American Family Insurance Group v. Schroedl

598 N.W.2d 704, 1999 Minn. App. LEXIS 992, 1999 WL 639288
CourtCourt of Appeals of Minnesota
DecidedAugust 24, 1999
DocketNo. C7-99-428
StatusPublished

This text of 598 N.W.2d 704 (American Family Insurance Group v. Schroedl) is published on Counsel Stack Legal Research, covering Court of Appeals of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Family Insurance Group v. Schroedl, 598 N.W.2d 704, 1999 Minn. App. LEXIS 992, 1999 WL 639288 (Mich. Ct. App. 1999).

Opinions

OPINION

CRIPPEN, Judge.

Appellant, a .retiree who asserted a claim against his No-Fault insurer for $1,472 lost income resulting from an automobile-related injury, disputes the trial court’s application of a policy exclusion for any “work loss” benefits. Appellant contends that respondent insurer was legally obligated to provide coverage for appellant’s lost income. We reverse the trial court and reinstate the income-loss award determined earlier by an arbitrator and vacated by the trial court.

FACTS

Appellant Harold Schroedl, a retiree, purchased an automobile insurance policy [705]*705from respondent American Family Insurance Group in 1992. Asked then whether “work loss” coverage was appropriate, he indicated that it was not. As a result, the policy excluded work loss coverage, defined elsewhere in the policy as coverage for all income and disability benefits mandated by Minn. Stat § 65B.44 (1998). Without further inquiry by respondent as to whether the work loss exclusion was still appropriate, the policy was renewed annually thereafter through 1997.

On December 6, 1997, appellant, then 77 years old, was seriously injured when struck by a car at a gas station.1 At the time of the incident, appellant owned a triplex. His conservator submitted to respondent insurer a claim for $1,472 paid to others for doing work previously done by appellant in his rental enterprise. Respondent denied the claims, reasoning that appellant’s waiver of work loss coverage barred such claims. Appellant then filed for arbitration.

The arbitrator determined that appellant’s 1992 decision to exclude work loss coverage did not relieve respondent of its responsibility, under Minn.Stat. § 65B.491 (1998), to re-determine, upon each policy renewal, if such an exclusion was appropriate. For this and other reasons, the arbitrator determined that appellant was entitled to income loss benefits calculated with regard to his income loss of $1,472.2

The trial court determined, notwithstanding the language of Minn. Stat. § 65B.491, which states that it is the “responsibility” of the insurer to “inquire as to the applicability of this section,” that the statute did not make the insurer “responsible for making certain that persons aged 65 or older are informed about wage loss reimbursement insurance if they could reasonably be expected to benefit from such coverage.” Rather, the court found that the purposes of the statute were fulfilled by any inquiry of the insurance company that would prevent it from avoiding a premium reduction for a senior citizen by claiming that the policy was purchased before the insured reached age 65 and that the insurer had “no way of knowing” whether the insured continued to need income-loss coverage.

ISSUE

Does Minn.Stat. § 65B.491 mandate that No-Fault insurers inquire at each policy renewal if senior-citizen insureds can benefit from wage-loss reimbursement coverage?

ANALYSIS

The interpretation of statutes is a question of law, which this court reviews de novo. Hibbing Educ. Ass’n v. Public Employment Relations Bd., 369 N.W.2d 527, 529 (Minn.1985).

The parties agree that, under certain circumstances, insured senior citizens are to enjoy a premium reduction associat[706]*706ed with eliminating unneeded wage loss coverage. But the parties differ in their approach to the application of the provisions of Minn.Stat. § 65B.491 (1998).3 Respondent suggests that the statute provides senior citizens with nothing more than an option to buy or forgo buying a particular type of coverage and its policy treats the issue as merely an offer for optional coverage, giving the insured “the opportunity to exclude or forgo excluding” work loss benefits. Thus, according to respondent’s reasoning, because appellant elected against work loss coverage in 1992, respondent’s agent did not need to inquire further about work loss coverage when appellant subsequently renewed his policy. This analysis coincides with the trial court’s view of the statute; the court concluded that the insurer had no ongoing responsibility to inquire whether income loss protection was necessary so long as it once gave the insured an opportunity to “keep or exclude” the work loss coverage provided under the policy.

