Martha Lee, Administratrix of the Estate of Robert William Lee v. Nationwide Mutual Ins. Co., 88-LW-2211
| Decision Date | 29 June 1988 |
| Docket Number | 406,88-LW-2211 |
| Parties | Martha LEE, Administratrix of the Estate of Robert William Lee, Deceased, Plaintiff-Appellee, v. NATIONWIDE MUTUAL INSURANCE CO., Defendant-Appellant. |
| Court | Ohio Court of Appeals |
Mollica Gall, Sloan & Sillery Co., James D. Sillery, Athens, for appellant.
Porter Little, Sheets & Frecker, Frank W. Porter, Jr., and John R. Lentes, Pomeroy, for appellee.
DECISION AND JUDGMENT ENTRY
This is an appeal from a judgment entered by the Meigs County Court of Common Pleas finding that Martha Lee, administratrix of the estate of Robert William Lee, deceased, plaintiff below and appellee herein, was entitled to recover $4,148.82 in medical and funeral expenses pursuant to an automobile insurance policy issued by Nationwide Mutual Insurance Co., defendant below and appellant herein.
Appellant assigns the following error:
"I.THE TRIAL COURT ERRED IN FINDING THAT THE "OTHER INSURANCE' PROVISION OF THE DECEDENT'S CONTRACT OF MOTOR VEHICLE INSURANCE WAS AMBIGUOUS AND IN PERMITTING THE STACKING OF THE DECEDENT'S MEDICAL PAYMENTS COVERAGE WITH THE MEDICAL COVERAGE PROVIDED BY ANOTHER MOTOR VEHICLE INSURANCE POLICY."
On January 30, 1987, appellee filed a complaint seeking the sum of $4,148.82 in medical and funeral expenses incurred in the injury and death of appellee's decedent under an automobile insurance policy issued by appellant. On March 18, 1987, appellant filed an answer denying most of the averments of appellee's complaint and further asserting that it was not liable under the issued policy since an "other insurance" limitation applied.
On May 14, 1987, the parties filed the following stipulations of fact:
"1.Plaintiff, Martha Lee, is the duly appointed, qualified and acting Administratrix of the Estate of Robert William Lee, Deceased, and has the capacity to bring this action on behalf of the decedent.
2.On March 22, 1986, the decedent, Robert William Lee, was a passenger occupying a 1983 Chevrolet Camaro owned by Arthur E. Johnson and operated by Patrick V. Johnson in the State of West Virginia, Mason County, on West Virginia Route 62.
3.On March 22, 1986, said 1983 Chevrolet Camaro was involved in an accident whereby it collided with a tree proximately causing the death of Robert William Lee.
4.At the time of said accident, the 1983 Chevrolet Camaro was insured by Defendant, Nationwide Mutual Insurance Co., under Policy No. 92 E 132490 which policy included a $5,000.00 medical payment provision.
5.On April 15, 1986, Defendant Nationwide paid to the Plaintiff the sum of Four Thousand One Hundred Forty-Eight Dollars and Eighty-Two cents ($4,148.82) within its capacity as insurer of the owner of the vehicle, Arthur E. Johnson.
6.The medical and funeral expenses incurred in the injury and death of the decedent, Robert William Lee, amounted to Four Thousand One Hundred Forty-Eight Dollars and Forty-Two Cents ($4,148.42).
7.At the time of his death on March 22, 1986, decedent, Robert William Lee, was the owner of a 1983 Chevrolet truck which was insured by Defendant Nationwide under a Century II auto policy, no. 92 H 265127 which included a $5,000.00 medical pay provision. The decedent paid the policy premium to the Defendant, including $10.80 for the med/pay coverage for the period of 12/19/85 to 04/19/86. (See "Exhibit A".) 9.The medical payments coverage of said policy provided:
Said policy also provided under "Coverage Extensions":
"In addition, you and relatives living in your household are covered 3. while occupying any other motor vehicle not owned by you or a resident relative." 10.The only exclusions, limits and conditions of payment are as follows:
"COVERAGE EXCLUSIONS
This Medical Payments insurance does not apply as follows:
1.It does not cover use by any insured of any vehicle to carry persons or property for a fee. However, shared-expense car pools will not be considered carrying persons for a fee.
