Mark Jenkinson
James A. McKowen
Hunt & Wilson
Charleston, West Virginia
Attorneys for the Plaintiff
Gray Silver III
Patrick J. Nooney
Steptoe & Johnson
Martinsburg, West Virginia
Attorneys for the Defendant
CHIEF JUSTICE McHUGH delivered the Opinion of the Court.
1. "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 motorists statutes." Syl. pt. 3, Deel v. Sweeney, 181
W. Va. 460, 383 S.E.2d 92 (1989).
2. When an insurer issues an automobile insurance policy
which provides both liability and underinsured motorists coverage,
but which policy contains what is commonly referred to as a "family
use exclusion" for the underinsured motorist coverage, and when, in
a single car accident, the passenger/wife receives payments under
the liability coverage for the negligence of the driver/husband,
such exclusion is valid and not against the public policy of this
state. That exclusion, which excludes from the definition of
"underinsured motor vehicle" any automobile owned by or furnished
for the regular use of the insured or a relative, has the purpose
of preventing underinsured coverage from being converted into
additional liability coverage.
3. "West Virginia Code § 33-6-31 (1992) does not forbid
the inclusion and application of an anti-stacking provision in an
automobile insurance policy where a single insurance policy is
issued by a single insurer and contains an underinsured endorsement
even though the policy covers two or more vehicles. Under the
terms of such a policy, the insured is not entitled to stack the
coverages of the multiple vehicles and may only recover up to the
policy limits set forth in the single policy endorsement." Syl.
pt. 5, Russell v. State Automobile Mutual Ins. Co., ___ W. Va. ___,
___ S.E.2d ___, No. 20491 (June 29, 1992).
McHugh, Chief Justice:
This case is before the Court upon certified questions of
the Circuit Court of Berkeley County. The plaintiff is Deborah
Thomas. The defendant is Nationwide Mutual Insurance Company.
Accordingly, this declaratory judgment action was filed
by the plaintiff to determine the rights and obligations of the
parties. Three questions were certified to this Court by the
circuit court:
1. May an insured who is covered
simultaneously by two or more underinsured
motorist policy endorsements on multiple
vehicles under the same policy recover under
all of such endorsements up to the aggregated
or stacked limits of the same, or up to the
amount of judgment obtained against the
underinsured motorist, whichever is less, as a
result of one accident and injury?
2. Whether an insured can stack such
underinsurance coverage on top of the limits
of liability coverage previously paid under
the same policy for the same accident up to
the aggregated or stacked limits of the same,
or up to the amount of judgment obtained
against the underinsured motorist, whichever
is less?
3. Whether in the instant case the
following definitional exclusion (known as the
Family Use Exclusion) is a valid exclusion in
light of the current law and public policy of
the State of West Virginia?
'2. We will not consider as an
underinsured motor vehicle: e) any
vehicle owned by or furnished for the
regular use of you or a relative.'
(emphasis in original)
We believe that the primary issue in this case is the
third certified question. Accordingly, we first address that
question.See footnote 2
(emphasis in original) The policy goes on to state, in the
underinsured motorists "definition" section, the following:
1. An underinsured motor vehicle is a motor
vehicle with respect to the ownership,
operation, or use of which there is
liability insurance applicable at the
time of the accident, but the limits of
that insurance are either:
a) less than limits the insured carried
for underinsured motorists coverage, or
b) has been reduced by payments to others
injured in the accident to limits less
than limits the insured carried for
underinsured motorists coverage.
2. We will not consider as an underinsured
motor vehicle:
. . . .
e) any vehicle owned by or furnished for
the regular use of you or a relative.
(emphasis in original)
Provision "2(e)," is commonly referred to as the family
use exclusion.
In Myers v. State Farm Mutual Automobile Ins. Co., 336
N.W.2d 288 (Minn. 1983), the Supreme Court of Minnesota held that
under that state's statutory provisions in effect at the time:
Underinsured motorist coverage is first-party coverage and, in that sense, the
coverage follows the person not the vehicle.
Here, however, the decedent passenger's heirs
have already collected under the liability
coverage of the insurer of the Stein car. To
now collect further under the same insurer's
underinsured motorist coverage would be to
convert the underinsured motorist coverage
into third-party insurance, treating it
essentially the same as third-party liability
coverage. The policy definition defining an
'underinsured motor vehicle' to exclude a
vehicle owned by or regularly furnished or
available to the named insured properly
prevents this conversion of first-party
coverage into third-party coverage.
The purpose of underinsured coverage is
to protect the named insured and other
additional insureds from suffering an
inadequately compensated injury caused by an
accident with an inadequately insured
automobile.
336 N.W.2d at 291 (emphasis supplied).
In Eisenschenk v. Millers' Mutual Ins. Assoc., 353 N.W.2d
662 (Minn. Ct. App. 1984), the Court of Appeals of Minnesota
followed the lead of that state's supreme court, in upholding the
validity of the family use exclusion. The Eisenschenk court
focused on the insured's failure to purchase additional insurance.
