Avery v. Diedrich

SHIRLEY S. ABRAHAMSON, C.J.

¶ 37. {concurring). The court phrases the question presented as follows: "If an insured requests an increase in insurance coverage and the insurance agent has not agreed to procure it, does the agent have a duty to procure it?" Majority op., ¶ 2. The majority opinion answers this easy question "No." Majority op., ¶ 2. I agree with the answer to the question posed.

¶ 38. Nevertheless, I am concerned because, in my opinion, the facts and parties present a more nuanced question than the one the majority opinion answers. In my opinion, the following question is presented by the instant case: If an insured and insurance agent have a pre-existing relationship and a course of past dealing, and if the insured asks the agent to procure increased insurance coverage on an existing insurance policy and the agent explicitly refuses to procure the requested increased insurance coverage but their relationship continues, is the insurance agent liable to the insured when a loss occurs in excess of the policy coverage? The majority opinion does not answer this question.

¶ 39. According to the court of appeals, an insurance agent's duty to the insured includes a duty to act *711with reasonable care, skill, and diligence in procuring the agreed-upon coverage and a duty to act in good faith and follow the insured's direction. Avery v. Diedrich, 2006 WI App 144, ¶¶ 9, 11, 294 Wis. 2d 769, 720 N.W.2d 103. In the present case, no increased coverage was agreed upon between the insurance agent and the insured. Because the insurance agent explicitly advised the insured that the agent would not follow the insured's direction, would not procure the requested increased coverage, and did not accept the obligation to procure the increased coverage, the insurance agent was not liable for failing to procure the increased coverage, according to the court of appeals. Avery, 294 Wis. 2d 769, ¶¶ 10, 12.

¶ 40. The circuit court viewed the case differently and denied the insurance agent's motion for summary judgment.1 The circuit court recognized that unless "special circumstances" exist, an insurance agent has limited duties to the insured. For example, absent special circumstances, an insurance agent ordinarily does not have the duty to advise the insured regarding available insurance. What constitutes special circumstances has been addressed by this court in Nelson v. Davidson, 155 Wis. 2d 674, 456 N.W.2d 343 (1990). The circuit court concluded as a matter of law that no special relationship existed between the insured and the insurance agent in the present case. Neither party argues in this court that the relationship between the insured and the agent amounted to special circumstances.

¶ 41. The circuit court, however, also recognized that insureds have the burden to know their insurance needs and the value of their property, and to communi*712cate requests for coverage to their insurance agents. The insurance agent's duty in the present case, according to the circuit court, was to follow the insured's instructions, which included at a minimum presenting the insured's request to the insurance company and allowing the company to decide whether to write the requested increased coverage. Because the insurance agent failed to honor the insured's request by not forwarding the request to the insurance company, the insurance agent may be liable for breach of the duty under the circuit court's decision.

¶ 42. The instant case presents, in my opinion, the question of the scope of an insurance agent's duty when the parties have a pre-existing relationship and a course of dealing with each other. To reach a decision on the question I framed, a court would have to address, in my opinion, the following arguments (among others) raised in the present case: (1) Did the pre-existing relationship impose a duty on the agent to adhere to the insured's request for increased coverage or at least to forward the request to the insurance company? (2) Was the insurance agent a dual agent, that is, an agent for both the insured and the insurance company, and how does a dual agency affect the relationship between the insured and the agent and the agent's obligations in the present case? (3) If the insurance agent refuses to follow the insureds' instructions, must the insurance agent terminate the agency relationship? (4) Do judicial public policy factors limit or expand the insurance agent's liability in the present case?

¶ 43. The majority opinion perhaps will he interpreted as supplying a "No" answer to the question I framed. Or perhaps the majority opinion will be interpreted as not grappling with the actual fact situation underlying the present case. In that event, the question *713raised by the facts of the present case probably remains unanswered in Wisconsin law and will have to await a definitive answer from this court on another day.

¶ 44. For the reasons set forth, I write separately.

¶ 45. I am authorized to state that Justices ANN WALSH BRADLEY and LOUIS B. BUTLER, JR. join this opinion.

Fond du Lac County Circuit Court, Dale L. English, Judge.