Blevio v. Aetna Ins. Co.

USCA1 Opinion













UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
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No. 94-1318

MARJORIE BLEVIO,
Administratrix of the Estate
of Noah W. Blevio,

Plaintiff - Appellee,

v.

AETNA CASUALTY & SURETY COMPANY, ET AL.,

Defendants - Appellants.

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APPEAL FROM THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF MASSACHUSETTS

[Hon. William G. Young, U.S. District Judge]
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Before

Torruella, Chief Judge,
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Boudin and Stahl, Circuit Judges.
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_____________________

Kevin Truland, with whom Gallagher & Gallagher, P.C., was on
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brief for appellants.
Doris R. MacKenzie Ehrens, with whom Richard W. Murphy and
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Murphy, Lamere & Murphy, P.C., were on brief for appellee.
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October 20, 1994
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TORRUELLA, Chief Judge. Ms. Marjorie Blevio ("Blevio")
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brought a declaratory judgment action, as administratrix of the

estate of her thirteen-year-old son Noah Blevio, against Aetna

Casualty & Surety Company ("Aetna") and Royal Insurance Company

of America, Inc. ("Royal"), to determine the rights and

liabilities of the parties under two motor vehicle underinsurance

policies. The parties filed cross-motions for summary judgment.

The disposition of these motions turned on the issue of whether,

under the law of Connecticut, two insurers, who each provide

underinsured motorist coverage to a party injured in an accident,

can each set off in full, from the limits of their coverage, the

amount of the recovery obtained from the party legally

responsible for the accident. The district court found that each

insurer was not entitled to set off the recovery from the

tortfeasor in full, but rather that the two insurers could only

deduct the amount of the recovery from the aggregated

underinsured motorist coverage limits. For the following

reasons, we affirm.

I. BACKGROUND
I. BACKGROUND
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A. Facts
A. Facts

The parties do not dispute the material facts of this

case. Noah Blevio died on August 9, 1991, from fatal injuries

sustained when he was hit by a pickup truck on June 30, 1991.

The combined limits of the tortfeasors' applicable bodily injury

liability policies totalled $200,000. This amount was offered to

Blevio.


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In addition, Noah Blevio had underinsured motorist

coverage up to $500,000 under his father's Aetna business policy

and up to $300,000 under his brother's Royal policy. Both

policies provided that their underinsured motorist coverage shall

be reduced by the amounts paid by, or on behalf of, the legally

responsible party. Specifically, the uninsured motorist coverage

endorsement of the Aetna Policy provides:

A. Coverage

1. We will pay all sums the "insured" is
legally entitled to recover as damages
from the owner or driver of an "uninsured
motor vehicle"1 . . .

D. Limit of Insurance

***

2. Any amount payable under this
coverage shall be reduced by:

***

b. All sums paid by or for anyone who is
legally responsible. . . .

The uninsured motorist coverage provisions of the Royal policy

provide:

A. We will pay compensatory damages
which an "insured" is legally entitled to
recover from the owner or operator of an
"uninsured motor vehicle" because of
"bodily injury,"

1. Sustained by an "insured," and

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1 The Aetna policy defines an "uninsured motor vehicle" as a
motor vehicle that is underinsured, in that "the sum of all
liability bonds or policies at the time of an 'accident' provides
at least the amounts required by the applicable law where a
covered 'auto' is principally garaged but that sum is less than
the Limit of Insurance of this coverage."

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2. Caused by an accident . . . .

In addition, the endorsement attached to the Royal policy,

entitled "Amendment of Policy Provisions - Connecticut,"

provides:

II. Uninsured Motorists Coverage2

Part C is amended as follows:

***

E. The Limit of Liability provision is
replaced by the following:

Limit of Liability

***

The limit of liability shall be reduced
by all sums:

1. Paid because of the "bodily injury"
by or on behalf of persons or
organizations who may be legally
responsible . . . .

The parties do not dispute that the legally responsible

parties were underinsured and that the underinsured motorist

coverage provided under Aetna's and Royal's policies are

applicable to Blevio's claims. Nor do the parties dispute that

Aetna and Royal are entitled to a setoff by virtue of the

existence of the legally responsible parties' liability payment.

Rather, the only issue is the extent to which liability insurance

payments made on the tortfeasor's behalf can be set off. Blevio

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2 The Royal policy defines "uninsured motor vehicle" as a motor
vehicle "[f]or which the sum of the limits of liability under all
bodily injury liability bonds or policies applicable at the time
of the accident is less than the sum of the limits of liability
for Uninsured Motorists Coverage applicable to each vehicle
insured for this coverage under this policy."

