Roslyn Clark-Payne
Mark A. Bramble
Wilbert A. Payne
Brent K. Kesner
Beckley, West Virginia
Ellen R. Archibald
Attorneys for the Appellant
Kesner, Kesner & Bramble
Charleston, West Virginia
Attorneys for the Appellee,
Anthem Casualty Insurance Company
Wesley W. Metheney
Paul T. Farrell, Jr.
Wilson, Frame, Benninger & Metheney, PLLC
Morgantown, West Virginia
Barry Hill
Law Offices of Barry Hill
Wheeling, West Virginia
Attorneys for Amicus Curiae,
West Virginia Trial Lawyers Association
JUSTICE DAVIS delivered the Opinion of the Court.
JUSTICE STARCHER concurs and reserves the right to file a concurring opinion.
JUSTICE MCGRAW concurs, in part, and dissents, in part, and reserves the right
to file a concurring and dissenting opinion.
1. 'A determination of the existence of public policy in West Virginia
is a question of law . . . .' Syllabus point 1, [in part,] Cordle v. General Hugh Mercer
Corp., 174 W. Va. 321, 325 S.E.2d 111 (1984). Syllabus point 1, in part, Page v.
Columbia Natural Resources, Inc., 198 W. Va. 378, 480 S.E.2d 817 (1996).
2. The Uninsured Motorist Law, Chapter 33, Article 6, Section 31,
Code of West Virginia, 1931, as amended, governs the relationship between an insured and
insurer and provisions within a motor vehicle insurance policy which conflict with the
requirements of the statute, either by adding to or taking away from its requirements are
void and ineffective. Syllabus point 1, Bell v. State Farm Mutual Automobile Insurance
Co., 157 W. Va. 623, 207 S.E.2d 147 (1974).
3. Insurers may incorporate such terms, conditions and exclusions in
an automobile insurance policy as may be consistent with the premium charged, so long
as any such exclusions do not conflict with the spirit and intent of the uninsured and
underinsured motorist statutes. Syllabus point 3, Deel v. Sweeney, 181 W. Va. 460, 383
S.E.2d 92 (1989).
4. An 'owned but not insured' exclusion to uninsured motorist coverage
is valid and enforceable above the mandatory limits of uninsured motorist coverage
required by W. Va. Code §§ 17D-4-2 (1979) (Repl. Vol. 1996) and 33-6-31(b) (1988)
(Supp. 1991). To the extent that an 'owned but not insured' exclusion attempts to preclude
recovery of statutorily mandated minimum limits of uninsured motorist coverage, such
exclusion is void and ineffective consistent with this Court's prior holding in Syllabus
Point 2 of Bell v. State Farm Mutual Automobile Insurance Company, 157 W. Va. 623,
207 S.E.2d 147 (1974). Syllabus point 4, Imgrund v. Yarborough, 199 W. Va. 187, 483
S.E.2d 533 (1997).
5. When an insurer incorporates, into a policy of motor vehicle
insurance, an exclusion pursuant to W. Va. Code § 33-6-31(k) (1995) (Repl. Vol. 1996),
the insurer must adjust the corresponding policy premium so that the exclusion is
consistent with the premium charged.
6. When an insurer has failed to satisfy the statutory criteria of W. Va.
Code § 33-6-31(k) (1995) (Repl. Vol. 1996) requisite to incorporating an exclusion in a
policy of motor vehicle insurance, the enforcement of such an exclusion is violative of this
State's public policy.
7. An insurance company seeking to avoid liability through the
operation of an exclusion has the burden of proving the facts necessary to the operation of
that exclusion. Syllabus point 7, National Mutual Insurance Co. v. McMahon & Sons,
Inc., 177 W. Va. 734, 356 S.E.2d 488 (1987).
8. An insurer wishing to avoid liability on a policy purporting to give
general or comprehensive coverage must make exclusionary clauses conspicuous, plain,
and clear, placing them in such a fashion as to make obvious their relationship to other
policy terms, and must bring such provisions to the attention of the insured. Syllabus
point 10, National Mutual Insurance Co. v. McMahon & Sons, Inc., 177 W. Va. 734, 356
S.E.2d 488 (1987).
Davis, Justice:
The appellant herein and plaintiff below, Paul Mitchell [hereinafter
Mitchell], as executor of the estate of Mary S. Mitchell [hereinafter Ms. Mitchell or
the decedent], appeals from an April 15, 1998, order entered by the Circuit Court of
Raleigh County. In that order, the circuit court awarded summary judgment and
declaratory judgment to the appellee herein and defendant below, Anthem Casualty
Insurance Company [hereinafter Anthem],See footnote 1
1
and ruled that Anthem was obligated to pay
to Mitchell, under the owned but not insured exclusion contained in the decedent's
policy of motor vehicle insurance, uninsured motorist [hereinafter UM] benefits equal
to the statutorily required minimum limits of such coverage, i.e., $20,000. See W. Va.
Code § 17D-4-2 (1979) (Repl. Vol. 1996); W. Va. Code § 33-6-31(b) (1995) (Repl. Vol.
