Grijalva v. Safeco Insurance Co. of America

985 P.2d 784, 329 Or. 36, 1999 Ore. LEXIS 384
CourtOregon Supreme Court
DecidedJuly 9, 1999
DocketCC 95-SV-0296-AB; CA A94209; SC S45472
StatusPublished
Cited by12 cases

This text of 985 P.2d 784 (Grijalva v. Safeco Insurance Co. of America) is published on Counsel Stack Legal Research, covering Oregon Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Grijalva v. Safeco Insurance Co. of America, 985 P.2d 784, 329 Or. 36, 1999 Ore. LEXIS 384 (Or. 1999).

Opinion

*39 GILLETTE, J.

This is an action for breach of an automobile insurance contract. The primary issue before this court concerns the proper method for calculating the amount of under-insured motorist (UIM) benefits payable to an individual claimant under a so-called “single-limit” policy, when other persons injured in the same accident also are seeking benefits under the policy. 1 The trial court ruled, and the Court of Appeals agreed, that, when the individual’s damages equal or exceed the policy limit, the individual’s award should be calculated by subtracting from the policy’s UIM limit the amounts recovered from other sources by the individual and all the other claimants. However, for the reasons that follow, we conclude that those courts were incorrect and that the claimant’s UIM proceeds should be calculated by subtracting from the policy limit only those amounts recovered by the claimant from other sources.

There is no dispute about the relevant facts. Plaintiff and a coworker, Edwards, were driving together in Edwards’ car when the car was struck by a car driven by Dawson. Plaintiff was injured and suffered damages in excess of $100,000.

At the time of the collision, Dawson had a liability insurance policy that provided combined single-limit liability coverage in the amount of $60,000. Plaintiff received $42,000 out of that policy while Edwards, who also had been injured, received $18,000. Plaintiff and Edwards also received workers’ compensation benefits because of their injuries. Plaintiff received $14,877.02 in unreimbursed workers’ compensation benefits from the accident; Edwards received $3,846.59.

Because neither plaintiff nor Edwards were made whole by the foregoing recoveries, both filed claims under the UIM provisions of Edwards’ automobile insurance policy. That policy, which defendant Safeco had issued, provided UIM coverage up to a single limit of $100,000. Safeco paid Edwards $4,755.37 on her claim; it denied plaintiffs claim.

*40 Plaintiff then filed the present action against Safeco, alleging breach of the insurance policy and seeking (after amendment) $58,000 in damages. Plaintiff claimed that, because her injuries exceeded the UIM policy’s $100,000 single limit, she was entitled to the full $100,000, less only the $42,000 that she had received from Dawson’s liability policy. 2

Safeco answered, denying liability in that amount. It also counterclaimed, seeking a declaration that the maximum benefits available under the policy were $16,521.02, together with an order allowing it to deposit that amount with the clerk of the court and directing plaintiff and Edwards to resolve their claims under the policy based on that amount. Safeco’s theory was that, because there was more than one claimant seeking UIM coverage for the same accident, plaintiffs award should equal the amount of the policy limit ($100,000) minus any amounts that all the claimants (i.e., plaintiff and Edwards) had recovered from other sources. Specifically, Safeco proposed that the following items were proper reductions: (1) the $4,755.37 already paid to Edwards out of the UIM policy; (2) the $60,000 paid to plaintiff and Edwards under Dawson’s liability policy; (3) the $14,877.02 paid to plaintiff by her employer’s workers’ compensation carrier; and (4) the $3,846.59 paid to Edwards on her workers’ compensation claim.

After motions for summary judgment, the trial court entered judgment for Safeco on its declaratory relief claim and awarded plaintiff the $16,521.02 in benefits that Safeco had argued was available. The trial court also entered judgment for Safeco on plaintiffs claim and denied Safeco’s inter-pleader claim. The court denied the parties’ competing claims for attorney fees, concluding that no party had prevailed on a claim that would allow an award of attorney fees.

Plaintiff appealed, assigning error to a number of items that the trial court had accepted as proper offsets against her UIM recovery, viz., (1) Edwards’ recovery from Dawson’s liability policy; (2) Edwards’ workers’ compensation recovery; and (3) plaintiffs own workers’ compensation *41 recovery. Plaintiff also assigned error to the trial court’s denial of her claim for attorney fees. The Court of Appeals concluded that the trial court had not erred in any respect that plaintiff had argued and affirmed. Grijalva v. Safeco Ins. Co., 153 Or App 144, 956 P2d 995 (1998).

In this court, plaintiff has abandoned any claim that her own recovery from her employer’s workers’ compensation carrier was an impermissible offset. However, plaintiff continues to press her argument that her UIM recovery cannot be reduced by Edwards’ recoveries from other sources, i.e., from Dawson’s liability policy or from workers’ compensation. She contends that the relevant statutes (i.e., those that provide minimum requirements for UIM insurance) are clear on that score — that a UIM insurer’s liability for a claimant’s injuries is to be reduced only by the amounts that the claimant has received from other sources. In so arguing, plaintiff particularly relies on two statutes, ORS 742.502(2)(a) and ORS 742.504(7)(c), both set out post.

Safeco acknowledges that the two statutes identified by plaintiff are the relevant point of departure. However, Safeco contends that, contrary to plaintiffs view, those statutes unambiguously provide that a claimant’s UIM recovery is to be reduced by the total amount paid by the tortfeasor’s liability insurer or in workers’ compensation to all insureds.

We agree with the parties that resolution of the present controversy lies in the proper interpretation of ORS 742.502(2)(a) and ORS 742.504(7). ORS 742.502(2)(a) is the general UIM mandate. It requires the inclusion of UIM coverage in any policy that provides uninsured motorist (UM) coverage in excess of the financial responsibility amounts and provides the following general formula for calculating UIM benefits:

“Underinsurance benefits shall be equal to uninsured motorist coverage benefits less the amount recovered from other automobile liability insurance policies.”

(Emphasis added.)

ORS 742.504(7) describes the limits of the insurer’s liability for both UM and UIM coverage and also sets out the *42 permissible reductions or offsets from such coverage. It provides, in relevant part:

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Bluebook (online)
985 P.2d 784, 329 Or. 36, 1999 Ore. LEXIS 384, Counsel Stack Legal Research, https://law.counselstack.com/opinion/grijalva-v-safeco-insurance-co-of-america-or-1999.