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contends that Aetna and Royal can only share one $200,000 setoff

equal to the amount that Blevio will actually collect from the

tortfeasors. Both Aetna and Royal claim, however, that they are

each entitled to deduct the tortfeasors' $200,000 liability

payment in order to give full effect to their separate

underinsurance setoff provisions, thereby reducing the aggregate

underinsurance coverage available to Blevio from $800,000 to

$400,000.3

B. Procedural History
B. Procedural History

Blevio filed a declaratory judgment action on June 11,

1993, asking that the district court determine the extent to

which Aetna and Royal are entitled to set off the limits of the

available bodily injury liability coverage from the underinsured

motorist coverage of their respective policies. Blevio then

filed a "Motion for Judgment on the Pleadings or for Summary

Judgment." Aetna and Royal cross-moved for summary judgment.

After a hearing, the district court entered judgment

for Blevio. The district court advised Aetna and Royal, however,

that because, at the time, no Connecticut appellate court had

directly addressed the issue, and a split of authority existed

between two Connecticut Superior Court decisions that had

addressed the issue, it would certify the issue presented to the

Supreme Court of Connecticut upon their request. Aetna and Royal

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3 Pursuant to the terms of the insurance contracts, the issue of
whether Blevio is legally entitled to recover, and if so, the
amount of damages, are subject to arbitration. Arbitration has
not yet commenced, but will take place after a final decision in
this case.

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then filed an "Ex Parte Motion for Certification of Question of

Law." The district court vacated the judgment in favor of

Blevio, and allowed certification to the Supreme Court of

Connecticut. The Supreme Court of Connecticut declined the

certification request. On February 24, 1994, the district court

then entered final judgment in favor of Blevio and against Aetna

and Royal. Aetna and Royal now appeal.

II. STANDARD OF REVIEW AND APPLICABLE LAW
II. STANDARD OF REVIEW AND APPLICABLE LAW
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Our review of the district court's grant of summary

judgment is plenary. Alan Corp. v. International Surplus Lines
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Ins. Co., 22 F.3d 339, 341 (1st Cir. 1994). Where, as here, the
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parties do not dispute the facts upon which coverage is allowed

or denied under an insurance policy, and the existence or amount

of coverage depends solely upon a construction of the policy, a

question of law is presented. Id. at 342 (citing Atlas Pallet,
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Inc. v. Gallagher, 725 F.2d 131, 134 (1st Cir. 1984)).
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Therefore, like other questions of law, we are not bound by the

district court's interpretation of the policy. Alan Corp., 22
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F.3d at 342.

The parties do not dispute that Connecticut law

applies. In interpreting Connecticut law, we are bound by

intermediate appellate state court decisions construing state law

unless we are convinced that the highest court of the state would

decide otherwise. Commissioner v. Estate of Bosch, 387 U.S. 456,
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465 (1967); Ground Air Transfer, Inc. v. Westates Airlines, Inc.,
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899 F.2d 1269, 1275 (1st Cir. 1990); see Cola v. Reardon, 787
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F.2d 681, 688 n.5 (1st Cir.), cert. denied, 479 U.S. 930 (1986)
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(stating that the First Circuit was bound to apply a state

appellate court's statement of local law). We note that since

the district court issued its decision in the present case, the

Connecticut Court of Appeals has released a decision, Allstate
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Ins. Co. v. Link, 645 A.2d 1052 (Conn. App. Ct. 1994), that
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resolves the question involved in this appeal. Because we have

no reason to believe that the Connecticut Supreme Court would not

reach a similar result, we are bound to apply this decision.4

III. ANALYSIS
III. ANALYSIS
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Connecticut law requires that each automobile liability

insurance policy provide uninsured motorist coverage for the

protection of persons insured thereunder against operators of

uninsured and underinsured motor vehicles.5 See Conn. Gen. St.
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38a-336(a). The statute requires that each policy provide a

minimum level of uninsured/underinsured motorist protection, but

also prevents an insured from obtaining a double recovery of

damages. See Buell v. American Universal Ins. Co., 621 A.2d 262,
___ _____ ___________________________

266-67 (Conn. 1993).

An insurance company shall be obligated
to make payment to its insured up to the
limits of the policy's uninsured motorist
coverage after the limits of liability
under all bodily injury liability bonds

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4 On September 20, 1994, the Connecticut Supreme Court denied
Allstate Insurance's petition for certification to appeal from
Allstate Ins. Co. v. Link, 645 A.2d 1052 (Conn. App. Ct. 1994).
_________________ ____

5 Statutory provisions applying to uninsured motorist coverage
apply equally to underinsured motorist coverage. Covenant Ins.
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Co. v. Coon, 594 A.2d 977, 978 n.3 (Conn. 1991).
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or insurance policies applicable at the
time of the accident have been exhausted
by payment of judgments or settlements,
but in no event shall the total amount of
recovery from all policies, including any
amount recovered under the insured's
uninsured motorist coverage, exceed the
limits of the insured's uninsured
motorist coverage.

