HARTFORD FIRE INSURANCE COMPANY, Plaintiff and Respondent, v. IRENE MACRI, Defendant and Appellant.
No. S025579
Supreme Court of California
Dec. 21, 1992.
318
John A. Luetto and Helen M. Luetto for Defendant and Appellant.
James T. Linford and Joseph Dunn as Amici Curiae on behalf of Defendant and Appellant.
Hawkins, Schnabel & Lindahl, Vipal J. Patel, Kelley K. Beck and Rena Denton Stone for Plaintiff and Respondent.
Murchison & Cumming, Jean M. Lawler, Bryan M. Weiss, Horvitz & Levy, George P. Schiavelli and Douglas G. Benedon as Amici Curiae on behalf of Plaintiff and Respondent.
OPINION
LUCAS, C. J.—We granted review to determine whether
Although underinsured motorist benefits, like uninsured motorist benefits, are governed by
FACTS
In 1986, Irene Macri was involved in an automobile accident caused by another driver‘s negligence. The tortfeasor was insured for liability by CNA Insurance Company in the amount of $50,000. Macri‘s injuries exceeded that figure. Hartford Fire Insurance Company (Hartford) insured Macri with underinsured motorist coverage up to the amount of $100,000.
Macri‘s attorney notified Hartford in writing of his representation of Macri in any potential action against the tortfeasor. Hartford acknowledged receipt of the letter and advised Macri‘s counsel that the general provisions of her policy, entitled “Our Right to Recover Payment, Subsection B,” stated, “If we made a payment under [the] policy and the [insured] recovers damages from another, [the insured] shall hold in trust for us the proceeds of the recovery and shall reimburse us to the extent of our payment.” Hartford informed Macri that “what this means is that if we pay to you, or someone else on your behalf, medical benefits and you should recover damages from another person or their insurance carrier, then we are entitled to reimbursement.”
Hartford‘s insurance policy contained the following exclusion: “We do not provide Uninsured Motorist Coverage for property damage or bodily injury sustained by any person: . . . [¶] 2. If that person or the legal representative settles the bodily injury or property damage claim without our consent.” (Italics added.) None of Hartford‘s correspondence, however,
Two years later, Macri settled with the tortfeasor‘s insurer for the policy limit ($50,000), and executed a “Release of all claims” against the tortfeasor. Macri did not seek Hartford‘s consent to the settlement. Instead, she filed a claim with Hartford for underinsured motorist benefits in the amount of $50,000—the difference between the tortfeasor‘s policy limits and her underinsured policy limits of $100,000. Hartford refused coverage on the ground that Macri settled her claim against the tortfeasor without Hartford‘s consent. Hartford then filed this declaratory relief action against Macri and was granted summary judgment on the consent issue. The trial court‘s order stated that the “policy language is too clear to ignore.”
The Court of Appeal affirmed, with one justice dissenting. It held that the “consent” requirement under the policy applied to both uninsured motorist and underinsured motorist claims. As we explain, we reverse the Court of Appeal judgment.
DISCUSSION
1. The Insurance Policy
Part C of the standard policy issued by Hartford is labeled “Uninsured Motorist Coverage” and is a separate endorsement that provides, “We will pay damages for which an insured is legally entitled to recover from the owner or operator of an uninsured motor vehicle, we will pay only after the limits of liability under any applicable liability bonds or policies have been exhausted by payment of judgments or settlements. [¶] Any judgment for damages arising out of a suit brought without our written consent is not binding on us.” Thereafter, “uninsured motor vehicle” is defined in four separate definitions. The second definition equates uninsured motor vehicle with an underinsured motor vehicle “with respect to damages for bodily injury only. An underinsured motor vehicle is one to which a liability bond or policy applies at the time of the accident but its limit for liability is less than the limit of liability for this coverage.”
Exclusions appear on the next page of the policy. As noted above, that section states, in part, “A. We do not provide Uninsured Motorists Coverage for property damage or bodily injury sustained by any person: . . . [¶] 2. If that person or the legal representative settles the bodily injury or property damage claim without our consent.”
