Antanovich v. Allstate Insurance

488 A.2d 571, 507 Pa. 68, 1985 Pa. LEXIS 305

• Court: Supreme Court of Pennsylvania
• Decided: February 20, 1985
• Docket: 17-19 W.D. 1984; 43 E.D. 1984
• Status: Published

Opinions

OPINION OF THE COURT

HUTCHINSON, Justice.

Before us are three appeals by allowance ¹ from orders of Superior Court. In Antanovich v. Allstate Insurance Company, 320 Pa.Superior Ct. 322, 467 A.2d 345 (1983), Superior Court en banc affirmed the judgment of Washington County Court of Common Pleas denying appellants’ claim to stack basic loss benefits payable under Section 202 of the Pennsylvania No-fault Motor Vehicle Insurance Act, Act of July 19, 1974, P.L. 489, No. 176, 40 P.S. § 1009.101-1009.701, since repealed.² In Brendlinger v. Allstate Insurance Company, 320 Pa.Superior Ct. 322, 467 A.2d 345, (1983), Superior Court reversed the judgment of Westmoreland County Common Pleas directing the payment of multiple basic loss benefits and in the third case, Wilson v. Keystone Insurance Company, 321 Pa.Superior Ct. 495, 468 A.2d 818 (1983), a panel of Superior Court vacated the judgment of Philadelphia Common Pleas on the basis of the en banc disposition of Antanovich and Brendlinger. All three cases were remanded for recomputation of benefits.

In each of these cases, appellants have claimed amounts in excess of the statutory coverage required by the No-fault Act for work loss based on their purchase of automobile insurance policies and payment of premiums covering the risk of such loss from operation of several automobiles which they or their decedents owned.³ They argue that the payment of a basic premium for insurance on one vehicle entitles them to the work loss benefits required by law.⁴ From this major premise they ask us to infer that the payment of additional premiums for coverage of the two to four other cars which they, or their decedents, owned entitles them to basic work loss benefits in spite of their insurance contracts’ prohibitions against such multiple recovery. In support of this reasoning they refer to one of the introductory legislative “findings” in the No-fault Act’s preamble:

(a) Findings. — The General Assembly hereby finds and declares that:

(3) the maximum feasible restoration of all individuals injured and compensation of the economic losses of the survivors of all individuals killed in motor vehicle accidents on Commonwealth highways, in intrastate commerce, and in activity affecting intrastate commerce is essential to the humane and purposeful functioning of commerce;

40 P.S. § 1009.102(a).

Appellants claim that this finding states a policy which precludes any contractual prohibition of multiple work loss benefits whenever several cars are insured. The findings in this section of the preamble are, however, prefatory to the “purposes” of the Act. Those purposes are stated in Subsection (b):

(b) Purposes. — Therefore, it is hereby declared to be the policy of the General Assembly to establish at reasonable cost to the purchaser of insurance, a Statewide system of prompt and adequate basic loss benefits for motor vehicle accident victims and the survivors of deceased victims.

40 P.S. § 1009.102(b). Reading together the particular finding and the Act’s purpose we do not believe they articulate appellants’ theory enough to overcome a plain unambiguous contract provision on the ground of policy. We, therefore, affirm the judgment of Superior Court.

Appellants’ arguments in support of “stacking” were fully and vigorously presented to the Superior Court en banc. In that court Judge (now President Judge) Spaeth, writing for the majority, summarized the opposing arguments:

