Earl J. TESCHENDORF and Linda Teschendorf, Plaintiffs, v. STATE FARM INSURANCE COMPANIES, Reliance National Indemnity Co. and American Family Mutual Insurance Co., Defendants. Bernard J. SHIRA and Maria Shira, Plaintiffs-Appellants, v. RELIANCE NATIONAL INDEMNITY CO., Defendant, AMERICAN FAMILY INSURANCE CO., Defendant-Respondent-Petitioner.
No. 2003AP3521
Supreme Court of Wisconsin
July 7, 2006
Oral argument November 8, 2005
2006 WI 89 | 717 N.W.2d 258
For the plaintiffs-appellants there was a brief by Eric S. Darling and Schmidt, Darling & Erwin, Milwaukee, and oral argument by Eric S. Darling.
An amicus curiae brief was filed by Martha H. Heidt and Doar, Drill & Skow, S.C., Baldwin, on behalf of the Wisconsin Academy of Trial Lawyers.
¶ 1. DAVID T. PROSSER, J. American Family Mutual Insurance Company (American Family) seeks review of a published decision of the court of appeals,1 which reversed a summary judgment granted to American Family by the Milwaukee County Circuit Court, Jeffrey Kremers, Judge. The issue presented is whether an insurer may reduce the uninsured motorist coverage limits in its policy by amounts paid under a worker‘s
¶ 2. We conclude that
I. BACKGROUND
¶ 3. The facts are undisputed. Scott Shira (Scott) died in the course of his employment when an uninsured motorist‘s vehicle struck the car in which he and his passenger, Earl Teschendorf, were riding.3 The accident occurred January 16, 1999, in Woodbury, Minnesota. Scott was 33 years old. Because he was unmarried and had no dependents, his worker‘s compensation death benefit was paid to the Fund as required by
¶ 4. Scott had purchased an automobile insurance policy from American Family with uninsured motorist coverage limits of $150,000. After his death, Scott‘s parents, Bernard and Maria Shira (the Shiras), brought a wrongful death action, based on Minnesota law, against American Family to recover the uninsured motorist benefits under Scott‘s policy. They sought $8000 in funeral expenses plus damages for loss of society and companionship.
¶ 5. Relying upon the reducing clause in the policy,5 American Family moved for summary judgment, claiming the uninsured motorist policy limits were reduced to $0 by the amount of worker‘s compensation benefits paid to the Fund.
¶ 6.
A policy may provide that the limits under the policy for uninsured or underinsured motorist coverage
for bodily injury or death resulting from any one accident shall be reduced by any of the following that apply:
- Amounts paid by or on behalf of any person or organization that may be legally responsible for the bodily injury or death for which the payment is made.
- Amounts paid or payable under any worker‘s compensation law.
- Amounts paid or payable under any disability benefits laws.
¶ 7. The circuit court granted American Family summary judgment. It held that (1) Minnesota law governs the wrongful death action; (2) Wisconsin law governs the interpretation of the insurance policy; and (3)
¶ 8. The court of appeals reversed. In a split decision, the court of appeals concluded that both
II. STANDARD OF REVIEW
¶ 9. We review a decision on summary judgment using the same methodology as the circuit court. Green Spring Farms v. Kersten, 136 Wis. 2d 304, 315, 401 N.W.2d 816 (1987). Summary judgment is appropriate where the record demonstrates “that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.”
III. THE STATUTE
¶ 10. We first examine
¶ 11. It has often been said that the goal of statutory interpretation “is to discern and give effect to the intent of the legislature.” State v. Morford, 2004 WI
¶ 12. The debate over statutory interpretation will surely continue. But this court adheres to the proposition that statutory interpretation begins with the language of the statute, and if the meaning there is plain, the inquiry ordinarily ends. Id., ¶ 45. In examining the statutory text, however, we emphasize that ascertaining plain meaning requires us to do more than focus on “a single, isolated sentence or portion of a sentence[.]” Landis v. Physicians Ins. Co. of Wis., Inc., 2001 WI 86, ¶ 16, 245 Wis. 2d 1, 628 N.W.2d 893. We are expected to look to “the role of the relevant language in the entire statute.” Id.; see Wis. Citizens Concerned for Cranes & Doves v. DNR, 2004 WI 40, ¶ 6, 270 Wis. 2d 318, 677 N.W.2d 612. Accordingly, we consider the context in which words appear, the structure of the statute, and the purpose of the statute where it is evident from the statutory text. Kalal, 271 Wis. 2d 633, ¶¶ 48, 49.