1996). Mitchell appealed the circuit court's decision to this Court and argued that the
owned but not insured exclusion should be declared void and that he should be permitted
to recover the full amount of uninsured motorist benefits provided for in the decedent's
Anthem policy, i.e., $300,000. We previously upheld the circuit court's order in a per
curiam opinion filed on July 16, 1999. See Mitchell v. Broadnax, No. 25539 (W. Va. July
16, 1999) (per curiam). Following Mitchell's petition for rehearing, we concluded that
justice required us to revisit the public policy attending the enforcement of owned but not
insured exclusions to motor vehicle insurance coverage, noting in our August 31, 1999,
rehearing order that our reconsideration of this case would be limited to the public
policy issue. Upon a second review of the pertinent authorities, the record presented for
appellate review, and the parties' arguments, we conclude that we cannot definitively
determine whether the circuit court's ruling was in error. Our decision of this case is
hindered by the absence, in the appellate record, of two vital pieces of information: (1)
evidence regarding whether Anthem, in incorporating the exclusionary language into Ms.
Mitchell's policy, charged her a premium consistent with such limitation of coverage and
(2) any indication that the circuit court considered whether Anthem had met the statutory
requirements of W. Va. Code § 33-6-31(k) (1995) (Repl. Vol. 1996) requisite to
incorporating such a policy exclusion. Accordingly, we vacate the ruling of the circuit
court and remand the matter for further proceedings consistent with this opinion.
Ms. Mitchell and Naomi jointly owned the Grand Am,See footnote 4
4
which was insured by a policy of
motor vehicle insurance issued by Kentucky National Insurance Company [hereinafter
Kentucky National].See footnote 5
5
In addition, Ms. Mitchell, who was a passenger in the Grand Am
at the time of the accident, held a policy of motor vehicle insurance for her separately
owned vehicle, a 1981 Buick Century, which policy had been issued by Anthem.See footnote 6
6
As a
result of the accident, Ms. Mitchell sustained numerous injuries, and it is averred that
these injuries contributed to her subsequent death in late March, 1997.
After unsuccessful attempts to recover the UM benefits provided by the
Kentucky National and Anthem policies, Paul Mitchell, on behalf of Ms. Mitchell,See footnote 7
7
filed
this action on March 24, 1997, in the Circuit Court of Raleigh County, seeking to collect
the UM benefits provided by both the Kentucky National and Anthem policies.See footnote 8
8
Kentucky
National ultimately settled with Mitchell and tendered the full policy limits of UM
coverage, i.e., $100,000.See footnote 9
9
Anthem, however, denied coverage based upon an owned but
not insured exclusion contained in that policy, which reads:
We do not provide Uninsured Motorists Coverage under this
endorsement for property damage or bodily injury sustained by
any person while occupying, or when struck by, any motor
vehicle owned by you or any family member which is not
insured for Uninsured Motorists Coverage under this policy.
This includes a trailer of any type used with that vehicle.
Following Anthem's motion for summary judgment and declaratory judgment, the circuit
court, in an order entered April 15, 1998, found the exclusion to be valid and enforceable
above the minimum statutory limits of UM coverage, consistent with our recent holding
in Imgrund v. Yarborough, 199 W. Va. 187, 483 S.E.2d 533 (1997).See footnote 10
10
The court also
ruled that Anthem's liability to the plaintiff is limited to the statutory minimum limit of
uninsured motorist benefits of $20,000.00, per person.See footnote 11
11
Thereafter, Anthem tendered
these benefits to Mitchell,See footnote 12
12
and Mitchell appealed to this Court.
In our first decision of Mitchell's appeal, which was filed on July 16, 1999,
and rendered per curiam, we upheld the circuit court's ruling. See Mitchell v. Broadnax,
No. 25539 (W. Va. July 16, 1999) (per curiam). Upon Mitchell's petition for rehearing,
we determined the need to further examine the public policy issues inherent in the
enforcement of owned but not insured exclusions to motor vehicle coverage, based
largely upon our conclusion that the parties had not adequately briefed this issue in their
original appellate briefs.See footnote 13
13
Accordingly, in our August 31, 1999, order granting rehearing,we instructed the parties that our reconsideration of this case would be limited to a
consideration of whether the 'owned but not insured' exclusion is against public policy
as set forth in West Virginia statutes and/or in case law, and requested their briefs on
rehearing to address the same. Our determination of that narrow issue follows.
In addition to the procedural posture of this case, we also must consider the
legal issue at the heart of this matter in determining the applicable standard of review. As
we previously have upheld the validity of exclusions to motor vehicle insurance coverage
generally, see Syl. pt. 3, Deel v. Sweeney, 181 W. Va. 460, 383 S.E.2d 92 (1989),See footnote 14
14
and
of owned but not insured exclusions specifically, see Syl. pt. 4, Imgrund v. Yarborough,
199 W. Va. 187, 483 S.E.2d 533 (1997),See footnote 15
15
we are primarily concerned in this appeal with
the public policy considerations attending the incorporation of such exclusions into policies
of motor vehicle insurance. Generally, '[a] determination of the existence of public
policy in West Virginia is a question of law . . . .' Syllabus point 1, [in part,] Cordle v.
General Hugh Mercer Corp., 174 W. Va. 321, 325 S.E.2d 111 (1984). Syl. pt. 1, in
part, Page v. Columbia Natural Resources, Inc., 198 W. Va. 378, 480 S.E.2d 817 (1996).
