Hepler v. Liberty Mutual Fire Insurance

13 Pa. D. & C.4th 528, 1992 Pa. Dist. & Cnty. Dec. LEXIS 373
CourtPennsylvania Court of Common Pleas, Cumberland County
DecidedFebruary 7, 1992
DocketNo. 4; no. 3528 Civil 1988
StatusPublished

This text of 13 Pa. D. & C.4th 528 (Hepler v. Liberty Mutual Fire Insurance) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Cumberland County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hepler v. Liberty Mutual Fire Insurance, 13 Pa. D. & C.4th 528, 1992 Pa. Dist. & Cnty. Dec. LEXIS 373 (Pa. Super. Ct. 1992).

Opinion

HESS, J.,

This case arises out of an automobile accident that occurred on May 19, 1988, in which it is alleged that the plaintiff, Diane E. Hepler, suffered serious injuries. The carrier for the tortfeasor paid its liability limits. The plaintiffs thereafter sought additional moneys from Liberty Mutual by virtue of underinsured motorists coverage. In that connection, they have requested arbitration. Liberty Mutual has responded that their policy of insurance with the Heplers was amended on April 3, 1988, to permit arbitration only with the mutual consent of the insured and the insurer. As the insurer now does not consent, Liberty Mutual contends that arbitration is barred.

[529]*529Inasmuch as Liberty Mutual refused to select an arbitrator, the Heplers brought the instant action. This court has previously held that arbitration is not required and that the parties are bound by the arbitration language contained in the policy amended April 3, 1988. Since our last ruling on this matter, the plaintiffs have been granted leave to file an amended complaint to compel arbitration. A hearing was held in the matter on January 16,1992. Our recent hearing adduced pivotal testimony which has not heretofore been a part of the record of this case.1 Our determination today is based upon the following facts gleaned from sworn testimony as well as assertions by the plaintiffs in the pleadings which are admitted by the defense.

Coverage was initially issued by Liberty Mutual Fire Insurance Company, to the plaintiffs, for the period April 3, 1986, to April 3, 1987. The original policy had a part (c) entitled, “Uninsured Motorist Coverage,” which provided an arbitration clause whereby either party could make a demand for arbitration. A declaration sheet forwarded by Liberty Mutual and covering the period of April 3, 1987, to April 3,1988, likewise, contained an arbitration provision permitting either party to make a demand for same. During the policy year of April 3, 1987, to April 3, 1988, Liberty Mutual, through Insured Services Offices Inc. (ISO), sought to have the existing arbitration clause changed to require mutual consent of both insurer and insured. In this regard, a formal request was submitted by Insurance [530]*530Services Offices Inc. through its regional manager, Kenneth J. Potavin. The letter was endorsed with an approval effective November 1,1987. The approval was accompanied by a written note reflecting Mr. Potavin’s representation to the insurance commissioner that the proposed change in arbitration language was not intended to alter the intent of the regulatory language regarding arbitration. This representation was reiterated, in writing, on December 7,1987, when Insurance Services Offices Inc. wrote a letter containing the following paragraphs:

“It is our intent to revise the ISO arbitration provision to bring it more in line with the procedures of the commercial arbitration panels, such as the AAA. These panels require mutual consent prior to entering into arbitration procedure. Major independents also use mutual consent as required by the AAA.

“We wish to point out that the approved arbitration language in Pennsylvania is to the insured’s favor in the event the insured does not wish to arbitrate. In that case, the insured’s refusal to arbitrate requires the insurer to go to court. Under the previous language (either party), which does not require mutual consent, the insurer could force the insured to go to arbitration in this situation.”

Despite the language of this letter, Liberty Mutual, the insurer, is the party now objecting to arbitration. At our recent hearing, the plaintiffs’ witnesses testified as experts in the insurance industry to the effect that arbitration was a procedure favorable to the insured. Their testimony is to the effect that, in what is tantamount to an adhesion contract, the defendant has sought to [531]*531impose upon the insured an arbitration provision favorable to itself and in violation of Pennsylvania’s regulatory scheme. They have done so, all the while representing to the insurance department a contrary intent.

On January 25, 1988, Mr. Michael Paynes, of the Bureau of Policy Examination, rescinded the approval of the uninsured/underinsured motorist coverage endorsement containing the mutual consent to arbitration requirement. Considerable correspondence was exchanged, during the spring of 1988, between Insurance Services Offices Inc. and the insurance department. This did nothing, however, to alter the position of the department that the proposed change, requiring mutual consent to arbitration, had been disapproved. On April 28, 1988, ISO submitted a filing which formally eliminated mutual consent arbitration language. Citing the enormous administrative burden on insurance companies to reprint their forms, ISO requested that their filing become effective June 1, 1988.

This case can be rather easily summarized. The defendant insurance company sought to amend its policy with the plaintiff to contain an arbitration clause which was not in conformity with Pennsylvania’s regulatory scheme. They obtained initial approval of this change by representing it as one favorable to the insured: a position which the instant litigation belies. The proposed change was disapproved by the insurance department and never, thereafter, approved. The April 28, 1988, submission of ISO was approved, effective June 1,1988, for reasons having to do with the clerical problems of the insurance industry. Nowhere in the April submission did ISO request the insurance department to approve mutual consent arbitration language [532]*532retroactively until June 1, 1988. It was therefore the case that, on the anniversary date of the plaintiff’s policy, Liberty Mutual unilaterally attempted to change its existing policy with the plaintiffs by using language which had been expressly disapproved by the insurance department.

The narrow question presented in this case is whether effect may be given to endorsements changing existing arbitration clauses of insurance policies where such endorsements have not been approved by the insurance department as of the date the endorsement is to become effective. We have found no cases on point, neither have counsel cited any. We are satisfied, however, that the Insurance Company Law, 40 Pa.C.S §341 et seq., as well as the Uninsured Motorist Clause Act, 40 Pa.GS §2000, resolve the question in favor of the plaintiff.

The Insurance Company Act, specifically at 40 Pa.C.S §477(b) provides that it shall be unlawful for any insurance company to use endorsements unless they have been formally approved by the insurance commissioner. In addition, the Act provides that approval “[s]hall become void upon any subsequent notice of disapproval from the insurance commissioner....” In addition, the Uninsured Motorist Clause Act, 40 Pa.C.S §2000,2 has [533]*533been construed to empower the insurance commissioner to promulgate regulations requiring arbitration clauses in automobile insurance policies. In Prudential Property and Casualty Insurance Company v. Muir, 99 Pa. Commw. 620, 513 A.2d 1129 (1986), alloc. denied, 514 Pa. 637, 522 A.2d 1106 (1987), the court laid to rest the question of the authority of the insurance commissioner to require arbitration clauses specifically in uninsured/underinsured coverage.

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Related

Prudential Property & Casualty Insurance v. Muir
513 A.2d 1129 (Commonwealth Court of Pennsylvania, 1986)

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Bluebook (online)
13 Pa. D. & C.4th 528, 1992 Pa. Dist. & Cnty. Dec. LEXIS 373, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hepler-v-liberty-mutual-fire-insurance-pactcomplcumber-1992.