Romano v. Mercury Insurance

27 Cal. Rptr. 3d 784, 128 Cal. App. 4th 1333
CourtCalifornia Court of Appeal
DecidedMay 27, 2005
DocketG033796
StatusPublished
Cited by22 cases

This text of 27 Cal. Rptr. 3d 784 (Romano v. Mercury Insurance) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Romano v. Mercury Insurance, 27 Cal. Rptr. 3d 784, 128 Cal. App. 4th 1333 (Cal. Ct. App. 2005).

Opinion

Opinion

SILLS, P. J.

Background

While driving a 1995 Pontiac Firebird, Katherine Romano was rear-ended by a Toyota Camry driven by Alex Perez, who at the time was insured by a Pennsylvania insurance company (Legion Insurance Company) in financial trouble. The accident occurred in September 2001 and within six months a court in Pennsylvania put the Pennsylvania insurer into “rehabilitation.” *1336 While the court order of “rehabilitation” was expressly not a “declaration of insolvency” such as would “activate” Pennsylvania’s or any other state’s insurance guaranty laws, 1 the order nevertheless made the payment of any claims a matter of the rehabilitator’s discretion 2

On December 30, 2001 (within four months of the accident), the Pennsylvania insurer filed financial statements with the California Department of Insurance showing that its net worth was a negative $293 million, and within another 16 months after that (in late April 2003), a California court actually ordered the Pennsylvania insurer into liquidation. Within 23 months of the accident, in late July 2003, a Pennsylvania court formally did the same thing.

Needless to say, Romano did not (and has not) received any money from the now-defunct Pennsylvania insurance company that insured the driver who hit her from behind. She did, however, have uninsured motorist coverage from her own insurer, Mercury Insurance Company, covering her injuries in cases where an at-fault driver has no insurance “because of insolvency.” Mercury, however, denied Romano’s uninsured motorist claim on the theory that the Pennsylvania insurer Legion was not an “insolvent insurer” within the meaning of certain California Insurance Code statutes because it was not formally ordered into liquidation by a court within one year of the accident. Romano then instituted this litigation, and each side brought competing summary judgment motions, with the trial court granting Romano’s. 3

The central issue in the appeal before us is whether Mercury is obligated to pay for Romano’s injuries under her uninsured motorist coverage given that there was no formal declaration of insolvency (by either court or state insurance commissioner) within one year of the accident. As we explain below, the operative phrase in both the insurance policy itself and in the *1337 Insurance Code is “because of insolvency,” which both common law and the Insurance Code would lead a reasonable insured to conclude meant actual insolvency precipitating nonpayment of a claim within a year, regardless of whether any court or insurance commissioner took the formal step of ordering that insurer into liquidation. By this definition, the reason that Romano wasn’t paid was indeed “because of insolvency,” thus she was owed coverage under her uninsured motorist coverage from Mercury. Accordingly, we shall affirm the judgment in Romano’s favor.

The Policy Language

Here is the insuring clause of the policy as it relates to uninsured and underinsured motorist coverage: Mercury is “To pay all sums which the Insured or his legal representative shall be legally entitled to recover as damages from the owner, or operator of an uninsured motor vehicle because of bodily injury, sustained by the Insured, caused by accident and arising out of the ownership, maintenance or use of such uninsured motor vehicles, provided, for the purpose of this coverage, determination as to whether the Insured or such representative is legally entitled to recover such damages, and if so the amount thereof, shall be made by agreement, between the Insured or such representative and the company or, if they fail to agree, by arbitration.”

Then comes the policy’s definition of “uninsured motor vehicle.” “Uninsured Motor Vehicle means: [][] (a) a motor vehicle with respect to the ownership, maintenance, or use of which there is no bodily injury liability insurance or bond applicable at the time of the accident, or there is such applicable insurance or bond but the company writing the same denies coverage thereunder or refuses to admit coverage thereunder except conditionally or with reservation; [1] (b) an ‘underinsured motor vehicle’; [f] (c) an insured motor vehicle where the liability insurer thereof is unable to make payment with respect to the legal liability of its insured within the limits specified therein, because of insolvency within one year of the accident; [I] (d) a motor vehicle used without the permission of the owner thereof if there is no bodily injury liability insurance or bond applicable at the time of the accident with respect to the owner or operator thereof; [|] (e) a motor vehicle whose owner or operator is unknown.” 4 (Italics added.)

*1338 Statutes Addressing the Same Subject

There is, however, a statutory context in which insurers issue uninsured and underinsured coverage. Under Insurance Code section 11580.2 , the Legislature requires all auto policies to have uninsured motorist coverage. 5 Here is what subdivision (a)(2) of the statute requires of such policies:

“Uninsured motorists coverage insures the insured, his or her heirs, or legal representatives for all sums within the limits established by law, that the person or persons are legally entitled to recover as damages for bodily injury, including any resulting sickness, disease, or death, to the insured from the owner or operator of an uninsured motor vehicle not owned or operated by the insured or a resident of the same household.” (§ 11580.2, subd. (a)(2).)

A swath of language in subdivision (b) of section 11580.2 tracks categories (a), (b), (d) and (e)—all quoted above—in Mercury’s policy: “As used in this section, the term ‘uninsured motor vehicle’ means a motor vehicle with respect to the ownership, maintenance or use of which there is no bodily injury liability insurance or bond applicable at the time of the accident, or there is applicable insurance or a bond but the company writing the insurance or bond denies coverage thereunder or refuses to admit coverage thereunder except conditionally or with reservation, or an ‘underinsured motor vehicle’ as defined in subdivision (p), or a motor vehicle used without the permission of the owner thereof if there is no bodily injury liability insurance or bond applicable at the time of the accident with respect to the owner or operator thereof, or the owner or operator thereof be unknown . . . .”

Two paragraphs later, the statute addresses the insolvency issue found in category (c) of Mercury’s policy, using the same “because of insolvency” phrase used in the insurance policy: “As used in this section, the term ‘uninsured motor vehicle’ also means an insured motor vehicle where the liability insurer thereof is unable to make payment with respect to the legal liability of its insured within the limits specified therein because of insolvency.

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Cite This Page — Counsel Stack

Bluebook (online)
27 Cal. Rptr. 3d 784, 128 Cal. App. 4th 1333, Counsel Stack Legal Research, https://law.counselstack.com/opinion/romano-v-mercury-insurance-calctapp-2005.