Garcia v. Nationwide Mutual Insurance

821 F. Supp. 2d 1264, 2011 U.S. Dist. LEXIS 128498, 2011 WL 5154733
CourtDistrict Court, D. Wyoming
DecidedAugust 29, 2011
Docket2:11-cv-00084
StatusPublished

This text of 821 F. Supp. 2d 1264 (Garcia v. Nationwide Mutual Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Wyoming primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garcia v. Nationwide Mutual Insurance, 821 F. Supp. 2d 1264, 2011 U.S. Dist. LEXIS 128498, 2011 WL 5154733 (D. Wyo. 2011).

Opinion

ORDER GRANTING PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT AND DENYING DEFENDANT’S CROSS-MOTION FOR PARTIAL SUMMARY JUDGMENT

SCOTT W. SKAVDAHL, United States Magistrate Judge.

This matter comes before the Court on cross-motions for summary judgment. The Court, having reviewed the motions and the parties’ written submissions, having heard oral argument, and considering *1266 itself otherwise fully advised in the premises of the motions, hereby FINDS and ORDERS as follows:

FACTUAL BACKGROUND

This lawsuit involves a claim for uninsured motorist (“UM”) benefits by Plaintiff Michael “Mickey” Garcia under a policy of insurance he purchased from Defendant Nationwide Mutual Insurance Company (“Nationwide”). The facts pertinent to the pending cross-motions are undisputed, and the Court’s factual recitation is drawn primarily from the parties’ agreed-upon undisputed facts.

On February 24, 2009, Garcia was injured in a motor vehicle collision with an uninsured motorist in Sweetwater County, Wyoming. Garcia sustained bodily injuries as a result of the collision that required medical treatment and rendered him unable to work for a period of time. Because Garcia was acting within the scope of his employment as a driver for A & C Driving Service LLC at the time of the collision, and because his employer had provided worker’s compensation coverage for him, Garcia was eligible for the payment of worker’s compensation benefits. The Wyoming Workers Compensation Division paid $5,434.28 in temporary total disability payments to Garcia and $34,264.73 in medical payments to Garcia or on his behalf. Although Garcia incurred a total of $69,447.08 in medical expenses as a result of the collision, all of Garcia’s medical expenses were satisfied by the worker’s compensation medical payments totaling $34,264.73.

At the time of the collision, Garcia was insured by Nationwide under a Nationwide automobile liability policy, policy number AACM0016904099-2. Garcia’s policy included an uninsured motorist endorsement that provided uninsured motorist coverage with a per person limit of $250,000. Nationwide charged and collected a premium for that coverage from Garcia. Exclusion “B” of Garcia’s uninsured motorist endorsement excludes coverage that would benefit any insurer under a workers’ compensation law; however, that exclusion “does not apply to the Workers Compensation Division of the Wyoming State Treasurer’s Office.” (UM Endorsement at 2.) As a matter of policy, however, the State of Wyoming does not assert subrogation hens against payments made to injured workers under insurance policies that they have personally purchased. Accordingly, no worker’s compensation lien is asserted against any recovery Garcia may receive from his uninsured motorist coverage in this case.

Nationwide’s contractual obligation to provide UM benefits to Garcia is set forth in the three-page UM endorsement. The UM Endorsement of Garcia’s policy provides:

A. We [Nationwide] 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”:
1. Sustained by an “insured”; and
2. Caused by an accident.

(Id. at 1.) The “Limit of Liability” Section of the uninsured motorist endorsement contains two additional provisions that the parties assert are relevant to the issues now before the Court. The first provides:

We [Nationwide] will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible.

(Id. at 2.) The second provision states:

No “insured” shall be entitled to recover payment in excess of damages sustained.

(Id.)

In addition to these policy provisions, there are state regulations which are ap *1267 plicable to the issues before the Court. The Wyoming Insurance Department has promulgated a “Regulation Governing Uninsured Motorist Endorsements” which applies to all uninsured motorist policies issued in the State of Wyoming. See Regulations, Wyoming Dept, of Insurance, ch. 23 §§ 1-10. Two sections of that regulation are pertinent to the Court’s discussion of these issues. Section 5 of the regulation provides as follows:

Section 5. Reduction of Uninsured Motorist Coverage by Sums Paid Under Automobile Medical Coverage, Bodily Injury Coverage, and Workmen’s Compensation
(a) In no instance shall the benefits payable under insured motorists coverage be reduced on account of payments made under any other section of the policy, including but not limited to, sums paid under automobile medical coverage and bodily injury liability coverage, where actual damages exceed the policy limits of the uninsured motorists coverage. Only when total proven or undisputed damages incurred by the insured do not exceed the policy limits of the uninsured motorist coverage may payments made under other provisions of the policy be used to reduce uninsured motorist benefits.
(b) In no instance shall the benefits payable under uninsured motorists coverage be reduced by amounts paid under Worker’s Compensation legislation.

Id. at § 5 (emphasis added). Section 10 of the regulation provides:

Section 10. Benefits in Excess of Actual Damages Not to be Inferred
Notwithstanding any other section of this regulation, no payments will be required under uninsured motorists coverage which would result in duplicate payment for the same elements of loss or payment in excess of damages sustained.

Id. at § 10. It is behind the backdrop of these regulatory provisions and the contractual language that the issues are presented.

STANDARD OF REVIEW

Summary judgment is appropriate when there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(a). Where, as here, the parties file cross-motions for summary judgment, the Court is “entitled to assume that no evidence needs to be considered other than that filed by the parties, but summary judgment is nevertheless inappropriate if disputes remain as to material facts.” James Barlow Family Ltd. Partnership v. David M. Munson, Inc., 132 F.3d 1316, 1319 (10th Cir.1997), cert. denied, 523 U.S. 1048, 118 S.Ct. 1364, 140 L.Ed.2d 513 (1998).

As a federal court sitting in diversity, this Court applies the substantive law of the forum state. Because the policy was issued in Wyoming, both parties agree Wyoming law governs this dispute.

DISCUSSION

I.

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Bluebook (online)
821 F. Supp. 2d 1264, 2011 U.S. Dist. LEXIS 128498, 2011 WL 5154733, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garcia-v-nationwide-mutual-insurance-wyd-2011.