Accordingly, the appropriate standard of review for our deliberation and determination of
the public policy issue also is plenary:
'Where the issue on an appeal from the circuit court is
clearly a question of law or involving an interpretation of a
statute, we apply a de novo standard of review.' Syllabus
point 1, Chrystal R.M. v. Charlie A.L., 194 W. Va. 138, 459
S.E.2d 415 (1995). Syllabus point 2, Webster County
Commission v. Clayton, ___ W. Va. ___, ___ S.E.2d ___
(No. 25625 July 16, 1999).
Syl. pt. 1, State ex rel. McGraw v. Combs Services, ___ W. Va. ___, ___ S.E.2d ___
(No. 26196 Dec. 10, 1999). Having ascertained the relevant standards of review, we
proceed to consider and decide the parties' arguments.
Issuing its opinion, the Court ultimately found the owned but not insured
exclusions to be void and inoperative to preclude Bell's recovery of UM benefits under her
and her father's policies of insurance. To reach this conclusion, the Court first examined
the public policy attending this State's motor vehicle insurance laws:
As automobile transportation has attained a pervasive
status in the organization of society and commerce, the State
has a legitimate interest in assuring that the burden of loss in
owning, operating, and maintaining automobiles be justly and
equitably distributed. For this reason the Legislature has
enacted the West Virginia Uninsured Motorist Law, Code, 33-
6-31, as amended, which contains specific requirements
applicable to insurance underwriters. This statute regulates,
in part, the relationship between an insured and the insurer,
and, therefore, an insurance contract cannot alter the terms as
provided by the statute. . . .
Bell, 157 W. Va. at 627, 207 S.E.2d at 150. Recognizing the State's preeminent interest
in protecting its citizens from the financial burdens of collisions with uninsured motorists,
this Court held that policies of motor vehicle insurance are required to comply with the
statutory requirements of W. Va. Code § 33-6-31.
The Uninsured Motorist Law, Chapter 33, Article 6,
Section 31, Code of West Virginia, 1931, as amended, governs
the relationship between an insured and insurer and provisions
within a motor vehicle insurance policy which conflict with the
requirements of the statute, either by adding to or taking away
from its requirements are void and ineffective.
Syl. pt. 1, Bell, 157 W. Va. 623, 207 S.E.2d 147. Then, invalidating the owned but not
insured exclusion at issue in that appeal, the Bell Court ostensibly found that such a
limitation of coverage conflicted with the statutory requirements requiring UM insurance:
An exclusionary clause within a motor vehicle insurance
policy issued by a West Virginia licensed insurer which
excludes uninsured motorist coverage for bodily injury caused
while the insured is occupying an owned-but-not-insured motor
vehicle is void and ineffective under Chapter 33, Article 6,
Section 31, Code of West Virginia, 1931, as amended.
Syl. pt. 2, id. Therefore, the owned but not insured exclusions were deemed to be void,
and Bell was permitted to recover her requested UM benefits.
Following Bell, the legal history of motor vehicle exclusions momentarily
veered off the path of judicial precedent and turned sharply towards the legislative arena.
In 1979, the West Virginia Legislature substantially amended the UM law of this State by
adding to W. Va. Code § 33-6-31 a new subsection (k). This amendment, which expressly
authorized insurers to incorporate exclusions to coverage in their policies of motor vehicle
insurance, provided:
(k) Nothing contained herein shall prevent any insurer
from also offering benefits and limits other than those
prescribed herein, nor shall this section be construed as
preventing any insurer from incorporating in such terms,
conditions and exclusions as may be consistent with the
premium charged.[See footnote 18
18
]
W. Va. Code § 33-6-31(k) (1979) (Repl. Vol. 1982) (emphasis added) (footnote added).
Thereafter, this Court was presented with another case involving owned but
not insured exclusions to motor vehicle insurance, Deel v. Sweeney, 181 W. Va. 460, 383
S.E.2d 92 (1989). Unlike the plaintiff in Bell, however, Deel attempted to recover
underinsured motorist [hereinafter UIM] benefits. Plaintiff Deel was involved in an
accident with Sweeney. Sweeney was an uninsured motorist, but the vehicle he was
driving at the time of the accident, which was owned by Ramsey, was insured.
Additionally, Deel owned the vehicle he was driving at the time of the accident and insured
the same, but he did not carry UIM coverage. After recovering insurance benefits from
Ramsey's insurer, Deel attempted to recover UIM benefits from his father's policy of
motor vehicle insurance.See footnote 19
19
This policy, like the ones at issue in Bell, contained an owned
but not insured exclusion upon which the issuing insurer based its declination of UIM
coverage. Deel, 181 W. Va. at 461-62, 383 S.E.2d at 93-94.
In deciding Deel, this Court considered its prior decision in the Bell case and
reiterated those tenets by holding that [s]tatutory provisions mandated by the Uninsured
Motorist Law, W. Va. Code § 33-6-31 [1988] may not be altered by insurance policy
exclusions. Syl. pt. 1, Deel, 181 W. Va. 460, 383 S.E.2d 92. Despite this admonition,
the Court recognized the substantial impact of the Legislature's adoption of subsection (k)
to W. Va. Code § 33-6-31, the practical effect of which was the allowance of motor
vehicle insurance exclusions.
Insurers may incorporate such terms, conditions and
exclusions in an automobile insurance policy as may be
consistent with the premium charged, so long as any such
exclusions do not conflict with the spirit and intent of the
uninsured and underinsured motorist statutes.
