Marvin W. Masters
Masters & Taylor, L.C.
Charleston, West Virginia
Attorney for Wehner, Fisher and Landau
Ancil G. Ramey
Laurie C. Barbe
Scott E. Johnson
Steptoe & Johnson, PLLC
Charleston, West Virginia
Attorneys for New Hampshire Insurance Company
Richard W. Gallagher
Jeffrey A. Kimble
Robinson & McElwee, PLLC
Clarksburg, West Virginia
Attorneys for Pennsylvania National Mutual Insurance Company
Avrum Levicoff
Brown & Levicoff, P.C.
Pittsburgh, Pennsylvania
Attorney for Bossio Enterprises and
Travelers Casualty & Surety Company,
f/k/a Aetna Casualty & Surety Company
and The Standard Fire Insurance Company
The Opinion of the Court was delivered Per Curiam.
JUSTICE STARCHER, deeming himself disqualified, did not participate in the
decision in this case.
JUDGE SPAULDING, sitting by temporary assignment.
2. A circuit court's entry of summary judgment
is reviewed de novo. Syl. Pt. 1, Painter v. Peavy, 192
W. Va. 189, 451 S.E.2d 755 (1994).
3. 'Language in an insurance policy
should be given its plain, ordinary meaning. Syl. Pt. 1, Soliva
v. Shand, Morahan & Co., 176 W. Va. 430, 345 S.E.2d 33 (1986).' Syllabus
point 2, Russell v. State Automobile Mutual Insurance Co., 188 W.
Va. 81, 422 S.E.2d 803 (1992). Syl. Pt. 2, American State Ins. Co.
v. Tanner, 211 W. Va. 160, 563 S.E.2d 825 (2002).
4. 'Where the provisions in an insurance
policy contract are clear and unambiguous they are not subject to judicial
construction or interpretation, but full effect will be given to the plain
meaning intended. Syllabus, Keffer v. Prudential Ins. Co., 153
W. Va. 813, 172 S.E.2d 714 (1970).' Syllabus point 1, Russell v. States
Automobile Mutual Insurance Co., 188 W. Va. 81, 422 S.E.2d 803 (1992). Syl.
Pt. 3, American State Ins. Co. v. Tanner, 211 W. Va. 160, 563 S.E.2d
825 (2002).
5. 'It is well[-]settled law in West Virginia
that ambiguous terms in insurance contracts are to be strictly construed
against the insurance company and in favor of the insured.' Syl. Pt. 4, National
Mut. Ins. Co. v. McMahon & Sons, Inc., 177 W.Va. 734, 356 S.E.2d
488 (1987). Syl. Pt. 2, State v. Janicki, 188 W. Va. 100, 422
S.E.2d 822 (1992).
6. 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. Syl. Pt.
10, National Mut. Ins. Co. v. McMahon & Sons, Inc., 177 W. Va.
734, 356 S.E.2d 488 (1987), overruled on other grounds by Potesta v. U.S.
Fidelity & Guar. Co., 202 W. Va. 308, 504 S.E.2d 135 (1998).
Per Curiam:
This is a consolidated appeal from a Circuit Court
of Monongalia County order dated April 8, 2003, granting summary judgment
to New Hampshire Insurance Company (hereinafter New Hampshire), (See
footnote 1) holding that no liability coverage existed
for Mr. Brett Weinstein and Mr. Matthew Kiser under Sigma Phi Epsilon fraternity
liability insurance policies and denying a motion for leave to amend the
complaint to include a bad faith claim against New Hampshire. Appellants,
including Nicole Fisher; Jessica Landau; William E. Wehner, Jr., as administrator
of the estate of Jennifer Wehner; Travelers Casualty & Surety Company,
as insurance carrier for Bossio Enterprises; and Pennsylvania National Mutual
Insurance Company, as insurance carrier for Mr. Kiser, contend that the lower
court erred in granting summary judgment to New Hampshire and in holding
that policies issued to the national fraternity of Sigma Phi Epsilon by New
Hampshire did not provide coverage for Mr. Weinstein and Mr. Kiser. Appellants
Wehner, Fisher, and Landau also assert that the lower court erred by denying
their motion to amend the complaint to include a bad faith action against
New Hampshire. (See
footnote 2) Upon thorough review of the record, briefs,
arguments of counsel, and applicable precedent, this Court reverses the decision of
the lower court and remands for further proceedings consistent with this
opinion.
