Giannini v. Proffitt, W2011-00342-COA-R3-CV
| Decision Date | 27 April 2012 |
| Docket Number | No. W2011-00342-COA-R3-CV,W2011-00342-COA-R3-CV |
| Parties | PAUL VINCENT GIANNINI v. AMANDA PROFFITT |
| Court | Tennessee Court of Appeals |
Appeal from the Circuit Court of Shelby County
No. CT-00424308 James F. Russell, Judge
This appeal involves a limitation of liability in an insurance policy. The plaintiff was working in a volunteer capacity for the city. While doing so, the plaintiff sustained injuries in an accident caused by the negligence of the defendant. The plaintiff's medical expenses were paid through the city's on-the-job-injury program. The plaintiff had uninsured motorist coverage under his insurance policy with the appellee insurance company. The appellee insurance company denied the plaintiff's claim based on language in the policy reducing the insurance company's liability by sums paid under laws similar to workers' compensation laws. The insurance company asserted that the city's on-the-job-injury program was similar to workers' compensation. The plaintiff filed this lawsuit, and the plaintiff and the insurance company filed cross-motions for summary judgment on the issue of coverage. The trial court granted summary judgment in favor of the insurance company, finding that the plaintiff's benefits under the city's on-the-job-injury program were similar to workers' compensation. The plaintiff now appeals. We affirm the grant of summary judgment, for the reason stated by the trial court.
Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed
and Remanded
Bradley C. Ball, Lakeland, Tennessee for Plaintiff/Appellant, Paul Vincent Giannini
William M. Jeter, Memphis, Tennessee for Defendant/Appellee, SafeCo Insurance Company of Illinois
FACTS AND PROCEEDINGS BELOW
On September 15, 2007, Plaintiff/Appellant Paul Vincent Giannini ("Giannini") was working in an unpaid volunteer capacity as a reserve police officer with the City of Memphis, directing traffic at an intersection. While doing so, Giannini was struck by the Honda Accord driven by Defendant, Amanda L. Proffitt ("Proffitt"). Giannini sustained serious injuries in the accident, ultimately incurring over $300,000 in medical expenses.
The City of Memphis ("City") is not covered by the Tennessee Workers' Compensation Act. Instead, it adopted an "on-the-job injury" ("OJI") program to compensate injured workers. The OJI program provides coverage for medical expenses and lost wages for City employees who suffer injury, death, or occupational disease during the performance of their jobs. Giannini's injury was covered by the City's OJI program, which paid approximately $324,000 toward his medical expenses. The record does not indicate that Giannini received any other benefits, such as lost wages, presumably because at the time of his injury, he was working for the City in an unpaid and/or temporary position.1
At the time of the accident, Proffitt had a liability insurance policy with insurance carrier Progressive Auto Insurance Company ("Progressive"). The Progressive policy had limits of $25,000.
Additionally, Giannini had his own insurance policy with the unnamed Defendant, Appellee SafeCo Insurance Company of Illinois ("SafeCo"). The SafeCo policy included uninsured/underinsured motorist coverage, with a policy limit of $100,000. In due course, Giannini filed a claim under the SafeCo policy.
On June 16, 2008, SafeCo denied coverage to Giannini. SafeCo noted that its underinsured motorist policy limit was $100,000, and Giannini had received payments of over $300,000 for his medical expenses under the City's OJI program. SafeCo took the position that any available coverage that Giannini would have had under the SafeCo policy would be reducedby the OJI benefits Giannini received. SafeCo relied on a limitation of liability in Part C of the SafeCo Policy entitled "Uninsured Motorist Coverage." This provision states:
SafeCo took the position that Giannini had received payment because of his injury under "workers' compensation law" or a "similar law," namely, the City's OJI program. As the OJI benefits exceeded the SafeCo policy limit, SafeCo maintained that it was not liable to Giannini.
On August 29, 2008, Giannini filed this lawsuit against Proffitt, with SafeCo as an unnamed defendant. In its answer denying liability, SafeCo asserted that "after offsetting the coverage that is available to [Proffitt], and those payments made by the City of Memphis, made under the City of Memphis Workers' Compensations Law or similar law including disability benefits, any and all limits that may be applicable under this policy would be exhausted."
