Loya v. State Farm Mutual Automobile Insurance

888 P.2d 447, 119 N.M. 1
CourtNew Mexico Supreme Court
DecidedNovember 16, 1994
Docket21375, 21545
StatusPublished
Cited by9 cases

This text of 888 P.2d 447 (Loya v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering New Mexico Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Loya v. State Farm Mutual Automobile Insurance, 888 P.2d 447, 119 N.M. 1 (N.M. 1994).

Opinion

OPINION

FRANCHINI, Justice.

We consolidated these two cases on appeal because they each raise the question of whether an automobile insurance policy definition that limits uninsured motorist coverage to only those spouses or relatives who live with a named insured at the time of an accident violates public policy. We hold that such a definition does not necessarily violate public policy, but that under the facts of each of these cases before us, coverage must extend to the plaintiffs.

Ramiro Loya appeals from a summary judgment denying Loya class-one coverage 1 under an uninsured motorist policy issued by State Farm Mutual Insurance Company to Ramiro and his wife, Sallie Loya. The narrow and dispositive issue in his appeal is whether, by defining “spouse” in a manner in which the spouse may at a future point during the life of the policy fail to meet a requirement of coverage, an insurance company may require a class-one insured to forfeit coverage. The uncontroverted evidence shows that at the time Sallie purchased the policy, Ramiro met the policy definition of insured spouse, the couple paid a premium for coverage for both spouses, they purchased the policy with community property, and the parties intended to provide class-one coverage for the couple and their son. We hold that because Ramiro qualified for and the couple paid for class-one coverage for both Ramiro and Sallie when they contracted for insurance coverage, State Farm cannot deny coverage to Ramiro during the policy period simply because he moved from the residence where Sallie lived and thereby no longer met the policy definition of “spouse.” We reverse.

In the second case, State Farm appeals from a summary judgment issued in favor of Wayne Smyth and his son, Sean Smyth. The court held that policy language requiring minor children to live with a named-insured parent in order to be protected under the uninsured motorist coverage is void as violative of public policy. The uncontroverted evidence shows that Wayne intended to provide uninsured motorist protection for all of his children including Sean (who lived with Wayne’s former wife), that Sean was dependent upon Wayne for support and that Wayne was a joint legal custodian for Sean. We hold that an insurance company may not exclude from uninsured motorist coverage an unemancipated minor child that the named insured is legally obligated to financially support by inserting a general definition applicable to other relatives in the policy. We affirm the trial court.

Facts and proceedings — the Loyas. The Loyas married in 1986 and experienced marital difficulties, separating three times after December 1989. In March 1991, during a period of reconciliation, they used community funds to purchase two automobile insurance policies from State Farm. The policies were for a car (“the Honda”) and a truck they jointly owned and both drove. The Honda policy listed only Sallie as the named insured but expressly included Ramiro as an insured on the declarations page and on the proof of financial responsibility card issued for that car. The truck policy listed both Sallie and Ramiro as named insureds, in that order. The automobiles were titled in both the Loyas’ names; Sallie drove the Honda most of the time.

The policies defined the “named insured” as the “first person named in the declarations” regardless of whether both spouses were named in the declarations as insureds. The policies provided class-one coverage for “the first person named in the declarations” and “his or her spouse.” In á separate section of the policies (on a different page) the definition of “spouse” was limited to “your husband or wife while living with you.” The policies were renewed for another six months in September 1991 while the couple was still living together.

In October 1991, the Loyas separated for the third time. Ramiro moved out of the marital residence and went to stay with his brother. Ramiro and Sallie each called State Farm and asked to have the other removed as a “named insured” on the policy of the respective automobiles they were driving. State Farm apparently did not refund any premium amounts reflecting a reduction in liability or uninsured motorist coverage on each auto from two covered drivers to one; nor did it issue a new policy on the Honda or notify Ramiro that he was no longer insured under the Honda policy. State Farm did issue a new policy listing only Ramiro as the named insured on the truck.

In December 1991 the couple met to discuss the dissolution of the marriage. Ramiro drove the couple around in the Honda while they were talking. At some point Sallie pulled a gun, they struggled over it, Ramiro threw the gun away, and he got out of the car. Sallie then ran over Ramiro with the car, severely injuring him.

State Farm paid Ramiro the uninsured motorist policy limits on the truck for which he was now designated as the named insured, but denied him the right to stack the Honda policy with the truck policy. Ramiro brought a declaratory judgment action to determine his rights under the Honda policy. After cross-motions for summary judgment were filed, the court held that the Honda policy was clear and unambiguous, that there were no material issues of fact, and that Ramiro should be denied the right to stack because he was not a class-one insured under the definition of “spouse” in the policy at the time of the accident.

Class-one uninsured motorist coverage is determined at the time the policy is purchased. When a married couple contracts for insurance coverage for the family, there is a presumption that the coverage applies with equal effect to both parties unless one of them is expressly excluded from coverage. Each person is considered to be a purchaser of the contract. See, e.g., Schmick v. State Farm Mut. Auto. Ins. Co., 103 N.M. 216, 217-20, 704 P.2d 1092, 1093-96 (1985) (characterizing wife as a purchaser of policies and holding that she was entitled to stack both policies even though she was not the “named insured” on one of the policies). The insurance company may not unilaterally decide who it will designate as the “named insured” in a contract of adhesion and thereby defeat the rights of the contracting member who does not actually sign the contract but who is a clear beneficiary thereof.

Further, the parties designate who is to be covered under the insurance contract, and the number of persons insured by thát contract establishes the amount of the premium, which must be paid in advance. If there is a disagreement between the parties, a court looks at the intent of the parties at the time the contract was executed to determine who the parties intended to insure. See, e.g., Jaramillo v. Providence Wash. Ins. Co., 117 N.M. 337, 341, 871 P.2d 1343, 1347 (1994) (remanding case for trial court to consider whether ambiguity existed in defining who was class-one insured by admitting extrinsic evidence of circumstances under which the parties contracted and purpose of contract); State ex rel. Santa Fe Sand & Gravel Co. v. Pecos Constr. Co., 86 N.M. 58, 61, 519 P.2d 294

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Cite This Page — Counsel Stack

Bluebook (online)
888 P.2d 447, 119 N.M. 1, Counsel Stack Legal Research, https://law.counselstack.com/opinion/loya-v-state-farm-mutual-automobile-insurance-nm-1994.