In Eisenschenk, the plaintiff was injured in a single car accident
in which he was a passenger in a car owned by his father and driven
by his sister. The pertinent policy excluded from the definition
of "uninsured" vehicle "an automobile furnished for the regular use
of the named insured or of any person resident in the same
household who is related to the named insured by blood, marriage or
adoption[.]" 353 N.W.2d at 663.
The court in Eisenschenk went on to reiterate the points
made in Myers:
We are unable to factually distinguish
the instant case from Myers. The plaintiff in
Myers was a 'covered person' under State
Farm's policy; Thomas Eisenschenk is a
'covered person' under Millers' policy here.
Just as the policy in Myers was 'not designed
to compensate (owner) or his additional
insureds from (owner's) failure to purchase
sufficient liability insurance,' [336 N.W.2d]
at 291, neither is the Millers' policy
designed to protect Dennis Eisenschenk or his
additional insureds (of which Thomas is one)
from Dennis' failure to purchase sufficient
liability insurance.
353 N.W.2d at 665.
In Fidelity & Casualty Co. v. Streicher, 506 So. 2d 92
(Fla. Dist. Ct. App.), review denied, 515 So. 2d 231 (Fla. 1987),
the court rejected the plaintiff's public policy argument that
underinsurance benefits should be stacked on liability coverage.
In Streicher, the plaintiff was seriously injured in an automobile
accident wherein she was a passenger in her family's car. The
defendant Fidelity had issued a policy which provided liability and
uninsured motorist coverage on three family vehicles, including the
one involved in the accident. The defendant Fidelity paid the
plaintiff the liability policy limits of $100,000. Although the
policy also included underinsured motorist coverage of $100,000 on
each vehicle, "the policy's definition of uninsured or underinsured
motor vehicle excluded any vehicle owned by the insured or a
relative." 506 So. 2d at 93.
In rejecting the plaintiff's contention that she be
entitled to recover all available underinsured motorist benefits
because her damages exceeded the liability coverage, the Florida
District Court of Appeal held:
The plaintiff argues that to deny her UM
[underinsured motorist] benefits under the
Fidelity policy would contravene the public
policy expressed in the statute. But we do
not feel it was the intent of the legislature
to require that an automobile insurance policy
provide both liability and underinsured
motorist coverage to the same injured party.
The result which the plaintiff seeks in this
case would have the effect of doubling the
limits of liability under the Fidelity policy.
We are confident that Fidelity intended to
provide limited liability coverage and to
provide underinsured motorist coverage, but
not to the same injured party, and that
Fidelity charged a premium accordingly. We do
not believe that Fidelity should be required
to double, in effect, its liability coverage
under the circumstances of this case.
506 So. 2d at 93.
Some courts have declared the family use exclusion
invalid on public policy grounds, while other courts have upheld
its validity because to declare it invalid would abrogate the
uninsured motorist insurance statute. See Martin J. McMahon,
Annotation, Validity, Under Insurance Statutes, of Coverage
Exclusion for Injury to or Death of Insured's Family or Household
Members, 52 A.L.R. 4th 18, 28 § 3 (1987) (collecting cases). See
also 3 Alan I. Widiss, Uninsured and Underinsured Motorist
Insurance § 35.7 (2d ed. 1992).See footnote 3
It has been pointed out that
it follows logically that a claimant cannot
recover third party liability benefits and
underinsured motorist coverage from the same
policy of insurance. Rather, the recovery of
underinsured motorist coverage is dependent on
the existence of two policies of insurance:
the tortfeasor's policy and the claimant's
policy. When a tortfeasor is underinsured,
the claimant recovers third party liability
benefits from the tort-feasor's insurance and
supplements this recovery with the
underinsured motorist benefits available
through his or her own policy of insurance.
Newkirk v. United Services Automobile Assoc., 564 A.2d 1263, 1268
(Pa. Super. Ct. 1989), appeal denied, 597 A.2d 1153 (Pa. 1990)
(emphasis in original). See also Wolgemuth v. Harleysville Mutual
Ins. Co., 535 A.2d 1145 (Pa. Super. Ct.), appeal denied, 551 A.2d
216 (Pa. 1988).See footnote 4
Recently, in Alexander v. State Automobile Mutual Ins.
Co., ___ W. Va. ___, 415 S.E.2d 618 (1992), we addressed a
situation where a guest passenger attempted to collect underinsured
benefits, despite not contracting for them, nor being the intended
beneficiary. We summarized our holding that such benefits could
not be collected by the guest passenger as follows:
In short, underinsured motorist coverage
is intended to compensate parties for injuries
caused by other motorists who are
underinsured. As long as the insured owns
both the underinsured motorist policy in
question and the vehicle, then the insured's
vehicle will not be considered an underinsured
motor vehicle for purposes of the insured's
own underinsured motorist coverage. Because
an underinsured motorist policy is intended to
benefit the person who bought the policy, we
conclude that underinsured motorist coverage
is not available to a guest passenger unless
the statute or policy language specifically
provides for such coverage.
