Auto Club Ins. Ass'n v. DeLaGarza

Riley, C.J.

(dissenting). I agree with the general principle set forth by the majority that ambiguities within an insurance contract are to be construed in favor of coverage. As the majority notes, construction of the terms of an automobile insur*221anee policy was addressed by this Court in Raska v Farm Bureau Ins Co, 412 Mich 355, 362; 314 NW2d 440 (1982):1

A contract is said to be ambiguous when its words may reasonably be understood in different ways.
If a fair reading of the entire contract of insurance leads one to understand that there is coverage under particular circumstances and another fair reading of it leads one to understand there is no coverage under the same circumstances the contract is ambiguous and should be construed against its drafter and in favor of coverage.
Yet if a contract, however inartfully worded or clumsily arranged, fairly admits of but one interpretation it may not be said to be ambiguous or, indeed, fatally unclear. [Emphasis added.]

While the majority purports to follow the rule which requires a "fair reading of the entire contract,” in fact it has chosen to hold as ambiguous a fifteen-page insurance contract on the basis of a strained analysis of one sentence.

However, I believe that a fair reading of this automobile insurance contract indicates that the estranged husband of the defendant was not covered under the policy. Moreover, throughout the course of this matter, the defendant has never argued that her estranged husband was intended to be covered, or that she believed he was covered, under her policy. Therefore, I would hold that the uninsured motorist provision of the policy is not ambiguous and that the defendant is not entitled to benefits for the death of Mr. DeLaGarza.

i

The present dispute involves the section of the *222contract titled, "Part IV — Uninsured Motorists Insurance Coverage.” Specifically, under the subtitle "Uninsured Motorists Coverage,” it provides:

We will pay damages for bodily injury which an insured person is legally entitled to recover from the owner or operator of an uninsured motor vehicle. Bodily injury must be caused by accident and arise out of the ownership, operation, maintenance or use of the uninsured motor vehicle.[2]

The majority feels that the first sentence of this paragraph, "does not explicitly limit recovery for bodily injury to those injuries sustained by insured persons.” Ante, p 213. Thus, the majority argues that it could be reasonably understood to mean that the automobile insurance policy provides benefits for the wrongful death of the defendant’s estranged husband merely because he was struck by a hit-and-run motorist. I disagree.

A fair reading of the entire contract begins with the definitions of the emphasized words as provided in the policy. Looking to the definitions in the uninsured motorist section, "Insured Person(s) means: you, if an individual, and any relative, any other person occupying your car.” The general definition section at the beginning of the policy defines "you” to include your spouse. However, the policy definition of "spouse” is clearly limited to "your husband or wife if a resident of your household.” In this case, the defendant’s estranged husband was not a member of the insured’s household and had not been so for the seven years preceding his death. Therefore, as acknowledged by the majority, he was not an insured person under the policy._

*223The definition of "uninsured motor vehicle” includes "a hit-and-run motor vehicle of which the operator and owner are unknown and which makes physical contact with you or a relative, or a motor vehicle which an insured person is occupying . . . Using the same definitional analysis, Mr. DeLaGarza was neither a resident spouse nor an insured person with whom the hit- and-run driver made contact. Further, the car Mr. DeLaGarza was occupying at the time of his accident was not occupied by an insured person. Because Mr. DeLaGarza’s accident did not involve an insured person, an insured person’s automobile, or a car occupied by an insured person, I am not persuaded that the uninsured motorists provision is so ambiguous that it should be read to provide Mrs. DeLaGarza benefits as a result of her estranged husband’s death.

ii

12A Couch, Insurance (2d ed), §45:634, p 127, provides, "[a]n insured or an insured vehicle must be involved in the accident in order to collect under the [uninsured motorist] endorsement.” This Court followed the rule when it decided Ruesing v Aetna Casualty & Surety Co, a companion to Bradley v Mid-Century Ins Co, 409 Mich 1; 294 NW2d 141 (1980). In Ruesing, the insured argued that he should recover benefits under the uninsured motorist provision of his policy because he was legally entitled to recover for the death of his son under the wrongful death act. In rejecting this argument, this Court unanimously held:

Were we to accept this argument, we would attribute to the Legislature an intent to mandate coverage in all cases where a liability insured has *224a relative whose death was caused by a negligent uninsured motorist and whose property, had he died intestate, would devolve in any part upon the insured, although the relative did not reside in the household of the insured and may have been a distant relation living in a different state.
We think that the Legislature meant that uninsured motorist coverage must be provided to protect those "insured thereunder” when they themselves suffer "bodily injury, sickness or disease, including death, resulting therefrom” and not to protect them when loss is incurred as a result of personal injury sustained by others. [409 Mich 41-42.]