¶ 13. There are three situations in which the court looks outside the statute. First, if the meaning of a statute is ambiguous after considering all intrinsic sources, we look to extrinsic sources such as legislative history to find legislative intent. Id., ¶ 50. This methodology is thoroughly familiar.
¶ 15. Third, if the meaning of the statute appears to be plain but that meaning produces absurd results, we may also consult legislative history. The purpose in this situation is to verify that the legislature did not intend these unreasonable or unthinkable results. See Green v. Bock Laundry Mach. Co, 490 U.S. 504, 527 (1989) (Scalia, J., concurring);6 Kalal, 271 Wis. 2d 633, ¶ 52 n.9; see also Public Citizen v. United States Dep‘t of Justice, 491 U.S. 440, 465 (1989) (invoking the Supreme Court‘s absurdity exception to the plain language of the statute); Robbins v. Chronister, 402 F.3d 1047, 1050 (10th Cir. 2005) (collecting federal circuit court and Supreme Court cases applying the absurdity exception). Because our purpose in these situations is grounded in open disbelief of what a statute appears to require, we are bound to limit our off-statute investigations to obvious aberrations.
¶ 17. Conversely, the Shiras argue that
¶ 18. The court itself is divided as to whether the meaning of
A. Wis. Stat. § 632.32(5)(i)2. Is Ambiguous
¶ 19. A statute is not ambiguous simply because the parties, the circuit court, and the court of appeals disagree as to its meaning. Bruno v. Milwaukee County, 2003 WI 28, ¶¶ 18, 21, 260 Wis. 2d 633, 660 N.W.2d 656. Rather, a statute is ambiguous “if it is capable of being understood by reasonably well-informed persons in two or more senses.” Kalal, 271 Wis. 2d 633, ¶ 47. Stated otherwise, a statute is ambiguous if the “statutory language reasonably gives rise to different meanings.” Id. (ellipsis omitted). Though not dispositive, the fact that the circuit court and court of appeals reached contradictory interpretations, despite both courts concluding that the statute was clear, is indicative of
¶ 20. Several years ago, this court held that
¶ 21. Sometimes, a statute is ambiguous based purely on its words. State of Wis. Dep‘t of Corrections v. Schwarz, 2005 WI 34, ¶ 14, 279 Wis. 2d 223, 693 N.W.2d 703. At other times, ambiguity arises from “the words of the provision as they interact with and relate to other provisions in the statute[.]” Id. Justices Bradley, Prosser, and Roggensack think this case presents the latter scenario and agree with the Shiras that
¶ 22. The literal reading of
¶ 23. On the other hand, when
¶ 24. The reason to doubt a literal meaning of
¶ 26. In 1995 the legislature authorized reducing clauses in 1995 Wis. Act 21. This legislation permitted insurers to offer a particular type of uninsured and underinsured motorist coverage. See Dowhower, 236 Wis. 2d 113. This type of coverage had the effect of reducing the total amount available to compensate an injured insured, but by limiting the insurer‘s exposure, it helped keep uninsured motorist premiums affordable and encouraged insureds to purchase a predetermined, fixed level of insurance coverage they thought they needed rather than having to rely on the unpredictable liability coverage of tortfeasors.
¶ 27.
¶ 28. Though
¶ 29. In view of this conflict, Justices Bradley, Prosser, and Roggensack conclude that
B. The Meaning of Wis. Stat. § 632.32(5)(i)2. Is Plain but Leads to Absurd Results
¶ 30. An alternative interpretation, which Justices Wilcox, Crooks, and Butler favor, may be stated as follows: There is no ambiguity in
¶ 31. The parties agree that Scott‘s worker‘s compensation insurance death benefit was paid to the Fund “under the worker‘s compensation law,”
¶ 32. Although the meaning of the statute appears to be plain, a literal application of the language would be absurd. As a general rule, courts apply the ordinary and accepted meaning of statutory language, unless it produces an absurd result. Seider, 236 Wis. 2d 211, ¶ 32. Because a literal application of
¶ 33. To understand the absurdity that flows from an interpretation that would allow policy limits to be reduced by payments to the Fund, some background on the Wisconsin Worker‘s Compensation Act (WCA) is necessary.