Syl. pt. 3, Deel v. Sweeney, 181 W. Va. 460, 383 S.E.2d 92. Based upon this permissive
provision and the fact that UIM coverage is optional, and not mandatory, as is the case
with UM coverage, 181 W. Va. at 463, 383 S.E.2d at 95, the Deel Court held the owned
but not insured exclusion valid and quashed Deel's attempt to recover UIM benefits under
his father's insurance policy.
This brings us now to our most recent decision impacting the viability of
owned but not insured exclusions, Imgrund v. Yarborough, 199 W. Va. 187, 483 S.E.2d
533 (1997).See footnote 20
20
The facts of Imgrund are akin to those presented by Bell and Deel. Imgrund
was involved in an accident while he was riding a motorcycle which he owned and for
which he had purchased motor vehicle insurance. Yarborough, the other driver involved
in the accident, was uninsured. Imgrund successfully recovered UM benefits from his own
insurance policy, and, as he was living with his parents at the time of the accident,
attempted to collect additional benefits from his parents' policy of motor vehicle insurance,
which insured their two vehicles. Again, however, the policy under which the plaintiff
sought to recover contained an owned but not insured exclusion to coverage, and the
issuing insurer denied coverage on this basis. 199 W. Va. at 188-89, 483 S.E.2d at 534-
35.
When faced with the question of the exclusion's validity in Imgrund, we were
forced to reconcile our prior decisions in this field. On the one hand, Bell expressly
denied the validity of owned but not insured exclusions, while on the other hand, Deel
acknowledged the Legislature's allowance of motor vehicle insurance exclusions and found
such a limitation to be valid and effective in denying UIM benefits. 199 W. Va. at 192,
483 S.E.2d at 538. Appreciating this inconsistency, this Court in Imgrund carefully
balanced our conflicting precedents while adhering to the statutory provisions governing
UM insurance and enabling insureds to purchase optional UM coverage above the statutory
minimum limits thereof.
An owned but not insured exclusion to uninsured
motorist coverage is valid and enforceable above the
mandatory limits of uninsured motorist coverage required by
W. Va. Code §§ 17D-4-2 (1979) (Repl. Vol. 1996) and 33-6-
31(b) (1988) (Supp. 1991). To the extent that an owned but
not insured exclusion attempts to preclude recovery of
statutorily mandated minimum limits of uninsured motorist
coverage, such exclusion is void and ineffective consistent with
this Court's prior holding in Syllabus Point 2 of Bell v. State
Farm Mutual Automobile Insurance Company, 157 W. Va.
623, 207 S.E.2d 147 (1974).
Syl. pt. 4, Imgrund v. Yarborough, 199 W. Va. 187, 483 S.E.2d 533. We therefore found
the owned but not insured exclusion in Imgrund's parents' policy to be valid.
Having recounted the historical treatment of owned but not insured
exclusions to motor vehicle insurance coverage in this State, we turn our attention to the
facts and circumstances of the instant appeal. In this case, like Imgrund and Bell, the
plaintiff seeking to recover UM benefits was involved in an accident with an uninsured
motorist. See Imgrund, 199 W. Va. at 188, 483 S.E.2d at 534; Bell, 157 W. Va. at 624,
207 S.E.2d at 148. Furthermore, Ms. Mitchell, who partly-owned the accident vehicle,
like Imgrund, who wholly-owned the accident vehicle, recovered the full policy limits of
UM benefits from the insurance company providing coverage for the vehicle involved in
the collision. See Imgrund, 199 W. Va. at 189, 483 S.E.2d at 535. Unlike Imgrund,
however, and more akin to the insurance facts of Bell, Ms. Mitchell also sought to collect
benefits from her own policy of insurance which insured her separately-owned vehicle, but
was precluded from doing so by the owned but not insured exclusion contained in that
policy.See footnote 21
21
See Bell, 157 W. Va. at 625-26, 207 S.E.2d at 149. As we have yet to consider
this particular fact pattern in light of the Legislature's allowance of insurance policy
exclusions pursuant to W. Va. Code § 33-6-31(k), we must therefore determine whether
enforcement of the owned but not insured exclusion, under these circumstances, violates
the public policy of this State.
In deciding whether a public policy violation is imminent, we consider both the facts and the law relevant to our inquiry. Stated otherwise, decision of a public policy issue is a legal query, but such a determination is made on a case-by-case basis: '[i]t is a question of law which the court must decide in light of the particular circumstances of each case.' Morris v. Consolidation Coal Co., 191 W. Va. 426, 433 n.5, 446 S.E.2d 648, 655 n.5 (1994) (quoting Cordle v. General Hugh Mercer Corp., 174 W. Va. at 325, 325 S.E.2d at 114 (quoting Allen v. Commercial Cas. Ins. Co., 131 N.J.L. 475, 477-78, 37 A.2d 37, 39 (1944) (citations omitted))). Where public policy issues are concerned,
[t]he rule of law, most generally stated, is that 'public policy'
is that principle of law which holds that 'no person can
lawfully do that which has a tendency to be injurious to the
public or against public good . . .' even though 'no actual
injury' may have resulted therefrom in a particular case 'to the
public.' . . .