Based upon the reversal by this Court, the jury's
allocation of fault was redistributed among the remaining defendants, as
follows: Mr. Weinstein, 83.33 percent; Bossio Enterprises, 11.11 percent;
and Mr. Kiser, 5.55 percent. Mr. Weinstein was able to satisfy his pro rata
share of liability, in part, through liability insurance coverage of $50,000
under a motor vehicle insurance policy covering his vehicle, as well as a
homeowner's insurance policy of $300,000 issued to Mr. Weinstein's parents
as named insureds. Mr. Weinstein was not, however, able to satisfy his entire
share of liability. Consequently, the remaining amount of the judgments,
under principles of joint and several liability, were paid by liability insurers
for Bossio Enterprises and Mr. Kiser. Aetna Casualty and Surety Company,
as predecessor to Travelers, was the insurance carrier for Bossio Enterprises,
and Pennsylvania was the carrier for Mr. Kiser. (See
footnote 7)
The purchases from New Hampshire by the Sigma Phi Epsilon
national fraternity included a primary general liability policy with a limit
of $1 million and an umbrella excess policy with an additional limit of $2 million.
While New Hampshire retained counsel to defend the fraternity itself during trial,
New Hampshire had not revealed that coverage might also exist directly for Mr.
Weinstein and Mr. Kiser under policies insuring members of the fraternity as
named insureds. The declarations of both the primary and excess policies specifically
included a typewritten Named Insured endorsement listing, specifying All
Sigma Phi Epsilon Fraternity, Inc., Members and Pledges as Named
Insureds.
In the primary general liability policy only, an
additional endorsement was included, identified as Additional Insured
- Club Members. This portion of the primary policy provided: It
is agreed that the 'Persons Insured' provision is amended to include as an
insured any member of the named insured but only with respect to his liability
for activities of the named insured or activities performed by such member
on behalf of the named insured. This Additional Insured provision
was not included in the $2 million excess policy.
The Appellants contend that the primary general liability policy issued by New Hampshire had included the Additional Insured - Club Members endorsement by mistake.
According to the Appellants, this alleged error was recognized by Mr. Beckman
and detailed in a February 9, 1989, letter to Mr. Dave Hyde, an underwriting
manager with New Hampshire. In that letter, Mr. Beckman explained that since
members and pledges were named insureds, adding them as additional insureds
was unnecessary. On February 21, 1989, approximately two months prior to
the accident at issue in this case, Mr. Hyde responded, I agree - effective
immediately let's delete on current National Fraternities. Consequently,
the Additional Insured - Club Members endorsement was deleted
during the next annual renewal of the policies. It did exist, however, on
the applicable primary general liability policy in question herein.
Based upon the existence of the New Hampshire policies,
Travelers and Pennsylvania, as insurers for Bossio Enterprises and Mr. Kiser,
respectively, asserted claims against New Hampshire, alleging that New Hampshire
should have afforded coverage for Mr. Weinstein's share of the liability.
In addition, Mr. Kiser's insurer, Pennsylvania, asserted that New Hampshire
should have afforded full coverage for Mr. Kiser's liability. (See
footnote 8) The personal representative of the Wehner estate,
Ms. Landau, and Ms. Fisher also asserted claims against New Hampshire based
upon New Hampshire's allegedly deceptive conduct in concealing the existence of $3 million in liability coverage that they
contend should have been available to satisfy the judgments.
