Bouton v. USAA Casualty Insurance

186 P.3d 1, 43 Cal. 4th 1190
CourtCalifornia Supreme Court
DecidedJune 9, 2008
DocketNo. S149851; No. S149847
StatusPublished
Cited by28 cases

This text of 186 P.3d 1 (Bouton v. USAA Casualty Insurance) is published on Counsel Stack Legal Research, covering California Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bouton v. USAA Casualty Insurance, 186 P.3d 1, 43 Cal. 4th 1190 (Cal. 2008).

Opinion

Opinion

MORENO, J.

Insurance Code section 11580.2 requires insurers to provide coverage for bodily injury or wrongful death caused by uninsured motorists. Subdivision (f) of this statute provides that if the insurer and the insured cannot agree whether the insured is legally entitled to recover damages from an uninsured motorist and the amount of such damages, those issues shall be determined by arbitration. (Ins. Code, § 11580.2, subd. (f).)

We granted review in these consolidated cases to decide two related issues. The insurer in Bouton v. USAA Casualty Insurance Company opposed a demand for arbitration on the ground that the claimant was not covered by the insurance policy. We held in Van Tassel v. Superior Court (1974) 12 Cal.3d 624, 627 [116 Cal.Rptr. 505, 526 P.2d 969] (Van Tassel) that “jurisdictional facts,” such as whether a claimant is insured under an uninsured motorist provision, are subject to arbitration. But we retreated from this holding the next year, saying in Freeman v. State Farm Mut. Auto. Ins. Co. (1975) 14 Cal.3d 473, 485 [121 Cal.Rptr. 477, 535 P.2d 341] (Freeman), that we “loosely and unfortunately” termed the issue in Van Tassel “jurisdictional.” We explained in Freeman that Insurance Code section 11580.2, subdivision (f), “read literally, requires arbitration of two issues only: (1) whether the insured is entitled to recover against the uninsured motorist and (2) if so, the amount of the damages.” (Freeman, supra, 14 Cal.3d at p. 480.)

We conclude that our holding in Van Tassel cannot be reconciled with our subsequent holding in Freeman and must be overruled. Determining whether a claimant is insured under an uninsured motorist provision is not a question of the underinsured tortfeasor’s liability or damages owed to the insured, and is therefore not subject to arbitration under Insurance Code section 11580.2, subdivision (f).

[1194]*1194O’Hanesian v. State Farm Mutual Insurance Company raises the related question whether an arbitrator or a court should decide if a default judgment obtained by the insured against the underinsured tortfeasor binds the insurer. We conclude that this issue is subject to arbitration, because Insurance Code section 11580.2, subdivision (f) requires an insured and his or her insurer to arbitrate the tortfeasor’s liability and damages owed to the insured, and the binding nature of a default judgment obtained against that tortfeasor falls squarely within those questions of liability and damages statutorily subject to arbitration.

Background

Bouton v. USAA Casualty Insurance Company

Plaintiff Lloyd Bouton was injured in an automobile accident, and settled his claim against Kevin Daniels, the driver of the other vehicle, for Daniels’s automobile insurance policy limit of $15,000. Bouton formally demanded arbitration with defendant USAA Casualty Insurance Company, his sister’s insurer, seeking damages exceeding the $15,000 policy limit payment he received from Daniels’s insurer. USAA denied coverage, claiming that Bouton was not a resident of his sister’s household, and was therefore not covered under her insurance policy.

Consistent with Insurance Code section 11580.2, subdivision (b),1 the policy’s underinsured motorist2 provision defines a “covered person” as the named insured “or any family member.” The policy defines a “family member” as “a person related to [the named insured] by blood, marriage, or adoption who is a resident of [the named insured’s] household.” Bouton contends that he constituted a family member of the named insured, his sister, Samela Bouton, because they were blood relatives permanently residing in the same household. The underinsured motorist provision of the policy provided that USAA would “pay compensatory damages which a covered person is legally entitled to recover from the owner or operator of an . . . underinsured motor vehicle because of [bodily injury] sustained by a covered person and caused by an auto accident.” Consistent with section 11580.2, subdivision (p)(3), the policy provided that no payment would be made until “the limits of liability under any applicable motor vehicle bodily injury liability bonds or policies have been exhausted by payment of judgments or settlements, and proof of such is submitted to [USAA].”

[1195]*1195The underinsured motorist provision of the policy contained an arbitration agreement, which stated: “If [USAA] and a covered person disagree as to: [][] 1. Whether a covered person is legally entitled to recover [bodily injury] or [property damage] damages from the owner or operator of an . . . underinsured motor vehicle; or [][] 2. The amount of [bodily injury] damages that the covered person is legally entitled to collect from that owner; [‘¡Q then, that disagreement shall be arbitrated .... This arbitration shall be limited to the two aforementioned factual issues and shall not address any other issues, including but not limited to, coverage questions. Any arbitration finding that goes beyond the two aforementioned factual issues shall be voidable by [USAA] or a covered person.”

USAA opposed Bouton’s demand for arbitration, arguing that Bouton was not covered under his sister’s policy, The trial court denied Bouton’s motion to compel arbitration, finding that because the arbitration provision of the insurance policy was no broader than section 11580.2, subdivision (f), the parties were only bound to arbitrate the issues of liability and damages, not coverage. Bouton appealed the trial court’s denial of his motion to compel arbitration. The Court of Appeal held that the trial court erred in denying Bouton’s motion to compel arbitration, and that the parties were required to arbitrate coverage as part of their agreement to arbitrate the liability and damages issues, consistent with this court’s decision in Van Tassel. USAA sought review in this court.

O’Hanesian v. State Farm Mutual Automobile Insurance Company

Plaintiff Charles Michael O’Hanesian was insured by defendant State Farm Mutual Automobile Insurance Company under a general insurance policy with a $100,000 limit for bodily injury, and under an umbrella policy with a $1 million limit for bodily injury. The underinsured motorist provision of the policies covered “damages for bodily injury an insured is legally entitled to collect from the owner or driver of an uninsured motor vehicle.” Following an accident, the policies required that the insured provide “all the details about the death, injury, treatment and other information” necessary to “determine the amount payable,” and “be examined by physicians chosen and paid by” the insurer.

The policies contained an arbitration provision as required by section 11580.2, subdivision (f), which stated: “Two questions must be decided by agreement between the insured and us: [][] 1. Is the insured legally entitled to collect damages from the owner or driver of the uninsured motor vehicle; and [1] 2. If so, in what amount? [][] If there is no agreement, upon written request of the insured or us, these questions shall be decided by arbitration as [1196]*1196provided by section 11580.2 of the California Insurance Code. ...

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Cite This Page — Counsel Stack

Bluebook (online)
186 P.3d 1, 43 Cal. 4th 1190, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bouton-v-usaa-casualty-insurance-cal-2008.