Teschendorf v. State Farm Ins. Cos.

2005 WI App 10, 691 N.W.2d 882, 278 Wis. 2d 354, 2004 Wisc. App. LEXIS 989
CourtCourt of Appeals of Wisconsin
DecidedDecember 7, 2004
Docket03-3521
StatusPublished
Cited by5 cases

This text of 2005 WI App 10 (Teschendorf v. State Farm Ins. Cos.) is published on Counsel Stack Legal Research, covering Court of Appeals of Wisconsin primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Teschendorf v. State Farm Ins. Cos., 2005 WI App 10, 691 N.W.2d 882, 278 Wis. 2d 354, 2004 Wisc. App. LEXIS 989 (Wis. Ct. App. 2004).

Opinions

KESSLER, J.

¶ 1. Bernard J. Shira and Maria Shira appeal from an order for summary judgment dismissing their claim against American Family Mutual Insurance Company. The dismissal was based on the trial court's conclusion that American Family's reducing clause, which is based on Wis. Stat. § 632.32(5)(i)2. (2001-02),1 unambiguously allows the reduction of uninsured motorist policy limits by worker's compensation funds that were paid to the State Work Injury Supplemental Benefit Fund ("the State") because the insured had no dependents as that term is defined by worker's compensation statutes. We conclude that the unambiguous language of both the statute and the insurance policy allows a reduction only for those payments paid or payable to the insured or the insured's heirs or estate. Accordingly, we reverse and remand for further proceedings.

BACKGROUND

¶ 2. Scott Shira, age thirty-three, died in an automobile accident in Woodbury, Minnesota, while in the course of his employment for Layne Christensen Company.2 The accident was allegedly caused by an uninsured motorist. Scott's parents, the Shiras, filed a [357]*357wrongful death action under Wis. Stat. § 895.04.3 They sought to collect uninsured motorist ("UM") benefits included in two American Family Insurance Company automobile policies purchased by Scott prior to his death.

¶ 3. At the time of his death, Scott was unmarried and had no children. Because Scott had no dependents as defined by the worker's compensation statutes, the majority of the worker's compensation benefits payable as a result of his death, $159,900, were required to be paid directly to the State of Wisconsin, specifically to the Work Injury Supplemental Benefit Fund.4 See Wis. Stat. § 102.49(5)(b).5 The provisions of § 102.49 essentially require worker's compensation insurance to pay the State the benefits it would otherwise "save" when a worker dies and, therefore, cannot personally receive [358]*358the benefits. If a partially dependent person survives the decedent, the payments to the State are reduced by the amount paid to that dependent.

¶ 4. American Family successfully argued to the trial court that the Shiras are not entitled to receive anything under Scott's UM policies because the net limits of those policies, totaling $150,000, must be reduced by the amount of worker's compensation paid to the State by the worker's compensation carrier or the employer, which in this case exceeded $150,000. This appeal followed.

STANDARD OF REVIEW

¶ 5. We review the trial court's grant of summary judgment de novo, using the same methodology as the trial court. Mullen v. Walczak, 2003 WI 75, ¶ 11, 262 Wis. 2d 708, 664 N.W.2d 76. Summary judgment is appropriate if the pleadings and other information on file show there is no "genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Id.; see also Wis. Stat. § 802.08(2). Here, the facts are undisputed, leaving only issues of law for our consideration. Specifically, this case involves the interpretation of American Family's insurance policy and Wis. Stat. § 632.32(5)(i)2. issues that we review de novo. See Mullen, 262 Wis. 2d 708, ¶ 12 (interpretation of an insurance policy); Gonzalez v. Teskey, 160 Wis. 2d 1, 7-8, 465 N.W.2d 525 (Ct. App. 1990) (interpretation of statutes).

[359]*359DISCUSSION

¶ 6. At issue is the application of a clause in American Family's insurance policy, generally known as a reducing clause, which states:

The limits of liability of this coverage will be reduced by:
3. A payment made or amount payable because of bodily injury under any workers' compensation or disability benefits law or any similar law.

(Emphasis added.) This clause is specifically authorized by Wis. Stat. § 632.32(5)(i)2., which provides:

(i) A policy may provide that the limits under the policy for uninsured or underinsured motorist coverage for bodily injury or death resulting from any one accident shall be reduced by any of the following that apply:
2. Amounts paid or payable under any worker's compensation law.

¶ 7. The Shiras do not dispute that the policy as written conforms with Wis. Stat. § 632.32(5)(i)2. However, they contend that interpreting the clause to reduce American Family's UM coverage limits by amounts paid to the State rather than to Scott or his heirs or estate is contrary both to the insured's common sense interpretation of the reducing clause and to public policy.

¶ 8. In response, American Family contends that because the clause does not explicitly limit its applica[360]*360tion to funds paid or payable to the insured, payments made to the State are also subject to the reducing clause. American Family also points out that reducing clauses that conform with Wis. Stat. § 632.32(5)(i)2. have been held unambiguous and enforceable, citing Badger Mutual Insurance Co. v. Schmitz, 2002 WI 98, 255 Wis. 2d 61, 647 N.W.2d 223; Taylor v. Greatway Insurance Co., 2001 WI 93, 245 Wis. 2d 134, 628 N.W.2d 916; Bellile v. American Family Mutual Insurance Co., 2004 WI App 72, 272 Wis. 2d 324, 679 N.W.2d 827; and Va n Erden v. Sobczak, 2004 WI App 40, 271 Wis. 2d 163, 677 N.W.2d 718.

¶ 9. We agree with American Family that both the Wisconsin Supreme Court and the Wisconsin Court of Appeals have concluded that reducing clauses that are consistent with Wis. Stat. § 632.32(5)(i)2. are unambiguous and enforceable. However, no prior cases (including the cases relied upon by American Family) have addressed the issue presented here: whether worker's compensation benefits paid to the State, rather than to the insured or the insured's heirs or estate, fall within § 632.32(5)(i)2. All of the cases cited by American Family involve payments to the insured or the insured's dependents. We conclude that § 632.32(5)(i)2. does not permit reduction of coverage by payments made by other persons or entities to the State and, interpreting the reducing clause consistent with the statute, neither does the reducing clause in American Family's policy.

¶ 10. Prior to 1995, courts in Wisconsin held unenforceable a variety of insurance policies containing reducing clauses.

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Bluebook (online)
2005 WI App 10, 691 N.W.2d 882, 278 Wis. 2d 354, 2004 Wisc. App. LEXIS 989, Counsel Stack Legal Research, https://law.counselstack.com/opinion/teschendorf-v-state-farm-ins-cos-wisctapp-2004.