¶ 34. The Fund creates a source of worker‘s compensation benefits for certain cases in addition to the benefits the WCA requires an employer or worker‘s compensation carrier to pay to an employee who is injured or who dies in the course of his employment. See
¶ 35. The Fund is financed by payments from employers or worker‘s compensation carriers. The payments are required anytime certain specified workplace injuries occur.
¶ 37. The administration of the Fund is consistent with the overall purpose of the WCA. The fundamental purpose of the WCA is to compensate injured employees. State v. LIRC, 136 Wis. 2d 281, 288, 401 N.W.2d 585 (1987); Duvick v. Indus. Comm‘n of Wis., 22 Wis. 2d 155, 161, 125 N.W.2d 356 (1963). The WCA ensures employees “smaller but more certain recoveries than might be available in tort actions, while employers are freed from the risk of large and unpredictable damage awards.” Byers v. LIRC, 208 Wis. 2d 388, 396, 561 N.W.2d 678 (1997). Accordingly, the WCA balances the interests of employers and employees by ensuring a recovery sufficient to meet an employee‘s economic damages while keeping the expense of funding worker‘s compensation manageable for employers.
¶ 38. Insofar as tort law and uninsured motorist coverage compensate an injured person for his or her economic damages, they overlap the WCA. Accordingly, in the majority of cases, the legislature‘s decision to link the operation of uninsured motorist reducing clauses to recovery of worker‘s compensation benefits has the reasonable purpose of preventing double recovery. However, when payments are made to the Fund instead of a deceased employee, there cannot be double recovery. It is hard to think of a reason for allowing uninsured motorist limits to be reduced by worker‘s compensation
¶ 39. The absurdity that results from American Family‘s interpretation of the statute is evident in the following examples. Many of the employees who die from an employment-related injury involving an uninsured or underinsured motor vehicle will have uninsured motorist and underinsured motorist coverage. In every case in which a worker‘s compensation death benefit is available for the employee‘s death, uninsured and underinsured motorist policy limits would be reduced by the amount of the death benefit actually received by the employee‘s dependents or by the amount deposited with the Fund, plus $5000 (now, $20,000). According to the logic of American Family‘s position, coverage limits would be reduced by $5000 (now, $20,000) in every case, regardless of whether a decedent‘s dependents were made whole. See
¶ 40. Similarly absurd is the suggestion that the legislature intended to reduce by $7000 (now, $20,000) the uninsured motorist and underinsured motorist limits available to an insured who has lost an arm, leg, or eye. See
¶ 41. Other results of American Family‘s interpretation illustrate its absurdity.
¶ 42. Moreover, an insured‘s recovery under his uninsured motorist coverage would depend entirely on fate. That is, if the insured were driving down a local highway on Wednesday morning during the course of his employment, he would receive $20,000 less for losing a leg when he was hit by an uninsured motor vehicle than if he had suffered the same injury on Sunday coming home from church. This result is contrary to our holding that uninsured and underinsured motorist coverage provides a predetermined, fixed level of coverage. See Welin v. Am. Family Ins. Co., 2006 WI 81, ¶¶ 46, 49-53, 292 Wis. 2d 73, 717 N.W.2d 690 (discussing cases).12
C. Legislative History and Public Policy
¶ 44. Upon review of legislative history and public policy, the court concludes that the more reasonable interpretation of the statute is that payments to the Fund cannot reduce uninsured motorist coverage limits. As we see it, the statute authorizes reductions in coverage limits by the total amount of worker‘s compensation payments made to or on behalf of the insured, the insured‘s heirs, or the insured‘s estate.
