Martin v. American Family Mutual Insurance

SCHUDSON, J.

¶ 15. (dissenting). All agree that if the "regular use" exclusion in Eric Johnsen's policy applies, then the $100,000 coverage under his American Family policy would not be available to supplement the $150,000 paid under his father's American Family policy for Karen Martin's injuries. All agree that whether the "regular use" exclusion precludes such coverage depends on whether it is trumped by Wis. Stat. § 631.43(1), which provides, in part:

When 2 or more policies promise to indemnify an insured against the same loss, no "other insurance" provisions of the policy may reduce the aggregate protection of the insured below the lesser of the actual insured loss suffered by the insured or the total indem*396nification promised by the policies if there were no "other insurance" provisions.

All agree that Eric Johnsen is "an insured" under both his and his father's policies. And, on the strength of the interpretation the Martins present in their careful navigation of the case law, it is relatively clear that a "regular use" exclusion is an " 'other insurance' provision[]" encompassed by the statute.

¶ 16. Thus, the majority correctly concentrates on the pivotal issue in this appeal: whether Eric Johnsen's policy and his father's policy "promise[d] to indemnify an insured against the same loss." See Wis. Stat. § 631.43(1). If not, the "regular use" exclusion of Eric Johnsen's policy applies, precluding coverage under his policy. If so, however, the "regular use" exclusion does not apply because it violates the statute by "reduc[ing] the aggregate protection of [Eric Johnsen] below the lesser of. .. the total indemnification promised by the policies if there were no 'other insurance' provi-sionQ."

¶ 17. The parties' briefs bravely wade through the case law and offer arguable interpretations supporting their respective positions. The majority has analyzed much of that law and provided a plausible interpretation. American Family and the 'majority, however, rely heavily on Agnew v. American Family Mutual Ins. Co., 150 Wis. 2d 341, 441 N.W.2d 222 (1989). But Agnew is significantly distinguishable.

¶ 18. In Agnew, the insured's father had purchased three American Family auto insurance policies — one policy for each of three vehicles he owned. Id. at 343. Here, by contrast, the insured and his father each had purchased one American Family auto insurance policy — each policy for his own vehicle. In Agnew, *397the plaintiff seeking coverage was attempting to aggregate coverage of the insured, who had not purchased any policy, under the insured's father's three policies. Id. at 342-43. Here, by contrast, the plaintiffs seeking coverage (the Martins) are attempting to aggregate coverage of the insured (Eric Johnsen), who had purchased a policy, under the insured's own policy for his own vehicle. These distinctions, I believe should warn us away from any conclusion anchored in Agnew.

¶ 19. Similarly, while the other cases on which the parties rely include passages that may be interpreted to support their arguments, all are factually and, I think, significantly distinguishable. See, e.g., Weimer v. Country Mut. Ins. Co., 216 Wis. 2d 705, 575 N.W.2d 466 (1998). And while the majority's interpretation of the additional case law is plausible, it is, I believe, far from conclusive. Thus, it appears that no case law really resolves this fair debate.

¶ 20. Therefore, I go 'back to basics' — the facts, the insurance policy, and the statute. Doing so, I reduce this case, perhaps all too simply, to this:

(1) Eric Johnsen was an "insured" under both policies.
(2) Both policies insured Eric Johnsen against loss, which in this case was, under Wis. Stat. § 631.32(1), the "same loss" — liability for the injuries suffered by Karen Martin.
(3) The "regular use" exclusion of Eric Johnsen's policy was " 'other insurance'" under the statute, as interpreted by the case law.
(4) Application of the "regular use" exclusion would "reduce the aggregate protection of the insured below... the total indemnification promised by the policies if there were no 'other insurance' provisions."
*398(5) Therefore, the "regular use" exclusion does not apply to reduce Eric Johnsen's coverage for the injuries the Karen Martin sustained.

¶ 21. This conclusion does not violate any of the public policy concerns so apparent in Agnew and several of the other cases on which American Family relies. This reason is clear: Eric Johnsen bought insurance and would be receiving no more than the coverage for which he paid, under the terms of his policy and by operation of Wis. Stat. § 631.43(1).

¶ 22. The majority, echoing Agnew, warns that " 'the purpose of the drive-other-car provision is to prevent a policyholder from insuring all the cars in one household by taking out just one policy and paying only one premium.'" Majority at ¶ 14 (quoting Agnew, 150 Wis. 2d at 350). But, as I have pointed out in distinguishing this case from Agnew, that simply is not the situation in this case. Moreover, as the Martins explain:.

What American Family fails to recognize is that a ruling in the Martins ['] favor will not result in all "regular use" exclusions being declared invalid. Section 631.43,... as a result of a 1995 amendment, specifically allows insurers to "exclude, limit or reduce coverage under s. 632.32(5)(b), (c) or (f) to (j)." Section 632.32(5)(j),... in turn, specifically authorizes "regular use" exclusions to preclude coverage under a policy for losses resulting from the use of a motor vehicle that:
1. Is owned by the named insured, or is owned by the named insured's spouse or a relative of the named insured if the spouse or relative resides in the same household as the named insured.
2. Is not described in the policy under which the claim is made.
*3993. Is not covered under the terms of the policy as a newly acquired or replacement motor vehicle.
A ruling in the Martins ['] favor will thus only invalidate "regular use" exclusions in those rare situations, as here, where a person is operating a nonowned vehicle or a vehicle not owned by a resident of the household. Thus, this Court will not be opening any "Pandora's Box" by ruling in the Martins' favor on appeal.

¶ 23. The majority concludes that "the Martins seek advantage of insurance coverage for which neither Eric Johnsen nor his father paid." Majority at ¶ 14. I disagree. The Martins, who have sustained injuries costing more than the $150,000 provided by the American Family policy for which Eric Johnsen's father paid, are seeking coverage for their injuries by aggregating the additional $100,000 provided by the American Family policy for which Eric Johnsen paid. By operation of Wis. Stat. § 631.43(1), they are entitled to gain that additional coverage under Eric Johnsen's policy.

¶ 24. Therefore, while acknowledging that the majority's interpretation of the case law may have merit, I conclude that this case presents an unprecedented circumstance that properly casts us back to the facts, the policies, and the dispositive statute. Analyzing them in a simple, literal and linear manner, and recognizing that the circumstances here clearly are not those against which Agnew warned, I respectfully dissent.