On October 24, 2008 the trial court (Thomson, J.) in Lackawanna County denied Preliminary Objections in a post-Koken case which was filed in the Court of Common Pleas of Lackawanna County arising out of a car accident involving an underinsured vehicle/driver.
In Moyer v. Harrigan/Erie Ins, the lawsuit was filed against the other driver in tort and the victim's insurance company in contract for UIM benefits. The trial court denied the Preliminary Objections which sought to separate the claims and writes, "the rights and responsibilities of the parties will be effectively and efficiently fixed by a single action." Further, the court notes "to sever the actions would force two trial on the same issues and with the same proofs. This would be a significant waste of judicial resources for the court and would cause significant delay and expense to the parties."
The Pennsylvania Supreme Court issued a decision recently in Generette v. Donegal. The Court, in a majority decision by Justice Baer (joined by C.J. Castille, Todd and McCaffery), reverses the Superior Court 5-4 en banc decision.
The Court holds that the Superior Court erred in concluding that the MVFRL provision relating to stacking and waiver applied to Generette, who was not an "insured" as defined by the MVFRL. Additionally, it holds that a portion of the "Other Insurance" clause in the Generette policy with Donegal is non-enforceable because it conflicts with the public policy of the MVFRL to provide "excess" rather than "gap" underinsured motorist coverage. Justice Saylor filed a separate concurring and dissenting opinion and Justice Eakin a separate dissenting opinion.
This is a very confusing issue to the lay person and the written opinion certainly bears that out. Just understand that it is a win for the good guys. It has made a direct, positive result in one of the underinsurance claims being litigated here at Carroll & Carroll, P.C.
Thanks, as always, to Scott Cooper, Esquire for providing this information.
On September 10, 2008, in Horace Mann Insurance Company v. Alben, the District Court for the Western District of Pennsylvania (Schwab, J.) held that the "reasonable expectations of the insured" estops an insurance company from denying underinsured motorist (UIM) benefits to a person who is a "listed driver" on another person's (girlfriends) policy.
Robert Alben (Alben) was injured in an accident which occurred in Ohio. He was driving his employer's vehicle and then sought UIM coverage on his girlfriend's personal policy with Horace Mann because he was a "listed driver".
The Court initially holds that under the terms of the policy the "listed driver" is not automatically considered an "insured" or "covered person" to allow UIM coverage. However, then the court addresses the reasonable expectations of the insured and the recent statement of the Third Circuit standard in West v. Lincoln Ben. Life. Ins., 509 F.3d 160 (3d. cir. 2007) which offered a "synthesized standard [as] the truest statement of of Pennsylvania law" regarding the doctrine of reasonable expectations.
Applying the standard the Court notes that the insurer must demonstrate by clear and convincing evidence that the insured did not have a reasonable expectation of coverage. Based upon this standard and the facts of the case, particularly the fact that everyone involved testified that they all thought that by adding Alben to the policy as a listed driver he would be fully covered, the Court finds that the "listed driver" who was injured in his employers vehicle at the time of the accident is entitled to UIM coverage on his girlfriend's personal policy.
Thanks to Scott Cooper, Esquire for this information. On August 26, 2008, the United States District Court for the Eastern District of Pennsylvania (Sanchez, J.) granted Foremost Insurance Group's Motion for Summary Judgment in Benner v. Foremost Insurance Group. This case involved the tragic death of a girl, Benner, who was killed while occupying her friend's vehicle. An underinsured motorist claim ("UIM") was pursued on a family member's Antique and Classic Auto insurance Policy and the insurance company denied the claim because it said that under the terms of the policy Benner had to be "actually occupying" the antique/classic vehicle at the time of the accident to qualify for UIM coverage.
Benner's Estate argued that under Quinney v. American Modern Home Insurance Company, 145 F.Supp.2d 603 (M.D. Pa. 2001) she was entitled to coverage as a family member/insured and did not need to be occupying the vehicle to qualify for coverage. However, the District Court observes that the policy language in Quinney is not the same as the language in Benner's policy. In Quinney the policy language stated that the coverage was provided to an insured/family member without the actual occupying requirement but in the Benner policy the family member/insured had to be occupying. Thus, since she was not occupying the antique/classic vehicle at the time of the accident, the Estate could not recover.
On July 28, 2008, Judge Joyner in the United States District Court for the Eastern District of Pennsylvania Granted the Insured's Motion for Summary Judgment in St. Paul Fire & Marine Insurance Co. v. Rhein. Judge Joyner holds that Rhein was occupying his police vehicle at the time he was injured while conducting a routine traffic stop.
In Rhein, the officer was injured in the course and scope of his employment. He pulled over a speeding vehicle, stopped behind the car with his emergency lights on and exited his cruiser to conduct the stop. At some point during the exchange of information the other driver's car began to roll backward and Rhein's hand became wedged inside the car door causing his injuries. He settled the third party case with the other drivers insurance company and then sought underinsured motorist coverage form the Township insurer which denied coverage arguing that Rhein was not a "protected person" under the policy because he was not "occupying" the cruiser at the time of the accident.
Applying the four (4) part "occupancy" test from the Pennsylvania Supreme Court decision in Utica Mutual Insurance Co. v. Contrisciane, 473 A.3d 1005 (Pa. 1984) the Court holds that Rhein was "occupying" the cruiser at the time of the accident. One of the main issue to the four part test was whether Rhein was "vehicle oriented". The court relies upon Property and Casualty Insurance Co. of Hartford v. Caperilla, 2004 WL 1551739 (E.D. Pa. July 9, 2004) where another officer was injure din a similar manner. Thus, he is a covered and protected person and entitled to the underinsured motorist coverage.
Thanks to Attorney Scott Cooper for this information.
On July 15, 2008 the District Court for the Western District of Pennsylvania (Lancaster, J.) held in Shaw v. State Farm Insurance Company that an insured is not allowed to recover UM/UIM benefits under his insurance policy with State Farm for injuries sustained during the course and scope of his employment due to the negligence of a co-worker. Shaw was injured in a work related accident when the garbage truck he was riding in was negligently driven by a co-worker. He sought and received workers compensation benefits and did not sue his employer or co-worker due to immunity under the Workers Compensation Act. He then sought UM/UIM benefits from State Farm which denied the claim by arguing that the benefits were not "legally entitled" and thus Shaw could not recover.
The Court relies mainly upon a not precedential Third Circuit case in Nationwide Mut Ins Co v. Chiao, 186 Fed.Appx. 181 (3d Cir. 2006) and grants State Farm's Motion for Summary Judgment. However, there is no mention or reference to the state trial court decision from Adams County in Brumbaugh v. Erie Insurance Exchange in 2006 where Judge Walker in Franklin County held that an insured was entitled to UM/UIM coverage in the same factual situation.