1. Legislative History
¶ 45. We return to history. Uninsured motorist coverage dates back to the mid-1950s. Helen Freedman, Uninsured Motorist Developments in Wisconsin, 30 The Gavel 3 (Dec. 1969). The legislature first required insurers to offer this coverage beginning in 1966. See
¶ 47. The take-away points from Nicholson are as follows. Before the legislature made uninsured motorist coverage mandatory in 1971, this court upheld reducing clauses that reduced uninsured motorist limits by amounts the insured received from any other source. E.g., Scherr v. Drobac, 53 Wis. 2d 308, 310-11, 193 N.W.2d 14 (1972); Leatherman v. Am. Family Mut. Ins. Co., 52 Wis. 2d 644, 650-51, 190 N.W.2d 904 (1971). In response to Drobac and Leatherman, the legislature prohibited reducing clauses. See ch. 72, Laws of 1973 (then-codified at
¶ 48. Thereafter, until 1995 Wisconsin Act 21, this court consistently struck down reducing clauses as contrary to the requirement that motor vehicle insur-
¶ 49. 1995 Wisconsin Act 21 was intended to overturn the Nicholson/Kleppe line of cases that refused to enforce reducing clauses in the context of uninsured motorist coverage. The analysis from the Legislative Reference Bureau stated:
The bill also permits motor vehicle insurance policies to reduce the limits payable under the policy for uninsured and underinsured motorist coverage by payments received from other sources. Payments for bodily injury or death may be reduced ... by amounts paid or payable under a worker‘s compensation law....
See 1995 Senate Bill 6, Analysis by the Legislative Reference Bureau (discussing proposed
¶ 50. The source of 1995 Wisconsin Act 21 was 1995 Senate Bill 6. 1995 Senate Bill 6 was introduced by Senator Joanne Huelsman. It was based in part on her 1993 Senate Bill 135. Senator Huelsman sent an early
(1) Amendments to Draft: We would like to amend the draft to include a provision permitting insurers to include language in their policies that would reduce the underinsured (UIM) limit shown in the policy by the total amount of other limits providing coverage to the owner of the underinsured vehicle. 1991 SB 105 did not include similar language. We suggest language inserted as subsec. (h) and reading as follows:
(h) Notwithstanding s. 631.43(1), a policy may provide that the limit under the policy for underinsured motorist coverage for bodily injury or death resulting from any one accident will be reduced by all of the following:
1. Amounts paid by or on behalf of persons or organizations who may be legally responsible.
2. Amounts paid or payable under any worker‘s compensation law.
3. Amounts paid or payable under any disability benefits laws.
¶ 51. It should be noted that Englund‘s letter makes reference only to reductions in underinsured motorist coverage. Reductions in uninsured motorist coverage came in a later draft. Englund‘s letter also references
When 2 or more policies promise to indemnify an insured against the same loss, no “other insurance” provisions of the policy may reduce the aggregate protection of the insured below the lesser of the actual
insured loss suffered by the insured or the total indemnification promised by the policies if there were no “other insurance” provisions. The policies may by their terms define the extent to which each is primary and each excess, but if the policies contain inconsistent terms on that point, the insurers shall be jointly and severally liable to the insured on any coverage where the terms are inconsistent, each to the full amount of the coverage provided.
¶ 52. Current
¶ 53. Despite having added “uninsured” motorist coverage to the proposal suggested by the Wisconsin Insurance Alliance, having changed the word “limit” to “limits,” having changed the text of
¶ 54. Nothing in the legislative history demonstrates that the legislature contemplated or intended that uninsured motorist limits should be reduced by payments to an entity unrelated to the insured (except a provider such as a hospital which stands in the place of the insured). Often, silence in legislative history is merely the result of an incomplete record, and there-
¶ 55. Prior to 1995—indeed prior to this very case—no Wisconsin case discussed the possibility that uninsured motorist limits could be reduced by payment of worker‘s compensation benefits to unrelated third parties such as the Fund. Moreover, in none of the leading treatises on uninsured motorist and underinsured motorist insurance is there even a hint that uninsured motorist limits could be reduced by worker‘s compensation payments made to anyone other than the insured or to someone on behalf of the insured, the insured‘s heirs, or the insured‘s estate. See generally, 2 Irvin Schermer & William Schermer, Automobile Liability Insurance §§ 28:3 to 28:8 (4th ed. 2004); 1 Alan Widiss, Uninsured and Underinsured Motorist Insurance §§ 14.3, 41.10 (Revised 2nd ed. 1999); 3 Matthew Bender & Co., Inc., No-Fault and Uninsured Motorist Automobile Insurance § 31.20 (2003); 12 Lee Russ & Thomas Segalla, Couch on Insurance §§ 171:37 to 171:43. Rather, a review of these treatises reveals that the application of a setoff or reducing clause presumes some payment to the insured, which in turn reduces the amount of uninsured motorist benefits owed to the insured. Because the result proposed by American Family is not suggested by any case or secondary source that we have been able to find, and because American Family has not directed our attention to any such
¶ 56. We are mindful of the instruction that a court should consider the “mischief sought to be remedied” by a statute when interpreting the statute. See Heyde Co., Inc. v. Dove Healthcare, LLC, 2002 WI 131, ¶ 15 n.3, 258 Wis. 2d 28, 654 N.W.2d 830. We think it telling that 1995 Wisconsin Act 21 was intended to “remedy” the refusal of Wisconsin courts to allow insurers to reduce uninsured motorist limits by amounts received by an injured person from other sources. See Kleppe, 174 Wis. 2d at 642. We think the legislature responded to a discrete series of cases and did not intend to permit insurers to reduce uninsured motorist limits by worker‘s compensation benefits paid to the Fund.
