Roberge v. Travelers Prop. Casualty Co. of America

112 F.4th 45
Court of Appeals for the First Circuit·Decided August 12, 2024·No. 24-1040·Published·Cited by 3 cases

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).

-- 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).

'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.

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.

was not driving a "covered 'auto'" and was not considered an "[i]nsured."

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

112 F.4th 45 (Roberge v. Travelers Prop. Casualty Co. of America) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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