Loomis v. ACE American Insurance Company

91 F.4th 565
Court of Appeals for the Second Circuit·Decided January 23, 2024·No. 22-863·Published·Cited by 11 cases

Opinion

22-863(L) Loomis v. ACE American Insurance Company

In the

United States Court of Appeals For the Second Circuit

August Term, 2023

(Argued: September 22, 2023 Decided: January 23, 2024)

Docket Nos. 22-863, 22-1037

WILLIAM LOOMIS,

Plaintiff-Appellant-Cross-Appellee, –v.–

ACE AMERICAN INSURANCE COMPANY, Defendant-Appellee-Cross-Appellant.

Before: BIANCO, ROBINSON, and NATHAN, Circuit Judges.

This case requires us to determine whether 1) an insurer who fails to comply with New York laws requiring insurers to offer optional supplemental uninsured/underinsured motorist coverage to motor vehicle liability insurance policyholders can be liable to an injured insured for the underinsured motorist coverage that should have been offered, and 2)

whether an insurer who issues an automobile liability insurance policy that provides coverage above a $3 million “retained limit” is liable to pay underinsured motorist benefits under Indiana law when an insured suffers

damages in excess of the tortfeasor’s $50,000 policy limit and has no other underinsured motorist coverage to cover damages up to the $3 million retained limit.

We conclude that Loomis is not entitled to the relief that he seeks under New York law. Although insurers are required to offer supplemental uninsured/underinsured motorist coverage to insureds in New York, the coverage is optional. Even if the insurer violated New York law by failing to offer the supplemental coverage, Loomis’s claim seeking reformation of the insurance contract between Loomis’s employer and the insurer to include the optional supplemental coverage is not supported by New York law. Accordingly, we AFFIRM the district court’s grant of summary judgment as to Loomis’s claim under New York law.

With respect to his argument that Indiana law requires the insurer to provide underinsured motorist coverage, we cannot confidently predict how the Indiana Supreme Court will interpret the relevant statute, and no controlling precedent from Indiana’s highest court resolves the important questions that this case raises about the state’s underinsured motorist insurance regime. Therefore, we CERTIFY questions to the Indiana Supreme Court.

MICHAEL J. LONGSTREET (Martha L. Berry, on the brief), Longstreet & Berry, LLP, Fayetteville, NY, for Plaintiff-Appellant-Cross-Appellee.

KURT M. MULLEN, Nixon Peabody LLP, Boston, MA (Michael B. de Leeuw, Tamar S. Wise, Cozen O’Connor, New York, NY, on the brief), for Defendant-Appellee-Cross-Appellant.

ROBINSON, Circuit Judge:

Plaintiff William Loomis is a truck driver who was injured in a car accident in New York. He recovered some damages from the underinsured tortfeasor’s

insurer, and subsequently sought recovery from Defendant ACE American Insurance Company (“ACE”), his employer’s insurance company, for his remaining damages.

When ACE declined to pay, Loomis sued under New York law and Indiana law. He claimed that ACE failed to comply with both states’ laws requiring an insurer to provide underinsured motorist coverage. The primary issue before the district court was whether ACE was liable to Loomis for underinsured motorist coverage under the law of either state.

Reviewing competing motions for summary judgment, the district court first granted ACE’s motion as to the applicability of New York law, and granted Loomis’s motions as to the applicability of Indiana law. Subsequently, the district court granted ACE’s motion for summary judgment on an additional question of Indiana law. On appeal, the parties challenge the respective grants of summary judgment.

First, under New York law, we must determine whether an insurer who fails to comply with New York laws requiring insurers to offer optional supplemental uninsured/underinsured motorist coverage to motor vehicle liability insurance policyholders is liable to an injured insured for the underinsured motorist coverage that should have been but was not properly

offered. Second, under Indiana law, we must assess whether an insurer who issues an automobile liability insurance policy that does not provide liability coverage until the insured pays a $3 million “retained limit” is liable to pay underinsured motorist benefits under Indiana law when the insured suffers damages in excess of the tortfeasor’s $50,000 policy limit and has no other underinsured motorist coverage to cover damages up to the $3 million retained limit.

We conclude that Loomis is not entitled to the relief that he seeks under New York law. Although insurers are required to offer supplemental uninsured/underinsured motorist coverage to insureds in New York, the coverage is optional. Even if ACE violated New York law by failing to offer supplemental underinsured motorist coverage, Loomis’s claim seeking reformation of the insurance contract between Loomis’s employer and the insurer to include the optional supplemental coverage is not supported by New York law. Accordingly, we AFFIRM the judgment of the district court on the question of New York law.

Loomis also argues that Indiana law requires the insurer to provide underinsured motorist coverage. On this question, we cannot confidently predict how the Indiana Supreme Court will interpret the relevant statute, and

no controlling precedent from Indiana’s highest court resolves the important questions that this case raises about the state’s underinsured motorist insurance regime. Therefore, we CERTIFY questions to the Indiana Supreme Court.

BACKGROUND

This case implicates two states’ respective statutes regulating underinsured motorist coverage. Underinsured motorist (“UIM”) coverage covers damages sustained by an insured victim caused by an identifiable at-fault driver who has some liability insurance, but for an amount that is 1) lower than the victim’s UIM limits and 2) insufficient to make the insured whole. 9 Couch on Insurance § 122:3 (3d ed. 2023). It is closely related to uninsured motorist (“UM”) coverage, which provides direct compensation to an insured who is injured by an at-fault motorist who has no liability insurance at all. Id. § 122:2. I. Loomis’s Claim In October 2017, a car crossed the center lane and slammed into a truck that Loomis was driving in New York for his employer, XPO Logistics (“XPO”). Loomis recovered the policy limit of $50,000 from the tortfeasor’s insurer and sought underinsured motorist benefits from ACE, which insured the XPO truck that Loomis was driving, to cover his remaining damages. ACE denied his claim. Loomis now challenges ACE’s denial, asserting that New York and

Indiana statutes regulating underinsured motorist insurance require ACE to cover his remaining damages up to the Policy’s liability limit of $7 million. II. The Policy The truck that Loomis was driving was insured under a policy that XPO had purchased from ACE (“the Policy”).

The Policy’s “Excess Business Auto Coverage Form” includes several provisions relevant here. First, in the “liability coverage” section, the Policy states in pertinent part that ACE “will pay the ‘insured’ for the ‘ultimate net loss’ in excess of the ‘retained limit’ because of ‘bodily injury’ or ‘property damage’ . . . caused by an ‘accident’ and resulting from the ownership, maintenance or use of a covered ‘auto’.” Jt. App’x at 204. “Ultimate net loss” is defined as “the total amount the ‘insured’ is legally obligated to pay as damages for a covered claim or ‘suit’” and “does not include any of the expenses incurred by the ‘insured’ or [ACE] in connection with defending the claim or ‘suit’.” Id. at 216.

Second, the form includes “Uninsured and Underinsured Motorists Coverage” in the list of exclusions from coverage. Id. at 209. It states that the “insurance does not apply to . . . ‘Bodily Injury’ or ‘Property Damage’ caused by an ‘accident’ with an uninsured or underinsured ‘auto’.” Id. at 205, 209.

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Loomis v. ACE American Insurance Company, 91 F.4th 565 (2d Cir. 2024).

91 F.4th 565 (Loomis v. ACE American Insurance Company) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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