¶ 57. This result is completely harmonious with the legislative goal that all motor vehicle policies include uninsured motorist coverage to protect persons injured in automobile accidents “who are legally entitled to recover damages from owners or operators of uninsured motor vehicles.”
2. Public Policy of the Worker‘s Compensation Statutes
¶ 58. American Family argues that allowing insurers to reduce uninsured motorist limits in this situation is consistent with the public policy reflected in
¶ 59. While American Family is correct that the Shiras do not qualify as dependents under the WCA, the policies underlying the WCA and tort law differ. The WCA reflects a decision to limit the amounts recovered by injured employees to avoid imposing burdensome expenses upon employers. See Threshermens Mut. Ins. Co. v. Gross, 217 Wis. 2d 451, 459-60, 577 N.W.2d 335 (1998) (explaining the compromise reached by the legislature to balance the interests of employers and employees); id. at 483 (Bradley, J., dissenting) (recounting the history of the compromise). The WCA ensures a minimal safety net for those financially dependent upon a deceased or injured employee by causing an employee to relinquish all common law remedies in exchange for the abrogation of the employer‘s defenses. See Gross, 217 Wis. 2d at 460, 469 n.7.13
¶ 61. In addition, American Family suggests that our decision should adhere to the analysis in Seider. In Seider we considered whether the Office of the Commissioner of Insurance (OCI) exceeded its authority in adopting an administrative rule interpreting the valued policy law,
¶ 62. Seider does not control this case. Unlike in Seider, where the statute was unambiguous,
IV. CONCLUSION
¶ 63. We conclude that
By the Court.—The decision of the court of appeals is affirmed.
¶ 64. SHIRLEY S. ABRAHAMSON, C.J. (concurring). I agree with the majority opinion that under
¶ 65. I write separately to point out that the majority opinion demonstrates the futility of labeling a statute as ambiguous or unambiguous as a means of statutory interpretation instead of just determining what a statute means.
¶ 67. This opinion demonstrates what I have written numerous times: The ambiguous/unambiguous, literal, plain meaning debate is a word game. The characterizations of “ambiguous,” “unambiguous,” “literal,” and “plain meaning” are in the eyes of the beholder and appear to be conclusory labels a court pins on a statute.3
¶ 68. The majority opinion explains on the one hand that “a statute is ambiguous ‘if it is capable of
¶ 69. Furthermore, this court (or a justice) has often stated that the consequences of an interpretation of a statute should not be considered. On the other hand, the court (or a justice) has stated that the consequences of an interpretation should be considered.7 In the instant case, the ambiguous and unam-
biguous analyses in the majority opinion rely heavily on the fact that the result (i.e., consequence) of interpreting the statute to allow the reduction of underinsured motorist coverage by amounts paid into the Fund would produce an absurd result. Indeed, regardless of what we
¶ 70. A better approach to statutory interpretation would be to drop the ambiguous/unambiguous/literal/plain meaning pretense and instead take a comprehensive view of statutory interpretation. It is time to take a holistic, less formalist approach to statutory interpretation. As I have explained previously, the court (some members more than others) silently takes a holistic approach anyway, despite lip service to the ambiguous/unambiguous/plain meaning shibboleths. In the present case, both the ambiguous and unambiguous/literal/plain meaning camps properly conclude that the “legislative history, legislative purpose, and public policy”8 must be examined to determine the meaning of
¶ 71. For the reasons set forth, I write separately.