In August 1997, the issue of New Hampshire's coverage
was presented to the lower court. At a status conference in May 2001, the
lower court announced a ruling from the bench, concluding that although Mr.
Weinstein and Mr. Kiser were named insureds, the Additional Insured
- Club Member endorsement of the primary general liability policy essentially
removed them as covered insureds while they were not engaged in fraternity
activities. Finding that attempting to move a parked vehicle was not a fraternity
activity, the lower court concluded that the New Hampshire primary general
liability policy did not provide coverage for Mr. Weinstein or Mr. Kiser.
The lower court further found that the excess policy also failed to provide coverage, despite the absence of similar Additional Insured - Club Members language. The lower court reasoned that the scope of coverage should be restricted to the very limited coverage provided under the Additional Insured - Club Members language in the primary general liability policy. Thus, the lower court granted summary judgment in favor of New Hampshire during the May 2001 status conference. Due to the inability of the various parties to agree upon language to be contained in a written summary judgment order, a final order was not completed until April 8, 2003.
The April 8, 2003, order articulates the lower court's
reasoning in granting summary judgment to New Hampshire and in denying a motion
to amend the complaint to include a bad faith claim. The lower court explained
that although Mr. Weinstein and Mr. Kiser are named insureds, such coverage was
too expansive and should be restricted to the Additional Insured - Club
Members language limiting liability to incidents occurring where the member
or pledge was engaging in fraternity activities. The lower court found that the
attempt to move the parked vehicle was not a fraternity activity and should therefore
not be covered by the New Hampshire policy. It is from that summary judgment
order that the Appellants now appeal.
This Court has consistently held that '[l]anguage in an insurance policy should be given its plain, ordinary meaning. Syl. Pt. 1, Soliva v. Shand, Morahan & Co., 176 W. Va. 430, 345 S.E.2d 33 (1986).' Syllabus point 2, Russell v. State Automobile Mutual Insurance Co., 188 W. Va. 81, 422 S.E.2d 803 (1992). Syl. Pt. 2, Tanner, 211 W. Va. at 162, 563 S.E.2d at 827. In syllabus point three of Tanner, this Court also explained:
'Where the provisions
in an insurance policy contract are clear and unambiguous they are not subject
to judicial construction or interpretation, but full effect will be given to
the plain meaning intended.' Syllabus, Keffer v. Prudential Ins. Co., 153 W. Va. 813, 172 S.E.2d 714 (1970). Syllabus point
1, Russell v. State Automobile Mutual Insurance Co., 188 W. Va. 81,
422 S.E.2d 803 (1992).
The problem of ambiguity in a contract of insurance has
been extensively addressed by this Court, and ambiguity has been defined as follows: Whenever
the language of an insurance policy provision is reasonably susceptible of two
different meaning or is of such doubtful meaning that reasonable minds might
be uncertain or disagree as to its meaning, it is ambiguous. Riffe v.
Home Finders Associates, Inc., 205 W. Va. 216, 221, 517 S.E.2d 313, 318 (1999).
Where an ambiguity exists, this Court has explained that certain rules of construction
will be implemented. First, any ambiguity in the language of an insurance
policy is to be construed liberally in favor of the insured, as the policy was
prepared exclusively by the insurer. This principle applies to policy language
on the insurer's duty to defend the insured, as well as to policy language on
the insurer's duty to pay. Horace Mann Ins. Co. v. Leeber, 180 W.
Va. 375, 378, 376 S.E.2d 581, 584 (1988). In syllabus point two of State v.
Janicki, 188 W. Va. 100, 422 S.E.2d 822 (1992), this Court stated that '[i]t
is well[-]settled law in West Virginia that ambiguous terms in insurance contracts
are to be strictly construed against the insurance company and in favor of the
insured.' Syl. Pt. 4, National Mut. Ins. Co. v. McMahon & Sons, Inc.,
177 W.Va. 734, 356 S.E.2d 488 (1987). See also Aetna Casualty & Sur.
Co. v. Pitrolo, 176 W. Va. 190, 194, 342 S.E.2d 156, 160 (1986) ([w]e
have long recognized that since insurance policies are prepared solely by insurers, any ambiguities in the language of insurance
policies must be construed liberally in favor of the insured).
