Carlton v. Worcester Ins. Co.

• Decision Date: 09 August 1990
• Docket Number: Civ. A. No. 89-303 L.
• Citation: 744 F. Supp. 395
• Parties: Gerald R. CARLTON and Priscilla Carlton, Individually and as Co-Administrators of the Estate of Brian Carlton, Plaintiffs, v. WORCESTER INSURANCE COMPANY, Defendant.
• Court: U.S. District Court — District of Rhode Island

744 F. Supp. 395

Gerald R. CARLTON and Priscilla Carlton, Individually and as Co-Administrators of the Estate of Brian Carlton, Plaintiffs, v. WORCESTER INSURANCE COMPANY, Defendant.

Civ. A. No. 89-303 L.

United States District Court, D. Rhode Island.

August 9, 1990.

Thomas Pearlman, Providence, R.I., for plaintiffs.

Dennis S. Baluch, Baluch, Mahoney & Gianfrancesco, Providence, R.I., for defendant.

MEMORANDUM AND ORDER

LAGUEUX, District Judge.

This matter is presently before the Court on the motion of defendant, Worcester Insurance Company (Worcester), for summary judgment pursuant to Rule 56 of the Federal Rules of Civil Procedure. Worcester claims that the exclusions contained in the medical payments provision and the uninsured motorist clause of the plaintiffs' insurance policy preclude plaintiffs' recovery for the expenses incident to their son's death. Worcester argues that based on Employers' Fire Insurance Co. v. Baker, 119 R.I. 734, 383 A.2d 1005 (1978), this Court must give effect to the policy exclusions and determine as a matter of law that plaintiffs are not entitled to collect on their policy. Plaintiffs cite Sentry Insurance Co. v. Castillo, 574 A.2d 138 (R.I.1990), as authority for the proposition that the Rhode Island Supreme Court would now conclude that an exclusion which denied underinsured motorist coverage for an accident which occurred on a public road between an underinsured motorist and an uninsurable dirt bike is void as a matter of public policy.

BACKGROUND

On or about June 26, 1986, Brian Carlton, the son of the plaintiffs, Gerald and Priscilla Carlton, struck an automobile while operating a dirt bike on Providence Pike in North Smithfield, Rhode Island. Brian died in August as a result of the accident. The operator of the automobile, George Palshan, maintained an insurance policy through Allstate Insurance Company. Although the police report indicates that all of the witnesses to the accident believe that Brian was driving at speeds in excess of fifty miles an hour, Palshan's insurance company paid the Carltons $50,000.00, the full limit of his policy.

At the time of the accident, Gerald and Priscilla had automobile liability coverage in effect through Worcester. The policy listed a 1973 Plymouth two-door and a 1977 Ford wagon as the covered automobiles. The policy insured Gerald and Priscilla and "family members". The policy defined "family member" as "a person related to you by blood ... who is a resident of your household." In addition to liability coverage, the policy also provided for medical payments and uninsured motorist protection. The medical payments coverage was as follows:

We will pay reasonable expenses incurred for necessary medical and funeral services because of bodily injury:

1. Caused by accident; and

2. Sustained by a covered person.

* * * * * *

`Covered person' as used in this Part means:

1. You or any family member

a. while occupying; or

b. as a pedestrian struck by;

a motor vehicle designed for use mainly on public roads.

The provision excluded coverage for bodily injuries "sustained while occupying any motorized vehicle having less than four wheels." It also excluded payments for injuries "sustained while occupying or, when struck by, any vehicle (other than your covered auto) which is owned by any family member." This provision limited liability to $2,000.00 for each person.

The uninsured motorists provision assured "We will pay damages which a covered person is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of bodily injury." This provision excluded coverage for any "bodily injuries sustained by any person: while occupying ... any motor vehicle owned by you or any family member which is not insured for this coverage under this policy." The policy limited liability to $50,000.00 for each accident.

The policy also contained a separate endorsement entitled "Uninsured/Underinsured Motorists Coverage Exclusion Endorsement." The addition provided "the following exclusion is added to Uninsured Motorists Coverage and, where afforded, Underinsured Motorists Coverage." The endorsement excluded coverage for punitive or exemplary damages.

At the time of the accident, Brian Carlton lived at home with his parents and siblings. A few months prior to the accident, Brian purchased a Kawasaki motor bike from a friend. He never registered the bike and never obtained insurance for the bike. Brian's father described the bike in his deposition as "what they call an off road vehicle" that has no muffler. He also described the bike as having "knobby" tires, i.e., "big round knobs that dig into dirt and sand." (Gerald Carlton depo. p. 13).

