Heffner v. Farmers Insurance

162 P.3d 277, 213 Or. App. 289, 2007 Ore. App. LEXIS 847
CourtCourt of Appeals of Oregon
DecidedJune 13, 2007
Docket040301L7; A128277
StatusPublished

This text of 162 P.3d 277 (Heffner v. Farmers Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Heffner v. Farmers Insurance, 162 P.3d 277, 213 Or. App. 289, 2007 Ore. App. LEXIS 847 (Or. Ct. App. 2007).

Opinion

LANDAU, P. J.

Plaintiffs are the parents of a minor daughter who was injured in an automobile accident. The daughter suffered $100,000 in noneconomic damages, and her parents paid $50,000 in medical expenses for her injuries. The driver who caused the accident was underinsured — that is, his insurance was not sufficient to cover the damages. Defendants are the insurance companies that issued a total of three motor vehicle insurance policies to plaintiffs for vehicles that were not involved in their daughter’s accident. Each of the three policies contains a provision for underinsured motorist (UIM) coverage up to $100,000 “per person,” subject to a provision that prohibits tapping into other policies to obtain benefits in excess of the limits of the single policy with the highest limit. Defendants agreed that they are obligated to provide UIM coverage up to the coverage limit of $100,000 for the daughter’s noneconomic damages expenses, and they paid those benefits. Defendants contend that they have no obligation to cover the $50,000 that plaintiffs spent on their daughter’s medical expenses because their UIM coverage was exhausted. Plaintiffs contend that they are entitled to coverage for the medical expenses. The trial court agreed with defendants and entered judgment accordingly. Plaintiffs appeal, and we affirm.

The facts, as stipulated by the parties, are as follows. Plaintiffs obtained liability insurance coverage on each of their three vehicles. Defendant Farmers Insurance Company issued a policy for each of two of the vehicles, while defendant Mid-Century Insurance Company — a member of theFarmers Insurance Group of Companies — issued a policy for the third vehicle. All three policies contain identical provisions. Each provides underinsured motorist coverage up to $100,000 “for bodily injury sustained by any person in any one occurrence.” The policies further provide that “[t]he limit for ‘each person’ is the maximum for bodily injury sustained by any person in any one occurrence.”

The coverage in each of the three policies is subject to the following “other insurance” clauses:

[292]*292“2. Any insurance we provide to an insured person while occupying a vehicle you do not own shall:
“a. be excess over any other valid and collectible insurance, and
“b. apply in the amount by which the applicable limit of this coverage exceeds the sum of the applicable limits of all other such insurance.
“3. If any applicable insurance other than this policy is issued to you or a family member by us or any other member company of the Farmers Insurance Group of Companies, the total amount payable among all such policies shall not exceed the limits provided by the single policy with the highest limits of liability.”

While the policies were in force, plaintiffs’ 15-year-old. daughter, Kayla, was injured in an motor vehicle accident. She was one of 12 passengers in a van — not one of plaintiffs’ three vehicles — that overturned and injured a number of the passengers. Her parents incurred medical expenses of $50,000, and Kayla further suffered noneconomic loss of $100,000. The owner of the van had liability insurance that covered the driver, with a total policy limit of $1,000,000. Because of the number of passengers injured in the accident, however, that amount was not sufficient to cover Kayla’s and her parents’ losses.

Kayla submitted a claim to defendants for UIM benefits under plaintiffs’ Farmers and Mid-Century policies. Plaintiffs also brought their own claims, seeking reimbursement for Kayla’s medical expenses. Defendants denied both claims.

Kayla and plaintiffs then initiated an action against defendants for breach of contract. They alleged that they are entitled to UIM benefits under each of the three policies that defendants issued. Defendants agreed that Kayla is entitled to an award of $100,000 for her noneconomic losses. They contended, however, that they are not required to cover the $50,000 for Kayla’s medical expenses that plaintiffs paid. Defendants reasoned that the policies provided for coverage only to an insured who sustained bodily injury. According to [293]*293defendants, plaintiffs are insureds, but they suffered no bodily injury, while Kayla, who is also an insured and who suffered bodily injury, cannot recover benefits for medical expenses that she did not personally incur. In the alternative, defendants argued that, even if UIM benefits are otherwise available, they cannot be paid in this case because of the other insurance limitations in each of the policies. The trial court agreed with defendants on both arguments and entered judgment in favor of defendants on the claim for medical expenses.

Plaintiffs appeal; Kayla does not. Plaintiffs contend that the trial court erred both in concluding that they are not entitled to UIM coverage at all and in concluding that, even if they are entitled to coverage, no further benefits are available. Defendants contend that the trial court was correct in both respects. We need not address the first of plaintiffs’ two contentions because, even assuming for the sake of argument that plaintiffs are otherwise entitled to UIM coverage for the $50,000 in medical expenses, the fact remains that, under the express terms of each of defendants’ policies, there are no benefits left to pay beyond the $100,000 that defendants agreed to pay.

As we have noted, each of the three policies at issue provides that the $100,000 limit of liability for “each person” is “the maximum for bodily injury sustained by any person in any one occurrence.” Defendants contend that, in this case, there was only one “occurrence” — the motor vehicle accident in which Kayla was injured — and only one “person” who suffered a bodily injury. Consequently, defendants contend, the maximum payable for that occurrence for injury to that one person is $100,000. Plaintiffs concede that the “each person” limit would apply to their recovery under any single policy. They insist, however, that that limit does not prevent them from claiming up to the same amount under each of the other policies when the limits of one have been exhausted.

Defendants respond that the “other insurance” provisions of the policies do prevent precisely that from occurring. Plaintiffs concede the applicability of the other insurance provisions. They argue that the provisions are simply [294]*294unenforceable because they are inconsistent with what, in their view, the law requires.

ORS 742.504(1) to (12) sets out comprehensive “model” policy provisions concerning uninsured and under-insured motorist coverage. Vega v. Farmers Ins. Co., 323 Or 291, 302, 918 P2d 95 (1996).1 Any UIM provisions that are less favorable to an insured than those required under the statute are unenforceable as against an insured in this state. See Erickson v. Farmers Ins. Co., 331 Or 681, 685, 21 P3d 90 (2001) (UM provisions that are less favorable to insured than what statute requires are unenforceable).

ORS 742.504(9) (2003) bears on the validity of the provisions at issue in this case. That subsection provides:

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Erickson v. Farmers Ins. Co. of Oregon
21 P.3d 90 (Oregon Supreme Court, 2001)
Vega v. Farmers Insurance
918 P.2d 95 (Oregon Supreme Court, 1996)
VanWormer v. Farmers Insurance
15 P.3d 612 (Court of Appeals of Oregon, 2000)

Cite This Page — Counsel Stack

Bluebook (online)
162 P.3d 277, 213 Or. App. 289, 2007 Ore. App. LEXIS 847, Counsel Stack Legal Research, https://law.counselstack.com/opinion/heffner-v-farmers-insurance-orctapp-2007.