An insurer needs to offer optional coverage only once. See, e.g., Randall v. State Farm Mut. Auto. Ins. Co., 335 N.W.2d 247, 250 (Minn.1983) (holding that insurers are required to make only one legally sufficient offer of optional coverage); Hastings v. United Pac. Ins. Co., 318 N.W.2d 849 (Minn.1982) (implying that optional coverage need not be re-offered at each policy renewal). These two cases involved Minn.Stat. § 65B.49, subd. 6 (1978) (repealed 1980), which stated only that insurers “shall offer” certain optional coverages. As discussed below, the language of Minn.Stat. § 65B.491 mandates something substantially different from an offer of optional coverage and thus makes the present case distinguishable from either Randall or Hastings. According to its plain meaning, the statute in this case, Minn.Stat. § 65B.491, does not deal with optional coverage but distinctly declares a responsibility of the insurer to determine its mandatory obligations when it issues or renews a plan of No-Fault coverage with a person who is age 65 or older.

Consistent with the language of the statute, appellant contends that Minn.Stat. § 65B.491 has implications other than a mere one-time election for or against coverage. Appellant properly suggests that there are two conflicting mandates put upon an insurer by the law. On the one hand, Minn.Stat. § 65B.44 compels a No-Fault insurer to provide “income loss benefits.” On the other hand, Minn.Stat. § 65B.491 compels the insurer to discount its premium and eliminate coverage for an insured senior citizen, respecting income “that the insured will not reasonably be expected to be able to receive.”

To resolve this apparent conflict, Minn. Stat. § 65B.491 explicitly makes insurers responsible for determining, as to each insured, whether they are mandated to provide coverage or mandated to exclude it. Contrary to respondent’s assertion, nothing in Minn.Stat. § 65B.491 suggests that the insured makes any election whatsoever.4 Instead, it is the duty of the insurer to determine whether or not Minn. Stat. § 65B.491 applies. When “issuing or renewing the plan,” it is the “responsibility” of the insurer “to inquire as to the applicability of this section.” Minn.Stat. § 65B.491. The insurer determines its [707]*707mandate, to formulate the mandatory coverage, by inquiring, as a matter of fact, as to what wage loss reimbursement coverage the insured will reasonably “be expected to be able to receive.” In other words, based on information provided by the insured, the insurer determines whether or not it must provide the insured wage loss reimbursement coverage.5 Except through the “inquiry” process of section 65B.491, the statutes make no provision for waiving the mandate of income loss coverage stated in Minn.Stat. § 65B.44.

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Related

Hibbing Education Ass'n v. Public Employment Relations Board
369 N.W.2d 527 (Supreme Court of Minnesota, 1985)
Tuma v. Commissioner of Economic Security
386 N.W.2d 702 (Supreme Court of Minnesota, 1986)
Hertz Corp. v. State Farm Mutual Insurance Co.
573 N.W.2d 686 (Supreme Court of Minnesota, 1998)
Streich v. American Family Mutual Insurance Co.
358 N.W.2d 396 (Supreme Court of Minnesota, 1984)
Hastings v. United Pacific Insurance Co.
318 N.W.2d 849 (Supreme Court of Minnesota, 1982)
Malmin v. Minnesota Mutual Fire & Casualty Co.
552 N.W.2d 723 (Supreme Court of Minnesota, 1996)
Randall v. State Farm Mutual Automobile Insurance Co.
335 N.W.2d 247 (Supreme Court of Minnesota, 1983)
Roering v. Grinnell Mutual Reinsurance Co.
444 N.W.2d 829 (Supreme Court of Minnesota, 1989)
Schmidt v. Clothier
338 N.W.2d 256 (Supreme Court of Minnesota, 1983)

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Bluebook (online)
598 N.W.2d 704, 1999 Minn. App. LEXIS 992, 1999 WL 639288, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-family-insurance-group-v-schroedl-minnctapp-1999.