Sublimity Ins. Co. v. Shaw
| Decision Date | 08 November 1995 |
| Docket Number | No. 21874,21874 |
| Citation | 127 Idaho 707,905 P.2d 640 |
| Parties | SUBLIMITY INSURANCE COMPANY, a foreign insurance company, Plaintiff-Appellant, v. Craig W. SHAW and Kiere Shaw, husband and wife, Defendants-Respondents. Coeur d'Alene, October 1995 Term |
| Court | Idaho Supreme Court |
Turner, Stoeve & Gagliardi, Spokane, Washington, and Dodson & Raeon, Coeur d'Alene, for appellant. Everett B. Coulter, Jr., Spokane, Washington, argued.
Winston & Cashatt, Spokane, Washington, and Stanley D. Moore, Coeur d'Alene, for respondents. Meriwether D. Williams, Spokane, Washington, argued.
This is an automobile insurance case concerning underinsured motorist (UIM) coverage. We conclude that the UIM coverage at issue in this case entitled the insurer to set off from the maximum liability limit the amount the insured received from the tortfeasor and the amount of medical payments the insurer paid the insured.
THE BACKGROUND AND PRIOR PROCEEDINGS.
While driving her car, Kiere Shaw (Shaw) was severely injured in an automobile accident with a vehicle operated by an underinsured driver (the underinsured motorist). Shaw received the $50,000 limit of the underinsured motorist's liability insurance policy.
Sublimity Insurance Company (Sublimity) insured Shaw under a policy (the policy) which provided $5,000 in medical payments for each person and UIM coverage of $100,000 for each person and $300,000 for each accident. Sublimity promptly paid Shaw $5,000 for her medical costs.
Shaw submitted a UIM claim to Sublimity for the maximum liability limit of $100,000 based on her damages in excess of $155,000 caused by the underinsured motorist. Sublimity paid Shaw $45,000 on this claim. This represented the $100,000 maximum UIM liability limit, less the $50,000 received from the underinsured motorist's insurance and the $5,000 Sublimity had paid for medical costs.
Sublimity sought a declaratory judgment determining that it had paid all it owed under the policy. Shaw and her spouse counterclaimed for the additional $55,000 they contend Sublimity owes them. On cross motions for summary judgment, the trial court ruled that the UIM coverage was ambiguous and ordered Sublimity to pay the Shaws the maximum UIM liability limit of $100,000. The trial court also awarded the Shaws attorney fees and costs pursuant to I.C. § 41-1839 (1991). Sublimity appealed.
THE UIM COVERAGE DOES NOT REQUIRE SUBLIMITY TO PAY SHAW MORE THAN THE AMOUNT IT HAS ALREADY PAID.
Sublimity asserts that the UIM coverage does not require it to pay more than the amount it has already paid Shaw. We agree.
The policy's UIM coverage contains the following clauses:
LIMIT OF LIABILITY
A. The limit of liability shown in the Schedule for this coverage is our maximum limit of liability for all damages resulting from any one accident. This is the most we will pay regardless of the number of:
1. "Insureds;"
2. Claims made;
3. Vehicles or premiums shown in the Declarations; or
4. Vehicles involved in the accident.
However, the limit of liability shall be reduced by all sums paid because of the "bodily injury" by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid under Part A [liability coverage] of this policy. (Emphasis added).
* * * * * *
If there is other applicable similar insurance we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits. However, any insurance we provide with respect to a vehicle you do not own shall be excess over any other collectible insurance. (Emphasis added).
The medical payments coverage of the policy contains the following limitation:
LIMIT OF LIABILITY
* * * * * *
B. Any amounts otherwise payable for expenses under this coverage shall be reduced by any amounts paid or payable for the same expenses under Part A [liability coverage] or Part C [UIM coverage].
The crux of this case is whether the final sentence of the OTHER INSURANCE clause of the UIM coverage is inconsistent with the LIMIT OF LIABILITY clause, making the policy ambiguous. To determine whether a policy is ambiguous, the Court must ask whether the policy " 'is reasonably subject to conflicting interpretation.' " City of Boise v. Planet Ins. Co., 126 Idaho 51, 55, 878 P.2d 750, 754 (1994) (quoting Bondy v. Levy, 121 Idaho 993, 997, 829 P.2d 1342, 1346 (1992)).
On its face, the LIMIT...
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...not apply to the facts of this case, and, therefore, has no bearing on the Court's ambiguity analysis. Cf. Sublimity Insurance Co. v. Shaw, 127 Idaho 707, 905 P.2d 640 (1995) (utilizing applicable A. The setoff provision does not apply to this case. In Shaw, the insured argued that a clause......
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...Justice. This is an automobile insurance case concerning underinsured motorist (UIM) coverage. As we held in Sublimity Ins. Co. v. Shaw, 127 Idaho 707, 905 P.2d 640 (1995), the UIM coverage at issue in this case is clear and unambiguous and entitles the insurer to set-off from the maximum l......