Nationwide Insurance v. Schneider

960 A.2d 442, 599 Pa. 131, 2008 Pa. LEXIS 2047
CourtSupreme Court of Pennsylvania
DecidedNovember 19, 2008
Docket11 MAP 2007
StatusPublished
Cited by45 cases

This text of 960 A.2d 442 (Nationwide Insurance v. Schneider) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nationwide Insurance v. Schneider, 960 A.2d 442, 599 Pa. 131, 2008 Pa. LEXIS 2047 (Pa. 2008).

Opinion

*135 OPINION

Justice SAYLOR.

We allowed appeal to determine whether the Motor Vehicle Financial Responsibility Law requires primary underinsured motorist benefits to be exhausted before secondary coverage is implicated and to consider the enforceability of a consent-to-settle clause in an underinsured motorist policy.

In October 1996, police officer Paul P. Schneider (“Appellee”) suffered injury when his cruiser was struck by a vehicle driven by Ayanna Lee Cooper. At that time, Ms. Cooper maintained a policy of insurance issued by American Independent Insurance Company providing, inter alia, up to $15,000 in liability coverage. Appellee’s employer, Upper Darby Township, maintained a policy with Granite State Insurance Company, which included underinsured motorist (“UIM”) coverage subject to a one million dollar limit.

Appellee lodged a civil action against Ms. Cooper, defended by American Independent, which offered to settle at the $15,000 limit in exchange for a general release. Granite State gave its consent, upon being informed by Appellee of the claim and offer. Appellee accepted the settlement in May 1999, executing the release and receiving payment.

Subsequently, Appellee pursued a claim for UIM benefits under the Granite State policy. On December 21, 2001, those parties (with Granite State acting on behalf of itself and Upper Darby Township) consummated a structured settlement having a present value of $750,000, or $250,000 less than the policy limit. This settlement also contained a general release.

Two months later, Appellee sought secondary UIM benefits under his personal automobile insurance policy issued by Appellant, Nationwide Insurance Company, which provided for up to $200,000 in stacked UIM coverage. The policy contained an exhaustion clause prescribing that “[n]o payment will be made until the limits of all other auto liability insurance and bonds that apply have been exhausted by payment.” The policy also included consent-to-settle provisions, indicating *136 that an insured must “preserve and protect Nationwide’s right to subrogate against any liable party” and obtain Nationwide’s written consent to settle any legal action brought against a liable party or release any party. 1 Correspondingly, an express exclusion indicated that coverage would not apply to “[b]odily injury of any insured if the insured settles, without our written consent with a hable party.” Appellee attempted to address the contractual exhaustion requirement by extending to Nationwide a “credit” of $1,015,000, the combined amount of limits of Ms. Cooper’s liability policy and the primary UIM coverage from Granite State, explaining that he would not seek any benefits from Nationwide unless he could prove that his damages exceeded this amount. After Nationwide denied Appellee’s claim, he made a demand for arbitration, as provided in the policy.

In response, Nationwide filed a declaratory judgment action seeking, in the relevant counts, a determination that it had no obligation to pay secondary UIM benefits to Appellee due to his failure to exhaust his primary UIM benefits and obtain Nationwide’s consent to settle his primary UIM claims, as required by the policy. Nationwide contended that exhaustion was required not only by the terms of the policy, but also under pertinent priority-of-recovery provisions of the Motor Vehicle Financial Responsibility Law, 2 which provides as follows in the UM/UIM context:

(a) General rule.—Where multiple policies apply, payment shall be made in the following order of priority:
(1) A policy covering a motor vehicle occupied by the injured person at the time of the accident.
*137 (2) A policy covering a motor vehicle not involved in the accident with respect to which the injured person is an insured.
(b) Multiple sources of equal priority.-The insurer against whom a claim is asserted first under the priority set forth in Subsection (a) shall process and pay the claim as if wholly responsible. The insurer is thereafter entitled to recover contribution pro rata from any other insurer for the benefits paid and the costs of processing the claim.

75 Pa.C.S. § 1733.

Nationwide pursued summary judgment, and Appellee responded with a cross-motion, arguing that there was no need for exhaustion of primary UIM benefits, as he had extended a credit to Nationwide for the full amount of those benefits as required by Boyle v. Erie Insurance Company, 441 Pa.Super. 103, 656 A.2d 941 (1995). Additionally, Appellee asserted that, pursuant to Nationwide Mutual Insurance Company v. Lehman, 743 A.2d 933 (Pa.Super.1999), the insurer was required to establish that its interests were prejudiced by Appellee’s failure to obtain its consent to settle.

The common pleas court awarded summary judgment in Nationwide’s favor. See Nationwide Ins. Co. v. Schneider, 69 Pa. D. & C.4th 94 (2004). Initially, the court summarized the circumstances as follows:

It is altogether undisputed that defendant never provided plaintiff with notice of this accident nor of his intention to pursue UIM benefits under the Nationwide policy [during the five-year period between the accident and the demand on Nationwide], There is also no question that he did not seek plaintiffs permission to settle either of the previous claims for benefits arising from the injuries sustained in this accident. There was also no question in this action that the applicable terms and conditions set forth in the within Nationwide policy clearly and expressly provided that no payment of underinsured motorist benefits would be made *138 until the limits of all other applicable automobile liability-coverage and bonds had been exhausted by payments.

Id. at 100. Relative to the exhaustion requirement, the common pleas court first agreed with Nationwide that Section 1733 of the MVFRL requires “exhaustion of one category of benefits before the next may be pursued.” Id. at 104. The court also observed that Boyle and other cases relied upon by Appellee involved the failure to exhaust third-party liability benefits before pursuing primary UIM benefits. Unlike the third-party/primary-UIM context, the court indicated that primary UIM benefits must be exhausted before secondary or excess UIM benefits may be obtained pursuant to Section 1733. See id. at 113, 656 A.2d 941 (citing, inter alia, State Farm Ins. Co. v. Ridenour, 435 Pa.Super. 463, 470, 646 A.2d 1188, 1191 (1994)).

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Bluebook (online)
960 A.2d 442, 599 Pa. 131, 2008 Pa. LEXIS 2047, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nationwide-insurance-v-schneider-pa-2008.