June 9 2010
DA 09-0242
IN THE SUPREME COURT OF THE STATE OF MONTANA
2010 MT 134
ELEANOR MONROE, Individually
and as the Personal Representative
of the Estate of Hugh Monroe,
Plaintiff and Appellant,
v.
COGSWELL AGENCY and SAFECO
INSURANCE COMPANY of ILLINOIS,
Defendants and Appellees.
APPEAL FROM: District Court of the Eighth Judicial District,
In and For the County of Cascade, Cause No. CDV 04-385
Honorable Kenneth R. Neill, Presiding Judge
COUNSEL OF RECORD:
For Appellant:
Thomas A. Marra (argued); Marra, Sexe, Evenson & Bell, P.C.;
Great Falls, Montana
For Appellees:
Richard E. Gillespie (argued); Keller, Reynolds, Drake, Johnson
& Gillespie, P.C.; Helena, Montana (Attorneys for Cogswell Agency)
Carey Matovich (argued); Eric E. Holm; Matovich & Keller, P.C.;
Billings, Montana (Attorneys for Safeco Insurance Company)
For Amicus Montana Trial Lawyers Association:
Lawrence A. Anderson, P.C. (argued); Attorney at Law; Great Falls,
Montana
Amy Eddy; Bottomly & Eddy Trial Attorneys, PLLP; Kalispell, Montana
Argued and Submitted: January 20, 2010
Decided: June 9, 2010
Filed:
__________________________________________
Clerk
Justice W. William Leaphart delivered the Opinion of the Court.
¶1 Appellant Eleanor Monroe (Monroe) appeals from the decision of the Eighth
Judicial District Court, Cascade County, denying her underinsured motor vehicle
coverage and granting summary judgment in favor Safeco Insurance Company (Safeco)
and Cogswell Agency (Cogswell). We affirm in part, reverse in part and remand for
further proceedings.
¶2 We consider the following issues on appeal:
¶3 1. Whether the District Court erred in granting summary judgment in favor of
Safeco.
¶4 2. Whether the District Court erred in granting summary judgment in favor of
Cogswell.
¶5 3. Whether the District Court erred in granting summary judgment on the issue
of whether Cogswell acted as Safeco’s agent.
FACTUAL AND PROCEDURAL BACKGROUND
¶6 On November 19, 2003, Eleanor and Hugh Monroe (the Monroes) were traveling
as passengers in Hugh Monroe’s 2003 Dodge Durango. Their daughter-in-law, Laura
Monroe (Laura) was driving the vehicle and lost control. In the ensuing accident all three
sustained serious injuries. Hugh Monroe suffered the worst injuries and has since died.
¶7 At the time of the accident the Monroes were named insureds on two Safeco
policies which provide coverage for their six vehicles. Under the Monroes’ two policies
bodily injury liability was limited to $100,000 each person and $300,000 each occurrence
while property damage liability was limited at $50,000 each occurrence. In addition,
medical payments under the policy were limited to $5,000. Finally, uninsured motorist
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coverage (UM) and underinsured motorist coverage (UIM) were limited to $100,000 each
person and $300,000 each accident. Laura and her husband Hughie also carried a Safeco
policy for their two vehicles. Laura and Hughie’s policy had the same coverage as the
Monroes.
¶8 Following the accident, the Monroes recovered $5,000 of medical payment
benefits for each of the six vehicles they owned and $5,000 of medical payment benefits
for each of the two vehicles covered under Laura and Hughie’s policy. Safeco also paid
an additional $100,000 to each of the Monroes under both their own policy and Laura and
Hughie’s policy. In total, Safeco paid out $480,000 to the Monroes. Nevertheless, on
April 13, 2004, Monroe, on behalf of herself and in her capacity as the personal
representative of the estate of Hugh Monroe, filed a complaint for declaratory judgment
claiming an entitlement to coverage under the UIM provisions of the insurance policies.
In addition, Monroe claimed that Cogswell, which had helped them secure the Safeco
policies at issue here, was negligent due to the agency’s failure to obtain sufficient
coverages.
¶9 On Safeco’s motion, the District Court granted summary judgment in Safeco’s
favor and certified that judgment as final pursuant to M. R. Civ. P. 54(b). Monroe filed a
notice of appeal which we dismissed without prejudice on December 7, 2006.
Subsequently, the District Court granted Safeco’s motion for summary judgment on the
grounds that Cogswell was not its agent. The District Court also granted Cogswell’s
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summary judgment motion on the grounds that it had no duty to advise the Monroes or to
produce adequate coverage. Monroe appeals.
¶10 Additional facts are set forth below where relevant.
STANDARD OF REVIEW
¶11 Summary judgment is proper only when no genuine issue of material fact exists
and the moving party is entitled to judgment as a matter of law. Newbury v. State Farm
Fire & Cas. Ins. Co. of Bloomington, Ill., 2008 MT 156, ¶ 14, 343 Mont. 279, 184 P.3d
1021. We review a district court’s summary judgment decision de novo using the same
criteria as the district court. Newbury, ¶ 14.
DISCUSSION
¶12 1. Whether the District Court erred in granting summary judgment in favor of
Safeco.
¶13 With respect to Safeco, the controversy here boils down to whether Monroe is
entitled to UIM coverage over and above the $480,000 she has already received from
Safeco under both her own policies and Laura and Hughie’s policy. In granting Safeco’s
motion for summary judgment the District Court, drawing parallels between our
reasoning in Stutzman v. Safeco Ins. Co. of Am., 284 Mont. 372, 945 P.2d 32 (1997) and
the case at bar, opined that in this instance “[t]he insuring language is clear, obvious and
unambiguous to a person of average intelligence.” The District Court held that the policy
language excluding from UIM coverage “any vehicle or equipment . . . [o]wned by or
furnished for the regular use of you or any family member” clearly and unambiguously
barred the Monroes from receiving UIM coverage. The District Court reasoned that since
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the injuries the Monroes sustained occurred in their own vehicle, Safeco was, as a matter
of law, not required to make UIM payments to the Monroes.