2. Section 11580.2
The above policy language is essentially identical to the statutory language in
The provisions governing uninsured and underinsured motorist coverage differ substantially in the area of settlement of claims, setoff, reimbursement, and procedures before settlement. For example, in contrast to the uninsured motorist provisions, there is no right to subrogation under the underinsured motorist provisions. Thus, an insurer who pays an underinsured motorist
Of significance in this case is
Macri asserts that although the consent requirement of
In response, Hartford contends that because uninsured and underinsured motorist coverage is sold as a single policy, and treated as one coverage under the statute, the Legislature intended the consent provision of
In a related argument, Hartford contends that the consent to settle provision of
As we explain, although the statute is not a model of clarity, we believe that Macri states the better interpretation of
3. Legislative Intent
In ascertaining the Legislature‘s intent in drafting the underinsured motorist provisions of
Our review of legislative history reveals the
Underinsured motorist coverage was introduced in 1984 as Assembly Bill No. 3984 (AB 3984) to “expand the definition of uninsured motor vehicle to include underinsured motor vehicles. . . .” (Leg. Counsel‘s Dig., Assem. Bill No. 3984, 4 Stats. 1984 (Reg. Sess.) Summary Dig., p. 539.) As originally submitted, AB 3984 amended the definition of uninsured motorist to include underinsured motorist coverage, but it provided for separate procedures for administering underinsured motorist claims. The Legislative Counsel‘s Digest also stated that “the procedures for administering the underinsured motorist coverage and claims thereunder will track with existing uninsured motorist statutes, except where inapplicable.” (Dig. of Sen. Republican Caucus (Aug. 29, 1984) regarding AB 3984.) Thereafter, the Legislature identified those areas where uninsured motorist provisions might not apply to underinsured motorist coverage. These include: “1. Coordination v. stacking of other available insurances. [¶] 2. Procedures utilized in claims out of multi-vehicle accidents. [¶] 3. Tracking of underinsured and third party actions. [¶] 4. Matter[s] of setoffs and credits.” (Ibid., italics added.)
Prior to becoming law, AB 3984 was amended to address the above four concerns with the addition of
As noted above,
Moreover, under
This reimbursement between insured and insurer is the foundation of
Thus, the “California underinsurance scheme focuses on the amount of the tortfeasor‘s automobile liability policy. Conversely, [other states‘] statutes concentrate on the amount of the injured driver‘s damages. [California‘s] focus on the tortfeasor‘s liability restricts the availability of underinsurance coverage even where the injured driver suffers uncompensated damages. Unless the tortfeasor‘s liability policy is in an amount less than the underinsured motorist policy of the injured driver, underinsurance is not available.” (Schmidt, Interpreting the Recently Enacted California Underinsurance Provisions of the Uninsured Motorist Statute (1987) 14 Pepperdine L.Rev. 691, 694-695, fns. omitted, italics added; Fagundes v. American Internat. Adjustment Co. (1992) 2 Cal.App.4th 1310, 1315.)
Therefore, because the insured cannot receive more than the policy limits from the insurer providing underinsurance motorist coverage, there is no
Accordingly, although the Legislature generally intended
4. Subrogation
Contrary to Hartford‘s assertion, we find that the right to subrogation in the underinsured motorist context is not consistent with the plain meaning of the statute and, if allowed, would lead to anomalous results.
