Roberge v. Travelers Prop. Casualty Co. of America

112 F.4th 45
CourtCourt of Appeals for the First Circuit
DecidedAugust 12, 2024
Docket24-1040
StatusPublished
Cited by3 cases

This text of 112 F.4th 45 (Roberge v. Travelers Prop. Casualty Co. of America) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Roberge v. Travelers Prop. Casualty Co. of America, 112 F.4th 45 (1st Cir. 2024).

Opinion

United States Court of Appeals For the First Circuit

No. 24-1040

CYNTHIA A. ROBERGE,

Plaintiff, Appellant,

v.

TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA,

Defendant, Appellee.

APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND

[Hon. John J. McConnell, Jr., U.S. District Judge]

Before

Barron, Chief Judge, Thompson and Gelpí, Circuit Judges.

James S. D'Ambra, with whom Wayne G. Resmini and Resmini Law LLC were on brief, for appellant. Jessica M. Savino, with whom John P. Graceffa and Morrison Mahoney LLP were on brief, for appellee.

August 12, 2024 THOMPSON, Circuit Judge. Insurance law is notoriously

complex and today's appeal proves that point. To explain, before

us we have Appellant Cynthia Roberge ("Roberge") and Appellee

Travelers Property Casualty Company of America ("Travelers").

Regrettably, Roberge was in a serious car accident with an

underinsured motorist1 during the course of her then-employment

for the State of Rhode Island ("the State"). Following the

accident, Roberge made a demand for uninsured/underinsured

motorist ("UM/UIM") coverage under an insurance policy ("the

Policy") issued by Travelers to the State, but Travelers ultimately

concluded she was not entitled to UM/UIM coverage under the Policy.

Believing that Rhode Island insurance law required that she be

afforded UM/UIM coverage under the Policy, Roberge sued. The

district court, however, disagreed and granted Travelers summary

judgment.

Now on appeal to us, both parties read Rhode Island

insurance law very differently and argue it undeniably requires

their preferred outcome. For our part, we don't view the issues

or the law nearly as cut-and-dry as the parties do. In fact, as

we see it, today's appeal would require us to answer complex

questions of Rhode Island insurance law regarding UM/UIM coverage

1 For those insurance-law newbies, a motorist is "underinsured" when the limits of their liability coverage are insufficient to cover the victim's injuries. See Ladouceur v. Hanover Ins. Co., 682 A.2d 467, 468 n.3 (R.I. 1996).

- 2 - -- questions upon which the Rhode Island Supreme Court has not had

a chance to opine. Accordingly, because the Rhode Island Supreme

Court has the final word on matters of Rhode Island law, Johnson

v. Johnson, 952 F.3d 376, 377 (1st Cir. 2020), we certify the two

unresolved questions identified below to that Court for insight.

FACTS AND TRAVEL

In comparison to the unsettled legal landscape we

referenced above and will describe in depth below, the material

facts are straightforward and not in dispute.

The Policy and UM/UIM Coverage

Travelers first issued the Policy to the State in January

2004, with the named insured2 being the "State of Rhode Island."

The Policy was continuously renewed over the years, including,

most pertinently to our purposes, for the period of February 1,

2018 to February 1, 2019.

Under the Policy, UM/UIM coverage is available only if

the claimant is considered an "[i]nsured." The only relevant

Policy definition of "[i]nsured" for purposes of UM/UIM coverage

is "[a]nyone 'occupying' a covered 'auto' or a temporary substitute

for a covered 'auto'. Any 'auto' that is owned by the [State] is

not a temporary substitute for a covered 'auto'. The covered

2 In insurance lingo, named insureds are also "commonly referred to as class-I insureds, and occupants of an insured vehicle[ are] commonly referred to as class-II insureds." Finch v. Centennial Ins. Co., 650 A.2d 495, 497 (R.I. 1994).

- 3 - 'auto' must be out of service because of its breakdown, repair,

servicing, 'loss' or destruction." Accordingly, being considered

an "[i]nsured" (and thus having access to UM/UIM coverage under

the Policy) turns on whether the car at issue is a "covered 'auto'

or a temporary substitute for a covered 'auto.'"

As for the definition of "covered 'auto,'" the Policy

provides a list of ten symbols from which the State could have

selected what constitutes a "covered 'auto.'" Here, the State

selected symbol "2" for UM/UIM coverage. Symbol "2" means "[o]wned

'[a]utos' [o]nly" -- defined in the Policy as "[o]nly those 'autos'

you own."3 What all this insurance mumbo-jumbo means here is that,

under the Policy, there was UM/UIM coverage for accidents involving

only cars owned by the State or temporary substitutes for cars

owned by the State. And, notably, the State specifically selected

a $50,000 limit per accident for UM/UIM coverage claims.

The Car Accident and Denial of Coverage

On October 18, 2018 (and while the Policy was in effect),

Roberge was in a car accident with an underinsured motorist. At

3 A brief aside for some other helpful contractual context. First, the use of "you" and "your" in the Policy "refer[s] to the Named Insured shown in the Declarations," which (to refresh) refers to the "State of Rhode Island." Second, to illustrate some of the other options available to the State on that ten-symbol list, symbol "1" would have afforded UM/UIM coverage to "[a]ny '[a]uto,'" and symbol "9" would have afforded such coverage to "[n]on-owned '[a]utos' [o]nly," which "includes 'autos' owned by your 'employees' . . . while used in your business." The State did not select either symbol for UM/UIM coverage.

- 4 - the time of the accident, she was acting within the course of her

employment for the State4 and she was driving her own personal car.

According to Roberge, it was common for employees to use their own

personal cars if all of the State's cars were in use by other

employees and, therefore, no State car was available -- as was the

case on the date of the accident.5 As a result of the accident,

Roberge sustained injuries and has been unable to return to work.

After the accident, Roberge made a claim against

Travelers for UM/UIM coverage under the Policy issued to the

State.6 Travelers denied Roberge UM/UIM coverage on September 19,

2019, and ultimately reaffirmed its denial on December 20, 2019

and October 2, 2020. In its denials, Travelers explained that

Roberge was not owed UM/UIM coverage under the Policy because she

was driving her own car at the time of the accident and, therefore,

4 Nowhere in its briefing before this Court or before the district court did Travelers attempt to refute that, at the time of the accident, Roberge was acting within the scope of her employment. Indeed, all the evidence in the record supports that conclusion. 5 In light of Roberge's concession that she used her own car on the day of the accident because "all of [the State's] vehicles were already in use by other [State employees]," her own car cannot be considered a "temporary substitute for a covered 'auto'" as the State's cars were not "out of service because of [their] breakdown, repair, servicing, 'loss' or destruction." 6 At the time of the accident, Roberge also had her own personal insurance policy with USAA.

- 5 - was not driving a "covered 'auto'" and was not considered an

"[i]nsured."

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112 F.4th 45, Counsel Stack Legal Research, https://law.counselstack.com/opinion/roberge-v-travelers-prop-casualty-co-of-america-ca1-2024.