¶14 On appeal, the parties vigorously dispute this conclusion. Parroting the District
Court’s ruling, Safeco argues that “[u]nder the contract’s usual, common sense language,
the Durango [in which the accident occurred] is not an ‘underinsured motor vehicle’
because it was owned by Hugh, who is an insured and is Eleanor’s husband (a resident
spouse and family member).” Safeco also contends our decision in Stutzman is both
applicable to, and dispositive of, the controversy presented here. Monroe counters that an
insurance policy, as a contract of adhesion, must be strictly construed with all ambiguities
being resolved in favor of the insured. She asserts that the policy language at issue here
is ambiguous and that the exclusionary provisions are in conflict with the declarations
pages so that “in practically all circumstances, [the] Monroes will recover nothing from
the UIM coverage.” She also maintains that our decision in Stutzman is inapplicable and
that the insurance contract violates public policy.
¶15 It is well established that in construing and analyzing the terms of an insurance
policy we look first to the policy’s plain language. Stutzman, 284 Mont. at 379. In doing
so we apply the “common sense meaning as viewed from the perspective of a reasonable
consumer of insurance products.” Stutzman, 284 Mont. at 376. We have explained that
as with any contract, a court “may not rewrite the contract at issue, but must enforce it as
written if its language is clear and explicit.” Stutzman, 284 Mont. at 376. After
construing the language of the policy itself, we next look at whether, in light of our
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construction, the insurance contract violates public policy. See generally Stutzman, 284
Mont. 372 (construing the policy language first and then looking to public policy in order
to determine if the policy is enforceable). In keeping with this mode of analysis, we turn
first to the policy language of the Monroes’ insurance contract to determine whether its
“common sense meaning” entitles the Monroes to UIM coverage.
¶16 In pertinent part, the UIM provisions of both the Monroes’ and Laura and
Hughie’s insurance policies provide that Safeco:
[w]ill pay damages which any insured is legally entitled to recover from the
owner or operator of an . . . underinsured motor vehicle because of bodily
injury:
1. Sustained by an insured; and
2. Caused by an accident.
The policy defines “underinsured motor vehicle” as:
a land motor vehicle or trailer of any type to which a bodily injury liability
bond or policy applies at the time of the accident but the amount paid for
bodily injury under the bond or policy to an insured is not enough to pay
the full amount the insured is legally entitled to recover as damages.
However, “underinsured motor vehicle” does not include any vehicle or
equipment:
1. Owned by or furnished for the regular use of you or any
family member.
¶17 Under these provisions alone, we agree with Safeco that the plain language of the
policy, clearly excludes the Monroes’ vehicles from the definition of an underinsured
motor vehicle. This so called “owned vehicle” exclusion clearly states that an
underinsured motor vehicle does not include motor vehicles “[o]wned by or furnished for
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the regular use of you or any family member.” It is undisputed that the Monroes owned
both the Dodge Durango in which the accident happened, and the five other motor
vehicles insured under their Safeco policies. As such, all of these vehicles are clearly and
unambiguously excluded from the policy definition of an underinsured motor vehicle.
Since the Monroes’ vehicles are excluded under the plain language of this “owned
vehicle” exclusion, Monroe is not entitled to UIM coverage under her own policies.
Having concluded that the plain language defeats Monroe’s claim to UIM coverage under
her own policies, we now turn to the question of whether this insurance contract violates
public policy.
¶18 With respect to public policy, Monroe first argues that the limiting language in the
Safeco policies violates public policy because it creates illusory UIM coverage. Monroe
contends that with the “owned vehicle” exclusion, the Monroes would have no
underinsured coverage in “virtually all circumstances where the highest probability of
injury would occur to them (riding in one of their six vehicles).” Monroe submits that,
based on our holdings in Hardy v. Progressive Specialty Ins. Co., 2003 MT 85, 315
Mont. 107, 67 P.3d 892 and Mitchell v. State Farm Ins. Co., 2003 MT 102, 315 Mont.
281, 68 P.3d 703, such illusory coverage is an impermissible violation of public policy.
We disagree that the coverage is illusory.
¶19 Once again, we begin our analysis by looking to the plain language of the policy.
Here, while the language makes UIM coverage unavailable for single car crashes that
only involve the insured’s own vehicle, UIM coverage is available in all other accidents
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so long as the accident involves another vehicle that is not owned by the insured. In other
words, even if the Monroes were driving or riding in their own vehicle, as long as another
motor vehicle they did not own was involved in the accident, the policy would provide
UIM coverage to the Monroes. In fact, the only instance in which the “owned vehicle”
exclusion renders UIM coverage per se unavailable is when the accident only involves
the insured’s own vehicle. Accordingly, far from being illusory, Monroe’s contention
that they paid valuable consideration for non-existent UIM coverage is unfounded and
thus, the provisions do not violate public policy.
¶20 Monroe also argues that the District Court erred in relying on Stutzman to support
summary judgment in favor of Safeco. In Stutzman, we concluded that public policy
supports enforcing UIM exclusionary language that denies coverage in a single car
accident if the only vehicle in the accident is owned by the insured. We explained that
“invalidat[ing] an exclusion which prohibits recovery of underinsured motorist benefits
where the vehicle in question is owned by or furnished for the regular use of the named
insured or any relative, would, in effect, convert underinsured motorist coverage into
liability coverage and permit policyholders to substitute inexpensive underinsured
motorist coverage for more expensive liability coverage.” Stutzman, 284 Mont. at 381
(citing Kim v. State Farm Mut. Automobile Ins. Co., 952 F.2d 314, 316 (9th Cir. 1991))
(citations omitted). To avoid this reasoning, Monroe maintains that the concern
expressed in Stutzman over substituting UIM coverage for liability coverage is not
present in this case because Laura and Hughie have a separate Safeco insurance policy of
8
their own. Monroe contends that since she did not demand liability coverage under their
own policy, the monies received from Safeco came first from Laura’s policy ($10,000 in
medical payments plus $100,000 to each of the Monroes) and secondly from the
Monroes’ own policy ($60,000 in medical payments plus $100,000 to each of the
Monroes). Thus, her argument proceeds, the Monroes are free to tap their own UIM
coverage without violating the principle laid out in Stutzman that policy holders should
not be able to substitute inexpensive UIM coverage for more expensive liability
coverage. The plain language of the policies however, makes this argument untenable.