The Antanovichs and Brendlingers do not argue that the Allstate policy is ambiguous, or that Allstate in some way misled them. Cf. Collister v. Nationwide Life Insurance Co., 479 Pa. 579, 388 A.2d 1346 (1978), cert. denied, 439 U.S. 1089 [99 S.Ct. 871, 59 L.Ed.2d 55] (1979); Habecker v. Nationwide Insurance Co., 299 Pa.Super. 463, 445 A.2d 1222 (1982); Adelman v. State Farm Mutual Automobile Insurance Co., 255 Pa.Super. 116, 386 A.2d 535 (1978); Barth v. State Farm Fire & Casualty Co., 214 Pa.Super. 434, 257 A.2d 671 (1969). Instead, they admit, as they must, that the policy clearly prohibits stacking. They argue, however, that this prohibition should be declared invalid as contrary to the No-fault Act. They acknowledge their inability to point to any provision of the Act explicitly providing that a policy may not prohibit stacking. Moreover, it is evident that the Insurance Commissioner is of the view that a policy that prohibits stacking is not contrary to the Act, for the Commissioner has approved the Allstate policy. See 31 Pa.Code § 66.101. However, even though the Commissioner has expert knowledge, to which a court must defer, Feingold v. Bell of Pennsylvania, All Pa. 1, 383 A.2d 791 (1977), he has on occasion issued invalid regulations, United Services Auto Ass’n Appeal, 227 Pa.Super. 508, 323 A.2d 737 (1974), and the position of the Antanovichs and Brendlingers is that here he has issued invalid regulations. While no provision of the No-fault Act explicitly provides that a policy may not prohibit stacking, neither does any provision explicitly provide that a policy may prohibit stacking. This being so, the Antanovichs and Brendlingers argue, we must consider the public policy underlying the Act. In their view, a proper understanding of that public policy leads to the conclusion that an insurance policy such as Allstate’s may not prohibit stacking.

Allstate generally agrees with this definition of the issue, but in its view, a proper understanding of the public policy underlying the No-fault Act leads to the conclusion that stacking is prohibited by the Act, and that therefore its insurance policy is valid.

Antanovich, supra, 320 Pa.Superior Ct. at 326-27, 467 A.2d at 347-48.

After examining the findings and purposes in Section 102 of the No-fault Act, 40 P.S. § 1009.102, Superior Court proceeded to set forth and analyze the Act’s relevant substantive provisions:

The owner of each vehicle registered in Pennsylvania is required to provide security (either by insurance or otherwise) for the payment of basic loss benefits. 40 P.S. § 1009.104. If an accident resulting in injury occurs, the victim or the survivor of a deceased victim “is entitled to receive basic loss benefits in accordance with the provisions of this act.” Id. § 1009.201(a). The “obligor providing security for the payment of basic loss benefits” is required to pay such benefits “without regard to fault to each individual entitled thereto, pursuant to the terms and conditions of this act.” Id. § 1009.111(b).

We have already briefly indicated, at the beginning of this part of our opinion, what are the several different items included within “basic loss benefits.” To state them more fully, they are as provided in Sections 202 and 103 of the Act:

§ 1009.202 Basic loss benefits

(a) Allowable expense limits. — Allowable expense, as defined in section 103 of this act shall be provided or the equivalent in the form of a contract to provide for services required.

(b) Work loss limits. — Work loss, as defined in section 103 shall be provided:

(1) up to a monthly maximum of:

(A) one thousand dollars ($1,000) multiplied by a fraction whose numerator is the average per capita income in this Commonwealth and whose denominator is the average per capita income in the United States, according to the latest available United States Department of Commerce figures; or

(B) the disclosed amount, in the case of a named insured who, prior to the accident resulting in injury, voluntarily discloses his actual monthly earnings to his obligor and agrees in writing with such obligor that such sum shall measure work loss; and

(2) up to a total amount of fifteen thousand dollars ($15,000).

(c) Replacement services losses. — Replacement services loss, as defined in section 103 shall be provided up to a daily maximum of twenty-five dollars ($25) for an aggregate period of one year.

(d) Survivors losses. — Survivors loss, as defined in section 103 shall be provided in an amount not to exceed five thousand dollars ($5,000).

40 P.S. § 1009.201(a)-(d).

The term “allowable expense” used in Section 202(a) is defined in Section 103 as follows:

“Allowable expense” means reasonable charges incurred for, or the reasonable value of (where no charges are incurred), reasonably needed and used products, services, and accommodations for:

(A) professional medical treatment and care;

(B) emergency health services;

(C) medical and vocational rehabilitation services;

(D) expenses directly related to the funeral, burial, cremation, or other form of disposition of the remains of a deceased victim, not to exceed one thousand five hundred dollars ($1,500); and

The term does not include that portion of a charge for a room in a hospital, clinic, convalescent, or nursing home, or any other institution engaged in providing nursing care and related services, in excess of a reasonable and customary charge for semiprivate accommodations, unless more intensive care is medically required; or any amount includable in work loss, replacement services loss, or survivor’s loss.