¶ 72. DAVID T. PROSSER, J. (concurring). I write separately to address American Family‘s policy. In my view, American Family‘s reducing clause would not pass muster on these facts—irrespective of any statute—because it is at war with the reasonable expectation of its insured.
¶ 73. In interpreting insurance policies, courts apply the same rules of interpretation that apply to contracts generally. Folkman v. Quamme, 2003 WI 116, ¶ 12, 264 Wis. 2d 617, 665 N.W.2d 857. The objective in interpreting insurance policies is to give effect to the intent of the parties. State Farm Mut. Auto. Ins. Co. v.
¶ 74. When interpreting an insurance policy courts begin by determining whether the policy is ambiguous. Langridge, 275 Wis. 2d 35, ¶ 41. An insurance policy is ambiguous if it is “susceptible to more than one reasonable interpretation.” Id., ¶ 48 (internal citations omitted). Ambiguity in an insurance policy may arise in different ways. First, the language of the disputed provision may be ambiguous because the import of the words is uncertain or the impact of the words is uncertain with respect to unusual facts. Second, a provision that is unambiguous when viewed in isolation may become ambiguous when considered in the context of the entire policy.1 Folkman, 264 Wis. 2d 617, ¶ 19.
¶ 75. The Shiras argue the reducing clause in their son‘s policy is ambiguous because it does not state that the uninsured motorist coverage limits will be reduced by the payment of worker‘s compensation benefits “to anyone.” Because the policy lacked the phrase “to anyone,” the Shiras contend American
¶ 76. In response, American Family argues that because the reducing clause in the policy mirrors
¶ 77. We have previously held that reducing clauses that mirror
¶ 78. Here the reducing clause produces a result that is completely at odds with the reasonable expectation of an insured, because the insured would expect that reductions in uninsured policy limits would be based on payments made to or on behalf of the insured, the insured‘s heirs, or the insured‘s estate. This is why the court of appeals upheld the reducing clause in a case where worker‘s compensation payments were paid to an insured and the payments exceeded the insured‘s uninsured motorist policy limits. See Myers v. Gen. Cas. Co. of Wis., 2005 WI App 49, 279 Wis. 2d 432, 694 N.W.2d 723.
¶ 79. The reducing clause in this policy is ambiguous because it is susceptible to more than one reasonable interpretation on the particular facts of this case. This is because the overall purpose of the policy is to provide coverage for the insured, the insured‘s heirs, or the insured‘s estate in the event of the insured‘s death,
¶ 80. A reasonable insured could not be expected to anticipate that coverage might vary dramatically depending on whether the insured was married or single, whether the insured had dependents, or whether the insured was working or vacationing at the time of a fatal automobile accident. If Scott Shira had been traveling in Minnesota to attend a sporting event instead of conducting business, his estate would have received full coverage.
¶ 81. As long as an interpretation is reasonable, insurance policy terms “should be interpreted as they would be understood from the perspective of a reasonable person in the position of the insured[.]” Langridge, 275 Wis. 2d 35, ¶ 47 (internal citations omitted). A rational consumer in Scott‘s position would not expect that the uninsured motorist coverage for which he paid money could be reduced to nothing even though neither he nor his estate or his heirs had received any compensation for his injuries.
¶ 82. The court has repeatedly held that a policy is consistent with the reasonable expectations of an insured where it clearly sets forth that the insured purchased a fixed level of recovery that is arrived at by combining payments from all sources. See Taylor v. Greatway Ins. Co., 2001 WI 93, ¶ 25, 245 Wis. 2d 134, 628 N.W.2d 916; Dowhower, 236 Wis. 2d 113, ¶ 33. Under American Family‘s interpretation, however, the reducing clause would not only deny an insured a fixed level of recovery but also do so without mentioning the
¶ 83. In fact, the policy is written in such a way that the insured is reasonably led to expect that coverage limits will be reduced only by payments that he actually receives. The Quick Reference page states: “This policy is a legal contract between you (the policyholder) and the company. ... The policy details the rights and duties of you and your insurance company.” This language combined with the very nature of insurance, where an insurer assumes financial responsibility for defined risks and losses suffered by an insured, establishes an expectation of contract benefits that is contrary to American Family‘s interpretation. Absent an explicit warning, an insured would not expect that payments from one third party to another third party could affect the contractual relationship the insured has with the insurer and give the insurer a windfall.