¶21 In relevant part the Monroes’ policies state that:
If there is other applicable liability 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 for a
vehicle you do not own shall be excess over any other collectible insurance.
[Emphasis added.]
This language clearly explains that under the Safeco policies, the initial $200,000 in
liability coverage paid to the Monroes came from their own policy, which covered Laura
as a permissive driver. Rather than being the primary source of liability coverage as
Monroe asserts, Laura and Hughie’s policy provided only secondary “excess” coverage
of $200,000.
¶22 As we reasoned in Stutzman, one of the purposes behind the exclusionary
language is to limit UIM coverage to situations where the injured party has no control
over the tortfeasor’s policy’s limits. In the present case, Laura was the tortfeasor and she
was insured by two liability policies—her own policy and the Monroes’ policy (because
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she was a permissive driver, and, thus an insured). The only way UIM coverage could
potentially be available is if the limits of both policies were exhausted. The Monroes
controlled how much those combined limits would be because one of the policies was
their own. Unlike Lemen v. Allstate Ins. Co., 938 F. Supp. 640 (D. Haw. 1995), in which
the Plaintiff had received liability coverage from a separate policy and sought only UIM
coverage under her father’s policy, Monroe is seeking liability and UIM coverage under
the same policy. Invalidating the exclusionary language of the Monroes’ policies would
create an incentive for policy holders such as the Monroes to substitute inexpensive
underinsured motorist coverage for more expensive liability coverage. This, as we
explained in Stutzman, contravenes public policy. Accordingly, Monroe’s argument that
Stutzman and the public policy concerns underlying that decision are not relevant here is
unfounded. The exclusionary language and public policy concerns support the District
Court’s granting of summary judgment in favor of Safeco.
¶23 The dissent contends that, although the Monroes’ vehicle is an “owned vehicle”
and thus excluded from UIM coverage, the two vehicles owned by Hughie and Laura are
not owned by Hugh and Eleanor and thus not excluded as the basis for UIM coverage.
This argument however, does not account for the plain meaning of the policy exception
which provides that, “[t]he owner’s or operator’s liability for these damages must arise
out of the ownership, maintenance or use of the . . . underinsured motor vehicle.” Here,
Laura’s liability for the Monroes’ damages did not arise out of the ownership of her two
uninvolved vehicles. Rather, her liability arose out of the fact that she was the tortfeasor
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and the negligent driver of the Monroes’ vehicle. Her liability as a driver is independent
of her ownership of two uninvolved vehicles.
¶24 The ownership language upon which the dissent relies would arguably have
application in a situation where John Doe, an owner of a vehicle, allows a permissive
driver to use his vehicle and the driver negligently injures a third party. The driver would
be liable as the user and Doe would be liable as the “owner” of the vehicle involved in
the accident. Here, the vehicles owned by Laura were not involved in the accident and
her ownership of them did not give rise to her liability.
¶25 The dissent’s argument that since Safeco paid $200,000 out of Laura’s policy,
Laura’s liability therefore arises out of her ownership of her own vehicles is untenable.
The $200,000 payment the Monroes received from Laura’s policy came from Laura’s
“Liability Coverage” not from her UIM coverage. Under her policy, Safeco “will pay
damages for bodily injury or property damages for which any insured becomes legally
responsible because of an auto accident.” Safeco’s payment under this “Liability
Coverage” was based solely on Laura’s status as a tortfeasor. It had nothing to do with
the fact that she owned vehicles of her own which were not involved in the accident.
Safeco’s payment under the “Liability Coverage” provision of Laura’s policy does not
trigger an obligation to pay UIM coverage. Rather, as the policy clearly states, UIM
coverage only attaches when the liability arises out of the “ownership, maintenance or
use” of her vehicle. As we have explained above, it did not.
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¶26 2. Whether the District Court erred in granting summary judgment in favor of
Cogswell.
¶27 In its order, the District Court concluded Cogswell was entitled to summary
judgment because Monroe could not, as a matter of law, meet her burden of proving the
causation, duty or breach elements of her negligence claim. On appeal, Monroe argues
that the pleadings, depositions, and affidavits present numerous genuine issues of
material fact which the District Court failed to address and which “preclude summary
judgment as to whether Cogswell was negligent under either a professional or reasonable
man standard.” She points to the following eight genuine issues of material fact that she
claims preclude summary judgment: (1) how Cogswell could procure insurance for the
Monroes and verify what insurance they sought without ever having communicated with
them; (2) whether Cogswell was negligent in failing to advise the Monroes that they had
inadequate coverage; (3) whether Cogswell explained how an umbrella policy worked;
(4) whether Cogswell failed to explain the limits of UIM coverage under the Safeco
policies; (5) whether the Monroes knew they had inadequate coverage and whether they
made a conscious choice to keep inadequate coverage; (6) whether Cogswell’s failure to
assess the financial status of the Monroes was negligent; (7) whether Cogswell acted as
an expert for the purposes of procuring insurance, given Cogswell’s representation to the
Monroes that it had specialized knowledge; and (8) whether in 2003-2004 an umbrella
policy was available in Montana for the Monroes that would have supplemented the
liability, UIM, and UM limits.
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¶28 Cogswell counters that the District Court properly granted summary judgment
because Monroe failed to meet the burden of presenting “material and substantial
evidence . . . to raise a genuine issue of material fact.” Cogswell further maintains that at
the time it procured insurance coverage for the Monroes there was no policy approved in
Montana that would have provided the Monroes with the coverage they now seek.
Cogswell argues that since Monroe did not produce evidence of such a Montana
approved policy, the District Court properly granted summary judgment in favor of
Cogswell.
¶29 It is well established that summary judgment is appropriate when there is no
genuine issue of fact material to the substantive principles upon which the movant relies
for judgment as a matter of law. Richland Natl. Bank & Trust v. Swenson, 249 Mont.
