Exclusions make policy ambiguous

The Missouri Western Court of Appeals for the Western District was looking at an auto policy to determine if the liability coverage "stacked."  In finding that the policy was ambiguous, the Court indicates that exclusions make a policy ambiguous.

In Durbin v. Detrick, Durbin was injured by Deitrick, [the insured or covered individual], while Deitrick was operating a vehicle he did not own. Because Deitrick’s four personal automotive liability policies are ambiguous as to whether they may be stacked in this specific circumstance, we must construe the policy language against American Family and in favor of permitting stacking of Deitrick’s four liability policies. On cross motions for summary judgment, the trial court found for the insured, and this was affirmed by the Court of Appeals.

The Court notes: “Where an insurance policy promises the insured something at one point but then takes it away at another, there is an ambiguity.” Thus, “if policy language is ambiguous as to whether stacking is permitted, we construe the language of the policy against the insurer and in favor of stacking.”

The Court concluded “that while the Limits of Liability provision and Section 3 of the General Provisions in the American Family policies appear to generally prohibit the stacking of multiple liability policies, the language of the second sentence of the Other Insurance provision, analogous to that of Ritchie and Niswonger, could reasonably be understood by a lay person to indicate an exception to this general prohibition in the specific case where liability coverage is afforded for injuries incurred through use of a vehicle not owned by a covered individual.”

 

Here is the policy language

 

PART I – LIABILITY COVERAGE ….

We will pay compensatory damages an insured person is legally liable for because of bodily injury and property damage due to the use of a car or utility trailer. ….

LIMITS OF LIABILITY

The limits of liability shown in the declarations apply, subject to the following. . . We will pay no more than these maximums no matter how many vehicles are described in the declarations, or insured persons, claims, claimants, policies or vehicles are involved. ….

OTHER INSURANCE

If there is other auto liability insurance for a loss covered by this Part, we will pay our share according to this policy’s proportion of the total of all liability limits. But, any insurance provided under this Part for a vehicle you do not own is excess over any other collectible auto liability insurance.

….

GENERAL PROVISIONS

….

3.         Two or More Cars Insured. The total of our liability under all policies issued to you by us shall not exceed the highest limit of liability under any one policy.

Consent to Settle assignable in Bankruptcy

After the Olahs sued him for malpractice, Dr. Baird filed bankruptcy. The Olahs asked the trustee of  Dr. Baird’s bankruptcy estate to “sell” them Dr. Baird’s right to consent to settlement under his medical liability insurance policy. The trustee balked,  writing that by the terms of the insurance contract he did “not believe that there  was any asset which the trustee could assume and assign to” the Olahs. The Olahs then sought a declaration that the “right to settle”  was indeed part of the estate. When the trial court refused to so hold, they appealed.  The Tenth Circuit ruled that the liability policy is properly part of the estate, and that the trustee has discretion to exercise Dr. Baird’s rights under  the policy (including the consent to settle) or to assign those rights to the Olahs. 

There were some interesting arguments made in this opinion.  The insurance company argued that making the consent to settle clause assignable would “drastically impact the risk and burden on [it].”  The Tenth Circuit didn’t buy it, noting that the insurance company had the right and duty to defend the claim, and that no one could force the insurance company to settle.  If the insurance company and the plaintiffs negotiated a mutually agreeable settlement, then it would be in the insurance company’s interest to have the plaintiffs and not Dr. Baird exercise consent.  Further, since Dr. Baird’s liability was discharged in bankruptcy, he had nothing to lose and everything to gain from frustrating a settlement.

In re Baird, Case No. 07-4282