Pennsylvania National Mutual Casualty Co. v. Black

916 A.2d 569, 591 Pa. 221, 2007 Pa. LEXIS 384
CourtSupreme Court of Pennsylvania
DecidedFebruary 21, 2007
Docket109 MAP 2005
StatusPublished
Cited by31 cases

This text of 916 A.2d 569 (Pennsylvania National Mutual Casualty Co. v. Black) 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
Pennsylvania National Mutual Casualty Co. v. Black, 916 A.2d 569, 591 Pa. 221, 2007 Pa. LEXIS 384 (Pa. 2007).

Opinions

[225]*225 OPINION

Justice BAER.

We granted review in this case to determine whether the Superior Court erred in concluding that a “setoff’ provision in an automobile insurance policy was unenforceable as against public policy. A setoff provision, generally, provides for the reduction of a claimant’s potential recovery under one part of an insurance policy, such as underinsured motorist coverage, by the amount the claimant recovered under another portion of the same insurance policy, such as bodily injury liability coverage. We conclude that the setoff provision at issue does not violate public policy. Accordingly, we reverse the decision of the Superior Court and reinstate the order of the Court of Common Pleas.

The facts of the case are undisputed. On May 15, 1999, an automobile driven by John R. Myers (John) and owned by his mother, Diane E. Myers, collided with an automobile driven and owned by Todd L. Jamison (Jamison). John and his passenger, Eric L. Black (Eric), died from injuries sustained during the accident. Jamison suffered injuries but survived. As discussed in detail below, the parents of Eric,1 acting in their own capacity and as representatives of their son’s estate, claimed that Eric’s death resulted in part from Jamison’s negligence in driving his car at an excessive speed. Accordingly, they sought recovery based on Jamison’s negligence pursuant to various insurance policies. The Blacks also claimed that the accident resulted in part from John’s negligence in failing to observe a stop sign. Consequently, the Blacks sought recovery based on John’s negligence.2

[226]*226The dispute before this Court arises from a declaratory judgment action filed by the Myers’ insurer, Appellant Pennsylvania National Mutual Casualty Insurance Company (Penn National), regarding the limits of coverage under the Myers’ policy available to the Blacks as a result of Eric’s death while a passenger in the Myers’ car. The Blacks seek recovery from Penn National under the Myers’ policy’s bodily liability coverage provision based on John’s negligence, in accord with traditional tort principals permitting a victim to recover from a tortfeasor. The Blacks also seek recovery from Penn National under the Myers’ policy’s underinsured motorist coverage provision, based on Jamison’s negligence, the insufficiency of Jamison’s (and Black’s) insurance to recompense the Blacks fully, and Eric’s status as a “class two insured”3 by virtue of his being a passenger in the Myers’ car.

At the time of the accident, Jamison was insured under a policy issued by Progressive Casualty Company providing bodily injury liability coverage of $15,000 per person and $30,000 per accident. Progressive tendered the per person limit of $15,000 to the Blacks in July 1999. Similarly, State Farm Insurance Company, which insured the Blacks, tendered to them $60,000, which was the limit of the underinsured motorist coverage under the Blacks’ insurance policy. It is undisputed that the losses suffered by the Blacks exceeded the aggregate $75,000 paid under the Progressive and State Farm policies. Accordingly, the Blacks sought coverage under the Myers’ insurance policy issued by Penn National providing, inter alia, bodily injury liability coverage with a limit of $100,000 per accident and underinsured motorist cov[227]*227erage with a limit of $100,000 per accident.4 As previously noted, under the policy, Eric qualified as a class two insured because he was a guest passenger in the Myers’ ear. The Blacks claimed coverage under the bodily injury liability provision of the Myers’ policy based on an assertion that John’s negligence caused Eric’s injuries. They additionally claimed under the underinsured motorist coverage of the Myers’ policy based on Jamison’s alleged negligence and the insufficiency of his insurance.

The Myers’ policy’s underinsured motorist coverage provision stated that Penn National would pay damages to which an insured “is legally entitled to recover from the owner or operator of an ‘underinsured motor vehicle’ because of ‘bodily injury.’” Reproduced Record (R.R.) at R50a. The policy defined “underinsured motor vehicle” to exclude vehicles “for which liability coverage is provided under ... this policy.” Id. Accordingly, the vehicle driven by John, within which Eric was a passenger, could not be considered an underinsured motor vehicle under the Myers’ policy because it was covered by that policy. Prior to recovery under the underinsured motorist provision, the policy also required that the party seeking recovery first exhaust “[t]he limits of liability under any applicable bodily injury bonds or policies.” Id. The policy also prohibited duplicate payments: “No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and ... [a]ny Underinsured Motorist Coverage provided by this policy.” R.R. at R23a. Significantly, the “setoff’ provision of the underinsured motorist coverage at issue provided, “The limit of liability under this coverage is reduced by any amount paid to the same person for the [228]*228same accident under Part A [Liability Coverage] or Part C. [Underinsured Motorist Coverage].” R.R. at R51a.

The Blacks sought $200,000 of coverage from Penn National claiming that they were not bound by the policy’s per person limits because Eric’s mother, father and estate were separate “personfs],” and thus, one “person” could claim up to $100,000 under the bodily liability provision, and another “person” could claim up to $100,000 under the underinsured motorist coverage without violating the duplicate recovery provision or the per person limitations of the setoff provision. Penn National responded that the maximum recovery under the policy for the injuries suffered by Black was $100,000.5

Although Penn National and the Blacks engaged in negotiations, they were unable to reach an agreement. Despite disagreements regarding the details and timing of the offers, the parties stipulated that Penn National had paid to Jamison $1000 in bodily injury liability coverage based on John’s negligence. Additionally, Penn National offered to settle the Blacks’ bodily injury liability claims premised upon John’s negligence by offering the remaining $99,000 of available coverage. Penn National later offered to settle the Blacks’ claims for underinsured motorist coverage for $1,000, arguing that the remaining $99,000 of underinsured motorist coverage had been properly setoff by the $99,000 already tendered to the Blacks under the policy’s bodily injury liability coverage.

In May 2001, the Blacks filed a complaint against Jamison and John’s estate setting forth claims of wrongful death and survivorship based on Jamison’s and John’s alleged negligence.6 In November 2002, Penn National filed a complaint against the Blacks and the Myers seeking a declaratory judgment limiting to $100,000 its total exposure to the Blacks [229]*229under the bodily injury liability coverage and the underinsured motorist coverage, and requiring the Blacks to exhaust coverage provided by other relevant insurance policies before pursuing underinsured motorist coverage under Penn National’s policy. After discovery, the parties stipulated to the relevant facts and filed cross-motions for summary judgment.

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Bluebook (online)
916 A.2d 569, 591 Pa. 221, 2007 Pa. LEXIS 384, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pennsylvania-national-mutual-casualty-co-v-black-pa-2007.