The sources determinative of public policy are, among
others, our federal and state constitutions, our public statutes,
our judicial decisions, the applicable principles of the common
law, the acknowledged prevailing concepts of the federal and
state governments relating to and affecting the safety, health,
morals and general welfare of the people for whom
government--with us--is factually established.
Id. With these precepts in mind, then, we must carefully weigh the factual and legal
components of the instant appeal.
At the center of the instant controversy is the policy of motor vehicle
insurance provided by Anthem to Ms. Mitchell and containing a limitation to her UM
coverage in the form of an owned but not insured exclusion.See footnote 22
22
The mandatory nature
of UM insurance is well-established in the law of this State. W. Va. Code § 33-6-31(b);
Syl. pt. 1, in part, Miller v. Lambert, 195 W. Va. 63, 464 S.E.2d 582 (1995) (Uninsured
motorist insurance coverage is mandatory.); Deel, 181 W. Va. at 463, 383 S.E.2d at 95
(same). 'The primary, if not sole purpose of mandatory uninsured motorist coverage is
to protect innocent victims from the hardships caused by negligent, financially
irresponsible drivers.' Perkins v. Doe, 177 W. Va. 84, 87, 350 S.E.2d 711, 714 (1986)
(quoting Lusk v. Doe, 175 W. Va. 775, 779, 338 S.E.2d 375, 380 (1985), overruled on
other grounds by Hamric v. Doe, 201 W. Va. 615, 499 S.E.2d 619 (1997)). In this
regard, W. Va. Code § 33-6-31
seeks to assure at least minimum relief from the consequences
of a loss caused by an uninsured motorist. Because every
citizen is exposed to the risk of loss, the Legislature has
provided through the uninsured motorist statute that the burden
of loss should be distributed among all owners of insured
motor vehicles registered in West Virginia. . . .
Bell, 157 W. Va. at 627, 207 S.E.2d at 150. Given that the purpose of UM insurance is
to alleviate the financial burdens of West Virginia motorists who are involved in accidents
with other motorists who are uninsured,See footnote 23
23
we have specifically held that [t]he uninsured
motorist statute, West Virginia Code § 33-6-31 (Supp. 1986), is remedial in nature and,
therefore, must be construed liberally in order to effect its purpose. Syl. pt. 7, Perkins
v. Doe, 177 W. Va. 84, 350 S.E.2d 711.
It is precisely this same UM statute upon which our prior decisions validating owned but not insured exclusions have based their rulings. See Syl. pt. 4, Imgrund, 199 W. Va. 187, 483 S.E.2d 533; Syl. pt. 3, Deel, 181 W. Va. 460, 383 S.E.2d 92. With specific regard to the public policy issue at hand, subsection (k) of W. Va. Code § 33-6-31
permits insurers to incorporat[e] in [policies of motor vehicle insurance] such terms,
conditions and exclusions as may be consistent with the premium charged. Because a
public statute[] may serve as a source of authority for public policy issues, see Morris,
191 W. Va. at 433 n.5, 446 S.E.2d at 655 n.5, a detailed analysis of this permissive
provision would be instructive to our inquiry.
'The primary object in construing a statute is to
ascertain and give effect to the intent of the Legislature.'
Syllabus point 1, Smith v. State Workmen's Compensation
Commissioner, 159 W. Va. 108, 219 S.E.2d 361 (1975).
Syllabus point 6, State ex rel. ACF Industries, Inc. v. Vieweg,
204 W. Va. 525, 514 S.E.2d 176 (1999).
Syl. pt. 3, Daily Gazette Co., Inc. v. West Virginia Dev. Office, ___ W. Va. ___, ___
S.E.2d ___ (No. 25437 May 19, 1999). Moreover, when we interpret a statutory
provision, this Court is bound to apply, and not construe, the enactment's plain language.
Syl. pt. 4, Daily Gazette Co., Inc. v. West Virginia Dev. Office, ___ W. Va. ___, ___
S.E.2d ___ (No. 25437 May 19, 1999) ('A statutory provision which is clear and
unambiguous and plainly expresses the legislative intent will not be interpreted by the
courts but will be given full force and effect. Syl. Pt. 2, State v. Epperly, 135 W. Va.
877, 65 S.E.2d 488 (1951).' Syllabus point 1, State v. Jarvis, 199 W. Va. 635, 487
S.E.2d 293 (1997).); DeVane v. Kennedy, ___ W. Va. ___, ___, ___ S.E.2d ___, ___,
slip op. at 17 (No. 25206 Mar. 26, 1999) (Where the language of a statutory provision
is plain, its terms should be applied as written and not construed. (citations omitted)).
Although a provision's language may be plain, there nevertheless may arise circumstances
in which the plain language does not speak completely on the subject to which it is
addressed. Therefore,
[t]hat which is necessarily implied in a statute, or must
be included in it in order to make the terms actually used have
effect, according to their nature and ordinary meaning, is as
much a part of it as if it had been declared in express terms.
Syllabus point 14., State v. Harden, 62 W. Va. 313, 58 S.E.
715 (1907).
Syl. pt. 4, Smith v. State Workmen's Compensation Comm'r, 159 W. Va. 108, 219 S.E.2d
361. Finally,
[i]t is the duty of a court to construe a statute
according to its true intent, and give to it such construction as
will uphold the law and further justice. It is well the duty of
a court to disregard a construction, though apparently
warranted by the literal sense of the words in a statute, when
such construction would lead to injustice and absurdity. Syl.
pt. 2, Click v. Click, 98 W. Va. 419, 127 S.E. 194 (1925).
