano, Condon & Frank v. Superior Court (1998)
An analogous situation exists in the context of excess insurance policies, which require that primary insurance be exhausted before excess coverage
City of Oxnard v. Twin City Fire Ins. Co. (1995)
Here, although Hurley putatively obtained a judgment for the full $15,000 limits of Dollar’s policy, it is undisputed that only $5,000 was actually paid on that policy. We cannot deem the policy limits to have been “exhausted by payment of judgments or settlements” without stretching the language far beyond its “usual and ordinary meaning.” (Birbrower, Montalbano, Condon & Frank v. Superior Court, supra,
Hurley cites only one decision in which a court has interpreted statutory language like that in section 11580.2(p)(3) so as not to require full payment of the underinsured’s policy limits.
Even if its interpretation of the exhaustion provision can properly be characterized as a holding rather than dictum, Longworth is readily distinguishable. The California Supreme Court has made clear that the exhaustion requirement set forth in section 11580.2(p)(3) is not merely a “definitional” provision, but is “a precondition to coverage” for underinsurance benefits. (Quintano v. Mercury Casualty Co. (1995)
More relevant to our analysis is the decision of the New York Court of Appeals in Federal Ins. Co. v. Watnick (1992)
Section 11580.2(p)(3), of course, does not expressly state that the under-insured’s full policy limits must be paid as a condition precedent to coverage, as did the statute in Federal Ins. Co. v. Watnick, supra,
We conclude the plain language of section 11580.2(p)(3) requires actual payment of the underinsured’s policy limits before underinsurance coverage can be invoked. A court may decline to give effect to the plain meaning of words in a statute only if “ ‘ “doing so would result in absurd consequences which the Legislature did not intend.” ’ ” (Calatayud v. State of California (1998)
It may be true, as Hurley argues, that in some cases strict enforcement of the exhaustion requirement will produce undesirable results. The insured may be compelled to pursue expensive litigation for only a minimal benefit, as where the underinsured’s carrier offers close to its limits but refuses to pay the entire amount. In other cases, however, equally undesirable results may occur from not requiring strict compliance. The insured in a questionable case might be willing to accept a token settlement from the underinsured’s carrier and credit the full limits against his or her underinsurance benefits, simply out of a perception that the underinsurance carrier will present an easier avenue of recovery.
Additionally, insurance rates are supposed to reflect the liability risks presented by the parties insured. The Legislature may have considered it
Other considerations also may militate in favor of strict enforcement. If the underinsured’s carrier knows the insured cannot settle for less than the policy limits, it may be more apt to pay promptly in cases where liability is relatively clear, rather than prolonging the matter in the hope of obtaining a discounted settlement. Additionally, requiring actual exhaustion “makes certain that the insureds need the underinsurance coverage, for the very purpose of such coverage is to indemnify the insured when the tortfeasor’s insurance coverage is inadequate.” (Amica Mut. Ins. Co. v. Morrison, supra,
Indeed, for that very reason, even courts in at least one jurisdiction which has held that payment of the underinsured’s full limits is not required have nonetheless denied underinsurance benefits when the amount paid is so far below the limits that the shortfall cannot be considered a saving in litigation costs. (Motorists Mut. Ins. Cos. v. Grischkan (1993)
In view of these considerations, we are unable to conclude the Legislature could not have intended that the language of section 11580.2(p)(3) be applied literally to require actual payment of the underinsured’s full policy limits. We therefore conclude the lower court properly granted Farmers’ motion for summary judgment.
Disposition
The judgment is affirmed. Costs to respondent.
Ward J., and Gaut J., concurred.
Notes
Section references are to the Insurance Code unless otherwise indicated. For convenience, we omit the word “subdivision” when referring to statutory subparts of section 11580.2.
Hurley also cites Niemann v. Travelers Ins. Co. (La. 1979)
Hurley cites other decisions which she contends construe statutory exhaustion provisions so as not to require actual payment of full policy limits. In Sutch v. State Farm Mut. Auto. Ins.
The issue in Quintano was whether section 11580.2(i), which requires that an insured in some cases make a claim under his or her uninsured motorist policy within one year of being injured, should apply to underinsured motorist coverage. The court held that, because it may take the insured more than a year to fulfill the preconditions for underinsurance coverage by reaching a settlement or judgment exhausting the underinsured’s policy limits, the one-year limitation should not apply. (
Concurrence Opinion
We reluctantly concur with the opinion. We believe that the correct result in this case is to make the insurer of the injured party responsible for the difference between the policy limits of the under-insured vehicle and the injured party’s own policy, regardless of whether the insurer of the underinsured vehicle pays its full policy limits. The obvious purpose of Insurance Code section 11580.2, subdivision (p)(3) is to prevent the injured party from receiving a windfall in the form of a payment from both the underinsured party’s carrier and a payment in full by his own insurance carrier.
Allowing the injured party’s carrier a credit for the underinsured party’s policy limit achieves this purpose. So long as the carrier receives that credit it is in the same position whether or not its insured is paid the full amount of the offending party’s policy. Further, an interpretation allowing the injured party to accept partial payment from the underinsured party’s insurance carrier serves a number of beneficial objectives. It encourages settlement, reduces litigation, saves court time, and reduces the costs to both parties. Perhaps most important, it prevents the injured party from incurring expenses in time and money in an effort to wring out the last dime from the underinsured party’s insurance company.
Unfortunately, we see no way around the statute as written. Subdivision (p)(3) of section 11580.2 of the Insurance Code is very specific. It provides that the underinsured coverage “does not apply to any bodily injury until the limits of bodily injury liability policies applicable to all insured motor vehicles causing the injury have been exhausted by payment of judgments or settlements . . . .” (Italics added.) We have tried to interpret that section to allow the injured party to request the difference between the amount of the underinsured vehicle’s policy and the face of the insured’s policy. Our inclination is, however, trumped by the section which explicitly requires exhaustion by payment of judgment or settlement coupled with proof of the payment being submitted to the insurer providing the underinsured motorist coverage.
We therefore bow to the inevitable and join in the majority opinion. At the same time, we encourage the Legislature to consider the wisdom of modifying the section to achieve the apparent purpose of the statute by allowing
Ward, J., concurred.
A petition for a rehearing was denied December 17, 1999, and the opinion was modified to read as printed above. Appellant’s petition for review by the Supreme Court was denied February 16, 2000.