Reynolds, S. v. Essentia Ins. Co.

Superior Court of Pennsylvania·Decided February 12, 2024·No. 2074 EDA 2023·Unpublished

Opinion

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT O.P. 65.37

SHANE D. REYNOLDS, INDIVIDUALLY : IN THE SUPERIOR COURT OF AND ON BEHALF OF A CLASS OF : PENNSYLVANIA SIMILARLY SITUATED PERSONS :

:

:

v. :

:

:

ESSENTIA INSURANCE COMPANY : No. 2074 EDA 2023 :

Appellant :

Appeal from the Order Entered July 3, 2023 In the Court of Common Pleas of Philadelphia County Civil Division at No(s): 210801568

BEFORE: DUBOW, J., KING, J., and LANE, J. MEMORANDUM BY LANE, J.: FILED FEBRUARY 12, 2024 Essentia Insurance Company (“Essentia”) appeals from the order which granted, in part, and denied, in part, the motion for partial summary judgment filed by Shane D. Reynolds (Reynolds).1 We quash the appeal as interlocutory.

The facts underlying this insurance coverage dispute are uncontested.

On June 30, 2018, Reynolds was involved in a motor vehicle accident while operating his 2003 Harley-Davidson motorcycle. The accident occurred when a vehicle operated by Christopher Heasley (“Heasley”) struck Reynolds, causing him to sustain serious and permanent injuries. The vehicle operated by Heasley was insured under a policy issued by Erie Insurance Exchange

1 Although the caption suggests that this is a class action, no class certification has yet been made in the action.

(“Erie”), which provided liability insurance coverage to Heasley in the amount of $100,000 per person/$300,000 per accident. Reynolds made a claim under the liability provisions of the Erie policy and received $85,000 in full settlement of his claim. Reynolds determined that the settlement amount was insufficient to compensate him for the injuries and damages he sustained in the accident; accordingly, he sought to recover additional insurance benefits.

In this regard, Reynolds tendered a claim for underinsured motorist (“UIM”) benefits under a Classic Automobile Policy issued by Essentia (“the Essentia policy”), which insured two classic vehicles owned by Reynolds: a 1970 Chevrolet Corvette Coupe; and a 1967 Chevrolet Chevelle SS Coupe. The Essentia policy provided uninsured motorist (“UM”) and UIM benefits in the amount of $25,000 per person/$50,000 per accident. The UIM endorsement to the Essentia policy included the following definition of an “insured” for purposes of UIM benefits:

B. “Insured” as used in this endorsement means:

1. Any person “occupying” “your covered auto[;]”[]

2. Any person for damages that person is entitled to recover of “bodily injury” to which this coverage applies sustained by a person described in b.1 above.

Essentia Policy, Endorsement No. 13 37 05 16, at 1.

The UIM endorsement to the Essentia policy additionally included, in relevant part, the following household exclusion:

A. We do not provide Underinsured Motorists Coverage for “bodily injury” sustained:

1. By you:

a. While “occupying” any motor vehicle owned by or furnished for the regular use of you or any “family member” which is not insured for this coverage under this policy. . . .

Essentia Policy, Endorsement No. 13 37 05 16, at 2.

Given that Reynolds sustained his injuries while operating a vehicle which was not insured under the Essentia policy, Essentia denied Reynolds claim for UIM benefits on the following bases: (1) the definition of “insured” required Reynolds to be an occupant of a vehicle insured by the Essentia policy to recover UIM benefits; and (2) the household exclusion excluded UIM benefits for any bodily injury sustained by Reynolds while occupying any motor vehicle not insured under the Essentia policy. See Denial of Coverage Letter, 8/28/18, at 3-4.

Reynolds thereafter initiated the present action against Essentia. In his amended complaint, Reynolds asserted four claims for relief: Count I declaratory relief—invalidity of definition of “insured;” Count II declaratory relief—household exclusion; Count III compensatory relief—UIM benefits; and (4) Count IV injunctive relief—seeking an order enjoining Essentia from asserting either the definition of “insured” or the household exclusion as a defense to claims for UM or UIM benefits. Essentia subsequently withdrew its

denial of coverage based on the household exclusion.2 Thus, the sole remaining basis for Essentia’s denial of UIM benefits to Reynolds was the definition of an “insured” under the UIM endorsement to the Essentia policy.

Reynolds moved for partial summary judgment on his remaining claim for declaratory relief at Count I of the amended complaint. In his prayer for relief, Reynolds requested that the trial court enter an order declaring: (1) Reynolds was eligible to recover UIM benefits under the Essentia policy; and (2) the restrictions in the definition of an “insured” in the UIM endorsement to the Essentia policy were void and unenforceable under the Pennsylvania Motor Vehicle Financial Responsibility Law (“MVFRL”), 75 Pa.C.S.A. § 1701, et seq. Essentia filed a response to Reynolds’ motion for partial summary judgment.3 Reynolds filed a reply brief in support of his motion for partial summary judgment in which he reiterated that he sought partial summary judgment on his “claim for declaratory relief,” and requested a declaration that the definition of “insured” in the Essentia policy was void and unenforceable as violative of the MVFRL, and that he was therefore “eligible” to recover UIM

2 The practical effect of Essentia’s decision to withdraw its denial of coverage

based on the household exclusion was to render as moot Count II of the amended complaint. Thus, the only claim for declaratory relief remaining in the action was Count I, which sought declaratory relief regarding the invalidity of definition of “insured.”

3 Although styled as a “Cross-Motion and Response,” Essentia’s filing did not

include any “motion,” and did not seek any ruling or relief from the trial court. Rather, in its filing, Essentia simply admitted or denied the assertions made by Reynolds in his motion for partial summary judgment.

benefits under the Essentia policy. Reply Brief in Support of Motion for Partial Summary Judgment, 8/1/22, at 9-10; see also Reynolds’ Answer to Cross[- ]Motion for Summary Judgment, 8/1/22, at 1 (clarifying that he was seeking “Partial Summary Judgment in his favor on the claim for declaratory relief”).

On July 3, 2023, the trial court entered an order granting, in part, and denying, in part, Reynolds’ motion for partial summary judgment. Specifically, the trial court ruled: (1) in favor of Essentia and against Reynolds regarding Reynolds eligibility to recover UIM benefits; and (2) in favor of Reynolds and against Essentia regarding the limitations in the definition of “insured.” See Order, 7/3/23. The trial court explained that, although it found the definition of “insured” in the UIM endorsement to the Essentia policy to be void and unenforceable, it could not grant the additional declaratory relief requested by Reynolds regarding his eligibility for UIM benefits under the Essentia policy because Reynolds had not demonstrated that he had first sought UIM benefits from Progressive Preferred Insurance Company (“Progressive”),4 in compliance with section 1733(a) of the MVFRL.5 The trial court reasoned:

4 At the time of the accident, the motorcycle operated by Reynolds was insured

under a policy issued by Progressive (“the Progressive policy”). The Progressive policy provided UIM benefits in the amount of $25,000 per person/$50,000 per accident.

5 Section 1733(a) sets forth the priority of sources for payment for UM and

UIM benefits when multiple insurance policies apply to a claim for benefits: (Footnote Continued Next Page)

[B]ased [on the MVFRL], this court is denying Reynolds[’]

claim for declaratory judgment regarding his specific entitlement.

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Reynolds, S. v. Essentia Ins. Co., (Pa. Ct. App. 2024).

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