Syl. pt. 2, Pristavec v. Westfield Ins. Co., 184 W. Va. 331, 400 S.E.2d 575 (1990).
Reviewing the pertinent language of subsection (k), we are convinced that
the language states, in plain and comprehensible terms, that an insurer may include in a
policy of motor vehicle insurance an exclusion. See W. Va. Code § 33-6-31(k); Syl. pt.
3, Deel, 181 W. Va. 460, 383 S.E.2d 92. This language further provides, in less certain
terms, that such an exclusion must be consistent with the premium charged for such
coverage. Inherent in this requirement, then, is the heretofore silent prerequisite that an
insurance policy may contain an exclusion only if the issuing insurer has appropriately
adjusted the corresponding premiums, thereby ensuring that the exclusion will be
consistent with the premium charged. In other words, just as [a] contract for greater
benefits generally justifies a greater premium, Deel, 181 W. Va. at 463, 383 S.E.2d at
95, so does a contract for benefits which have been reduced through the inclusion of an
exclusion to coverage warrant a reduced premium. This interpretation also is consistent
with the correlative statutory provision mandating that premiums be appropriately
adjusted with respect to variable UM and UIM coverage limits. See W. Va. Code § 33-
6-31(b). See also Syl. pt. 4, in part, State ex rel. Hechler v. Christian Action Network,
201 W. Va. 71, 491 S.E.2d 618 (1997) (In ascertaining legislative intent, effect must be
given to each part of the statute and to the statute as a whole so as to accomplish the
general purpose of the legislation. (internal quotations and citations omitted)); Syl. pt. 2,
in part, Mills v. Van Kirk, 192 W. Va. 695, 453 S.E.2d 678 (1994) (To determine the
true intent of the legislature, courts are to examine the statute in its entirety and not select
'any single part, provision, section, sentence, phrase or word.' Syllabus Point 3, in part,
Pristavec v. Westfield Ins. Co., 184 W. Va. 331, 400 S.E.2d 575 (1990).); Syl. pt. 1,
Parkins v. Londeree, 146 W. Va. 1051, 124 S.E.2d 471 (1962) (same). To construe the
language of subsection (k) otherwise would produce a result contrary to the express
legislative intention that UM provisions are remedial in nature and should be liberally
construed in favor of the insured. See Syl. pt. 2, Pristavec, 184 W. Va. 331, 400 S.E.2d
575; Syl. pt. 7, Perkins v. Doe, 177 W. Va. 84, 350 S.E.2d 711. Accordingly, we hold
that when an insurer incorporates, into a policy of motor vehicle insurance, an exclusion
pursuant to W. Va. Code § 33-6-31(k) (1995) (Repl. Vol. 1996), the insurer must adjust
the corresponding policy premium so that the exclusion is consistent with the premium
charged. As a corollary to this holding, we reiterate our admonition in Deel that such
exclusions must not conflict with the spirit and intent of the uninsured and underinsured
motorist statutes. Syl. pt. 3, Deel, 181 W. Va. 460, 383 S.E.2d 92.
At this juncture, we wish also to clarify our prior holdings, particularly in
Deel and in Imgrund, wherein we found exclusions to policies of motor vehicle insurance
to be statutorily permissible. See Syl. pt. 4, Imgrund, 199 W. Va. 187, 483 S.E.2d 533;
Syl. pt. 3, Deel, 181 W. Va. 460, 383 S.E.2d 92. As is customary with the interpretation
of legislative enactments, a finding that a particular provision is legally sound presupposes
that the actor, whose conduct the statute was designed to govern, has satisfied the
requirements thereof. Therefore, we hold further that when an insurer has failed to satisfy
the statutory criteria of W. Va. Code § 33-6-31(k) (1995) (Repl. Vol. 1996) requisite to
incorporating an exclusion in a policy of motor vehicle insurance, the enforcement of such
an exclusion is violative of this State's public policy. To facilitate the enforcement of this
statutory requirement and to ensure that an appropriate premium adjustment does, in fact,
accompany an insurer's incorporation of coverage exclusions, we restate our holding in
Syllabus point 7 of National Mutual Insurance Co. v. McMahon & Sons, Inc., which
cautioned that [a]n insurance company seeking to avoid liability through the operation of
an exclusion has the burden of proving the facts necessary to the operation of that
exclusion. 177 W. Va. 734, 356 S.E.2d 488 (1987). Applying this holding to our
pronouncement herein requiring insurers to adjust policy premiums commensurate with
their policy exclusions, the burden borne by insurers in instances similar to the case sub
judice would include proof that such a premium adjustment has, in fact, taken place.
Looking now to the facts with which we are confronted in the instant appeal, we are unable to locate in the appellate record any evidence that Anthem satisfied its statutory duty by adjusting Ms. Mitchell's policy premium to account for the inclusion of her owned but not insured exclusion. If such proof of a premium adjustment was, in fact, proffered to the lower court, the parties had a burden of preserving such evidence for appellate consideration. The responsibility and burden of designating the record is on the parties, and appellate review must be limited to those issues which appear in the record presented to this Court. Syl. pt. 6, In re Michael Ray T., ___ W. Va. ___, ___ S.E.2d ___ (No. 26639 Dec. 3, 1999). Absent proof of these facts, we cannot determine whether Anthem properly included the owned but not insured exclusion in Ms. Mitchell's policy of insurance.