The majority attempts to distinguish Ruesing as "an interpretation of statutory language and considerations of legislative intent.” Ante, p 217. However, I remain unpersuaded. While it is true that the present action involves an insurance contract as opposed to a statute, the issue and the insured’s argument in Ruesing were identical to those currently before this Court. Also, the policy language in question in this case was taken verbatim from the statute interpreted in Ruesing, supra.3

It is not unreasonable to assume that insurance companies adopted standard uninsured motorist endorsements from the repealed statute with the expectation that courts would interpret such lan*225guage consistently. For nearly a decade, this Court has provided insurers a legitimate reason to expect that damages compensable under the wrongful death act would not be compensable under an uninsured motorist provision. Just as this Court refused to attribute to the Legislature an intent to "mandate coverage in all cases where a liability insured has a relative whose death was caused by a negligent uninsured motorist,” I would not now attribute such an intent to the plaintiff. To do so would expose all insurers to untold risks from which they reasonably expected to be protected.

in

The majority holds that the plaintiff "has failed to clearly express a limitation on coverage so as to fairly apprise the insured of the extent of the coverage purchased . . . .” Ante, p 214. The implication here is that the insured reasonably expected the extent of her coverage to include benefit payments for the death of her estranged husband. However, the insured has never argued that she expected her uninsured motorist coverage would extend to Mr. DeLaGarza.4

Moreover, the insured has never advanced any evidence of her expectations. During both Mrs. DeLaGarza’s deposition and the summary disposition hearing it was never contended that the insured reasonably expected to invoke her unin*226sured motorist provision as a vehicle to recover wrongful death benefits. In fact, Mrs. DeLaGarza’s initial argument was that the policy did not specifically exclude nonresident spouses from coverage. This argument was correctly rejected by the Court of Appeals. Nevertheless, the Court of Appeals found the uninsured motorist coverage subsection to be ambiguous.

I believe that the analysis offered by Professor Robert E. Keeton in his advancement of the doctrine of reasonable expectations is instructive:

The conclusion is inescapable that courts have sometimes invented ambiguity where none existed, then resolving the invented ambiguity contrary to the plainly expressed terms of the contract document. To extend the principle of resolving ambiguities against the draftsman in this fictional way not only causes confusion and uncertainty about the effective scope of judicial regulation of contract terms but also creates an impression of unprincipled judicial prejudice against insurers. If results in such cases are supportable at all, generally it is because the principle of honoring policyholders’ reasonable expectations applies. [Keeton, Insurance law rights at variance with policy provisions, 83 Harv LR 961, 972 (1970).]

Because the insured has not argued her reasonable expectations were any different than that of the insurer, the "ambiguity” being decided by the majority today appears to be judicially created. Thus, the majority raises the specter of Professor Keeton’s "unprincipled judicial prejudice” against insurers without the saving reason that it supports the reasonable expectations of this policyholder.5

*227CONCLUSION

The Raska Court said that a contract is ambiguous when its words may be "reasonably understood” in different ways. However, in limiting the scope of what is reasonable, this Court continued, "[s]till, the expectation that a contract will be enforceable other than according to its terms surely may not be said to be reasonable.” 412 Mich 362 (emphasis added). In pointing out that the insured does not always prevail if there is an ambiguity, the Court of Appeals has held that "[i]t is still the duty of the courts to determine the true intent of the parties insofar as this is possible. A patently unreasonable interpretation of a contractual ambiguity will not be employed merely to allow the insured to recover his losses.” Smith v Lumbermen’s Mutual Ins Co, 101 Mich App 78, 83; 300 NW2d 457 (1980).

A fair reading of the uninsured motorists section of the policy before us indicates that coverage only applies to the insured person, a resident spouse or relative, or any other person occupying the named insured’s car. Because Mr. DeLaGarza’s death did not involve any of these situations, and because it was not argued that the insured reasonably expected coverage for the death of her estranged husband, I do not find the insurance contract fatally ambiguous. Therefore, I would reverse the decision of the Court of Appeals.

Griffin, J., concurred with Riley, C.J._

Ante, p 213.

The emphasis indicates the words which were printed in bold, block letters in the policy. This was to alert the policyholder that these words were defined within the policy.

MCL 500.3010; MSA 24.13010 provided in pertinent part:

No automobile liability or motor vehicle liability policy . . . shall be delivered or issued for delivery in this state . . . unless coverage is provided therein or supplemental thereto ... for the protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of uninsured motor vehicles, . . . because of bodily injury, sickness or disease, including death, resulting therefrom, unless the named insured rejects such coverage in writing as provided herein.

See Note, A reasonable approach to the doctrine of reasonable expectations as applied to insurance contracts, 13 U Mich J L R 603, 620 (1980). "No coverage or primary liability should be created where none was contemplated by the insured.” The note also provides that the doctrine of reasonable expectations directs a court’s attention on the insured’s reasonable expectations during contract formation, "when the most accurate assessment of the parties’ original intentions may he obtained.” Id. However, the author warns, "[m]ore troublesome is that the only available evidence of an insured’s expectations may be his self-serving testimony.” Id. at 619.

According to Widiss, Uninsured motorist coverage: Observations on litigating over when a claimant is "legally entitled to recover,” 68 Iowa LR 397, 429-430 (1983), over the past twenty-five years of appellate decisions resolving suits over uninsured motorist insurance *227coverage, many of the disagreements regarding the extent of coverage "seem to be more a product of divergent attitudes about the purpose of the insurance than of the actual inadequacies in the definition of the coverage terms.”

The purpose of uninsured motorist coverage reflects a strong public policy in favor of providing indemnification for persons who are injured by uninsured motorists. Id. at 427. In the present case, the defendant was not the person injured. Therefore, her claim is not within the ambit of the policy favoring coverage.