Dаle REBERNICK, Sandra Rebernick and Gregory Rebernick by his Guardian ad Litem, Plaintiffs-Appellants-Petitioners, v. WAUSAU GENERAL INSURANCE COMPANY, Defendant, AMERICAN FAMILY MUTUAL INSURANCE COMPANY, Defendant-Respondent.
No. 2004AP487
Supreme Court of Wisconsin
Decided March 30, 2006.
2006 WI 27 | 711 N.W.2d 621
Oral argument January 10, 2006.
Supreme Court
No. 2004AP487. Oral argument January 10, 2006.—Decided March 30, 2006.
2006 WI 27
(Also reported in 711 N.W.2d 621.)
An amicus curiae brief was filed by Beth Ermatinger Hanan and Gass Weber Mullins LLC, Milwaukee, on behalf of Wisconsin Insurance Alliance, Civil Trial Counsel of Wisconsin, and Property Casualty Insurers Association of America.
An amicus curiae brief was filed by Lynn R. Laufenberg and Laufenberg & Hoefle, S.C., Milwaukee, on behalf of the Wisconsin Academy of Trial Lawyers.
¶ 1. ANN WALSH BRADLEY, J. Dale and Sandra Rebernick, along with their minor son, Gregory, petition for review of a published court of appeals decision affirming a circuit court order dismissing their claim against their insurer, American Family Mutual Insurance Company.1 The Rebernicks assert that they are entitled to retroactively purchase underinsured motorist (UIM) coverage under their umbrella policy because American Family failed to notify them of the availability of UIM coverage under the policy pursuant to
¶ 2. We determine that American Family was required to notify the Rebernicks of the availability of UIM coverage under their umbrella policy pursuant to
I
¶ 3. The facts are undisputed for purposes of our decision. Dale Rebernick was seriously and permanently injured when the lawn mower he was riding was hit by a car. The driver of the car had $25,000 in liability insurance, which was paid to Rebernick. In addition, Rebernick collected the $100,000 limits of UIM coverage under the Rebernicks’ automobile insurance policy with American Family.
¶ 4. The Rebernicks also had a $1 million umbrella policy through American Family that required them to maintain their underlying automobile policy as primary insurance. They sued American Family for additional funds under the umbrella policy. Although the terms of the umbrella policy expressly excluded UIM coverage, the Rebernicks asserted that they were entitled to reformation of the policy because American Family had failed to provide them with notice of the availability of UIM coverage for that policy. Such notice, they asserted, was required under
¶ 6. The circuit court concluded that the purpose of the notice provisions in
II
¶ 8. The central issue before us is whether American Family was required to notify the Rebernicks of the availability of UIM coverage under their umbrella policy pursuant to
¶ 9. We determine that American Family was required to notify the Rebernicks of the availability of
¶ 10. In addition, we determine that, given the circumstances of this case, American Family provided notice to the Rebernicks of the availability of UIM coverage under their umbrella policy. Thus, we need not address what remedy would be appropriate had American Family failed to notify the Rebernicks of the availability of UIM coverage.
III
¶ 11. The Rebernicks argue that
¶ 12. Section
Scope. Except as otherwise provided, this section applies to every policy of insurance issued or delivered
Thus,
¶ 13. Section
¶ 14. In an opinion also released today, Rocker v. USAA Casualty Insurance Co., 2006 WI 26, ¶ 37, 289 Wis. 2d 294, 711 N.W.2d 634, this court explained how the scope clause in
According to
Wis. Stat. § 632.32(1) , “[e]xcept as otherwise provided, this section applies to every policy of insurance issued or delivered in this state against the insured‘s liability for loss or damage resulting from accident caused by any motor vehicle....” Hence, the broad scope of the entire section is dependent upon whether a policy includes motor vehicle coverage, but each subsection can include provisions which exempt certain coverages from the scope as defined in§ 632.32(1) . Therefore, in any particular case, it is improper to conclude that, because one subseсtion has been held to apply to a certain type of policy, all the
Thus, the court in Rocker determined, “[t]he language of
¶ 15. The Rebernicks’ umbrella policy includes automobile liability coverage. For example, the policy covers an insured‘s liability for an accident causing personal injury or property damage arising out of the use of a car the insured owns. Thus, there can be no real dispute that the Rebernicks’ umbrella policy falls within the general scope of
¶ 16. Consistent with Rocker, however, we must also examine the language in
¶ 17. The Rebernicks’ umbrella policy insures “against loss resulting from liability imposed by law for bodily injury or death arising out of the ownership, maintenаnce or use of a motor vehicle.” American Family asserts, however, that
¶ 18. We are not persuaded that such a construction of
¶ 19. Even assuming, however, that American Family‘s interpretation is correct, the Rebernicks’ umbrella policy does insure with respect to a particular motor vehicle. Their umbrella policy, like any “true” umbrella policy, requires underlying primary insurance.7 In the center of the declaration page of the umbrella policy appears a heading in bold capital letters: ”SCHEDULE OF UNDERLYING INSURANCE.” Immediately below that heading, the umbrella policy declaration page references the underlying primary “Car Liability Insurance” policy, together with the underlying insurance policy limits. The declaration page is specifically made part of the umbrella policy.