410, 417, 816 P.2d 1045 (1991). In proving her negligence claims, Monroe has the
ultimate burden of proving (1) a duty (2) breached by Cogswell in some way (3) that
caused (4) the damages claimed. Abraham v. Nelson, 2002 MT 94, ¶ 11, 309 Mont. 366,
46 P.3d 628. As a general principle however, we have held that negligence issues are
generally not susceptible to summary judgment adjudication but should be resolved by
trial in the ordinary manner. Fisher v. Swift Transp. Co., 2008 MT 105, ¶ 12, 342 Mont.
335, 181 P.3d 601. Nevertheless, at the summary judgment stage the moving party bears
the initial burden and must “make a clear showing as to what the truth is so as to exclude
any real doubt as to the existence of any genuine issue of material fact.” Toombs v.
Getter Trucking, 256 Mont. 282, 284, 846 P.2d 265 (1993).
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¶30 In determining whether genuine issues of material fact exist, all reasonable
inferences must be drawn in favor of the non-moving party so that if there is any doubt as
to the existence of a genuine issue of material fact, that doubt must be resolved in favor
of the party opposing summary judgment. Lorang v. Fortis Ins. Co., 2008 MT 252, ¶ 38,
345 Mont. 12, 192 P.3d 186; Newbury, ¶ 14. Therefore, not until Cogswell meets its
initial burden to exclude any real doubt as to what the truth is, does the burden shift to
Monroe and force her to “present substantial evidence, as opposed to mere denial,
speculation or conclusory statements . . . .” Thornton v. Flathead Co., 2009 MT 367, ¶
13, 353 Mont. 252, 220 P.3d 395 (citations omitted).
¶31 Turning to the duty element of Monroe’s negligence claim, we note at the outset
that duty is a question of law. Nautilus Ins. Co. v. First Natl. Ins., 254 Mont. 296, 299,
837 P.2d 409 (1992). In its order, the District Court concluded that an insurance agency
does not owe a duty of care to advise clients “as to [their] coverage needs.” Without
concluding that a professional duty of care should never be applied to insurance agencies,
we acknowledge that no such heightened duty of care has yet been recognized under
Montana law. See Lee v. Andrews, 204 Mont. 527, 532-33, 667 P.2d 919 (1983)
(explaining that a duty arises once a client requests specific coverage); see also R.H.
Grover, Inc., v. Flynn Ins. Co., 238 Mont. 278, 777 P.2d 338 (1989). However, we need
not address the issue of a heightened duty in the present case because the facts and
arguments advanced by Monroe do not warrant such consideration. With respect to
whether Cogswell breached a duty of care in failing to advise the Monroes or assess their
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insurance needs, Monroe has relied on the alleged failures of Cogswell’s agent John
David Summerhays (Summerhays). However, the record demonstrates that Summerhays
was not involved in soliciting or procuring the Safeco policy at issue here. Because
Monroe’s claims that Summerhays negligently failed to advise the Monroes or assess
their insurance needs were only relevant to the Hartford policy that Summerhays
procured (the Hartford policy lapsed and is separate from the Safeco policy under which
Monroe’s claims arise), we conclude that the District Court properly determined that
Cogswell was entitled to summary judgment on Monroe’s claims that: (1) Cogswell
negligently failed to advise the Monroes that they had inadequate coverage; (2) that
Cogswell failed to explain how an umbrella policy worked; (3) that Cogswell negligently
failed to explain the limits of UIM coverage under the Safeco policies; (4) that Cogswell
negligently failed to assess the financial status of the Monroes; and (5) that Cogswell
acted as an expert for the purposes of procuring insurance. This conclusion
notwithstanding, summary judgment is not appropriate with respect to whether Cogswell
was negligent is failing to provide the Monroes with higher policy limits.
¶32 It is well established that an insurance agent owes an absolute duty to obtain the
insurance coverage which an insured directs the agent to procure. See Lee, 204 Mont. at
532-33 (citing Gay v. Lavina State Bank, 61 Mont. 449, 458, 202 P.2d 753 (1921)). In
her first amended complaint, Monroe alleged that Cogswell negligently failed to procure
the insurance coverage that the Monroes requested. Thus, the issue at summary judgment
is whether the Monroes requested higher policy limits, and if so, whether Cogswell failed
15
to honor that request. Accordingly, in order to shift the burden to Monroe and require her
to present substantial evidence in support of her claim, Cogswell must make an initial
showing as to what the truth is so as to exclude any real doubt as to the existence of a
genuine issue of material fact. See Farmers Union Mut. Ins. Co. v. Staples, 2004 MT
108, ¶ 18, 321 Mont. 99, 90 P.3d 381 (explaining that the moving party must establish the
absence of a genuine issue of material fact before the burden shifts to the non-moving
party); Toombs, 256 Mont. at 284; Grenz v. Prezeau, 244 Mont. 419, 423, 798 P.2d 112
(1990) (explaining that “[t]he moving party through supporting affidavits first must
demonstrate that a genuine issue of fact does not exist”); Kober v. Stewart, 148 Mont.
117, 122, 417 P.2d 476 (1966). In other words, in order to obtain summary judgment,
Cogswell bore the heavy burden of demonstrating, in a manner sufficient to exclude any
real doubt, that the Monroes did not request higher policy limits than they received.
¶33 Here, in granting Cogswell’s motion for summary judgment, the District Court
specifically acknowledged that Jennifer Webster (Webster), the Cogswell representative
who wrote and sold the Safeco policy to the Monroes, and the only living person who
could shed light on what coverage the Monroes requested, failed to testify or provide an
affidavit. The District Court’s conclusion that summary judgment was appropriate
because “Eleanor cannot remember the details of the transaction . . . Robin and Dave did
not participate in the transaction . . . [and] Hugh died in 2006” improperly placed the
initial burden at summary judgment on the non-moving party. As we have explained, the
initial burden to exclude any real doubt as to what the truth is, rests squarely on
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Cogswell. In moving for summary judgment, Cogswell has made no affirmative showing
of any facts. Rather, in showing that four of five potential witnesses have either died or
have no recollection or knowledge of the events, Cogswell has demonstrated that the case
hinges on the testimony of its former employee Webster. Without a deposition or
affidavit from Webster, Cogswell has not met its initial burden of affirmatively excluding
any real doubt as to the facts. Accordingly, Cogswell did not shift the burden to Monroe
to provide “substantial evidence that raises a genuine issue of material fact,” Glacier
Tennis Club at the Summit, LLC v. Treweek Constr. Co., 2004 MT 70, ¶ 21, 320 Mont.