As the lower court acknowledges in its summary
judgment order, Mr. Weinstein and Mr. Kiser are named insureds under both
the primary and excess policies issued by New Hampshire. In the primary general
liability policy, we find that the existence of the Additional Insureds
- Club Members endorsement creates an ambiguity which must be resolved. (See
footnote 9) It is simply unreasonable and internally inconsistent
to postulate that members and pledges are to be characterized as both named
insureds with full coverage and additional insureds with limited coverage.
In resolving the ambiguity in favor of the insured, we are compelled to find
that the inclusion of members and pledges as named insureds provides a legitimate
basis for coverage and that the existence of the Additional Insureds
- Club Members endorsement should not be interpreted or applied to
diminish that coverage. Representatives of the insurance company acknowledged
that the inclusion of members and pledges as additional insureds was unnecessary
where members and pledges had already been designated as named insureds.
As acknowledged by the correspondence between Mr. Beckman and Mr. Hyde and the decision to delete the endorsement, the inclusion
of the Additional Insureds - Club Members endorsement on the
primary general liability policy
was unnecessary; fraternity members and pledges were already included as
named insureds. No additional endorsement was required.
Moreover, our conclusion is supported by this Court's
consistent adherence to the principle that any exclusionary language in an
insurance policy must be strictly construed. We scrutinize more carefully
any policy language that has the effect of excluding an insured from coverage. Erie
Ins. Property & Cas. Co. v. Stage Show Pizza, 210 W. Va. 63, 67,
553 S.E.2d 257, 261 (2001) (quoting Riffe, 205 W. Va. at 222, 517
S.E.2d at 319). We have also emphasized that any exclusionary language must
be presented clearly and unambiguously by the policy language. In syllabus
point ten of National Mutual Insurance Co. v. McMahon & Sons, Inc.,
177 W. Va. 734, 356 S.E.2d 488 (1987), overruled on other grounds by Potesta
v. U.S. Fidelity & Guar. Co., 202 W. Va. 308, 504 S.E.2d 135 (1998),
this Court stated: 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.
The lower court also pronounced rulings on what it termed
the contingent issue of New Hampshire's argument that certain other
exclusionary language would foreclose coverage. The court explained that language
in the policy excluding from coverage bodily injury and property damage arising
from certain uses of specified automobiles would not apply to the facts
of this case and would not bar coverage. (See
footnote 10) We agree and affirm the lower court in that regard.
As the lower court found, the automobiles specified in the exclusionary language
do not include the pizza vehicle in question, and we consequently find that any
examination of exclusions to those exclusions is not of assistance in our evaluation.
The lower court also addressed policy language
purporting to limit coverage to only businesses conducted by the named insureds
on the property as the sole owner. The lower court stated that
it found:
that the language of the policy could not possibly have
been intended to be that limited in its scope. Such an interpretation would render
the coverage of the policy illusory in that it would really provide no coverage
at all because, as far as the court can determine from the record, there are
no businesses conducted on the fraternity property by anyone.
Thus, the court refused to construe the policy as providing coverage
for active members or pledges only to the extent that they conduct a business. We
affirm the decision of the court in that regard and find that such language
addressing the conduct of business is of no assistance in resolving the questions
before this Court.
Upon review, while we express no view regarding
the ultimate outcome of a bad faith action against New Hampshire, we find
that the Appellants seeking to assert a bad faith claim may amend their complaint,
as requested. Such amendment shall relate back to the date the complaint
was filed based upon the fact that the delay in granting leave to file and
serve the amended complaint was not the fault of the Appellants.