Lagunas v. American Heartland Insurance Co.

2023 IL App (1st) 220627-U
CourtAppellate Court of Illinois
DecidedAugust 30, 2023
Docket1-22-0627
StatusUnpublished

This text of 2023 IL App (1st) 220627-U (Lagunas v. American Heartland Insurance Co.) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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

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 1-22-0627

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

-2- 1-22-0627

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.” -3- 1-22-0627

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

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Bluebook (online)
2023 IL App (1st) 220627-U, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lagunas-v-american-heartland-insurance-co-illappct-2023.