Allwein v. Donegal Mutual Insurance

26 Pa. D. & C.4th 280, 1994 Pa. Dist. & Cnty. Dec. LEXIS 70
CourtPennsylvania Court of Common Pleas, Lebanon County
DecidedJuly 25, 1994
Docketno. 94-00239
StatusPublished

This text of 26 Pa. D. & C.4th 280 (Allwein v. Donegal Mutual Insurance) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Lebanon County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allwein v. Donegal Mutual Insurance, 26 Pa. D. & C.4th 280, 1994 Pa. Dist. & Cnty. Dec. LEXIS 70 (Pa. Super. Ct. 1994).

Opinion

WALTER, P.J.,

Before us is the petition to modify or correct arbitration award filed by Donegal Mutual Insurance Company, defendant/ petitioner. It was listed for argument and, after the submission of briefs, orally argued. The petition is now ripe for disposition.

On August 13, 1992, Michael A. Allwein was riding his bicycle to work when he was struck by a vehicle operated by Jeremiah Lauver. Michael Allwein died as a result of injuries suffered during the accident.

The vehicle operated by Jeremiah Lauver and owned by Henry Lauver was insured by the self-insured Eastern Pennsylvania Mennonite Church. The vehicle carried $15,000/$30,000 in automobile liability insurance coverage.

At the time of the accident, Michael Allwein resided with his parents, James H. Allwein and Christine M. Allwein. The Allweins owned three vehicles insured with automobile insurance issued by Donegal Mutual Insurance Company. This policy provided underinsurance coverage of $35,000 per vehicle and allowed stacking of the coverages for a total underinsured motorist liability coverage of $105,000.

Both Donegal and Robert J. Allwein, administrator c.t.a. of the estate of Michael A. Allwein, deceased, admit the value of the loss experienced by Allwein because of the death of Michael Allwein exceeds the $15,000 liability limits of the party at fault, the operator Jeremiah Lauver and the owner Henry Lauver, and the $105,000 underinsurance liability of Donegal.

[282]*282Allwein filed a claim against Donegal seeking payment of underinsurance benefits in the amount of $105,000. Donegal has admitted its obligation to pay underinsurance benefits but has taken the position that it owes only $90,000 in underinsurance benefits because it may offset the amount it owes by the $15,000 of liability insurance benefits from the Lauvers’ policy. Donegal bases its position on the following limiting language found in its policy:

“C. The limit of liability shall be reduced by all sums paid because of the ‘bodily injury’ by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid for an ‘insured’s’ attorney either directly or as part of the amount paid to the ‘insured.’ It also includes all sums paid for the same damages under part A of this policy.”

See exhibit A of exhibit 1 of the petition, Form PPD 04 19 3/92, page 2 of 3. Pursuant to a stipulation between the parties, Donegal has paid Allwein $90,000 in underinsurance benefits.

The sole legal issue to be determined by this court is whether the cited language in Donegal’s policy is valid or whether Donegal owes Allwein an additional $15,000 in underinsurance benefits. The issue was submitted to arbitration in accordance with the Pennsylvania Arbitration Act of 1927. The three member panel held two to one in favor of Allwein, stating Allwein was entitled to the full $105,000 of underinsurance coverage from Donegal, and Donegal was not allowed to reduce its underinsurance coverage by the $15,000 paid to Allwein under the Lauvers’ liability policy. Donegal filed the present petition to modify or correct that decision.

Both parties agree the “error of law” standard of review provided by 42 Pa.C.S. §7302(d)(2) applies to [283]*283a petition to modify or correct an arbitration award where the underinsurance arbitration was conducted pursuant to an insurance policy providing for arbitration in accordance with the Pennsylvania Arbitration Act of 1927.1 Therefore, we shall use that standard of review.

Donegal argues the limiting language in its policy, cited earlier herein, is fully enforceable. Allwein argues this type of gap underinsurance is void as a violation of public policy.

Both parties agree with the underlying concepts of gap and excess coverage. Under gap coverage, the party at fault is underinsured when liability limits are less than a specified policy limit of the insured victim. To determine the amount of the insured’s underinsurance recovery, the recovery from the tortfeasor’s policy is deducted from the amount recoverable under the insured’s policy. The insured’s recovery fills the gap between the two policies up to the total amount of damages suffered or policy limits, whichever is less.

Under excess coverage, the party at fault is under-insured when his liability limits are less than the insured victim’s total damages. The tortfeasor’s policy acts as primary coverage, and the insured victim’s policy acts as secondary coverage. The victim recovers under the tortfeasor’s policy up to the policy limits and then recovers under his own policy up to coverage limits or up to the total amount of damages, whichever is less.

[284]*284Pennsylvania’s Motor Vehicle Financial Responsibility Law provides that an underinsured motor vehicle is “a motor vehicle for which the limits of available liability insurance and self-insurance are insufficient to pay losses and damages.” 75 Pa.C.S. §1702 (Purdon 1994).

In analyzing the meaning of this wording, court of common pleas, in Conrad v. Progressive Casualty Insurance Co., 48 D.&C.3d 71 (C.P. Blair Cty. 1987), stated, “The legislative mandate to insurance carriers issuing motor vehicle insurance policies in Pennsylvania was to provide coverage to insureds for those cases when third party liability limits were inadequate or not enough to satisfy an injured parties’ [sic] losses. A determination of inadequacy can only be made by reference to the injured party’s losses and damages.” Id. at 79-80.

In Conrad, the defendant argued that an insured’s underinsurance coverage should be reduced or offset by the third party’s liability coverage. The court stated that were it to follow the defendant’s argument to its logical extension:

“anytime an insured receives third party benefits which are equivalent to or which exceed the limits of the underinsured motorist benefits in his own policy, he will be unable to recover those benefits, even if his injuries and damages exceed the third party’s limits of liability. We believe that such an interpretation and application of the Motor Vehicle Financial Responsibility Law would render the underinsured motorist coverage illusory, since its very existence would be dependent upon the entirely fortuitous circumstance of what a third party tortfeasor’s liability limits happen to be.” Id. at 80.

[285]*285In the present case, Allwein argues the setoff provision in Donegal’s policy prevents Pennsylvania’s statutory scheme from having its desired effect of requiring insurers to provide underinsured motorist coverage in excess of the tortfeasor’s liability coverage, and is, therefore, contrary to public policy and unenforceable. In support of its position, Allwein cites a third circuit court of appeals case, North River Insurance Company v. Tabor, 934 F.2d 461 (3rd Cir. 1991). There the court announced that the legal issue such as ours in the present case had not yet been addressed by the appellate courts of this Commonwealth.

In North River,

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Bluebook (online)
26 Pa. D. & C.4th 280, 1994 Pa. Dist. & Cnty. Dec. LEXIS 70, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allwein-v-donegal-mutual-insurance-pactcompllebano-1994.