351, 87 P.3d 431, overruled on other grounds, and the District Court’s grant of summary
judgment was premature.
¶34 While we acknowledge that a complete failure of proof concerning an essential
element of a claim makes judgment appropriate as a matter of law, we cannot conclude
that here there is a complete failure of proof. Without the testimony of Webster, which
Cogswell admits, and the District Court determined, was directly relevant to the issuance
of the Safeco policy at issue, it is premature to conclude that Monroe cannot meet her
ultimate burden at trial. In this instance, where all the parties (and the District Court)
agree that it was Webster who sold the Monroes the Safeco policy, her testimony must be
presented before a court can conclude as a matter of law that Monroe cannot succeed on
her negligence claim. To hold otherwise would ignore the plain language of our case law
which clearly explains that, in order to meet its burden, the moving party, through
supporting affidavits, must make a clear showing as to what the truth is so as to exclude
17
any real doubt as to the existence of any genuine issue of material fact. Furthermore, the
dissent’s concern that our conclusion today will result in sending every case to trial
because litigants will avoid summary judgment by withholding their evidence is
unfounded. This is not an instance of mere speculation as to the existence of a potential
witness on the part of a litigant so as to avoid summary judgment. Here, the District
Court acknowledged, and Cogswell implicitly conceded, that the only individual that can
affirmatively testify as to whether the Monroes requested higher limits is Webster. In the
absence of her testimony, summary judgment is not appropriate.
¶35 The District Court also reasoned that Monroe, having failed to produce an
alternate, more expansive UIM or umbrella insurance policy, could not meet the
causation element of her negligence claim. However, if, as alleged, Monroe requested
higher limits of liability coverage, that request could have been honored within the
context of the Safeco policy that was issued. Monroe did not need to produce a different
or alternative policy in order to prove her claim that she requested higher liability limits.
¶36 3. Whether the District Court erred in granting summary judgment on the issue
of whether Cogswell acted as Safeco’s agent.
¶37 At the outset, we note that for the purposes of determining whether Cogswell and
Safeco had an agency relationship we must first determine whether Cogswell, as an
insurance agency, is an independent soliciting agent or a general agent. An independent
soliciting agent is one that does not have an exclusive relationship with one particular
insurer. Since Cogswell had access to, and offered the policies of, at least six different
18
insurance companies at the time it engaged with the Monroes, Cogswell was acting as an
independent soliciting agent when it performed the insurance transactions at issue here.
¶38 As an independent soliciting agent, the process Cogswell goes through in
obtaining insurance coverage for a client consists of two independent steps. First,
Cogswell discusses the client’s specific situation and individual needs. At that point,
Cogswell has not selected a specific insurer to cover the client’s needs. Second, after the
client has described his or her specific needs, Cogswell selects a specific policy from a
specific insurer to which the client then applies. This distinct two-step process is at the
heart of the agency issue and, although we have not specifically addressed it, our
jurisprudence suggests, and other jurisdictions conclude, that for the purposes of agency
analysis, an independent soliciting agent only becomes an agent of the insurer during the
second step—after it has selected that insurer’s specific policy.
¶39 In Deonier & Assocs. v. Paul Revere Life Ins. Co., 2000 MT 238, 301 Mont. 347,
9 P.3d 622, on which Monroe relies heavily, we addressed the issue of agency between
an insurance agent and the insurance provider and concluded that once an agency selects
a particular policy from an insurer, that agency becomes the agent of that insurer. In that
case, the original plaintiff, Kathryn Vestal, alleged that Deonier had negligently
misrepresented the coverage under the Paul Revere insurance policy that Deonier had
selected for her. In holding that Deonier was the agent of the insurer, we explained that
“for purposes of soliciting and procuring the insurance and preparing the application
[insurance agencies] are agents for the insurer.” Deonier, ¶ 56. Although we did not
19
specifically acknowledge it, our resolution of that case only considered the second step in
the insurance procurement process—after the agent has selected a specific provider’s
policy. We concluded that while an agent who accesses the policies of several insurance
companies and who is solicited by the client to investigate and select the appropriate
insurance company is acting as the agent of the client, once the agency has solicited and
procured a specific policy, that agency becomes an agent of the insurer. Deonier, ¶ 56.
This reasoning is supported by the conclusions of other jurisdictions as well.
¶40 In Etheridge v. Atlantic Mut. Ins. Co., 480 A.2d 1341 (R.I. 1984), the Rhode
Island Supreme Court overturned a lower court’s holding that an insurance agent who
represented numerous insurance companies was the agent of the insurer when
determining the appropriate amount of insurance. The Etheridge Court explained that an
independent soliciting agent is the authorized agent for the insurer only once the agent
has selected a policy from that particular insurer. Etheridge, 480 A.2d at 1346. The
Etheridge Court opined that at all times before the procurement of a specific policy, the
soliciting agent is an agent of the client seeking insurance coverage. Etheridge, 480 A.2d
at 1346.
¶41 The Rhode Island Supreme Court’s decision in Etheridge is eminently sensible
and thus, we reject Monroe’s argument that an agency is an agent of the insurer from the
moment a client solicits the agency to procure insurance. Under such an approach, as
soon as a client solicits an entity such as Cogswell to assist in procuring insurance, all
insurance companies from which the agent could possibly select a policy would become
20
liable through their principal/agent relationship with the insurance agency. Accordingly,
we now explicitly conclude what we implicitly assumed in Deonier—that the insurance
procurement process is logically divided into two steps and only after the insurance
agency solicits a specific policy from a particular insurer does the principal/agent
relationship arise with the insurer. Applying this analytical approach, we now turn to the
specific facts of the case at bar.
