Nationwide Mutual Insurance Company v. William Cosenza Angelina C. Cosenza, H/w Patsy Dezii William Cosenza Angelina C. Cosenza, Patsy Dezii

258 F.3d 197, 2001 U.S. App. LEXIS 15993, 2001 WL 811122
CourtCourt of Appeals for the Third Circuit
DecidedJuly 18, 2001
Docket00-4151
StatusPublished
Cited by100 cases

This text of 258 F.3d 197 (Nationwide Mutual Insurance Company v. William Cosenza Angelina C. Cosenza, H/w Patsy Dezii William Cosenza Angelina C. Cosenza, Patsy Dezii) 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. William Cosenza Angelina C. Cosenza, H/w Patsy Dezii William Cosenza Angelina C. Cosenza, Patsy Dezii, 258 F.3d 197, 2001 U.S. App. LEXIS 15993, 2001 WL 811122 (3d Cir. 2001).

Opinion

OPINION OF THE COURT

COWEN, Circuit Judge.

This appeal presents a question of first impression relating to the construction and enforceability of an exclusion in an automobile insurance contract stating that an insured cannot recover benefits under both the liability coverage and the underinsured motorist coverage of the insurance contract. The District Court exercised jurisdiction based on diversity of citizenship under 28 U.S.C. § 1332. We exercise appellate jurisdiction under 28 U.S.C. § 1291. We hold that, on the facts of this case, the “dual recovery” prohibition is invalid and unenforceable pursuant to Pennsylvania’s Motor Vehicle Financial Responsibility Law (MVFRL). 75 Pa.C.S.A. § 1701 et seq.

I

This case is a dispute about insurance coverage arising from the following facts. *201 On July 16, 1995, Mrs. Cosenza was driving a vehicle in which her husband and mother (Ms. Dezii) were passengers when they collided with a vehicle driven by Angela Nicolucci. Mr. Cosenza and Dezii were very seriously injured in the crash and Mrs. Cosenza sustained some injuries as well. They instituted suit in state court against Nicolucci. Nicolucci joined Mrs. Cosenza as a defendant, claiming that she was contributorily negligent. Nationwide Insurance, the Cosenzas’ insurer and the appellee in this case, assumed the defense of Mrs. Cosenza and consistently asserted her lack of fault. On the eve of trial, the suit was settled.

Under the terms of the settlement, appellants received $15,000 from Nicolucci’s insurer, the full amount of coverage available under her liability policy. Mr. Cosen-za and Dezii also received some payment under the liability portion of Nationwide’s auto policy, but did not exhaust the full amount of the coverage available under that policy. The Cosenzas’ vehicle was covered by an auto insurance policy issued by Nationwide Insurance. That policy provided $500,000 in liability coverage and $500,000 in underinsured motorist coverage. Mr. Cosenza also maintained an umbrella insurance policy that provided an additional $1,000,000 in total liability coverage and $500,000 in underinsured motorist coverage. The settlement did not include any payments by Nationwide under either the underinsured motorist portion of the policy or under the umbrella policy.

Thereafter, the Cosenzas and Dezii, the appellants in this appeal, notified Nationwide of their intention to proceed with underinsured motorist arbitration under their auto insurance policy and the supplemental umbrella insurance policy. They filed a petition in state court to compel arbitration. In response, Nationwide filed a notice of removal of the proceedings to the district court and also filed a complaint seeking a declaratory judgment preventing arbitration. Each of the parties moved for summary judgment with the following results:

1) The District Court determined that the dispute did not fall within the insurance contract’s arbitration clause and was, therefore, properly before the court;
2) Mr. Cosenza and Dezii, who recovered under the liability portion, were prohibited from recovering underinsured motorist benefits for their own injuries under the auto policy or the umbrella policy;
3) Mrs. Cosenza, who did not recover under the liability coverage, was allowed to seek recovery under the underinsured motorist provision of the auto policy and the umbrella policy;
4) Mrs. Cosenza was prohibited from recovering loss of consortium benefits for her husband’s injuries under the un-derinsured motorist provisions; 3
5) Mr. Cosenza was allowed to seek loss of consortium benefits for his wife’s injuries under the underinsured motorist provision;
6) The court determined that Nationwide was not entitled to a credit in the amount of payments already received by the insureds pursuant to the state court settlement.

Appellants appeal the District Court’s ruling that this dispute is not subject to arbitration. Alternatively, they appeal the court’s holding that Mr. Cosenza and Dezii are barred from recovering under the un-derinsured motorist provision of the auto policy and under the umbrella policy. They also appeal the court’s ruling that Mrs. Cosenza is barred from recovering loss of consortium damages based on her husband’s injuries under the underinsured motorist provision of the auto policy and *202 under the umbrella policy. Nationwide purports to cross-appeal the district court’s findings as to Mrs. Cosenza’s eligibility for recovery, Mr. Cosenza’s right to recover for loss of consortium for his wife’s injuries, and the court’s ruling that Nationwide is not entitled to a credit for payments made in the state court settlement.

II

Before proceeding to a discussion of the substantive issues in this case there are two threshold issues that must be addressed—whether the district court had jurisdiction to decide the issues raised in this case and whether this Court can properly entertain Nationwide’s purported cross-appeal of the adverse portions of the District Court’s judgment. As a federal court sitting in diversity, we are bound to adjudicate the case in accordance with applicable state law. See Erie Railroad v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed. 1188 (1938). Both parties agree that Pennsylvania law governs this dispute.

A. Jurisdiction/Arbitrability of Claims Raised

To determine the arbitrability of a dispute a court must address two issues: 1) whether the parties formed an agreement to arbitrate; and 2) whether the dispute in question falls within the scope of that agreement. Messa v. State Farm Ins. Co., 433 Pa.Super. 594, 641 A.2d 1167, 1168 (1994). In this case, both parties concede the existence of an agreement to arbitrate. Thus, the sole question is whether the dispute regarding appellants’ entitlement to seek recovery under the underinsured motorist (UIM) provision of the contract falls within the scope of the arbitration agreement.

Appellants argue that the District Court did not have jurisdiction to rule on the summary judgment motions that are the subject of this appeal because the insurance contracts require arbitration of their claim. 1 The UIM provision of the Cosen-za’s insurance policy provides:

RECOVERY

1. Before recovery, we and any party seeking protection under this [UIM] coverage must agree on two points:
a) whether there is a legal right to recover damages from the owner or driver of an underinsured motor vehicle; and if so,
b) the amount of such damages.
If agreement can’t be reached, the matter will go to arbitration.
2.

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Bluebook (online)
258 F.3d 197, 2001 U.S. App. LEXIS 15993, 2001 WL 811122, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nationwide-mutual-insurance-company-v-william-cosenza-angelina-c-cosenza-ca3-2001.