This is a diversity jurisdiction case. Gerald and Priscilla filed this suit, individually and as co-administrators of Brian's estate, seeking a declaration that Worcester is liable under the medical payments provision and the underinsured motorists coverage of their policy. Plaintiffs, as Brian's beneficiaries under the wrongful death statute, seek damages for the economic loss due to Brian's death in the amount of $442,498.00. They also seek, for the estate, an estimated $100,000.00 in medical and hospital expenses. Worcester argues that it is entitled to summary judgment, because the plain language of the exclusions within the insurance policy bars any recovery by plaintiffs. Plaintiffs, however, attempt to differentiate between the underinsured motorists provision of their policy and the uninsured motorists provision, claiming that the latter's exclusions do not apply to this case. Plaintiffs, in the alternative, claim that the uninsured motorist exclusion is void in light of the uninsured motorist statute, R.I.Gen.Laws § 27-7-2.1. Having heard oral arguments on the motion, the Court took the matter under advisement. It is now in order for decision.

DISCUSSION

I. Summary Judgment Standard

Defendant's motion for summary judgment requires this Court to apply a well established Rule 56 standard. This Court has articulated in the past:

It is well settled that summary judgment can be granted only where there is no genuine issue as to any material fact and where the movant is entitled to judgment as a matter of law. In determining whether these conditions have been met, the Court must view the record in the light most favorable to the party opposing the motion, indulging all inferences favorable to that party.

Gonsalves v. Alpine Country Club, 563 F.Supp. 1283, 1285 (D.R.I.1983), aff'd, 727 F.2d 27, 29 (1st Cir.1984) (citations omitted).

II. Applicable Law

Since this is a diversity jurisdiction case, this Court must look to the law of Rhode Island to settle this dispute. Erie R.R. Co. v. Tompkins, 304 U.S. 64, 78, 58 S.Ct. 817, 822, 82 L.Ed. 1188 (1938); Gleason v. Merchants Mut. Ins. Co., 589 F.Supp. 1474, 1478 (D.R.I.1984). Rhode Island courts have applied general rules of contract construction to insurance contract disputes. See Malo v. Aetna Casualty & Sur. Co., 459 A.2d 954, 956 (R.I.1983). The law is that courts must enforce the plain and unambiguous contract terms as the parties have written them. Id. Courts, however, must construe any ambiguities against the insurer. Gleason, supra, 589 F.Supp. at 1480. When reviewing uninsured motorist provisions, however, courts also must ascertain whether the contract language conflicts with the statutory mandates and public policies established in Rhode Island's Uninsured Motorist Statute. Id. at 1482; see also Castillo, supra, 574 A.2d at 140. When conflicts do exist, of course, the statute prevails. Gleason, supra, 589 F.Supp. at 1482.

A. Medical Payments Coverage

This Court agrees with Worcester that the clear language of the medical payments coverage provision of the policy bars plaintiffs' recovery for Brian's medical expenses. Not only does that provision require that the covered person at the time of the injury be occupying a "motor vehicle designed for use mainly on public roads," it also excludes injuries arising while operating or occupying a "motorized vehicle having less than four wheels." It further excludes coverage for injuries arising while occupying a vehicle owned by a family member. The undisputed deposition testimony of Brian's father, Gerald, indicates that Brian had purchased the dirt bike he was riding at the time of the accident with his own money. He also testified that Brian's dirt bike constituted an "off road vehicle" with only two wheels. Both parties agree that Brian was injured while operating his dirt bike. Even if it could be argued that the dirt bike was, in fact, a "motor vehicle designed for use mainly on public roads," Cf. Castillo, supra, 574 A.2d at 139-40, plaintiffs cannot overcome the totally unambiguous requirement that the injuries must occur while occupying a four wheeled vehicle which was not owned by a family member.

No court in Rhode Island has found that exclusions in medical payment coverage provisions violate the public policy of the statute. Therefore, this Court must apply the plain and ordinary language of the insurance policy. The policy clearly prevents plaintiffs from recovering medical payments in this case.

B. Uninsured Motorists Coverage

Although plaintiffs initially attempt to distinguish their uninsured from their underinsured motorists coverage as a means of separating the uninsured motorists exclusions from the present case, their argument fails when the insurance policy is viewed in conjunction with the statute. Although the uninsured motorists provision in plaintiffs' contract makes no reference to underinsured motorists coverage, it appears clear from the policy endorsement that the policy grouped the two categories together. Cf. Sentry Ins. Co. v. Grenga, 556 A.2d 998, 999-1000 (R.I.1989). Even if the policy intended to provide underinsured motorists coverage separate and apart from uninsured motorists protection, the statutory definition of uninsured...