Neither can we find in the appellate record any indication that the circuit
court weighed the limitation of coverage with the corresponding policy premium in
awarding Anthem summary judgment and declaratory judgment. As with facts not
appearing in the record below, this Court is also limited in its ability to consider, for the
first time on appeal, issues which a lower tribunal has not yet deliberated and decided.
'In the exercise of its appellate jurisdiction, this
Court will not decide nonjurisdictional questions which were
not considered and decided by the court from which the appeal
has been taken. Syllabus Point 1, Mowery v. Hitt, 155
W. Va. 103[, 181 S.E.2d 334] (1971).' Syl. pt. 1,
Shackleford v. Catlett, 161 W. Va. 568, 244 S.E.2d 327
(1978). Syllabus point 3, Voelker v. Frederick Business
Properties Co., 195 W. Va. 246, 465 S.E.2d 246 (1995).
Syl. pt. 7, In re Michael Ray T., ___ W. Va. ___, ___ S.E.2d ___ (No. 26639 Dec. 3,
1999). Given the lack of record evidence suggesting that the circuit court contemplated
whether Anthem's exclusion correlated to the policy premiums it charged Ms. Mitchell,
we cannot rule definitively on the propriety of the circuit court's decision to uphold the
exclusion above the statutorily required minimum limits for UM coverage. Accordingly,
we vacate the circuit court's order finding the owned but not insured exclusion to be
valid above the statutory limits of UM coverage, in accordance with our prior holding in
Syllabus point 4 of Imgrund v. Yarborough, 199 W. Va. 187, 483 S.E.2d 533, and remand
this matter for further proceedings consistent with this opinion and pursuant to our
instructions delineated below. Upon reconsideration of this matter, we direct the circuit
court to base its determination of whether Anthem appropriately adjusted Ms. Mitchell's
premium to reflect the owned but not insured exclusion contained in her policy, as well
as its final decision regarding the exclusion's validity, upon the evidence already contained
in the record of this case. In other words, we do not believe that special deference should
be accorded to Anthem to permit it to make a new or more detailed record of its alleged
premium adjustments when, pursuant to our holding in Syllabus point 7 of McMahon &
Sons rendered over a decade ago, insurers have long been charged with the burden of
proving facts necessary to permit the enforcement of their policy exclusions. See Syl. pt.
7, 177 W. Va. 734, 356 S.E.2d 488 (An insurance company seeking to avoid liability
through the operation of an exclusion has the burden of proving the facts necessary to the
operation of that exclusion.).
Before concluding our discussion herein, we would like to take this opportunity to speak on a matter that has troubled us during our decision of this case. Policies of insurance, including those providing coverage for motor vehicles, are regulated and approved by this State's Insurance Commissioner [hereinafter the Commissioner]. W. Va. Code § 33-6-8 (1994) (Repl. Vol. 1996). Inherent in the Commissioner's statutory duty to oversee policy provisions is his/her corresponding obligation to reject those policies that do not comply with West Virginia insurance law. Specifically, W. Va. Code § 33-6-9 (1957) (Repl. Vol. 1996) directs that
[t]he commissioner shall disapprove any such form of
policy, application, rider, or endorsement or withdraw any
previous approval thereof:
(a) If it is in any respect in violation of or does not
comply with this chapter.
(b) If it contains or incorporates by reference any
inconsistent, ambiguous, or misleading clauses, or exceptions
and conditions which deceptively affect the risk purported to be
assumed in the general coverage of the contract.
(c) If it has any title, heading, or other indication of its
provisions which is misleading.
(d) If the purchase of such policy is being solicited by
deceptive advertising.
(e) If the benefits provided therein are unreasonable in
relation to the premium charged.
(f) If the coverages provided therein are not sufficiently
broad to be in the public interest.
(Emphasis added). Thus, it is apparent that the Legislature has vested the Commissioner
with sufficient authority to reject policy provisions which do not clearly and accurately
inform the insured as to the coverage provided by such policy.
Despite the Commissioner's regulatory powers, we are mindful, from the policy language at issue in this case, that two marginally viable practices continue to accompany the incorporation of insurance policy exclusions. First, we observe that the owned but not insured exclusion in this case, though it was clearly designated as a limitation of the available UM coverage, most likely would not have been apparent to the majority of insurance consumers given its less-than-prominent placement in the appropriate policy endorsement. We previously have counseled insurance companies that
[a]n insurer wishing to avoid liability on a policy
purporting to give general or comprehensive coverage must
make exclusionary clauses conspicuous, plain, and clear,
placing them in such a fashion as to make obvious their
relationship to other policy terms, and must bring such
provisions to the attention of the insured.