2.It does not cover maintenance or use of vehicles in an automobile business operation, such as an auto repair shop, public garage or parking place, sales agency, or service station. However, coverage is provided for the maintenance and use of your auto by you, a member of your household, or anyone associated with you in such a business.
BENEFITS PAYABLEThe amount payable under this coverage to or for one person in one accident is limited as stated in the attached Declarations. Limits apply to each insured vehicle as stated in the Declarations. The stated limit is not increased by the insuring of more than one person or vehicle under this policy. However, the stated limit will be increased 50 percent for a person who is wearing an approved motor vehicle seat belt at the time of an accident.
OTHER INSURANCEIn any loss involving the use of a vehicle you do not own, or being hit by any motor vehicle or trailer, we will pay only the insured benefit over and above the amount of other collectible automobile Medical Payments or Family Compensation insurance.' 11.Demand for payment was duly made on the Defendant Nationwide by the Plaintiff under the medical payment provision of said policy for the medical and funeral expenses of the decedent. Defendant Nationwide has not made payment under decedent's policy # 92 H 265127." On July 24, 1987, the trial court filed an opinion finding that appellant was liable under the policy for the medical and funeral expenses incurred. On August 5 1987, the trial court entered a judgment reflecting its earlier opinion. Appellant's sole assignment of error asserts that the trial court erred in finding that the "OTHER INSURANCE" provision of the decedent's motor vehicle insurance policy was ambiguous and in permitting the stacking of the decedent's medical payments coverage with the medical coverage provided by another motor vehicle insurance policy. Medical payments coverage is commonly provided in insurance policies and is, in effect, an extension of accident and automobile liability insurance coverage. 12A Couch on Insurance 2d (1982), Sec. 48.71, p. 54. In the case at bar, the insurance policy's medical payments coverage provided payment of medical and funeral expenses for the insured decedent and the policy's medical payments coverage extensions included coverage "while occupying any other motor vehicle not owned" by the decedent. Thus, the medical payments provision of the automobile insurance policy covered medical and funeral expenses for the insured decedent, who incurred such expenses while occupying another vehicle which he did not own. However, the medical payments portion of the automobile insurance policy also contained the following pertinent limitation to coverage: "OTHER INSURANCEIn any loss involving the use of a vehicle you do not own, or being hit by any motor vehicle or trailer, we will pay only the insured benefit over and above the amount of other collectible automobile Medical Payments or Family Compensation insurance." (Emphasis added) The purpose of provisions restricting medical payments coverage in terms of other insurance or benefits available from other sources is to avoid a duplication of coverage. 8A Appleman, Insurance Law and Practice (1981), Sec. 4902.75, p. 288. Furthermore, medical payments coverage in insurance contracts is neither mandated nor governed by statute; consequently, it is a matter of contract between the insurer and the insured. Karabin v. State Auto Mut. Ins. Co. (1984), 10 Ohio St.3d 163, paragraph two of the syllabus. Appellant asserts that the "OTHER INSURANCE" limitation concerning the "use of a vehicle" by the insured clearly and unambiguously includes the occupancy of the vehicle by the insured, thereby precluding recovery by appellant herein. The predominant concern is to ascertain the intent of the parties from a reading of the contract in its entirety, and to settle upon a reasonable interpretation of the disputed terms in a manner calculated to give the agreement its intended effect. Dick v. Allstate Ins. Co. (1986), 34 Ohio App.3d 28, 31. The meaning of a contract is to be gathered from a consideration of all its parts, and no provision is to be wholly disregarded as inconsistent with other provisions unless no other reasonable construction is possible. Karabin, supra at p. 167. In order for an anti-stacking or other insurance provision to apply, it must be clear and unambiguous. Karabin, supra; Auto-Owners Mut....
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