Badger Mutual Insurance v. Schmitz

2002 WI 98, 647 N.W.2d 223, 255 Wis. 2d 61, 2002 Wisc. LEXIS 496
CourtWisconsin Supreme Court
DecidedJuly 10, 2002
Docket00-2682
StatusPublished
Cited by69 cases

This text of 2002 WI 98 (Badger Mutual Insurance v. Schmitz) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Badger Mutual Insurance v. Schmitz, 2002 WI 98, 647 N.W.2d 223, 255 Wis. 2d 61, 2002 Wisc. LEXIS 496 (Wis. 2002).

Opinions

DAVID T. PROSSER, J.

¶ 1. This is a review of an unpublished decision of the court of appeals1 that reversed a decision of the circuit court for Outagamie County, James T. Bayorgeon, Judge. There are two issues before the court.

¶ 2. First, does this court's decision in Dowhower v. West Bend Mutual Insurance Co., 2000 WI 73, 236 Wis. 2d 113, 613 N.W.2d 557, preclude a court from finding that an unambiguous clause reducing the un-derinsured motorists (UIM) liability of an insurer, is ambiguous in the context of a specific policy?

¶ 3. Second, if the answer to the first question is "no," is the reducing clause in the policy before the court ambiguous in the context of the entire policy, thereby rendering the reducing clause illusory and unenforceable?

¶ 4. This case involves an automobile liability insurance policy that provided UIM coverage and had a [66]*66reducing clause that conforms to Wis. Stat. § 632.32(5)(i) (1999-2000).2 The statute reads in part:

(i) A policy may provide that the limits under the policy for uninsured or underinsured motorist coverage for bodily injury or death resulting from any one accident shall be reduced by any of the following that apply:
(1) Amounts paid by or on behalf of any person or organization that may be legally responsible for the bodily injury or death for which the payment is made.

Wis. Stat. § 632.32(5)(i).

¶ 5. The reducing clause in the policy in question provided that the limit of UIM liability would be reduced by payments made to the insured by or on behalf of parties legally responsible for damages caused by an underinsured motorist. In this case, after the insured suffered injuries in an accident involving an underinsured motorist, and after the insured received payments from the underinsured motorist, the insurer applied the reducing clause in the insured's policy to reduce its liability to its insured by the amount of the payments received from the underinsured motorist.

¶ 6. The insured moved for a judgment declaring’ the UIM provisions invalid. The circuit court granted the declaratory judgment, determining that the insurance policy was illusory and unenforceable. The court of appeals reversed, holding that the policy was unambiguous and could not be deemed illusory.

¶ 7. After a thorough review of the insurance policy in question, we determine that while the reducing clause complies with the provision in Wis. Stat. [67]*67§ 632.32(5) (i), its limitation on UIM coverage is ambiguous in the context of the entire policy. We believe that a reasonable insured would not realize or expect that the insured's recovery under the UIM provision of the policy would be reduced by the payments received from the underinsured motorist. Thus, in the context of the entire policy, the reducing clause is ambiguous and renders the UIM coverage illusory. We further conclude that the inquiry undertaken by the circuit court was wholly consistent with the inquiry contemplated in the Dowhower decision. Accordingly, we reverse the decision of the court of appeals.

I. FACTS

¶ 8. The facts of this case are undisputed. On November 22, 1997, Dennis Schmitz was injured in a single vehicle accident. Schmitz was riding as a guest passenger in a 1997 Chevrolet pick-up truck traveling southbound on U.S. Highway 441 in Appleton. The vehicle slid on a patch of ice and rolled over. Schmitz sustained injuries in the accident and was rendered a quadriplegic.

f 9. The driver of the truck, Valerie Johnson, was insured by Badger Mutual Insurance Company (Badger Mutual).3 Her automobile insurance policy contained a liability limit of $100,000 per person. Badger Mutual commenced this action seeking a declaration of its rights, duties and obligations with respect to the liability insurance proceeds it wished to pay in settlement of Schmitz's personal injury claim.

¶ 10. Schmitz himself had an automobile insurance policy issued by American Merchants Casualty [68]*68Company4 (American Merchants) which included UIM coverage with a liability limit of $250,000 per person. Schmitz filed a cross-claim against American Merchants, asserting that the vehicle in which he was a passenger was an underinsured motor vehicle as defined in the American Merchants policy and that he was "entitled to the entirety of the $250,000 per-person limit of liability set forth in that policy."

¶ 11. In its answer, American Merchants acknowledged that the vehicle in question was an under-insured motor vehicle under its policy and "admit[ted] that Schmitz will be entitled to underinsured motorists coverage" under the American Merchants policy. It denied, however, that Schmitz was entitled to the entire $250,000 per-person limit of liability. It "affirmatively allege [d] that the applicable limit of liability must be reduced by the sums paid Schmitz by Badger Mutual Insurance Company."

¶ 12. American Merchants' claim of reduction in its $250,000 liability relied on a reducing clause in the policy, which reads in part: "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." American Merchants applied this clause to reduce the $250,000 UIM limit of liability by the $100,000 that Schmitz received from Badger Mutual. Thus, American Merchants paid [69]*69Schmitz only $150,000 on the policy. As a result, Schmitz filed a motion for summary declaratory judgment against American Merchants, seeking recovery of the full $250,000 limit of liability of his UIM coverage.

¶ 13. After extensive briefing by the parties, Judge Bayorgeon acknowledged that the reducing clause in the American Merchants policy conformed to the requirements of Wis. Stat. § 632.32(5)(i). He determined, however, that the reducing clause failed to clearly set forth that UIM payments would be reduced by sums paid by others, "so that there is no mistake, confusion or illusion with respect to what is being provided for the premium being paid." Judge Bayorgeon concluded that, "The contract is illusory and therefore unenforceable." Consequently, the circuit court granted Schmitz's motion for summary declaratory judgment.

¶ 14. On appeal, the court of appeals reversed in a unanimous, unpublished, per curiam opinion. Badger Mut. Ins. Co. v. Schmitz, unpublished slip op. (Wis. Ct. App. July 31, 2001). The court noted that, "A policy that contains an unambiguous reducing provision under [Wis. Stat. § 632.32(5)(i)] is valid and enforceable, and may no longer be deemed illusory." Id. at ¶ 4 (citing Sukala v. Heritage Mut. Ins. Co., 2000 WI App 266, ¶¶ 15-20, 240 Wis. 2d 65, 622 N.W.2d 457). It determined that the American Merchants policy "sets forth an unambiguous, enforceable reducing clause, limiting [American Merchants'] liability in this case." Id. at ¶ 1.

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Bluebook (online)
2002 WI 98, 647 N.W.2d 223, 255 Wis. 2d 61, 2002 Wisc. LEXIS 496, Counsel Stack Legal Research, https://law.counselstack.com/opinion/badger-mutual-insurance-v-schmitz-wis-2002.