¶ 20. The terms of the policy require, as a condition of insurance, that there be underlying automobile insurance coverage in a specified amount. The underlying primary automobile policy, in turn, refers to a particular motor vehicle. Thus, the Rebernicks’ umbrella policy insures “with respect” to a particular motor vehicle that is named or described in the policy by incorporation of the underlying policy.
¶ 21. Our reading of the statute is thus consistent with the court of appeals’ interpretation of the statute. Both the majority and dissent of the court of appeals agreed that American Family was required to provide the Rebernicks with notice of the availability of UIM
¶ 22. Also consistent with our reading, at least one commentator has criticized the interpretation advanced by American Family and accepted by another court. The gist of the criticism is that this interpretation ignores the reality that an umbrella policy typically requires an underlying primary policy:
[O]ne judicial decision, sustaining the view that an insurer providing excess coverage is not subject to the statutory requirement, reasoned that “umbrella policies insure the policy holder in general, rather than a particular automobile within the state” and, therefore, “umbrella insurance policies are not issued ‘with respect to a motor vehicle registered or principally garaged in this commonwealth....‘” However, this observatiоn seems to ignore the fact that the coverage provided by excess (including umbrella) insurance is generally conditioned on the existence of one or more primary coverages. Typically, for example, an insurer providing a layer of excess liability insurance—which applies to liability arising from the operation of a motor vehicle—will require the insured to have a specified amount of primary motor vehicle liability insurance coverage.
Alan I. Widiss & Jeffrey E. Thomas, 3 Uninsured and Underinsured Motorist Insurance, § 32.5, at 25 (3d ed. 2005) (footnote omitted; quoting Stoumen v. Public Serv. Mut. Ins. Co., 834 F. Supp. 140, 143 (E.D. Pa. 1993)).
¶ 23. Thus, it is something of a fiction to suggest that an umbrella policy does not insure with respect to a particular motor vehicle when the policy requires underlying insurance that does. Accordingly, we determine that pursuant to
¶ 25. From both the language of the statute and the sparse legislative history, it is thus evident that a central purpose of
¶ 26. We note that in some states, the legislature has expressly exempted umbrella policies from uninsured or underinsured motorist statutes. See, e.g.,
¶ 28. When the legislature enacted
¶ 29. At oral argument, counsel for American Family explained that the reason for buying an umbrella policy is that “you want to make sure that everything you worked for all your life is now protected.” Counsel acknowledged that American Family had available underinsured motorist coverage as part of an endorsement to its umbrella policies. Yet, how would conscientious consumers know of its existence?
¶ 30. The legislature enacted
¶ 31. We turn now to the question of whether, given the circumstances presented here, American Family notified the Rebernicks of the availability of UIM coverage under their umbrella policy pursuant to the statute. The Rebernicks assert that American Family failed to provide the required notice. Additionally, the Rebernicks assert that the remedy for American Family‘s failure to provide such notice is that the umbrella policy be reformed. What they mean by this assertion is that they should be given the opportunity to retroactively purchase UIM coverage under their umbrella policy.
An insurer writing policies [to which these notice requirements apply]... shall provide to one insured under еach such insurance policy that goes into effect after October 1, 1995, that is written by the insurer and that does not include underinsured motorist coverage written notice of the availability of underinsured motorist coverage, including a brief description of the coverage. An insurer is required to provide the notice required under this subdivision only one time and in conjunction with the delivery of the policy.
¶ 33. The facts here reveal that the Rebernicks were apparently aware of the availability of UIM coverage before receiving any required notice because they had requested such coverage in their underlying primary automobile policy before receipt of such notice. Their underlying primary automobile policy was issued with $100,000 in UIM coverage. American Family issued that policy on April 29, 2001.
¶ 34. There is no dispute that American Family provided the Rebernicks with the required notice under
SPECIAL NOTICE TO POLICYHOLDERS
This special notice is being given in accordance with Wisconsin law to advise you of the availability of Underinsured Motorist (UIM) coverage. If you do not presently carry UIM coverage, this message is especially important to you.
Underinsured Motorist coverage provides payment for legally collectible damages for bodily injury or death if you or any person riding in your vehicle is injured or killed in an accident with a vehicle whose driver has insurance coverage that is less than the limit of your underinsured motorist coverage.
Please see the actual policy for exact terms and conditions.
Contact your American Family agent if you have questions about this coverage.