¶42 In keeping with the two-step nature of the insurance procurement process, Safeco
argues that “the Monroes’ allegations of negligence against Cogswell fall under the first
step of this process” when Cogswell was acting on behalf of the Monroes not as an agent
of Safeco. To support this contention, Safeco characterizes Monroe’s allegations as
focused on Cogswell’s failure to select appropriate insurance coverage from one of many
insurance carriers with which Cogswell was affiliated. Based on this characterization,
Safeco maintains that no agency relationship existed because at the stage Cogswell’s
negligence was alleged to have occurred, Cogswell had not selected the Safeco policy at
issue. Safeco thus urges that we uphold the District Court’s summary judgment decision
in its favor. While we agree with Safeco that no agency relationship existed with regard
to those allegations of negligence alleged to have occurred before Cogswell selected
Safeco’s policy, we conclude that for at least one of Monroe’s contentions, the alleged
negligence occurred after Cogswell selected the specific Safeco policy and thus, after
Cogswell became Safeco’s agent.
21
¶43 Here, Monroe’s complaint alleges that Safeco and Cogswell negligently failed to
procure “appropriate and/or adequate amounts of coverage” for the Monroes. As we
have already explained, Monroe’s claims regarding Cogswell’s failure to properly assess
their financial status, or explain how an umbrella policy worked were appropriately
resolved in favor of Cogswell at summary judgment. However, throughout the course of
this controversy, Monroe has also contended that Cogswell acted negligently by failing to
procure adequate coverage, including higher policy limits that the Monroes requested.
Monroe’s allegation that Cogswell negligently failed to procure the higher policy limits
they requested, necessarily implies that Cogswell had solicited the specific Safeco policy
at issue—a contention that clearly falls under the second step of the insurance
procurement process and implicates an agency relationship between Cogswell and Safeco
as a matter of law.
¶44 Thus, we affirm the District Court to the extent that its conclusions applied to
Monroe’s claims that were alleged to have occurred before Cogswell selected the Safeco
policy. With respect to Monroe’s allegation that Cogswell negligently failed to procure
the higher policy limits the Monroe’s requested however, we conclude that the District
Court erred and that Cogswell was acting as Safeco’s agent.
¶45 Affirmed in part, reversed in part, and remanded for proceedings in accordance
with this Opinion.
/S/ W. WILLIAM LEAPHART
We concur:
/S/ MIKE MCGRATH
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Justice Michael E Wheat dissents.
¶46 I concur with the Court’s disposition of Issues 2 and 3. I dissent from the Court’s
resolution of Issue 1.
¶47 At the outset, I agree with the Court that it is well established that in construing
and analyzing the terms of an insurance policy, we first look to the plain language of the
policy. See Stutzman v. Safeco Ins. Co. of Am., 284 Mont. 372, 376, 945 P.2d 32, 34
(1997). We “may not rewrite the contract at issue, but must enforce it as written if its
language is clear and explicit.” Id.
¶48 Before looking specifically at the language of the policy, there are several points
to be made: (1) under Part C (UNINSURED/UNDERINSURED MOTORISTS
COVERAGE), the Monroes’ policy provides for UIM coverage from either the owner or
operator of an underinsured vehicle; and, (2) UIM coverage is available after liability
coverage is exhausted under any applicable liability policy. In my view, the plain and
unambiguous language of the Monroes’ policy provides that Laura’s vehicle is
“underinsured” for the purpose of providing UIM coverage.
¶49 Under Part A of both Laura’s and the Monroes’ policies, Safeco’s obligation to
provide liability coverage is described as follows:
We will pay damages for bodily injury . . . for which any insured becomes
legally responsible because of an auto accident.
Laura is a named insured under her own policy, and under the Monroes’ policy, she is a
“person using [the Monroes’] covered auto.” Laura is an “owner” under her own policy,
and she is an “operator” and permissive user under the Monroes’ policy. Safeco was
23
obligated to pay liability coverage—and in fact did pay liability coverage—because
under both policies, Laura was legally responsible for the Monroes’ injuries.
¶50 Under Part C of the Monroes’ policy, Safeco’s obligation to provide UIM
coverage arises from the Monroes’ legal right to recover damages that exceed the liability
coverage from either an owner or operator of an underinsured vehicle. By removing all
language related to operator and leaving only language related to owner, the pertinent
parts of Part C read as follows:
A. We [Safeco] will pay damages which an insured [the Monroes] is
legally entitled to recover from the owner [Laura] . . . of an . . .
underinsured motor vehicle because of bodily injury:
1. Sustained by an insured; and
2. Caused by an accident.
The owner’s [Laura’s] . . . liability [legal responsibility to pay
damages] for these damages must arise out of the ownership . . . of
the . . . underinsured motor vehicle.
. . .
We will pay under Underinsured Motorists Coverage only if . . . :
1. The limits of liability under any applicable bodily injury
liability . . . policies have been exhausted by payment of
. . . settlements . . . .
(Emphasis added.) To me, this language is clear and unambiguous. Laura is the owner
of a motor vehicle covered by an applicable liability policy, the limits of which were paid
to the Monroes because of Laura’s legal responsibility for the Monroes’ injuries in an
auto accident. Under the plain language of the Monroes’ policy, Safeco is obligated to
24
provide UIM coverage because Laura is the owner of an underinsured vehicle as defined
under the policy.
¶51 The Court correctly concludes that under the plain language of the Monroes’
policy, their vehicles are excluded as “underinsured vehicles.” Opinion, ¶ 17. However,
Laura’s vehicle is not excluded as an “underinsured vehicle.” Again, removing all
language related to operator and leaving language related to owner, Part C of the
Monroes’ policy defines an underinsured vehicle as follows:
C. “Underinsured motor vehicle” means a land motor vehicle . . . to
which a bodily liability . . . policy [Laura’s] applies at the time of the
accident but the amount paid for bodily injury under that . . . policy
to an insured [the Monroes] is not enough to pay the full amount the
insured [the Monroes] is legally entitled to recover as damages.
However, “underinsured motor vehicle” does not include any vehicle
...:
1. Owned by . . . you [the Monroes] . . . .
(Emphasis added.) Again, the language is clear and unambiguous. Laura is the owner of
a vehicle covered by a liability policy under which policy limits were paid to the
Monroes. Thus, her vehicle qualifies as an underinsured vehicle under the policy
definition. The only vehicles excluded under the policy definition are those owned by the
Monroes. Laura’s vehicle is not excluded.