¶ 84. The second paragraph within the uninsured motorist portion of the policy, which sets forth American Family‘s general obligation, states:
We will pay compensatory damages for bodily injury which an insured person is legally entitled to recover from the owner or operator of an uninsured motor vehicle. The bodily injury must be sustained by an insured person and must be caused by accident and arise out of the use of the uninsured motor vehicle.
Based on this paragraph, a reasonable insured would expect American Family (“We“) to have to pay the Shiras. Scott suffered bodily injury—death—as that term is defined by the policy. Scott‘s death was caused by the driver of an uninsured motor vehicle. The Shiras are insured persons as that term is defined by the
¶ 85. Finally, the immediate context of the reducing clause does nothing to dispel this expectation. In its entirety, the reducing provision states:
The limits of liability of this coverage will be reduced by:
1. A payment made by the owner or operator of the uninsured motor vehicle or organization which may be legally liable.
2. A payment under the Liability coverage of this policy.
3. A payment made or amount payable because of bodily injury under any workers’ compensation or disability benefits law or any similar law.
Clearly, the first example—a payment made by an owner or operator legally responsible—contemplates a scenario in which the insured receives payment. Similarly, the second example—a payment under the policy‘s liability coverage—contemplates a scenario in which an injured person would otherwise receive duplicate pay-
¶ 86. Thus it is after two subparts in which uninsured motorist limits can be reduced only by payments to the insured that the insured reaches the portion of the policy in dispute. Given the context in which the worker‘s-compensation reducing clause appears, we conclude that a reasonable insured would reasonably expect that the uninsured motorist coverage limits would be reduced only by the worker‘s compensation benefits that the insured, the insured‘s heirs, or the insured‘s estate actually received.
¶ 87. The court has held that a policy is contrary to the reasonable expectations of an insured and offers illusory coverage where the policy does not “clearly set forth that the insured is purchasing a fixed level of UIM recovery arrived at by combining payments from all sources.” Schmitz, 255 Wis. 2d 61, ¶ 75. A fortiori, a policy in which a reducing clause is effective before the insured ever receives the amount of the uninsured motorist limits from all sources, and which contains no mention of this possibility, is contrary to the reasonable expectations of an insured. If such a reducing clause were allowed by
¶ 88. I am authorized to state that Justice PATIENCE DRAKE ROGGENSACK joins this opinion.
Notes
As Arnold Anderson explains, the Shiras are Class III insureds; that is, “someone who has a derivative claim based on injury to a Class I [named insured] or Class II [occupancy insured] insured.” Arnold P. Anderson, Wisconsin Insurance Law § 4.18 (5th ed. 2004).
Majority op., ¶ 19 (quoting State ex rel. Kalal v. Circuit Court for Dane County, 2004 WI 58, ¶ 47, 271 Wis. 2d 633, 681 N.W.2d 110).In addition to the payment required under par (a) [$5000], in each case of injury resulting in death leaving no person dependent for support, the employer or insurer shall pay into the state treasury the amount of the death benefit otherwise payable....
Id. (citing Bruno v. Milwaukee County, 2003 WI 28, ¶¶ 18, 21, 260 Wis. 2d 633, 660 N.W.2d 656).The limits of liability of this coverage will be reduced by:
- A payment made by the owner or operator of the uninsured motor vehicle or organization which may be legally liable.
- A payment under the Liability coverage of this policy.
- A payment made or amount payable because of bodily injury under any workers’ compensation or disability benefits law or any similar law.
For various statements of a reasonable interpretation of a statute or an interpretation of a statute by a reasonably well-informed person, see, e.g., Bruno v. Milwaukee County, 2003 WI 28, ¶ 22, 260 Wis. 2d 633, 660 N.W.2d 656; id., ¶¶ 31-32 (Bradley, J., concurring); State v. Delaney, 2003 WI 9, ¶ 14, 259 Wis. 2d 77, 658 N.W.2d 416.I think it entirely appropriate to consult all public materials, including the background of [the federal rule of evidence in question] and the legislative history of its adoption, to verify that what seems to us an unthinkable disposition... was indeed unthought of, and thus to justify a departure from... the ordinary meaning of the word “defendant” in the Rule.