Id,., 320 Pa.Superior Ct. at 330-31, 467 A.2d at 349-50.

The court then analyzed the Act’s distinction between unlimited recovery under Sections 103 and 202(a) for allowable medical expense and the limited recovery under Section 202(b) for basic work loss saying:

This distinction ... is at least some indication that basic loss benefits should not be stacked. For stacking is a way to avoid a specified limit. But if recovery is unlimited, there is no need to stack. However, there is another feature of Section 202, which clearly manifests an intention that basic loss benefits may not be stacked.

In providing in Section 102(a)(6) that recovery of work loss, replacement services loss, and survivor’s loss should be limited to “a reasonable amount,” the General Assembly did not say what it meant by “reasonable.” In Section 202, it did say: up to $15,000 for work loss, $25 per day for an aggregate period of one year for replacement services loss, and up to $5,000 for survivor’s loss. This is simply another way of saying that to permit recovery of more than these amounts, which is what would happen if stacking were permitted, would be “unreasonable.”

Id., 320 Pa.Superior Ct. at 333, 467 A.2d at 351.

We have listened with care to the arguments of appellants’ counsels but find their policy arguments unpersuasive. Without necessarily approving Superior Court’s entire analysis, we hold that the No-fault Act, since repealed, contains no indication of policy clear enough to void a plain, unambiguous provision in an insurance contract which precludes stacking work loss benefits. See Standard Venetian Blind Co. v. American Empire Insurance Co., 503 Pa. 300, 469 A.2d 563 (1983). Moreover, in the face of such a plain and unambiguous preclusion, appellants could have had no reasonable expectation of obtaining stacked benefits.⁵

The opinions of Superior Court in Antanovich, Brendlinger and Wilson are affirmed.

McDERMOTT, J., joins in this opinion and files a concurring opinion. LARSEN, J., files a dissenting opinion in which ZAPPA-LA, J., joins.

1 . We note that jurisdiction in this case is predicated on 42 Pa.C.S. § 724. Such appeals are governed by Pa.R.A.P. 1112, not by other appellate rules relating to direct appeals.

2 . Act of February 12, 1984, P.L.-, No. 1984-11, as amended by Act of February 12, 1984, P.L.-, No. 1984-12.

3 . In Antanovich v. Allstate, the parents and administrators of Gary Lee Antanovich sued to recover work loss benefits in the amount of $60,000.00 on the theory that because the no-fault policy issued by Allstate covered four vehicles, the benefits of each coverage should be stacked. The premiums paid by Mr. Antanovich for uninsured motorist coverage and personal injury protection for the period November 21, 1980 to May 21, 1981 amounted to $28.40 on a 1974 Chevrolet, $27.40 on a 1976 Chevrolet, $57.00 on another 1974 Chevrolet and $24.00 on a 1970 Chevrolet. Mr. and Mrs. Antanovich received $15,000.00 from the third party tortfeasor’s insurance company and $578.00 every four weeks from Allstate up to a total of $15,000. Appellants had argued below that they were entitled to a lump sum payment for work loss, which issue was decided in their favor below and not raised before us.

In Brendlinger v. Allstate, the widow, who is also the executrix, and children of Kenneth Brendlinger brought suit on a no-fault policy issued to him by Allstate. The policy covered a 1977 Dodge and a 1971 Catalina. The premiums paid respectively for uninsured motorist coverage and personal injury protection amounted to $4.40 and $13.00 for each car. Allstate paid Mrs. Brendlinger a lump sum work loss benefit of $13,903.00, $5,000.00 in survivors’ benefits and $1,500.00 in funeral expenses.

In Wilson v. Keystone, the widower, Louis D. Wilson, and the administrator, Gerald Alan Wilson, sued to recover an additional $35,000.00 in work loss, $579.50 additional in funeral expense and $10,000.00 additional for survivors benefits. Premiums had been paid for statutory and excess coverage on each of two cars.

4 . We note that the record shows the premium on additional vehicles covered in a single policy is discounted.

5 . See this writer’s concurring opinion in Standard Venetian Blind, supra.