Federal Insurance v. Watnick

80 N.Y.2d 539
New York Court of Appeals·Decided December 17, 1992·Published·Cited by 27 cases

Opinion

OPINION OF THE COURT

Smith, J.

This appeal arises from a car accident that occurred in the Province of Quebec, Canada. On September 6, 1988, Jay and Marianna Watnick, residents of New York State, were driving through St. Agathe, Quebec, when their automobile was struck by a vehicle operated by Jay Anderson, a resident of Quebec. Jay and Marianna Watnick were severely injured.

When the accident occurred, the Watnicks were insured under a motor vehicle liability policy issued by Federal Insurance Company, a New York State insurance carrier. The policy contained an uninsured motorist endorsement and an optional supplementary uninsured motorist endorsement (denominated "Underinsured Motorists Coverage”) in the single limit of $300,000 (see, Insurance Law § 3420 [¶] [1], [2]; Vehicle and Traffic Law § 311 [4] [a]). The purpose of the uninsured motorist endorsement was to " 'provid[e] coverage to insured persons who suffer automobile accident injuries at the hands [543] of financially irresponsible motorists’ ” (see, Rowell v Utica Mut. Ins. Co., 77 NY2d 636, 640). The underinsured motorist endorsement provided protection to a covered person for bodily injury sustained in an automobile accident where the applicable bodily injury liability bond or policy provided coverage that was less than the limit of the subject policy. Under the policy in this case and the applicable section of the Insurance Law, Federal was obligated to pay underinsured motorist coverage only after the limits of liability under any applicable bodily injury liability bonds or policies had been exhausted by payment of judgments or settlements (see, Insurance Law § 3420 [¶] [2]). Although the underinsured motorist endorsement in the insurance policy allowed a setoff for any amount paid or payable under workers’ compensation, the endorsement allowed Federal to reduce the limit of bodily injury liability only by sums paid by or on behalf of persons or organizations who might be legally responsible. The endorsement did not permit Federal to reduce the limit of bodily injury insurance coverage by the maximum amount payable, as opposed to paid, under applicable bodily injury liability insurance policies. The policy allowed either party to make a written demand for arbitration if the parties did not agree (1) whether the covered person was legally entitled to recover damages, or (2) as to the amount of damages.

Anderson’s vehicle was insured for "bodily injury” liability under the Quebec Automobile Insurance Act (QAIA), a mandatory system of insurance reparations administered by the provincial government of Quebec. That program affords insurance coverage to all "owners” of road vehicles who use a public highway within the Province of Quebec (see, QAIA §§ 1.1, 17). Through applications made to its automobile insurance board, the Regie, the QAIA compensates nonresident claimants "to the extent that [they are] not responsible for the accident” (see, QAIA § 8) to a maximum of $20,000 (see, QAIA § 44). Claimants aggrieved by a determination by an officer of the Régie regarding compensation for bodily injury may appeal to the Appeals Section of the Régie and then to the Commission des Affaires Sociales (see, QAIA § 56). The record indicates that in addition to bodily injury coverage under the QAIA, the Anderson vehicle was insured by Commerce Insurance Company, an insurance company not licensed to do business in New York.

Jay and Marianna Watnick sought compensation from the Régie for their injuries. The Régie awarded Jay Watnick [544] $82.12 * for suffering and loss of enjoyment of life and denied Marianna Watnick’s claim, finding her 100% at fault for the accident. The Watnicks did not appeal from the Régie’s determinations.

Prior to receiving the determination from the Régie regarding Jay Watnick’s claim, the Watnicks filed claims with Federal under the uninsured and underinsured motorist endorsements of the motor vehicle liability policy. Federal denied coverage and commenced this proceeding, seeking to stay arbitration of both claims. Federal contended that the offending vehicle was neither uninsured or underinsured, as defined by the statutory and decisional laws of New York. The Watnicks argued that the offending vehicle was uninsured because the QAIA was not a "bodily injury liability bond or policy” within the meaning of New York’s Insurance Law.

In separate orders, Supreme Court, Nassau County, concluded that the offending vehicle was neither uninsured nor underinsured, and granted Federal’s applications to stay arbitration of both claims. The Appellate Division affirmed as to the uninsured claim but reversed as to the underinsured claim, denied Federal’s application to permanently stay arbitration of the underinsured motorist claim, and directed the parties to proceed to arbitration on that claim (see, 176 AD2d 38). The Court also allowed Federal to set off "the maximum amount [that Jay Watnick may receive] pending the Regie’s determination,” to satisfy the statutory requirement of exhaustion by payment and "expedite the arbitration” (see, id., at 43). The Appellate Division held that since the limit of the QAIA bodily injury liability coverage was less than that provided under the Watnicks’ underinsured motorist endorsement, the offending vehicle was underinsured (see, id., at 42).

The issues presented on appeal are whether the Watnicks may recover damages under the uninsured and underinsured motorist endorsements in their vehicle liability insurance policy with Federal.

Federal does not challenge the conclusion by the prior courts that the Anderson vehicle was not uninsured. However, the Watnicks maintain that those courts erred in concluding that the offending vehicle was not "uninsured” within the meaning of the Insurance Law and the subject policy. The [545] Watnicks argue that the legislative purpose of providing maximum and expeditious protection to the innocent victims of financially irresponsible motorist coverage in New York mandates liberal construction of the statute and the policy, and the conclusion that the offending vehicle was either uninsured or underinsured.

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Federal Insurance v. Watnick, 80 N.Y.2d 539 (N.Y. 1992).

80 N.Y.2d 539 (Federal Insurance v. Watnick) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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