Spearman v. Progressive Classic Insurance Co.

396 P.3d 885, 361 Or. 584, 2017 Ore. LEXIS 420
CourtOregon Supreme Court
DecidedJune 22, 2017
DocketCC 1302-01718; CA A155674; SC S063995
StatusPublished
Cited by9 cases

This text of 396 P.3d 885 (Spearman v. Progressive Classic Insurance Co.) is published on Counsel Stack Legal Research, covering Oregon Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Spearman v. Progressive Classic Insurance Co., 396 P.3d 885, 361 Or. 584, 2017 Ore. LEXIS 420 (Or. 2017).

Opinion

*586 LANDAU, J.

ORS 742.061(1) generally provides for an award of attorney fees when an insured brings an action against his or her insurer and recovers more than the amount tendered by the insurer. ORS 742.061(3) provides a “safe harbor” for the insurer in uninsured motorist (UM) cases: An insured is not entitled to attorney fees if, within six months of the filing of a proof of loss, the insurer states in writing that it has accepted coverage, that it agrees to binding arbitration, and that the only remaining issues are the liability of the uninsured motorist and the “damages due the insured.”

At issue in this case is what the safe-harbor statute means when it refers to the “damages due the insured.” The insurer, Progressive Classic Insurance Company, responded to plaintiffs claim by agreeing that the accident was covered by the policy, but challenging the nature and extent of plaintiffs injuries, as well as the reasonableness and necessity of his medical expenses. Plaintiff argues that, by reserving the right to challenge the nature and extent of his injuries, Progressive raised issues that went beyond the “damages due the insured.” According to plaintiff, to qualify for the safe harbor in ORS 742.061(3), an insurer must agree that it owes some amount above zero in benefits, so that the only remaining issues must concern the particular amount above zero that the insurer owes.

The trial court and the Court of Appeals, Spearman v. Progressive Classic Ins. Co., 276 Or App 114, 366 P3d 821 (2016), both rejected plaintiffs construction of the safe-harbor statute. For the reasons that follow, we do as well and affirm the decision of the Court of Appeals and the judgment of the circuit court.

I. FACTS

Plaintiff purchased an automobile insurance policy from Progressive. The policy included UM coverage with a limit of $25,000.

Plaintiff was injured in an automobile accident with an uninsured motorist. Plaintiff filed a proof of loss for UM benefits with Progressive. Within six months, Progressive sent a letter to plaintiff that stated:

*587 “Pursuant to ORS 742.061(3)(a) and (b), please be advised that Progressive Classic Insurance Company has accepted coverage for the above matter and the only issues are the liability of the [u]ninsured motorist and damages due to [plaintiff]. Progressive Classic consents to submit this case to binding arbitration if we cannot resolve this matter.”

Progressive paid plaintiff some benefits, but the parties were unable to resolve their dispute about the extent of the insurer’s UM liability. So plaintiff filed an action against Progressive in circuit court. Plaintiffs complaint alleged:

“4. That on or about August 5, 2012, Plaintiff, an insured person under the terms of Defendant’s aforesaid insurance policy, was operating the insured vehicle southbound on NE 82nd Avenue near its intersection with NE Brazee Street, public roadways in Portland, Multnomah County, Oregon, when he stopped his automobile [for] traffic stopped ahead and was struck by an automobile operated by [a named driver].
“5. That the aforesaid accident was caused by an uninsured vehicle and motorist as defined in the policy and at ORS 742.502(2)(a).”

It further alleged that, as a result of the accident, plaintiff was required to incur medical expenses that should have been reimbursed as part of his uninsured motorist coverage. And it alleged that plaintiff had “performed all preconditions to the recovery of benefits under the policy of insurance” that Progressive had issued. Plaintiff prayed for an award of his unpaid UM damages in an amount not to exceed the $25,000 UM policy limit.

In its answer, Progressive alleged that it “[a]dmits the allegations contained in paragraph 4, except that [it] lacks information and knowledge as to whether or not plaintiff was stopped at impact.” Progressive further stated that it “admits that plaintiff sustained ‘some’ injury as a result of the alleged accident; but disputes the nature and extent of plaintiffs alleged injuries.” It also admitted that plaintiff had submitted a claim for some medical expenses, but denied “the reasonableness and necessity of some of plaintiffs accident-related medical expenses.”

*588 Plaintiff served Progressive with a request for admissions. In response, Progressive admitted that plaintiff had done everything required of him to be eligible for uninsured motorist benefits; admitted that plaintiff had suffered “some” injury, although Progressive disputed the nature and extent of the injury; and admitted that plaintiff had suffered “some” economic damages, although Progressive denied “the reasonableness, necessity, relatedness, and extent” of the economic damages that plaintiff had claimed.

The matter was transferred to the court’s arbitration program, and the arbitrator awarded plaintiff $6,022.80 under the UM provisions of the policy. Plaintiff requested attorney fees under ORS 742.061(1). Progressive asserted that it was entitled to the safe harbor of ORS 742.061(3). The arbitrator agreed with Progressive and denied the fee request.

Plaintiff challenged in circuit court the arbitrator’s failure to award attorney fees. The parties did not dispute that the conditions generally necessary for a fee award under ORS 742.061(1) had been met. The sole dispute was over whether Progressive had met the requirements for the safe harbor set out in ORS 742.061(3). Relying on this court’s decision in Grisby v. Progressive Preferred Ins. Co., 343 Or 175, 182-83, 166 P3d 519, adh’d to as modified on recons, 343 Or 394, 171 P3d 352 (2007), plaintiff argued that, because Progressive had raised issues that could have resulted in an award of zero damages, the insurer had raised issues beyond “the damages due the insured.” Plaintiff argued that, although Grisby concerned a statutory provision that applied only to personal injury protection (PIP) benefits, its holding should be extended to this case. That means, he contended, that Progressive “was required to frame its pleadings to concede that the trier of fact was required to award some damages.” (Emphasis in original.)

The trial court rejected plaintiffs argument and denied the fee request.

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Cite This Page — Counsel Stack

Bluebook (online)
396 P.3d 885, 361 Or. 584, 2017 Ore. LEXIS 420, Counsel Stack Legal Research, https://law.counselstack.com/opinion/spearman-v-progressive-classic-insurance-co-or-2017.