Frank v. Allstate Ins. Co.
| Decision Date | 08 July 1986 |
| Docket Number | No. 60014,60014 |
| Citation | 1986 OK 42,727 P.2d 577 |
| Parties | Gary B. FRANK, individually and as husband and personal representative of Linda Frank, deceased, Appellant, v. ALLSTATE INSURANCE COMPANY, Appellee. |
| Court | Oklahoma Supreme Court |
Ernest J. Istook, Jr., Oklahoma City, for appellant.
Jim T. Priest, McKinney, Stringer & Webster, Oklahoma City, for appellee.
The issues presented are: whether the terms of the medical payment coverage of the automobile insurance policy are ambiguous insofar as they afford benefits on each of two vehicles when only one was in the accident giving rise to the claim; and, if they are not found to be ambiguous, whether--as a matter of public policy--the insured is entitled to aggregate the limits of medical payment benefits afforded for each vehicle.
According to the stipulated facts, Gary B. Frank [insured] and his deceased wife, Linda Frank, owned two automobiles and were the named insureds of an automobile insurance policy issued by Allstate Insurance Company [Allstate] which covers both vehicles. Separate premiums were paid for medical payment coverage on each vehicle.1 While occupying one of their cars, insured and his wife were struck by a vehicle driven by an admittedly negligent uninsured motorist. Linda Frank died as a result of the accident. Insured suffered personal injuries and incurred medical expenses that exceeded his policy limits for medical payment coverage on the vehicle he was occupying when the accident occurred. Allstate tendered the full amount of its liability limit for medical payment coverage on that vehicle. Upon Allstate's refusal to allow insured's claim to the medical payment benefits on his other vehicle--which was not involved in the accident--the insured brought this action.
Allstate's denial of liability for the additional coverage is based upon the following terms of the policy:
"COVERAGE CC--Automobile Medical Payments Insurance
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Limit of Allstate's liability
Regardless of the number of automobiles insured, only one of the limits of liability stated in the declarations as applicable to 'each person' is the total limit of Allstate's liability for all expenses incurred by or for each person as the result of any one accident. Further, if the accident involves an owned automobile, then the limit stated in the declarations as applicable to that automobile shall be the total limit of Allstate's liability for each person.
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GENERAL CONDITIONS
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3. Insurance On Two or More Automobiles
When two or more automobiles are insured by this policy, the terms of this policy shall apply separately to each,...."
Insured contends that when the limit of liability clause is read in conjunction with the general condition an ambiguity arises, which if construed against Allstate, would entitle him to "stack" his medical payment coverage purchased on each vehicle protected by the policy.
The quoted limit-of-liability clause states plainly that Allstate's liability for payment of medical expenses is limited to the amount of coverage purchased for and applicable to the insured's "owned automobile" involved in the accident. The general condition, also quoted above, provides that the terms of the policy shall apply separately to each automobile insured by the policy. A reading of this condition in conjunction with the limitation clause does not compel us to conclude that the second vehicle's coverage limit may be applied cumulatively. Unless ambiguous, an insurance policy should be construed according to its terms as any other contract.2
While the insured did pay an additional premium for the medical payment coverage for his other vehicle, that premium was for an additional and separate risk of loss which did not occur. Allstate would have become contractually liable for the extra coverage only if the insured's second vehicle had been involved in an accident. Hence, we conclude that, under the facts of this case, the policy terms in question clearly and unambiguously preclude the stacking of medical payment coverage.
Lastly, insured argues that Oklahoma's public policy that authorizes the stacking of uninsured motorist [UM] coverage should apply also to medical payment coverage. We have held that, where multiple premiums have been paid, the extent of UM coverage available to an insured is the aggregate limit of the coverages purchased on each vehicle.3 The UM coverage stacking rule is based upon the public-policy mandate of 36 O.S.1981 § 3636, the statute that specifically governs UM protection. There exist no statutory or other public-policy requirements which would provide a basis for either invalidating or modifying the medical payment provisions of the insurance policy here in contest. The matter must simply rest on contract between the insurer and its insured.
