Israel v. State Farm Mutual Automobile Insurance

789 A.2d 974, 259 Conn. 503, 2002 Conn. LEXIS 59
CourtSupreme Court of Connecticut
DecidedFebruary 19, 2002
DocketSC 16474
StatusPublished
Cited by33 cases

This text of 789 A.2d 974 (Israel v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Israel v. State Farm Mutual Automobile Insurance, 789 A.2d 974, 259 Conn. 503, 2002 Conn. LEXIS 59 (Colo. 2002).

Opinion

Opinion

VERTEFEUILLE, J.

The dispositive issue in this case, which comes to us upon acceptance of two certified questions from the United States Court of Appeals for the Second Circuit,1 is whether certain language in an umbrella insurance policy issued by the defendants is ambiguous, with the result that the policy must be construed so as to provide the plaintiffs with coverage. We answer the first certified question in the affirmative.2

[506]*506The named plaintiff, David Israel (plaintiff),3 brought this breach of contract action individually and as personal representative of the estate of his wife, Susan Israel, in the Superior Court after the defendants, State Farm Mutual Automobile Insurance Company and State Farm Fire and Casualty Company, denied the plaintiffs claim for underinsured motorist benefits. The defendants removed the case to the United States District Court for the District of Connecticut. The District Court rendered summary judgment in favor of the defendants, from which the plaintiff appealed to the United States Court of Appeals for the Second Circuit. The Court of Appeals then certified two questions of law to this court, which we accepted. See footnote 2 of this opinion. We conclude that the insurance policy in question is ambiguous and, therefore, we construe the policy so as to afford the plaintiff underinsured motorist coverage.

The following stipulated facts are relevant to our resolution of the certified questions. The plaintiff was injured, and his wife was killed, when their automobile, which he was driving and in which his wife was a passenger, collided with a vehicle driven by an underinsured motorist. The underinsured motorist had automobile liability insurance, but his coverage fell short of fully compensating the plaintiff and the estate of his wife. Following exhaustion of the underinsured motorist’s coverage, the plaintiff filed a claim for underinsured motorist benefits under a personal liability umbrella insurance policy issued by the defendants to the plaintiffs mother, with whom he lived on a part-time basis.4 The defendants denied the claim because, [507]*507inter alia, the plaintiff had failed to maintain underlying uninsured motorist coverage on his automobile, as allegedly required by his mother’s insurance policy. The plaintiff thereafter initiated the underlying litigation and appeal.

We begin by setting forth the standard of review that governs our resolution of the certified question. “[Construction of a contract of insurance presents a question of law for the court which this court reviews de novo.” (Internal quotation marks omitted.) Hansen v. Ohio Casualty Ins. Co., 239 Conn. 537, 543, 687 A.2d 1262 (1996).

The issue that we must resolve is whether the umbrella policy issued by the defendants is ambiguous because it is inconsistent regarding the consequences of the plaintiffs failure to maintain the underlying coverage required by the policy. Specifically, we must decide if the policy is ambiguous as to whether such failure vitiates the umbrella coverage, or merely results in the insured being personally responsible for the amount of the required underlying coverage before the umbrella coverage takes effect. We conclude that the policy is ambiguous.

The policy at issue in the present case consists of four parts: a nine page booklet entitled “Personal Liability Umbrella Policy” (umbrella booklet), an addendum to that booklet entitled “Uninsured Motor Vehicle Coverage” (uninsured addendum), a declarations page, and four pages of endorsements. The umbrella booklet provides in relevant part: “YOUR DUTIES TO US. These are things you must do for us. We may not provide coverage if you refuse to .... 4. maintain your under[508]*508lying insurance. All insurance listed in the Declarations must be maintained at all times. The limits listed in the Declarations are the minimum you must maintain. If the required underlying limits are not maintained, you will be responsible for the underlying limit amount of any loss. ...” (Emphasis added.)

The uninsured addendum provides in relevant part as follows: “Coverage U—Uninsured Motor Vehicle . . . These conditions apply: 1. You must maintain underlying limits for uninsured motorist motor vehicle coverage equal to the limits listed in the Declarations. If these underlying limits are not maintained, this coverage will not apply. . . . All other provisions of this policy apply.” (Emphasis added.)

The plaintiff claims that these provisions conflict, creating an uncertainty as to the status of the umbrella coverage when the underlying coverage is not maintained and rendering the policy ambiguous. The plaintiff therefore claims that the policy must be construed so as to provide him with coverage. We agree with the plaintiff.

Our analysis of the language of the insurance contract is governed by the well established principle of insurance law that “policy language will be construed as laymen would understand it and not according to the interpretation of sophisticated underwriters, and that ambiguities in contract documents are resolved against the party responsible for its drafting; the policyholder’s expectations should be protected as long as they are objectively reasonable from the layman’s point of view. . . . The premise behind the rule is simple. The party who actually does the writing of an instrument will presumably be guided by his own interests and goals in the transaction. He may choose shadings of expression, words more specific or more imprecise, according to the dictates of these interests. ... A further, related [509]*509rationale for the rule is that [s]ince one who speaks or writes, can by exactness of expression more easily prevent mistakes in meaning, than one with whom he is dealing, doubts arising from ambiguity are resolved in favor of the latter.” (Internal quotation marks omitted.) Hansen v. Ohio Casualty Ins. Co., supra, 239 Conn. 544. This canon, commonly styled contra proferentem, is more rigorously applied in the context of insurance contracts than in other contracts. Id., 545.

The doctrine of contra proferentem applies, however, only if we conclude that the language of the insurance policy is ambiguous. Thus, we must decide whether, reading the policy “from the perspective of a reasonable layperson in the position of the purchaser of the policy,” the policy is ambiguous. Ceci v. National Indemnity Co., 225 Conn. 165, 168, 622 A.2d 545 (1993). In construing the document, we “look at the [policy] as a whole, consider all relevant portions together and, if possible, give operative effect to every provision in order to reach a reasonable overall result.” (Internal quotation marks omitted.) Hansen v. Ohio Casualty Ins. Co., supra, 239 Conn. 545-46. Utilizing this approach, we conclude that the policy language is ambiguous.

The “Your Duties to Us” provision of the umbrella booklet and the “Coverage U” section of the uninsured addendum provide the defendants with inconsistent remedies for the plaintiffs failure to maintain the requisite underlying insurance on his automobile.

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Cite This Page — Counsel Stack

Bluebook (online)
789 A.2d 974, 259 Conn. 503, 2002 Conn. LEXIS 59, Counsel Stack Legal Research, https://law.counselstack.com/opinion/israel-v-state-farm-mutual-automobile-insurance-conn-2002.