Lagunas v. American Heartland Insurance Co.

2023 IL App (1st) 220627-U
Appellate Court of Illinois·Decided August 30, 2023·No. 1-22-0627·Unpublished

Opinion

2023 IL App (1st) 220627-U

THIRD DIVISION

AUGUST 30, 2023

No. 1-22-0627

NOTICE: This order was filed under Supreme Court Rule 23 and is not precedent except in the limited circumstances allowed under Rule 23(e)(1).

IN THE

APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT

)

FERNANDO LAGUNAS, ) Appeal from the ) Circuit Court of

Plaintiff-Appellant, ) Cook County.

)

v. ) No. 19 CH 05881 )

AMERICAN HEARTLAND INSURANCE COMPANY, ) Honorable ) Alison C. Conlon,

Defendant-Appellee. ) Judge Presiding.

)

JUSTICE REYES delivered the judgment of the court.

Presiding Justice McBride and Justice R. Van Tine concurred in the judgment.

ORDER

¶1 Held: Affirming the denial of the insured’s motion for summary judgment and grant of the insurer’s motion for summary judgment where (1) the insured settled with a driver who may have been liable for the insured’s injuries in violation of automobile policy’s exclusion barring such settlement without the insurer’s consent, and (2) the insured’s settlement substantially prejudiced the insurer’s right to recover against the other driver.

¶2 Plaintiff Fernando Lagunas was injured in a motor vehicle accident involving two other drivers, Keona Baker (Baker) and Patrick Stephens (Stephens), one of whom (Stephens) was uninsured. Plaintiff filed an uninsured motorist claim with his insurance company, defendant

American Heartland Insurance Company, followed by a demand for arbitration with the American Arbitration Association (AAA) which he ultimately did not pursue. Plaintiff, at defendant’s direction, also filed suit against the other two drivers. In the course of that litigation, plaintiff settled his claim with Baker and executed a release releasing her and her insurer from any liability for his injuries. Upon learning of the settlement, defendant denied plaintiff’s uninsured motorist claim, based on an exclusion in plaintiff’s insurance policy which barred coverage if plaintiff settled with anyone “who may be legally liable” to plaintiff without defendant’s written consent.

¶3 Plaintiff filed a complaint for declaratory judgment, asking the circuit court to declare that Baker was not legally liable to plaintiff and, therefore, he was entitled to uninsured motorist coverage. Defendant filed a counterclaim for declaratory judgment, asking the circuit court to declare that plaintiff’s claim was properly excluded and that defendant was not required to pay plaintiff under the policy. On the parties’ cross-motions for summary judgment, the circuit court granted defendant’s motion and denied plaintiff’s motion, finding that the exclusion barred plaintiff’s claim. In addition, the circuit court found that plaintiff was barred from recovery since he did not proceed with AAA arbitration. Plaintiff appealed and, for the following reasons, we affirm.

¶4 BACKGROUND

¶5 The Insurance Policy and the Incident at Issue

¶6 In October 2013, defendant issued plaintiff an automobile insurance policy consisting of bodily injury coverage of $20,000 per person/$40,000 per accident and property damage coverage of $15,000 per accident. The policy also included uninsured motorist coverage of $20,000 per person/$40,000 per accident. As relevant to the instant case, the policy contained an

exclusion stating that uninsured motorist coverage did not apply if the insured settled with any person “who may be legally liable” for the injury without defendant’s written consent. The policy further provided that any payment under the uninsured motorist portion of the policy would be reduced by any sums paid on account of the injury by the owner of the uninsured vehicle or by any other person jointly or severally liable for the injury. In addition, the policy stated that if defendant paid the insured pursuant to an uninsured motorist claim, defendant would be subrogated to the insured’s rights of recovery against any person or organization legally responsible for the injury and would be entitled to the proceeds of any settlement or judgment, to the extent of its payment. The policy expressly provided that the insured “shall do nothing after loss to prejudice such rights.” The policy also included an arbitration provision which required that any dispute as to the applicability or extent of uninsured motorist coverage be submitted to the AAA for binding arbitration.

¶7 On March 3, 2014, plaintiff was injured during an accident involving two other vehicles, driven by Stephens and Baker. According to plaintiff’s complaint, Stephens drove his vehicle southbound through a red light at the intersection of Lake Street and Cicero Avenue, striking the rear end of Baker’s vehicle, which was completing a left turn from Cicero Avenue onto westbound Lake Street. After striking Baker’s vehicle, Stephens continued through the intersection and struck plaintiff’s vehicle,1 which was stopped at the intersection, waiting for traffic to clear in order to travel eastbound on Lake Street. Plaintiff suffered injuries from the

1 We note that, in his motion for summary judgment and in his arbitration demand, plaintiff contended that Baker’s vehicle was forced to strike plaintiff’s vehicle after Stephens’ vehicle collided with hers. We further note that plaintiff’s complaint was not verified, and plaintiff’s motion for summary judgment was not supported by any affidavit or deposition testimony which attested to the facts of the accident, despite plaintiff’s reference to “deposition testimony and affidavits” in his appellate brief. In its answer, defendant admitted the allegations of plaintiff’s complaint as to the facts of the accident “upon information and belief.”

collision.

¶8 Stephens was not covered by automobile insurance, while Baker had an insurance policy with AMCO Insurance Company (AMCO). 2

¶9 Plaintiff sought coverage from defendant pursuant to the uninsured motorist portion of his policy. In June 2014, defendant mailed plaintiff a letter notifying him that it was denying coverage for his claim and would be handling the matter under a reservation of rights, as plaintiff failed to properly report the loss and failed to cooperate with the investigation. Slightly over one week later, defendant mailed plaintiff another letter, notifying him that it could not accept plaintiff’s uninsured motorist claim “at this time.” The letter explained that Baker had provided insurance information in the accident report, so “[y]ou must file suit against all parties involved in this loss and if [Baker] is found negligent and has a valid policy,” then the loss would not constitute an uninsured motorist claim. If both parties were found to have no valid insurance policies in effect, then plaintiff would be required to certify their status with the Illinois Department of Transportation before defendant would take any further action with respect to an uninsured motorist claim. Defendant also requested documentation as to the extent of plaintiff’s injuries and medical bills.

¶ 10 On March 13, 2015, plaintiff made a demand for arbitration of his uninsured motorist claim with the AAA. 3 Approximately one week later, defendant mailed plaintiff a letter notifying him that defendant could not accept plaintiff’s uninsured motorist claim “at this time,” as Stephens had not been certified as uninsured and plaintiff had failed to file suit against Baker.

2 AMCO is an affiliate of Nationwide Insurance Company. Accordingly, the record contains references to “Nationwide” as well as to AMCO.

3 While plaintiff paid his portion of the administrative fee at the time he filed the arbitration demand, there is no indication that defendant paid its portion, nor did plaintiff pay defendant’s portion. Consequently, the AAA file was closed in October 2015 and all files were purged in April 2017.

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Lagunas v. American Heartland Insurance Co., 2023 IL App (1st) 220627-U (Ill. Ct. App. 2023).

2023 IL App (1st) 220627-U (Lagunas v. American Heartland Insurance Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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