¶52 Because the plain, clear, and unambiguous language of the Monroes’ policy is
broad enough to incorporate Laura’s vehicle under its definition of underinsured motor
vehicle, the Monroes are entitled to make a claim for UIM coverage under their policy.
This claim would not violate any of the principles of public policy established in
25
Stutzman—i.e., “double-dipping” from the same policy and converting cheap UIM
coverage to expensive liability coverage when the insured controls the amount of liability
coverage. Stutzman, 284 Mont. at 382, 945 P.2d at 36. The Monroes had no control over
the amount of liability coverage that Laura had obtained for her vehicle.
¶53 To me, the Monroes’ policy clearly provides that Safeco should pay UIM benefits
for any damages in excess of the liability coverage from both the Monroes’ and Laura’s
policy. However, other members of this Court, as well as some of the parties, interpret
this language differently. Although I disagree with their interpretation, it is another
interpretation and as we have held, when the language of the contract is subject to two
interpretations, it is ambiguous. Giacomelli v. Scottsdale Ins. Co., 2009 MT 418, ¶ 32,
354 Mont. 15, 221 P.3d 666. Furthermore, when the language of an insurance contract is
ambiguous, courts construe the ambiguous provisions against the insurer and in favor of
extending coverage. Giacomelli, ¶ 31. Applying these well-established principles of
interpretation of ambiguous insurance contracts, we should conclude that Part C of the
Monroes’ policy is ambiguous as to whether Laura’s vehicle qualifies as underinsured.
¶54 By way of illustration, I note that the Court points to the policy language that
provides, “[t]he owner’s or operator’s liability . . . must arise out of the ownership,
maintenance or use of the . . . underinsured motor vehicle,” for the proposition that
Laura’s liability arose from her use of the Monroes’ vehicle “independent of her
ownership of two uninvolved vehicles.” Opinion, ¶ 23. On the other hand, when the
above language is read in conjunction with the language defining an underinsured motor
26
vehicle as one “to which a bodily injury liability . . . policy applies at the time of the
accident,” I maintain that an equally plausible interpretation is that Laura’s vehicles
qualify as UIM vehicles. Nowhere in the policy does it state that the underinsured
vehicle has to be “involved in the accident,” as asserted by the Court. Opinion, ¶ 24. At
the very least, the definition of an underinsured motor vehicle is ambiguous and can be
read to mean either the Monroes’ vehicle or Laura’s vehicles. Because this language is
ambiguous, we should construe it in favor of the Monroes. Giacomelli, ¶ 31.
¶55 Additionally, the Court states that “the $200,000 payment the Monroes received
from Laura’s policy came from Laura’s ‘Liability Coverage’ not from her UIM
coverage” means that this payment “was based solely on Laura’s status as a tortfeasor”
and had nothing to do with her ownership of vehicles not involved in the accident.
Opinion, ¶ 25. I do not dispute Laura’s status as a tortfeasor. I do dispute that the policy
restricts the tortfeasor to a particular vehicle. The policy language refers instead to “any
applicable bodily injury . . . policies . . . [that] have been exhausted by payment of . . .
settlements” and says nothing about a particular vehicle. Because Laura’s vehicles
provided liability coverage that was exhausted by payment of settlements to the Monroes,
her vehicles qualify as underinsured, thus allowing UIM coverage available to the
Monroes under their policies.
¶56 At the very least, the contrast between my interpretation and the Court’s
interpretation of this policy provision demonstrates that reasonable minds can differ in
their reading of this language. This language is subject to two competing interpretations
27
and therefore is ambiguous. Giacomelli, ¶ 32. I maintain, again, that we should construe
this ambiguity in favor of the Monroes.
¶57 I would therefore reverse the District Court’s grant of summary judgment in favor
of Safeco and remand the case for further proceedings. I dissent from our failure to do
so.
/S/ MICHAEL E WHEAT
District Court Judge Katherine M. Irigoin, sitting for Justice James C. Nelson, joins in the
foregoing dissent.
/S/ KATHERINE M. IRIGOIN
Justice Brian Morris dissents.
¶58 I dissent. I agree with that portion of Justice Wheat’s dissent that deems
ambiguous Part C of the Monroes’ policy. ¶ 53. I believe that Part C presents a situation
where the definition of “underinsured motor vehicle” reasonably could be construed in
two different ways by a consumer with average intelligence, but untrained in the law or
the insurance business. Mitchell v. State Farm Ins. Co., 2003 MT 102, ¶ 26, 315 Mont.
281, 68 P.3d 703. The construction most favorable to the insured must prevail where this
ambiguous definition attempts to exclude the liability of the insurer. Pablo v. Moore,
2000 MT 48, ¶ 17, 298 Mont. 393, 995 P.2d 460. The District Court construed this
28
ambiguous definition in favor of Safeco. I would reverse the District Court’s grant of
summary judgment in favor of Safeco and remand for further proceedings.
/S/ BRIAN MORRIS
Justice Jim Rice, concurring in part and dissenting in part.
¶59 I concur with the Court on Issue 1 and with affirming the claims in favor of
Cogswell under Issue 2. However, I would likewise affirm the entry of summary
judgment on the remaining claim and thus dissent from that portion of Issue 2.1 I would
thus not address the agency relationship between Cogswell and Safeco under Issue 3.
¶60 I part ways with the Court’s conclusion that because Cogswell has not produced
testimony from Jennifer Webster, summary judgment is inappropriate. Opinion, ¶ 33.
The Court states that, because Cogswell is the moving party, it “bore the heavy burden of
demonstrating, in a manner sufficient to exclude any real doubt, that the Monroes did not
request higher policy limits than they received.” Opinion, ¶ 32. While this may be true
in a general sense, the Court overplays the principle and, I believe, distorts the law of
summary judgment. To satisfy its burden as movant, Cogswell needed only to
demonstrate that Monroes had provided no evidence that they had actually requested
1
I understand the Court’s opinion to reverse the District Court’s entry of summary judgment
only on Monroes’ claim that Cogswell should have obtained higher liability limits. Based on
that assumption, I address that claim only.