The policy under scrutiny provides the insured with both UM and medical payment coverage. Although both types of protection entitle him to receive benefits because of bodily injury, medical payment coverage remains manifestly distinct from the statutorily-mandated UM protection. Entitlement to medical payment coverage does not depend on whether bodily injury is sustained as a result of an uninsured motorist's negligence, and insurance companies are not legally required to offer that form of coverage to their insureds.
Clearly, the circumstances surrounding an insured's bodily injury determine the types of coverage from which an insured may benefit. The mere fact that both medical payment and UM coverage can provide compensation for the same class of harm--bodily injury--does not authorize our extension of the specific legislative mandate for UM coverage to medical payment protection.
We hold that, under the facts of this case, the insured is not entitled to stack the medical payment coverage on both his vehicles.4 Our decision is consistent with the vast majority of other jurisdictions that have dealt with the stacking of medical payment coverage under similar conditions.5
The trial court's judgment is affirmed.
I must dissent from the Court's pronouncement that the insured, Gary B. Frank (appellant), is not entitled to aggregate ("stack") medical payment insurance coverage limits of an automobile liability policy insuring more than one automobile where the policy terms preclude stacking.
Although this Court has not addressed itself before today to stacking in the context of medical payments coverage, my view is in accord with many other jurisdictions. E.g., Alabama Farm Bur. Mut. Cas. Ins. Co. v. Presley, 384 So.2d 122 (Ala.Civ.App.1980); Kansas City Fire & Marine Ins. Co. v. Epperson, 234 Ark. 1100, 356 S.W.2d 613 (1962); Central Surety and Ins. Corp. v. Elder, 204 Va. 192, 129 S.E.2d 651 (1963); Southwestern Fire & Casualty Co. v. Atkins, 346 S.W.2d 892 (Tex.Civ.App.1961). See also, 21 A.L.R.3d 900.
I am persuaded that this Court's strong and clear declaration of public policy concerning stacking of uninsured motorist (UM) coverage should extend to medical payments coverage of the same automobile policy. State Farm Mut. Auto. Ins. Co. v. Wendt, 708 P.2d 581 (Okla.1985); Lake v. Wright, 657 P.2d 643 (Okla.1982); Richardson v. Allstate Ins. Co., 619 P.2d 594 (Okla.1980); Keel v. MFA Ins. Co., 553 P.2d 153 (Okla.1976). If multiple premiums have been paid, then multiple coverage exists for the named insured notwithstanding a disclaimer in the policy. In the instant case, the insured has paid two premiums for medical payments coverage. Such coverage is not attributed to the car causing the damage or which car described in the policy that was occupied by the named insureds. He is not receiving a windfall as he has paid the insurer for this protection. The denial of medical coverage for each separate premium would indeed be a violation of our public policy.
There is no fundamental distinction between uninsured motorist benefits and medical pay benefits. Basic fair play and due process dictate that when a person pays a separate premium twice, then the insurer is obligated to honor the commitment of double coverage. Public policy will not let the insurer escape that for which it has charged and for which the insured has paid. If the insurer wants to limit medical pay coverage to one policy, then it should only require the payment of one premium.
I would, therefore, hold that where the insured has paid multiple premiums for medical payments coverage contained in a single policy covering multiple automobiles, the extent of medical payments coverage is the aggregate limit of coverage corresponding to the number of separate premiums paid by the insured regardless of express terms in the policy to the contrary. I would reverse the trial court's judgment and remand the case to the trial court with instructions to enter judgment for the insured.
I am authorized to state that Chief Justice SIMMS, Justice ALMA WILSON and Justice YVONNE KAUGER concur in the views expressed herein.
On June 19, 1980, the appellant Gary B. Frank and his wife Linda Frank were riding together in their 1973 Toyota automobile. Mr. Frank was driving the car and Mrs. Frank was riding as a passenger when they suddenly became involved in a serious automobile accident. Their car was struck by another vehicle driven by an uninsured motorist who was undisputedly negligent. Mrs. Frank was killed in the accident, and Mr. Frank was severely injured. Specifically, Mr. Frank suffered permanent and disabling brain damage as a result of the accident.
Over the following year, medical expenses due to Mr. Frank's injuries totalled $9,792.23 and the funeral expenses for Mrs. Frank totalled $2,610.00. In 1978, Mr. and Mrs. Frank had purchased an...
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