Miralles v. Snoderly, 31554.
| Decision Date | 30 June 2004 |
| Docket Number | No. 31554.,31554. |
| Court | West Virginia Supreme Court |
| Parties | Anthony MIRALLES, III and Madeline Miralles, Plaintiffs Below, Appellants, v. Lloyd L. SNODERLY, Penelope Sue Zangari, dba P & R Trucking, Inc., a West Virginia corporation, and National Union Fire Insurance Company of Pittsburgh, PA., a corporation, Defendants Below. National Union Fire Insurance Company of Pittsburgh, Pa., a corporation, Defendant Below, Appellee. |
William L. Frame, Esq., Paul T. Farrell, Jr., Esq., Wilson, Frame, Benninger & Metheney, Morgantown, for Appellants.
Ancil G. Ramey, Esq., Jennifer R. Anderson, Esq., Steptoe & Johnson, Charleston, for Appellee.
Anthony Miralles, III and Madeline Miralles, plaintiffs below and appellants herein, appeal an order of the Circuit Court of Monongalia County, West Virginia, which granted summary judgment in favor of National Union Fire Insurance Company of Pittsburgh, Pa. (hereinafter "National Union"), a defendant below and appellee herein. At issue in this appeal is whether, under the National Union policy issued to Mr. Miralles' employer, underinsurance motorist benefits are available to Mr. Miralles for injuries he received during the course of his employment as the result of the negligence of a third-party tortfeasor and for which injuries Mr. Miralles received workers' compensation benefits.
For the reasons discussed herein, the circuit court's order granting summary judgment in favor of National Union is hereby reversed and this case is remanded for further proceedings.
Mr. Miralles was employed as a Community Services Specialist with the Northern West Virginia Center for Independent Living (hereinafter "Center for Independent Living"), a non-profit organization.1 On November 18, 1999, Mr. Miralles was driving his own automobile from meetings he attended on behalf of his employer when he was involved in a serious automobile accident. As a result of the accident, Mr. Miralles sustained grave and permanent injuries.2 To date, Mr. Miralles has incurred medical expenses in excess of $780,000.00.
Following the accident, Mr. Miralles made claims against Lloyd L. Snoderly, the at-fault driver, and Mr. Snoderly's employer, Penelope Sue Zangari, doing business as P & R Trucking, Inc.3 Mr. and Mrs. Miralles entered into a settlement agreement with these defendants on or about October 5, 2000, for $1 million, which represents the applicable insurance policy's limits of liability. On or about October 25, 2000, Mr. and Mrs. Miralles also settled their claim for underinsured motorist ("UIM") benefits under their own automobile insurance policy, for $100,000.00. Additionally, Mr. Miralles, whose injuries occurred in the course of his employment with the Center for Independent Living, received workers' compensation benefits.4
Eventually, Mr. Miralles sought UIM benefits under the Center for Independent Living's automobile insurance policy, which was purchased from National Union through the West Virginia Board of Risk and Insurance Management (hereinafter "the Board"), pursuant to W.Va.Code § 29-12-5 [1996]. More precisely, the Center for Independent Living was issued a "Certificate of Liability Insurance" by the Board pursuant to the insurance policy issued to the State of West Virginia. The circuit court found that the subject "policy included `business auto' coverage with an underinsured [UIM] endorsement." Finding of Fact No. 6, December 4, 2002 Order.5 The comprehensive business automobile policy issued to the Center for Independent Living included, in relevant part, "West Virginia Uninsured and Underinsured Motorists Coverage":
We will pay all sums the `insured' is legally entitled to recover as compensatory damages from the owner or driver of an `uninsured' or `underinsured motor vehicle.'
It is undisputed that Mr. Miralles is an "other insured" as defined in the "Certificate of Liability Insurance" issued to the Center for Independent Living.6
The policy at issue also includes Endorsement # 11, "Amendments to Uninsured Motorists and Underinsured Motorists Coverage," which provides:
By letter dated June 22, 2000, National Union, through its authorized representative, AIG Claim Services, Inc., "disclaimed [UIM] coverage" to Mr. Miralles based upon Endorsement # 11, above (hereinafter "the workers' compensation exclusion"). As a result, Mr. and Mrs. Miralles instituted the instant declaratory judgment action in the Circuit Court of Monongalia County for the purpose of determining whether Mr. Miralles is entitled to UIM benefits in this case.
