Nationwide Mutual Insurance Company v. Anne Marie Budd-Baldwin

947 F.2d 1098, 1991 U.S. App. LEXIS 24772, 1991 WL 209104
CourtCourt of Appeals for the Third Circuit
DecidedOctober 21, 1991
Docket91-1171
StatusPublished
Cited by22 cases

This text of 947 F.2d 1098 (Nationwide Mutual Insurance Company v. Anne Marie Budd-Baldwin) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nationwide Mutual Insurance Company v. Anne Marie Budd-Baldwin, 947 F.2d 1098, 1991 U.S. App. LEXIS 24772, 1991 WL 209104 (3d Cir. 1991).

Opinion

*1100 OPINION OF THE COURT

McCLURE, District Judge.

Appellant Nationwide Mutual Insurance Company (Nationwide) appeals from the district court’s order granting summary judgment in favor of appellee Anne Marie Budd-Baldwin 1 (Baldwin) and awarding her first party and underinsured motorist benefits for the death of her brother, David Michael Budd (Budd), under an automobile insurance policy Nationwide issued to Baldwin. We reverse, and direct that summary judgment be entered in favor of Nationwide.

I. BACKGROUND

Budd died from injuries sustained in a one-vehicle accident that occurred on December 16, 1989 while he was a passenger in a vehicle owned and operated by third parties who have not been joined in this lawsuit. At the time of his death, Budd did not own a vehicle and was not a named insured on any automobile policy issued to him. 2 He was, however, listed as an “occasional driver” on a policy issued by Nationwide to his sister, the appellee.

Based on that designation, as well as her contention that Budd was a resident of her household under the terms of the policy, Baldwin sought underinsured and first party benefits from Nationwide. When Nationwide denied coverage, Baldwin filed this declaratory judgment action 3 seeking a determination that she is entitled to recover such benefits.

The district court granted summary judgment in Baldwin’s favor, on the basis that Nationwide was estopped from denying coverage because it accepted an additional premium from Baldwin for carrying Budd as an “occasional driver” on her policy-

Nationwide seeks reversal of the district court’s order, contending that there is no basis for extending coverage to Budd under the terms of the policy and no basis for estoppel. First, Nationwide argues that Budd is not an insured under the policy, because he does not qualify as a resident relative under the terms of the policy. Second, Nationwide contends that Budd’s designation as an “occasional driver” is of no relevance, since persons so designated have no right to recover first party or underin-sured benefits if injured while driving or riding in a vehicle other than a vehicle listed in the subject policy. Finally, Nationwide asserts that there is no factual basis for a finding of estoppel.

II. DISCUSSION

A. Standard of Review

We exercise plenary review of the district court’s order on an appeal from summary judgment. Goodman v. Mead Johnson & Co., 534 F.2d 566, 573 (3d Cir. 1976), cert. denied, 429 U.S. 1038, 97 S.Ct. 732, 50 L.Ed.2d 748 (1977). Construction of the term “resident” in the policy is a matter of law, see Myers v. State Farm Ins. Co., 842 F.2d 705, 708 (3d Cir.1988); Ram Construction Co. v. American States Insurance Co., 749 F.2d 1049, 1053 (3d Cir.1984), as is the application of principles of estoppel, see Murray v. Silberstein, 882 F.2d 61 (3d Cir.1989), over which we exercise plenary review, but to the extent that summary judgment is dependent on the determination of historical facts, it can be granted only if there is no issue of material fact in dispute. See Fed.R.Civ.P. 56(c).

B. Policy terms

1. First party benefits.

The policy Nationwide issued to Baldwin limits coverage for first party benefits to *1101 the policyholder and his or her relatives, as defined in the policy. It states (on page 8):

We will pay First Party Benefits for bodily injury of an insured as a result of an accident that arises out of the maintenance or use of a motor vehicle as a motor vehicle. We will pay these benefits regardless of who is at fault in the accident.
You and your relatives are covered while occupying or injured by any motor vehicle.
# afs s¡c sfc ♦
For purposes of this coverage:
1. The words ‘YOU’ and ‘YOUR’ mean the policyholder first named in the attached Declarations. They do not include that policyholder’s spouse.
2. ‘RELATIVE’ means the following residents of your household:
* * * * sit *
b) anyone related to you by blood, marriage or adoption; and
Ht * * * * *
A relative may live temporarily outside your household.

(emphasis original.)

2. Uninsured/Underinsured Motorist Coverage.

The provisions governing underinsured coverage state, from Endorsement 2113A:

We will pay compensatory damages that you or your legal representative are legally entitled to recover from the owner or driver of an uninsured motor vehicle or underinsured motor vehicle because of bodily injury. Damages must result from an accident arising out of the ownership, maintenance or use of the uninsured motor vehicle or underinsured motor vehicle.
Relatives living in your household also have this protection.

3.Definitions.

“Relative” is defined in the generally applicable “Definitions” portion of the policy (on page 2) as:

... one who regularly lives in your household, related to you by blood, marriage or adoption (including a ward or foster child). A relative may live temporarily outside your household. 4

C. Pennsylvania insurance law

It is this court’s obligation to review the claims asserted under Pennsylvania law. 5 The Pennsylvania appellate courts have not been confronted with a case requiring them to construe the exact phrase used here, i.e. who qualifies as a person who “regularly lives” in the insured’s household, but the Superior Court 6 *1102 has construed similar phrases governing the coverage extended to resident relatives. In Donegal Mutual Insurance Company v. State Farm Mutual Insurance Company, 377 Pa.Super.

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Bluebook (online)
947 F.2d 1098, 1991 U.S. App. LEXIS 24772, 1991 WL 209104, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nationwide-mutual-insurance-company-v-anne-marie-budd-baldwin-ca3-1991.