Clearly, when faced with an uninsured claim, the insurer must be made aware of any potential judgment or settlement in order to protect its subrogation rights and to prevent double recovery. (Mills v. Farmers Ins. Exchange (1964) 231 Cal.App.2d 124.) There is no need, however, for such protection in the underinsured motorist context. This is so because the underinsured carrier is not required to indemnify its insured until the insured has exhausted the limits of the tortfeasor‘s liability policies by either settling the claim or obtaining a judgment against the tortfeasor and submits proof of payment to the insurer. (
Courts have recognized that in an uninsured motorist claim, in which there is far less chance of securing any other recovery, the insurer‘s right of subrogation under
Another commentator has observed that “The fundamental characteristic of the underinsured motorist insurance is that it is only relevant when the tortfeasor‘s insurance is not adequate to provide indemnification. . . . It is patently inappropriate to consider that the underinsured motorist insurer would be entitled to reimbursement from these funds. In this context, allowing an insurer to be subrogated to amounts which may be recovered from the tortfeasor, from joint tortfeasors, or collateral sources (such as workers’ compensation) serves to reduce the underinsured motorist insurance. Thus, when the possible sources of indemnification against which a subrogation right might be exercised are considered, it seems evident that a persuasive case can be made for precluding an insurer from seeking reimbursement unless the insured has been fully indemnified. Furthermore, it seems probable that courts in those states which hold that setoffs or reductions of liability are unenforceable, will also restrict insurers to a limited right of subrogation (that only applies when an insured has been fully indemnified.)” (3 Widiss, Uninsured and Underinsured Motorists Insurance (2d ed. 1990) § 41.1-44.4, at pp. 129-130, fns. omitted; see also Eisler, Uninsured Motorist Law, supra, § 15.50, at p. 12-4.)
In addition, the facts in this case illustrate that the potential for double recovery on the part of the insured does not exist in the underinsurance context. As discussed above, Macri‘s counsel notified Hartford of the pending claim against the tortfeasor soon after the accident pursuant to
Soon thereafter, Macri notified Hartford that she had settled her claim with the underinsured tortfeasor for the tortfeasor‘s insurance policy limits and submitted proof of the settlement payment to Hartford pursuant to
Hartford relies on Rudd v. California Casualty Gen. Ins. Co. (1990) 219 Cal.App.3d 948, 953, to support its contention that
In Rudd, the court held that an insurer is entitled to reduce the amount it owed under the underinsured policy provision by the amount of workers’ compensation benefits received by the insured. In so holding, the court rejected the insured‘s argument that the omission of any mention of a workers’ compensation setoff in
In accepting the insurer‘s argument that the setoff provision in
Thus, in contrast to the present case, the Rudd court found no conflict between the worker‘s compensation provision of
Finally, Hartford asserts that if we conclude
CONCLUSION
Based on the foregoing, we conclude that because an insurer is not obligated under
Mosk, J., Kennard, J., Arabian, J., Baxter, J., and George, J., concurred.
PANELLI, J.—I reluctantly concur with the majority‘s opinion. The language of
However, as noted during oral argument, this result leads to an inequity demonstrated by the following hypothetical. Assume two tortfeasors each have $300,000 in assets subject to execution. One tortfeasor does not buy automobile insurance. The other purchases the minimum policy limit required by law. Each tortfeasor is involved in an automobile accident. Under the current provisions, the uninsured motorist is potentially liable to the uninsured motorist carrier of the victim while the underinsured motorist‘s assets cannot be reached by the underinsured motorist carrier of the victim. Thus, an uninsured motorist carrier may always have the opportunity to recover its costs directly from the tortfeasor, while the underinsured motorist carrier is forced to depend on its insured to seek the tortfeasor‘s assets. The distinction in subrogation rights between the two insurers in this situation makes little sense and in effect makes the underinsured motorist carrier an excess policy carrier to the tortfeasor.
The current legislative scheme is also unfair because it may in certain cases, promote an incentive to underinsure. In such cases, the motoring public will be forced to pay for the impending increase in underwriting costs in the form of increased premiums. The Legislature has shown its intent to shift the costs of motor vehicle accidents from the motoring public to those more suited to bear this cost. (Rangel v. Interinsurance Exchange, ante, at p. 1, citing California State Auto. Assn. Inter-Ins. Bureau v. Jackson (1973) 9 Cal.3d 859, 869 [In enacting the arbitration provisions of