29
higher policy limits and thus failed to carry their burden to support their claim with
evidence, a burden the Court overlooks.
¶61 In Grenz v. Prezeau, 244 Mont. 419, 420, 426, 798 P.2d 112, 112-13, 116 (1990),
we affirmed the entry of summary judgment in favor of the lawyer-defendant,
recognizing that, while the client-claimant bore the burden of persuasion to support his
claim, “no facts” supported the allegations. We thus concluded that “[a]s a matter of law,
Prezeau is entitled to summary judgment because of the absence of facts indicating that
he negligently handled Grenz’s legal affairs.” Grenz, 244 Mont. at 426, 798 P.2d at 116
(emphasis added).
¶62 This is a common principle of summary judgment recognized by commentators
and other courts. James Wm. Moore, Moore’s Federal Practice vol. 11, § 56.13 (3d ed.,
Mathew Bender Supp. 2010) explains:
In addition to these basic procedural burdens (always imposed on the
movant if summary judgment is to be granted) and counterburdens
(imposed on the nonmovant when movant satisfies its initial burden), the
burden of persuasion applicable to the substantive claims of the case also
plays a role in summary judgment practice. For example, . . . if the movant
is defending the claim at issue, the initial summary judgment burden is
satisfied if the movant establishes that the claimant lacks adequate proof of
an essential element of the claim. Similarly, the substantive trial burden
affects the nonmovant’s procedural burdens. . . . [I]f the nonmovant is a
claimant, its response burden requires it to submit more substantial material
that would support a judgment in its favor after a trial at which nonmovant
bore the burden of persuasion.
(Emphasis added.) See also Charles Alan Wright, Arthur R. Miller & Mary Kay Kane,
Federal Practice and Procedure vol. 10A, § 2727 (3d ed., West 1998). The U.S.
Supreme Court has explained:
30
In our view, the plain language of Rule 56(c) mandates the entry of
summary judgment, after adequate time for discovery and upon motion,
against a party who fails to make a showing sufficient to establish the
existence of an element essential to that party’s case, and on which that
party will bear the burden of proof at trial. In such a situation, there can be
“no genuine issue as to any material fact,” since a complete failure of
proof concerning an essential element of the nonmoving party’s case
necessarily renders all other facts immaterial. The moving party is
“entitled to a judgment as a matter of law” because the nonmoving party
has failed to make a sufficient showing on an essential element of her case
with respect to which she has the burden of proof.
Celotex Corp. v. Catrett, 477 U.S. 317, 322-23, 106 S. Ct. 2548, 2552 (1986) (emphasis
added); see also Lujan v. Natl. Wildlife Fedn., 497 U.S. 871, 884, 110 S. Ct. 3177, 3186
(1990); Corales v. Bennett, 567 F.3d 554, 570 (9th Cir. 2009); Thomson v. Idaho Ins.
Agency, Inc., 887 P.2d 1034, 1037-38 (Idaho 1994); Klose v. N.D., 752 N.W.2d 192, 197
(N.D. 2008); Franks v. Olson, 975 P.2d 588, 593 (Wyo. 1999); Torrealba v. Kesmetis,
178 P.3d 716, 720 (Nev. 2008); Howell v. Spokane & Inland Empire Blood Bank, 818
P.2d 1056, 1059 (Wash. 1991).
¶63 Thus, it is inconsequential that Cogswell produced no statement from Jennifer
Webster. Cogswell satisfied its initial summary judgment burden by demonstrating the
absence of any evidence in support of Monroes’ claim that they had requested Cogswell
to obtain higher liability limits. Cogswell outlined that the Monroes’ daughter, Robin,
had submitted an affidavit stating she had called Cogswell to set up a meeting, but had no
other involvement; Eleanor Monroe could not recall any conversations with Cogswell
because “[a]ll she ever did was pay them”; and, finally, Hugh Monroe had passed away
December 5, 2006, without testifying as to his conversations with Cogswell. Thus,
31
Cogswell demonstrated that the Monroes had failed to provide factual support for their
alleged request of higher limits. The burden then shifted to the Monroes to “present
substantial evidence, as opposed to mere denial, speculation, or conclusory statements,
raising a genuine issue of material fact.” Peterson v. Eichhorn, 2008 MT 250, ¶ 13, 344
Mont. 540, 189 P.3d 615. Monroes might well have satisfied their burden by presenting
an affidavit from Jennifer Webster or other individuals supporting their claim that they
asked for higher limits, but they did not do so. Cogswell is thus entitled to summary
judgment. Although the Court admits “that a complete failure of proof” by Monroes
would entitle Cogswell to summary judgment, Opinion, ¶ 34 (emphasis in original), it
fails to acknowledge that such failure of proof by the Monroes exists here.
¶64 Correctly applying this summary judgment principle becomes all the more
important in light of recent cases. Recently, the Court reversed a district court’s
dismissal of a case on the pleadings, explaining that the plaintiff should be given the
opportunity to prove his case until the point of summary judgment:
We cannot say beyond doubt that McKinnon can prove no set of facts in
support of his claim that would entitle him to relief under these
circumstances. At a minimum, the District Court should have afforded
McKinnon the opportunity to develop the record through discovery to
attempt to show intentional and deliberate action on the part of Western
Sugar. McKinnon’s claim may fail at the summary judgment stage if he
fails through further discovery to establish sufficient evidence to support
his allegations.
McKinnon v. Western Sugar Coop. Corp., 2010 MT 24, ¶ 20, 355 Mont. 120, 225 P.3d
1221 (emphasis added, citations omitted). If a party must neither plead nor prove his
case, then we encourage litigants to withhold their evidence and potentially send every
32
case to trial—one by ambush. The Court reasons that it is “premature” to conclude that
Monroes could not meet their burden at trial, Opinion, ¶ 34, but it is precisely at the
summary judgment stage when Monroes must demonstrate that evidence exists to support
their claim, or face dismissal. They failed to do so.
¶65 I would affirm.
/S/ JIM RICE
Justice Patricia O. Cotter joins in the concurring and dissenting Opinion of Justice Rice.
/S/ PATRICIA O. COTTER
33