Accordingly, on April 29, 2001, American Family had advised the Rebernicks of the availability of UIM coverage and had provided them with a basic description of the nature of such coverage. The terms of the notice do not limit its application to only primary or underlying policies.
¶ 35. American Family issued the Rebernicks’ umbrella policy approximately one week later, on May 7, 2001. Thus, a very short period of time had elapsed since the Rebernicks were advised of the availability of UIM coverage by the same insurance company that subsequently issued their umbrella policy.
¶ 36. In addition, the umbrella policy contained the following exclusion: ”Uninsured/Underinsured Motorists. We will not cover any claims which may be made under Uninsured Motorists Coverage, Underinsured Motorists Coverage or similar coverage, unless
¶ 37. Considering all of these circumstances in combination, we determine that American Family notified the Rebernicks of the availability of UIM coverage under their umbrella policy. Thus, we need not determine what remedy would be appropriate if American Family had failed to notify the Rebernicks.
¶ 38. We caution, however, that the only way for insurance companies to be certain that they have provided proper notice pursuant to
IV
¶ 39. In sum, we determine that American Family was required to notify the Rebernicks of the availability of UIM coverage under their umbrella policy pursuant to
By the Court.—The decision of the court of appeals is affirmed.
¶ 40. LOUIS B. BUTLER, JR., J. (dissenting). The majority concludes that American Family was required to notify the Rebernicks of the availability of Underinsured Motorists (UIM) coverage under their umbrella policy pursuant to
¶ 41. However, I disagree with the majority‘s determination that American Family provided the required notice. Id. I conclude that American Family failed to meet the explicit statutory notice requirements established under
I
¶ 42. The majority‘s summary of the facts accurately reflects the record in this case. Majority op.,
II
¶ 43. Whether American Family adequately notified the Rebernicks of the availability of UIM coverage under their umbrella policy requires the application of
III
¶ 44. Whether an insurer is required to provide a separate written notice for each insurance policy under
An insurer writing policies [to which these notice requirements apply]... shall provide to one insured under each such insurance policy that goes into effect after October 1, 1995, that is written by the insurer and that does not include underinsured motorist coverage written notice of the availability of underinsured motorist coverage, including a brief description of the coverage. An insurer is required to provide the notice required under this subdivision only one time and in conjunction with the delivery of the policy.
¶ 45. It is undisputed that when the Rebernicks were issued their underlying auto policy on April 29, 2001, American Family provided the Rebernicks with the required notice for that policy. That notice informed the Rebernicks of the availability of UIM coverage:
SPECIAL NOTICE TO POLICYHOLDERS
This special notice is being given in accordance with Wisconsin law to advise you of the availability of Underinsured Motorist (UIM) coverage. If you do not presently carry UIM coverage, this message is especially important to you.
Underinsured Motorist coverage provides payment for legally collectible damages for bodily injury or death if you or any person riding in your vehicle is injured or killed in an accident with a vehicle whose driver has
insurance coverage that is less than the limit of your underinsured motorist coverage.
Please see the actual policy for exact terms and conditions.
Contact your American Family agent if you have questions about this coverage.
¶ 46. However, when American Family issued the Rebernicks’ umbrella policy on May 7, 2001, approximately one week after the Rebernicks obtained their primary automobile policy, American Family failed to include any “written notice” of the availability of UIM coverage, “in conjunction with the delivery of the [umbrella] policy,” as required by
¶ 47. The majority reasons that only a short period of time had passed since the Rebernicks had received the required written notice for their separate but related underlying policy, and therefore the Rebernicks were aware of the nature of UIM coverage available under an American Family policy. Majority op., ¶ 35.
¶ 48. In addition, the umbrella policy itself contained an exclusion provision, which notified the insured that UM/UIM coverage was not included unless “this” policy was endorsed to provide such coverage. According to the majority, the exclusion provision contained in the umbrella policy alerted the Rebernicks that UIM coverage was available under the umbrella policy. Majority op., ¶ 36.
¶ 49. Although the majority concedes that the exclusion provision alone would not constitute notice, it conсludes that, in view of all the facts, American Family substantially complied with the written notice requirement. Majority op., ¶ 37. The majority has essentially determined that American Family‘s compliance with the
¶ 50. I disagree. This is not horseshoes, and close is not good enough. The majority disregards the plain language of the statute. American Family failed to notify the Rebernicks of the availability or description of UIM coverage under their umbrella policy pursuant to the explicit requirements of
¶ 51. American Family did not provide the Rebernicks with a written description of UIM coverage “in conjunction with the delivery” of their umbrella policy, as
¶ 52. In addition, the notice of exclusion in the Rebernicks’ umbrella policy cannot constitute sufficient “written notice” of the “availability” of UIM coverage. The exclusion merely indicates that UIM claims will not be covered unless “this” policy is endorsed to provide such coverage.1 The exclusion does not indicate that separate UIM сoverage is available, nor does it describe the additional UIM coverage that is available. This
¶ 53. Moreover, under the facts here, a reasonable insured may have been confused as to just what the exclusion really meant. On the one hand, a reasonable insured may have been led to believe that UIM coverage was not available under the umbrella policy, despite the exclusion. A reasonable insured might infer that such coverage was not available under the policy because the insurance company did not provide the same separate “SPECIAL NOTICE TO POLICYHOLDERS” of the availability of UIM coverage that it provided with the underlying automobile policy. Stated another way, a reasonable insured might believe that the absence of the “special notice” with the umbrella policy indicated that UIM coverage was not available under that policy.