___ W. Va. at ___, 415 S.E.2d at 625 (footnote omitted). Accord,
Starr v. State Farm Fire & Casualty Co., ___ W. Va. ___, ___ S.E.2d
___, No. 21170 (Nov. 13, 1992), slip op. at 3.
The same rationale would apply to the exclusion at issue
in this case, namely, the family use exclusion. We believe that to
declare such an exclusion invalid would emasculate this state's
underinsured motorist statutory provisions, and, in effect, be
transforming the underinsured coverage into liability coverage.See footnote 5
W. Va. Code, 33-6-31(k) [1988] provides: "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 such terms, conditions and exclusions as may be
consistent with the premium charged." In syllabus point 3 to Deel
v. Sweeney, 181 W. Va. 460, 383 S.E.2d 92 (1989), we held:
"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
motorists statutes." Accord, note 6, infra.
Because recovery by a plaintiff of underinsured motorist
benefits is dependent on the existence of two policies, the
tortfeasor's and the plaintiff insured's, when a tortfeasor is
underinsured, the plaintiff insured normally recovers third-party
liability benefits from the tortfeasor's insurance coverage and
supplements this recovery, if necessary, with underinsured motorist
benefits through his or her own insurance. A family use exclusion,
which excludes from the definition of "underinsured motor vehicle"
any vehicle owned by or furnished for the regular use of the
insured or a relative, or in like terms, has the purpose of
preventing underinsured coverage from being converted into
additional liability coverage, because when the exclusion is
applied, it is the liability coverage that has been paid for by the
insured, and not underinsured coverage. Therefore, such an
exclusion would not violate the public policy of full compensation
of an insured.
Accordingly, we hold that when an insurer issues an
automobile insurance policy which provides both liability and
underinsured motorists coverage, but which policy contains what is
commonly referred to as a "family use exclusion" for the
underinsured motorist coverage, and when, in a single car accident,
the passenger/wife receives payments under the liability coverage
for the negligence of the driver/husband, such exclusion is valid
and not against the public policy of this state. That exclusion,
which excludes from the definition of "underinsured motor vehicle"
any automobile owned by or furnished for the regular use of the
insured or a relative, has the purpose of preventing underinsured
coverage from being converted into additional liability coverage.
Therefore, the third certified question is answered in
the affirmative.
However, in granting review of the questions in this
case, we suspended submission of this case pending the Court's
decision in Russell v. State Automobile Mutual Ins. Co., ___ W. Va.
___, ___ S.E.2d ___, No. 20491 (June 29, 1992), wherein this issue
was discussed.
In syllabus point 5 to Russell, we held:
West Virginia Code § 33-6-31 (1992) does
not forbid the inclusion and application of an
anti-stacking provision in an automobile
insurance policy where a single insurance
policy is issued by a single insurer and
contains an underinsured endorsement even
though the policy covers two or more vehicles.
Under the terms of such a policy, the insured
is not entitled to stack the coverages of the
multiple vehicles and may only recover up to
the policy limits set forth in the single
policy endorsement.
The reach of Youler and Pristavec was not extended in
Russell for the obvious reason that in Russell, a single insurance
policy was involved. In Russell, we reasoned that
because of the multi-car discount given, it is
obvious that the insured appellee bargained
for only one policy and only one
underinsurance motorist coverage endorsement.
This multi-car discount is of particular
import since it signifies that the [insured]
was receiving a reduced rate on his automobile
insurance in return for taking out only one
policy instead of two. Meanwhile, the insurer
was assuming an increased risk of injury which
could occur while the insured was occupying
the second vehicle as consideration for the
second premium. The insured was therefore
receiving the benefit of that which he
bargained for and should not receive more.
Had this multi-car discount not been given by
the insurer and had the insured paid a full
premium for both vehicles, a different result
may have been reached by this Court.
___ W. Va. at ___, ___ S.E.2d at ___, slip op. at 9.See footnote 6
In this case, there was but a single vehicle involved in
the accident, and a single insurance policy, under which the
liability insurance limits have been paid to the plaintiff insured.
The plaintiff, in light of our decision in Russell, all but
concedes this. Accordingly, the first certified question is
answered in the negative.
The defendant, on the other hand, points out the holding
of a Washington appeals court, decided two years prior to Tissell,
but not even mentioned in Tissell. In Holz v. North Pacific Ins.
Co., 765 P.2d 1306 (Wash. Ct. App. 1988), the court held that the
family member exclusion does not violate public policy, and that
any attempt to stack the uninsured coverage onto the liability
coverage would, in essence, transform the less expensive uninsured
coverage into liability insurance.
Obviously, the holding of a lower appeals court would not be binding upon that state's supreme court. In any event, rather than attempting to reconcile these decisions, we focus above on the rationale of other courts that have upheld the family use exclusion as valid because we believe that this rationale is well supported in logic and sound legal principles.