Thereafter, Progressive tendered its policy limit of $25,000 to Giannini. In exchange, Giannini voluntarily dismissed with prejudice all claims against both Proffitt and Progressive. That left the only remaining disputes between Giannini and SafeCo. The trial court entered an order severing the issue of SafeCo's coverage from issues concerning the nature and extent of Giannini's personal injuries.
After the issue of coverage was severed, Giannini filed a motion for summary judgment against SafeCo as to coverage. The motion asserted that SafeCo is contractually obligated to pay Giannini the difference between the $100,000 face value of the policy and the $25,000 Giannini received from Progressive. Giannini contended that the OJI benefits paid for his medical expenses did not affect SafeCo's liability. SafeCo filed a response denying that Giannini was entitled to summary judgment.
SafeCo then filed a cross-motion for summary judgment, based on the limitations of liability policy provision cited above. SafeCo also filed a statement of material undisputed facts in support of its motion. Both parties took the position that there are no material disputed facts relevant to the cross-motions for summary judgment on coverage.
On December 15, 2010, the trial court entered an order granting summary judgment in favor of SafeCo and denying Giannini's motion for summary judgment. The trial court found "that under the same terms and conditions of the policy the limit of liability shall be reduced by all sums paid because of the bodily injury under a similar law of workers' compensation law" and that "the City of Memphis On-The-Job Injury Policy is in fact a similar law to workers' compensation." On this basis, the trial court concluded that "after deducting the medical benefits paid by the City of Memphis, the limit of liability under the underinsured motorist coverage provisions of the policy of insurance offered by [SafeCo] is reduced below the limit and therefore no funds would be payable under the terms and conditions of the [SafeCo] policy."2
Giannini now appeals.
ISSUES ON APPEAL AND STANDARD OF REVIEW
On appeal, Giannini argues that the trial court erred in granting summary judgment in favor of SafeCo.3
The parties agree that there are no genuine issues of material facts in dispute. This being the case, we are left with issues regarding the interpretation of the SafeCo insurance policy, which are questions of law. Wellmont Health Sys. v. Qualls, No. E2009-00918-COA-R3-CV, 2010 WL 3294112, at *2; 2010 Tenn. App. LEXIS 534, at *5 (Tenn. Ct. App. Aug. 20, 2010) ); Victoria Ins. Co. v. Hawkins, 31 S.W.3d 578, 580 (Tenn. Ct. App. 2000). Therefore, we review the trial court's interpretation of the policy language, as well as its grant of summary judgment to SafeCo, de novo with no presumption of correctness. Travelers Indem. Co. of Am. v. Moore & Assocs., Inc., 216 S.W.3d 302, 305 (Tenn. 2007) (citing Allstate Ins. Co. v. Watson, 195 S.W.3d 609, 611 (Tenn. 2006)). See also Martin v. Norfolk Southern Ry. Co., 271 S.W.3d 76, 84 (Tenn. 2008); Warren v. Estate of Kirk, 954 S.W.2d 722, 723 (Tenn. 1997).
ANALYSIS
The issue to be decided in this appeal is whether the SafeCo policy should be interpreted to reduce the amount payable under the policy by the $324,000 in benefits received by Giannini from the City's OJI program. The pertinent language at issue is the limit of liability provision of the SafeCo policy:
C. The limit of liability shall be reduced by all sums:
Giannini first appears to make a policy argument, namely, if SafeCo is allowed to reduce its liability by the City's payment of medical expenses, Giannini will be unable to be fully indemnified, which conflicts with the goal of uninsured motorist insurance, which is to compensate an innocent accident victim for his or her injuries.
However, that policy determination has been made by Tennessee's legislature. Tennessee statutes regarding uninsured motorist insurance coverage reflect a "legislative purpose to provide an insured motorist a right of recovery under the uninsured motorists provisions of his policy only up to the statutory required minimum." Terry v. Aetna Casualty & Surety Co., 510 S.W.2d 509, 513-14 (Tenn. 1974). As noted by SafeCo, Tennessee Code Annotated § 56-7-1205 provides:
Nothing contained in this part shall be construed as requiring the forms of coverage provided pursuant to this part, whether alone or in combination with similar coverage afforded under other automobile liability policies, to afford limits in excess of those that would be afforded had the insured under the policies been involved in an accident with a motorist who was insured undera policy of liability insurance with the minimum limits described in § 55-12-107, or the uninsured motorist liability limits of the insured's policy if the limits are...
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