McCracken v. Progressive Direct Ins. Co.

896 F.3d 1166
CourtCourt of Appeals for the Tenth Circuit
DecidedJuly 24, 2018
Docket17-1285; 17-1286
StatusPublished
Cited by11 cases

This text of 896 F.3d 1166 (McCracken v. Progressive Direct Ins. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McCracken v. Progressive Direct Ins. Co., 896 F.3d 1166 (10th Cir. 2018).

Opinion

MORITZ, Circuit Judge.

The plaintiffs in these consolidated appeals each settled a claim under their automobile-insurance policies with the defendants. But now the plaintiffs maintain that the defendants illegally reduced their settlement offers by taking into account certain benefits they had previously paid the plaintiffs. The district courts dismissed the plaintiffs' putative class-action lawsuits after concluding the plaintiffs each waived their rights to collect further damages from the defendants on their settled claims.

*1168 We reverse in part and remand to the district court with instructions to vacate its judgment in favor of USAA Casualty Insurance Company because it lacked jurisdiction to hear the claims against that defendant. Otherwise, we affirm.

Background

I. Legal Background

These cases involve the interplay between two categories of automobile insurance that insurers must offer under Colorado law: uninsured/underinsured-motorist (UM/UIM) coverage and medical payments (MedPay) coverage. See Colo. Rev. Stat. §§ 10-4-609 (1)(a), 10-4-635(1)(a). UM/UIM coverage insures the policyholder for injuries caused by a third-party driver without sufficient insurance to cover the policyholder's injury. See Colo. Rev. Stat. § 10-4-609 (1)(a), (4). MedPay coverage insures the policyholder for any bodily injury "resulting from the ownership, maintenance, or use of [a] motor vehicle," regardless of fault. § 10-4-635(1)(a).

In 2007, the Colorado legislature amended its insurance law to mandate that "the amount of the coverage available" under UM/UIM policies "shall not be reduced by a setoff from any other coverage, including" MedPay. 1 An Act Concerning the Payment of Uninsured Motor Vehicle Insurance as Excess to Other Insurance, § 1, 2007 Colo. Legis. Serv. 1921 , 1921 (2007) (codified at § 10-4-609(1)(c) ). This amendment initially caused some confusion. Focusing on the word "coverage" in § 10-4-609(1)(c), a number of Colorado courts held that the amendment only prohibited insurers from taking a setoff from a UM/UIM claim if the setoff would effectively reduce the amount of coverage available. See, e.g. , Carrion-Kozak v. Alghamdi , No. 13CV92, slip op. at 2 (Arapahoe Cty., Colo. Dist. Ct. Dec. 13, 2013) ("While [ § 10-4-609(1)(c) ] prohibits a setoff which reduces coverage, it does not prohibit a setoff which merely adjusts the amount an insurer must pay to prevent a double recovery."); Willyard v. Am. Family Mut. Ins. Co. , No. 11CV931, slip op. at 4 (Boulder Cty., Colo. Dist. Ct. May 8, 2012) (upholding insurance contract that "allows for a setoff of the amount paid " in MedPay but "does not affect the coverage available under either the [MedPay] or the [UM/UIM] benefits policy"). In other words, these courts held that if a policyholder's UM/UIM claim exceeded the maximum amount of coverage available under the policy, then the insurer owed the maximum coverage amount without a setoff because taking a setoff in such a situation would effectively reduce the maximum amount of coverage available under the UM/UIM policy. See Carrion-Kozak , slip op. at 3; Willyard , slip op. at 4. But in cases in which the policyholder's claims were for amounts less than their coverage limits, these courts held that a setoff was proper to prevent double recovery. See Carrion-Kozak , slip op. at 3; Willyard , slip op. at 4. And because such claims don't meet or exceed the coverage limit, taking the setoff in such cases wouldn't have affected the coverage limit. 2 Carrion-Kozak , slip op. at 3; Willyard , slip op. at 4.

*1169 But in November 2016, the Colorado Supreme Court issued an opinion that contravened this understanding. See Calderon v. Am. Family Mut. Ins. Co. , 383 P.3d 676 (Colo. 2016). The plaintiff in Calderon had an insurance policy with the defendant that included $300,000 in UM/UIM coverage and $5,000 in MedPay coverage. Id. at 677 . After the plaintiff sustained injuries in a collision with an uninsured driver, the defendant paid the plaintiff's full $5,000 in MedPay benefits. Id. Yet the parties couldn't agree on how much the defendant owed the plaintiff in UM/UIM benefits. Id. A jury eventually awarded the plaintiff about $68,000. Id. Following the approach many courts took at the time, the trial court reduced the jury's award by $5,000 to set off the MedPay benefits the plaintiff had already received. Id.

The plaintiff appealed, and the Colorado Court of Appeals held that the setoff was proper under § 10-4-609(1)(c). Id. The Colorado Supreme Court granted certiorari and reversed. Id. It held that § 10-4-609(1)(c) 's prohibition on setoffs "refers not to the coverage limit but rather to the amount of UM/UIM coverage available on a particular claim." Id. Thus, under Calderon , the amount a policyholder may claim in UM/UIM benefits is unaffected by any MedPay benefits the policyholder previously received.

II. Factual Background

The plaintiffs in the cases before us each settled a UM/UIM claim after § 10-4-609(1)(c) 's effective date but before the Colorado Supreme Court issued Calderon . The parties thus reached these settlements under the pre- Calderon

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Bluebook (online)
896 F.3d 1166, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mccracken-v-progressive-direct-ins-co-ca10-2018.