Syl. pt. 10, National Mut. Ins. Co. v. McMahon & Sons, Inc., 177 W. Va. 734, 356
S.E.2d 488. Therefore, we urge the Commissioner to review proffered policies of
insurance to ensure that coverage exclusions are not so incognito as to be deceptive or
misleading as to the true scope of coverage available to the insured. See W. Va. Code
§ 33-6-9.See footnote 24
24
Second, the Commissioner is obligated to uphold the law of this State and to
reject any policy, endorsement, and the like [i]f it is in any respect in violation of or does
not comply with this chapter. W. Va. Code § 33-6-9(a). In this regard, we note that the
language of Anthem's owned but not insured exclusion does not suggest, in any manner,
that an insured is entitled to recover a statutory minimum amount of UM insurance
benefits. Our prior decision in Imgrund clarified this entitlement vis-a-vis owned but not
insured exclusions, and we recognize that strict application of the Imgrund requirements
to this case would result in an improper retroactive application of the law.See footnote 25
25
See Syl. pt.
4, King v. Kayak Mfg. Corp., 182 W. Va. 276, 387 S.E.2d 511 (1989) (discussing factors
to consider regarding retroactivity); Syl. pt. 5, Bradley v. Appalachian Power Co., 163
W. Va. 332, 256 S.E.2d 879 (1979) (same). Nevertheless, our statutory law mandating
such coverage was in effect long before the events at issue herein, thereby placing insurers
on notice as to required coverage provisions. See, e.g., W. Va. Code § 33-6-31(b) (1972)
(Repl. Vol. 1972). Thus, it appears to this Court that, regardless of any curative measures
incorporated in the terms of the policy, e.g., a severability clause,See footnote 26
26
or by statute, e.g.,
W. Va. Code § 33-6-17 (1957) (Repl. Vol. 1996),See footnote 27
27
an insured could very likely
understand an exclusion, which does not reference his/her statutory entitlement to
minimum UM benefits, as completely precluding any recovery of UM benefits thereunder.
Accordingly, we caution the Commissioner to be ever watchful for exclusionary language
that could prevent an insured from appreciating the true measure of coverage afforded by
his/her policy of insurance.
In conclusion, we charge the West Virginia Insurance Commissioner to be
ever vigilant in safeguarding the rights of insurance consumers in this State while
upholding the law permitting insurers to incorporate exclusions to coverage.
Vacated and Remanded.
generally W. Va. Code § 17B-4-3 (1994) (Repl. Vol. 1996) and W. Va. Code § 17C-5-2 (1996) (Repl. Vol. 1996).
An owned but not insured exclusion to uninsured motorist coverage is valid and enforceable above the mandatory limits of uninsured motorist coverage required by
W. Va. Code §§ 17D-4-2 (1979) (Repl. Vol. 1996) and 33-6-
31(b) (1988) (Supp. 1991). To the extent that an owned but
not insured exclusion attempts to preclude recovery of
statutorily mandated minimum limits of uninsured motorist
coverage, such exclusion is void and ineffective consistent with
this Court's prior holding in Syllabus Point 2 of Bell v. State
Farm Mutual Automobile Insurance Company, 157 W. Va.
623, 207 S.E.2d 147 (1974).
Syl. pt. 4, Imgrund v. Yarborough, 199 W. Va. 187, 483 S.E.2d 533 (1997).
(b) Nor shall any such policy or contract [of motor
vehicle insurance] be so issued or delivered unless it shall
contain an endorsement or provisions undertaking to pay the
insured all sums which he shall be legally entitled to recover
as damages from the owner or operator of an uninsured motor
vehicle, within limits which shall be no less than the
requirements of section two, article four, chapter seventeen-d
of this code, as amended from time to time . . . .
W. Va. Code § 17D-4-2, one of the statutes regulating motorists' financial responsibility,
requires an owner or operator of a motor vehicle to possess insurance in a minimum
amount of
twenty thousand dollars because of bodily injury to or death of one person in any one accident, and, subject to said limit for one person, in the amount of forty thousand dollars because of
bodily injury to or death of two or more persons in any one accident, and in the amount of ten thousand dollars because of injury to or destruction of property of others in any one accident.
(commanding petition for appeal to include 1. The kind of proceeding and nature of the ruling in the lower tribunal[;] 2. A statement of the facts of the case[;] 3. The assignments of error relied upon on appeal and the manner in which they were decided in the lower tribunal[; and] 4. Points and authorities relied upon, a discussion of law, and the relief prayed for.). See also Hanlon v. Logan County Bd. of Educ., 201 W. Va. 305, 310 n.17, 496 S.E.2d 447, 452 n.17 (1997) ('Failure to [heed the applicable court rules] not only wastes the precious and limited resources of this Court, but also those of the lawyers and their clients. We do not wish to be perceived as sticklers, precisians, nitpickers, or sadists. But in an era of swollen appellate dockets, courts are entitled to insist on diligence and good faith efforts from the practicing bar so that the appellate decisional process can proceed as it should.' (emphasis in original) (quoting Coleman v. Sopher, 194 W. Va. 90, 96, 459 S.E.2d 367, 373 (1995) (quoting Avitia v. Metropolitan Club of Chicago, Inc., 49 F.3d 1219, 1224 (7th Cir. 1995)))). Our review of the briefs on rehearing, as well as of the original appellate briefs filed in this case, indicates that they contain little more than bald assertions regarding the public policy considerations discussed in this opinion with scant supportive authority for such contentions.
[a]ny insurance policy, rider, or endorsement hereafter issued and otherwise valid which contains any condition or provision not in compliance with the requirements of this chapter, shall not be thereby rendered invalid but shall be construed and applied in accordance with such conditions and provisions as would have applied had such policy, rider, or endorsement been in full compliance with this chapter.