Economy Preferred Insurance v. Jia

2004 NMCA 076, 92 P.3d 1280, 135 N.M. 706
CourtNew Mexico Court of Appeals
DecidedMay 4, 2004
Docket23,587
StatusPublished
Cited by13 cases

This text of 2004 NMCA 076 (Economy Preferred Insurance v. Jia) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Economy Preferred Insurance v. Jia, 2004 NMCA 076, 92 P.3d 1280, 135 N.M. 706 (N.M. Ct. App. 2004).

Opinion

OPINION

FRY, J.

{1} This ease requires us to consider the meaning of “bodily harm, sickness or disease” in the context of a policy of automobile liability insurance, and as applied to the emotional distress suffered by a witness to an accident. Defendant Quanxi Jia (Jia), as parent and legal guardian of Richard Jia (Richard), appeals a declaratory judgment regarding the uninsured and underinsured motorists (UM) benefits of a policy issued by Plaintiff Economy Preferred Insurance Company (EPIC). The coverage dispute stems from an accident in which Xuming Wu, Jia’s wife and Richard’s mother, was struck and killed by a drunk driver. Richard, then five years old, witnessed the fatal accident. Jia argues that, under the policy’s UM provisions, Richard is entitled to assert a separate claim for damages for emotional distress suffered as a result of witnessing the accident. In addition, Jia argues that Richard’s emotional distress is accompanied by physical manifestations. EPIC contends that the policy language excludes coverage for emotional injuries, and that Richard’s injuries are purely emotional or psychological in nature. For the reasons that follow, we agree with the trial court that the UM coverage does not extend to Richard’s injuries, and we affirm.

BACKGROUND

{2} In June 2001, a drunk driver hit several pedestrians who were out for an evening walk on a residential street in Los Alamos. The car struck Richard’s mother, a family friend, and the friend’s infant child, who was being pushed in a stroller. Richard was also with the group, riding his bicycle in front of his mother at the time of the accident. He was not struck by the vehicle. On appeal the parties dispute whether Richard saw the moment of impact, but there is no disagreement that he was present and witnessed his mother’s injuries. She died from the injuries several hours later.

{3} Jia turned to the family’s UM coverage for compensation. At the time of the accident, the family had two policies of insurance with EPIC. Combined, the policies provided UM coverage of $200,000 in damages arising out of bodily injury to each person, and $600,000 in damages for bodily injury resulting from each accident. The Estate of Xuming Wu (the Estate) sought $200,000 in compensatory damages for wrongful death, and on Richard’s behalf Jia sought an additional $200,000 for negligent infliction of emotional distress (NIED). Pursuant to a court-approved stipulated settlement, EPIC paid $200,000 to the Estate in wrongful death benefits, but it did not pay additional compensation to Richard, arguing that Richard’s injuries were not within the definition of bodily injury and that his claims were therefore subsumed by the per person limit of $200,000.

{4} EPIC sought a declaratory judgment, asking the trial court to rule that the policies provide no UM coverage for emotional distress, and that Richard’s claims were subsumed under the $200,000 limit for damages arising out of his mother’s death. Jia timely answered and also moved for partial summary judgment on the grounds that the term “bodily injury” was ambiguous as a matter of law, and that the terms “sickness and disease” within the definition of bodily injury created a reasonable expectation on the part of an insured that emotional injuries such as Richard’s would be covered separately from his mother’s injuries. Consequently, Jia argued, an additional $200,000 in UM coverage remained available to Richard as compensation for NIED. Jia further argued to the trial court that Richard exhibited physical manifestations of emotional distress. In a cross-motion for summary judgment, EPIC contended that, as a matter of law, the insurance policies provided no coverage for emotional distress claims such as Richard’s. The trial court granted summary judgment in favor of EPIC, ruling that the UM provisions do not cover emotional distress. Jia appeals.

DISCUSSION

{5} The parties agree there are no genuine issues of material fact in this case. Therefore, we review whether the trial court properly applied the law to the undisputed facts. Wiard v. State Farm Mut. Auto. Ins. Co., 2002-NMCA-073, ¶ 6, 132 N.M. 470, 50 P.3d 565.

{6} ”An insurance claim arises from the policy language.” Gonzales v. Allstate Ins. Co., 122 N.M. 137, 140, 921 P.2d 944, 947 (1996). Accordingly, to determine the extent of UM coverage, we look to the specific language of the UM provisions in the EPIC policy. Id. at 139, 921 P.2d at 946; Wiard, 2002-NMCA-073, ¶ 7, 132 N.M. 470, 50 P.3d 565.

{7} The UM coverage provides as follows:

A. We will pay compensatory damages which an insured is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of bodily injury sustained by an insured and caused by an auto accident. The owner’s or operator’s liability for these damages must arise out of the ownership, maintenance or use of the uninsured motor vehicle.
B. Insured as used in this Part means:
1. you or any family member.
2. any person occupying your covered auto.
3. any person for damages that person is entitled to recover because of bodily injury to which this coverage applies sustained by a person described in 1. or 2. above.

Under subpart (A), compensatory damages payable to “an insured” may be owed because of injury to “an insured.” This can be read as referring to two different insureds, which suggests that Richard could recover compensatory damages because of injury to his mother. It also appears that Richard falls under the definition of “any person” in subpart (B)(3), which further indicates that Richard might be able to recover damages he sustained as a result of injury to his mother. The policy’s “Limit of Liability,” however, explicitly constrains Richard’s potential recovery by the following terms:

The limit of liability shown in the Declarations for each person for Uninsured Motorists Coverage is our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of bodily injury to any one person in any one auto accident. Subject to this limit for each person, the limit of liability shown in the Declarations for each accident for Uninsured Motorists Coverage is our maximum limit of liability for all damages for bodily injury resulting from any one auto accident. This is the most we will pay regardless of the number of insureds, claims made, vehicles or premiums shown in the Declarations, or vehicles involved in the auto accident.

This language unambiguously limits the coverage based on “bodily injury.” Under this language, if the only bodily injury was that of Richard’s mother, then the “each person” limit is the maximum that can be recovered. However, if Richard also sustained bodily injury, then the “each accident” limit provides the maximum. This leads to the dis-positive issue: the meaning of bodily injury, which the policy explicitly defines as “bodily harm, sickness or disease, including death that results.”

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Bluebook (online)
2004 NMCA 076, 92 P.3d 1280, 135 N.M. 706, Counsel Stack Legal Research, https://law.counselstack.com/opinion/economy-preferred-insurance-v-jia-nmctapp-2004.