Conn. Gen. St. 38a-336(b). Correspondingly, the insurance

commissioner has adopted a regulation that provides, in pertinent

part, that an insurance policy "may provide for the reduction of

limits [of underinsured motorist liability] to the extent that

damages have been . . . paid by or on behalf of any person

responsible for the injury . . . ." Conn. Agencies Regs. 38a-

334-6(d)(1). The Aetna and Royal policies' underinsured motorist

coverage provisions contain language that essentially track the

Connecticut law, and provide that their policies' liability

limits shall be reduced by any sum paid by, or for, anyone who is

legally responsible.

As noted above, the Connecticut Court of Appeals has

recently construed Conn. Agencies Regs. 38(a)-334-6(d)(1), and

addressed the situation of setoffs in the context of multiple

underinsured motorist coverage in Allstate Ins. Co. v. Link, 645
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A.2d 1052 (Conn. App. Ct. 1994). The Court of Appeals held that

multiple insurers providing underinsured motorist coverage to an

insured cannot each setoff in full the amount of the recovery

from the tortfeasor. Id. at 1058. In Allstate Ins. Co., Link
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was injured when the automobile she was driving was struck by a

vehicle operated by a tortfeasor. Id. at 1054. The tortfeasor's
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insurance company paid $100,000 to Link, exhausting the limits of

the tortfeasor's bodily injury liability coverage. Id. At the
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time of the accident, Link held two separate automobile insurance

policies with Allstate. Id. One policy provided for $200,000 of
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uninsured/underinsured motorist coverage, and the other policy

provided for $400,000 of such coverage. Id. Link claimed
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underinsured motorist benefits under both policies. Id. After
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arbitration, the Connecticut Superior Court found that the

tortfeasor was underinsured, and that Link was entitled to

underinsured motorist benefits from each of the two policies.

Id. The court determined that the amount of available
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underinsured motorist coverage was $600,000, but that each policy

should have deducted from its cumulative limit the sum of

$100,000 previously paid by the tortfeasor. Id. at 1054-55.
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Link appealed, claiming that the court improperly reduced the

amount of underinsured motorist benefits awarded to her by

crediting Allstate with twice the amount actually paid out by the

tortfeasor, thus creating a windfall to Allstate and depriving

Link of a payment of $100,000 due her that she did not receive.

Id. at 1057.
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The Connecticut Court of Appeals agreed and found that

Link was entitled to have available a total of $600,000 in

underinsured motorist benefits under the two Allstate policies.

Id. at 1057-58. While noting that no Connecticut Supreme Court
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case had specifically addressed this issue, the Court of Appeals

stated that some related cases had implied that a tortfeasor's


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contribution should be shared among the policies covering the

insured. Id. at 1057. The court stated:
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The amount of damages paid by the
tortfeasor may reduce the total amount of
underinsured motorist benefits available
to a claimant. It may not reduce the
amounts paid out by each policy. To hold
otherwise would mean that an award due an
insured is reduced unfairly by twice the
amount actually paid out by or on behalf
of the tortfeasor and that an insured is
entitled to double the tortfeasor's
credit merely by issuing separate
policies. Such a result would be
unfairly detrimental to the insured.

Id. at 1058. The court then concluded that from the $600,000
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total, Allstate should have been credited with only the $100,000

actually paid by the tortfeasor. Id.
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A similar result is mandated here. Blevio was entitled

to an aggregate of up to $800,000 of underinsured motorist

benefits under the two policies -- up to $500,000 from the Aetna

policy and up to $300,000 under the Royal policy. Because the

tortfeasor effectively contributed $200,000, Aetna and Royal are

entitled to reduce the total amount of underinsured benefits

available to Blevio, $800,000, to $600,000 of available benefits.

The two insurers must allocate the $200,000 deduction between

them fairly, sharing the loss pro rata to the extent of their

coverage.6

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6 The parties do not challenge the district court's
determination that both Aetna and Royal should be considered
"primary" insurers in the context of this appeal, and that if
this Court upholds the district court's determination that Aetna
and Royal are required to allocate the deduction between them,
they should share the loss pro rata to the extent of their
coverage (i.e., Aetna with $500,000 coverage may take 5/8th or

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For the foregoing reasons, the judgment of the district

court is affirmed.
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$125,000 of the setoff, and Royal with $300,000 coverage may take
3/8th or $75,000).

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