¶ 54. On the other hand, a reasonable insured may have been led to believe that UIM coverage was already provided under the policy precisely because of the “SPECIAL NOTICE TO POLICYHOLDERS” of the availability of UIM coverage that was provided with the underlying automobile policy. After being given notice of the existence of UIM coverage, the policyholders (Rebernicks) elected to have such coverage. Since the insurance company provided no new “SPECIAL NOTICE,” a reasonable insured may have concluded that the purchase of UIM coverage made one week earlier was sufficient for purposes of electing UIM coverage in the umbrella policy.
¶ 55. I agree with the majority that the best way for insurance companies to be certain that they have
¶ 56. The question becomes what is the proper remedy for American Family‘s failure to provide the required notice for the Rebernicks’ umbrella policy. As the majority notes, the Rebernicks assert that the remedy is that the umbrella policy be reformed, meaning they should be given the opportunity to retroactively purchase UIM coverage under thеir umbrella policy. Majority op., ¶ 31.
¶ 57. Under
¶ 58. If American Family had complied with
¶ 59. Likewise, even assuming that they would have purchased such coverage, we cannot be certain on this record of whether (or to what extent) the coverage
It is undisputed that Mr. Rebernick was acting within the scope of his employment at the time of his accident. American Family‘s UIM endorsement contains a reducing clause which allows American Family to reduce the limit of its UIM coverage by the amount of any worker‘s compensation payments that have been made.
¶ 60. In short, the remedy question in this case involves factual issues that cannot be resolved based on the current record.
¶ 61. Unlike other cases where reformation of the policy under
¶ 62. In this case, however, we are not presented with a policy that is easily “conformed to the statute or rule,”
IV
¶ 64. Because American Family failed to meet the explicit statutory requirements under
¶ 65. I am authorized to state that Chief Justice SHIRLEY S. ABRAHAMSON joins this dissenting opinion.
Notes
American Family asserts that the language of exclusion 21 of the umbrella policy puts the insured on notice that excess UM/UIM coverage can be purchased. The actual language of the exclusion provides:
We will not cover any claims which may be made under Uninsured Motorists Coverage, Underinsured Motorists Coverage or similar coverage, unless this policy is endorsed to provide such coverage.
Wisconsin Stat. § 632.32(4m) reads in pertinent part as follows:
Underinsured motorist coverage. (a)1. An insurer writing policies that insure with respect to a motor vehicle registered or principally garaged in this state against loss resulting from liability imposed by law for bodily injury or death suffered by a person arising out of the ownership, maintenance or use of a motor vehicle shall provide to one insured under each such insurance policy that goes into effect after October 1, 1995, that is written by the insurer and that does not include underinsured motorist
(continued content):
coverage written notice of the availability of underinsured motorist coverage, including a brief description of the covеrage. An insurer is required to provide the notice required under this subdivision only one time and in conjunction with the delivery of the policy.
2. An insurer under subd. 1. shall provide to one insured under each insurance policy described in subd. 1. that is in effect on October 1, 1995, that is written by the insurer and that does not include underinsured motorist coverage written notice of the availability of underinsured motorist coverage, including a brief description of the coverage. An insurer is required to provide the notice required under this subdivision only one time and in conjunction with the notice of the first renewal of each policy occurring after 120 days after October 1, 1995.
Wisconsin Stat. § 632.32(1) provides, in pertinent part, as follows:
Scope. Except as otherwise provided, this section applies to every policy of insurance issued or delivered in this state against the insured‘s liability for loss or damage resulting from accident caused by any motor vehicle, whether the loss or damage is to property or to a person.
The language in
Every policy of insurance subject to this section that insures with respect to any motor vehicle registered or principally garaged in this state against loss resulting from liability imposed by law for bodily injury or death suffered by a person arising out of the ownership, maintenance or use of a motor vehicle....
Section
polices that insure with rеspect to a motor vehicle registered or principally garaged in this state against loss resulting from liability imposed by law for bodily injury or death suffered by a person arising out of the ownership, maintenance or use of a motor vehicle....