By order entered December 4, 2002, the circuit court granted summary judgment in favor of National Union, concluding, inter alia, that because Mr. Miralles received workers' compensation benefits for his injuries resulting from the subject automobile accident, the workers' compensation exclusion in the subject insurance policy clearly and unambiguously precludes Mr. and Mrs. Miralles from also receiving underinsured motorist benefits.7 It is from this December 4, 2002 order that Mr. and Mrs. Miralles now appeal.
In this appeal, this Court conducts a de novo review of the circuit court's December 4, 2002 order granting summary judgment in favor of National Union: Syl. pt. 1, Glascock v. City Nat. Bank of W.Va., 213 W.Va. 61, 576 S.E.2d 540 (2002).
At issue in this appeal is whether the workers' compensation exclusion to the uninsured/underinsured motorist coverage in the commercial business auto policy covering the Center for Independent Living precludes Mr. and Mrs. Miralles from receiving UIM benefits for injuries Mr. Miralles sustained during the course of his employment as the result of the negligence of a third-party tortfeasor and for which injuries Mr. Miralles also received workers' compensation benefits. National Union argues (and the circuit court agreed) that the denial of UIM coverage in this case is dictated by this Court's decision in Trent, which involved similar facts and an insurance policy with a similar exclusion. See n. 7, supra. Importantly, however, we must acknowledge the fact that resolution of the instant case hinges on the language of the workers' compensation exclusion and whether it applies to an employee's UIM claim under his employer's insurance policy to compensate the employee for work-related injuries caused not by a co-employee or his employer, but by a third party. The omission, in Trent, of any analysis of (or argument regarding)8 this exclusionary language in light of the crucial fact that the plaintiff employee in that case was injured by a third party does not alter our conclusion that the language of the workers' compensation exclusion does not preclude UIM coverage in this case.
As indicated above, pursuant to the disputed exclusionary language in the Center for Independent Living's business auto policy, uninsured and underinsured motorist coverage does not apply to:
[a]ny obligation for which the `insured' may be held liable under any workers' compensation, disability benefits or unemployment compensation law or any similar law.
In Henry v. Benyo, 203 W.Va. 172, 506 S.E.2d 615 (1998), this Court examined comparable statutory language in the context of a similar factual scenario. Even though the disputed language in Henry was statutory rather than contractual, considering their parity, we are constrained to apply the plain meaning of the instant workers' compensation exclusion in a manner consistent with our holding in Henry.
In Henry, a construction company employee was injured in the course of his employment while operating a crane owned by his employer. The employee's injuries were caused by a third party, who had no employment relationship with the injured employee's employer. The injured employee received workers' compensation benefits as a result of his injuries. Additionally, the employee noticed his employer and its insurer that he intended to seek UIM benefits under the employer's motor vehicle insurance policy covering the crane on which he was injured in the event judgment against the third-party tortfeasor exceeded the limits of the tortfeasor's automobile insurance coverage.
...
To continue reading
Request your trial
-
Norris v. National Union Fire Ins. Co.
...that have considered the issue have held the exclusions do not apply when a negligent third party is at fault. In Miralles v. Snoderly, 216 W.Va. 91, 602 S.E.2d 534 (2004), the West Virginia Supreme Court considered whether a workers' compensation exclusion to uninsured motorist coverage in......
-
Reed v. Orme, 33291.
...was inappropriate because this Court's decisions in Henry v. Benyo, 203 W.Va. 172, 506 S.E.2d 615(1998), and Miralles v. Snoderly, 216 W.Va. 91, 602 S.E.2d 534 (2004) (per curiam), permit the recovery of underinsured motorists coverage benefits afforded under an employer's policy of insuran......
-
Thompson v. Avon Prods., Inc.
...Maryland Cas. Co, 144 P.3d 1273, 1278 (Kan. 2006); Cincinnati Ins. Co. v. Samples, 192 S.W.3d 311, 314 (Ky. 2006); Miralles v. Snoderly, 602 S.E.2d 534, 536 (W. Va. 2004); Haman v. Maco Ins. Co., 86 P.3d 34, 35 (Mont. 2004); Frazier v. St. Paul Ins. Co., 880 So. 2d 406, 410 (Ala. 2003); Ela......
-
United Fin. Cas. Co. v. Ball, 18-1657
...negligence claim, and the district court erred in holding that the Worker’s Compensation exclusion applied. See Miralles v. Snoderly , 216 W.Va. 91, 602 S.E.2d 534, 540–41 (2004) (recognizing that the workers’ compensation exclusion to uninsured/underinsured motorist coverage in an employer......