United Services Automobile Ass'n v. McCants

1997 OK 73, 944 P.2d 298, 1997 WL 338560
CourtSupreme Court of Oklahoma
DecidedSeptember 9, 1997
Docket82981
StatusPublished
Cited by5 cases

This text of 1997 OK 73 (United Services Automobile Ass'n v. McCants) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United Services Automobile Ass'n v. McCants, 1997 OK 73, 944 P.2d 298, 1997 WL 338560 (Okla. 1997).

Opinions

HODGES, Justice.

¶ 1 Dennis McCants (Husband), a single man, purchased a house in 1985 and insured it with United Services Automobile Association (USAA). Husband married Rhonda McCants (Wife) in 1987. They lived in the house until August 28, 1991, when the house was heavily damaged by fire.

¶ 2 The couple filed a claim on the insurance policy, which had been renewed from year to year. USAA promptly paid the mortgage holder, but declined to pay benefits to Husband and Wife on grounds of arson. USAA then commenced this action against Husband and Wife to recover damages for insurance fraud. Husband and Wife counterclaimed for benefits due under the insurance contract and for bad faith maintaining that the fire was an accident. A jury found for USAA in its fraud action and awarded $73,-222.13 in damages which included $31,499.49 to compensate for expenses USAA incurred in investigating the fire and $41,722.64 for payment to the mortgage holder as loss payee. The jury also found against Husband and Wife on their contract claim for policy benefits. The trial court granted summary judgment in favor of USAA on the bad faith counterclaim. The trial court also granted a judgment notwithstanding the verdict only to Husband on USAA’s fraud claim. Husband and Wife brought this appeal. USAA brought a counter appeal.

¶ 3 The Court of Civil Appeals concluded that both Husband and Wife should have been granted judgment notwithstanding the verdict on USAA’s fraud claim. That court went on to conclude that Husband was entitled to a new trial on his contract claim but that USAA would not have to cover Wife’s fire losses. This Court granted certiorari review. The opinion of the Court of Civil Appeals is now vacated and the trial court’s decision is affirmed.

I. Husband and Wife Were Joint Insureds Under the Terms of the Contract of Insurance

¶ 4 The contract of insurance in effect for the renewed policy period of May 19, 1991, through May 19,1992, provided the following definitions:

In this policy, “you” and “your” refer to the “named insured” shown in the Declarations and the spouse if a resident of the same household....
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3. “insured” means you and residents of your household who are:
a. your relatives; or
[300]*300b. other persons under the age of 21 and in the care of any person named above.

Despite these definitions, the Court of Civil Appeals reasoned that, because the property was not held in joint tenancy, only Husband was an insured. It held that Wife never became a party to the contract and that she received coverage only in a “beneficiary” status.

¶ 5 Who is an insured under a policy of insurance is determined by the contract itself. Babcock v. Adkins, 695 P.2d 1340, 1342 (Okla.1985). “Every insurance contract shall be construed according to the entirety of its terms and conditions as set forth in the policy and as amplified, extended, or modified by any rider, endorsement, or application attached to and made part of the policy.” Okla.Stat. tit. 36, §, 3621 (1991).

¶ 6 The reasoning of the Court of Civil Appeals cannot be reconciled with the terms of the insurance agreement. Husband and Wife were both insureds under the policy, Husband as the insured named on the declarations page and Wife as a spouse residing in the household. This determination is consistent with the fact that wife had an insurable interest in the property by virtue of being a spouse who resided there.

II. USAA was Entitled to Deny Husband and Wife’s Claim under the Terms of the Contract of Insurance.

¶7 In the “EXCLUSIONS” section of the policy, the parties agree that USAA will not insure the following:

h. Intentional Loss, meaning any loss arising out of any act committed:
(1) by or at the direction of an insured; and
(2) with the intent to cause a loss.

Also, the “CONDITIONS” section of the policy provides:

2. Concealment or Fraud. The entire policy will be void if, whether before or after a loss, an insured has:
a. intentionally concealed or misrepresented any material fact or circumstances;
b. engaged in fraudulent conduct; or
c. made false statements; relating to this insurance.

Either of these provisions provided sufficient grounds for denying the claim. As the Court of Civil Appeals observed, USAA “offered sufficient competent expert evidence to support the jury’s finding” that Wife set the fire. However, that court’s conclusion that Husband was entitled to policy benefits was based on its misapplication of Short v. Oklahoma Farmers Union Insurance Co., 619 P.2d 588 (Okla.1980).

¶ 8 In Short, a husband, who was both a joint tenant and a joint insured, burned down the couple’s house when the wife filed for divorce. Short provided two separate bases for precluding recovery by a spouse on a policy of insurance when the other spouse intentionally damages or destroys the insured property. One was the joint nature of the property ownership. Id. at 590. The other was the joint nature of the insurance coverage. Id.

¶ 9 The Short opinion did not hold that both joint ownership and joint insurance must be present before coverage may be denied. Speaking only to joint coverage, this Court reasoned that “[t]o allow recovery on an insurance contract where the arsonist has been proven to be a joint insured would allow funds to be acquired by the entity of which the arsonist is a member and is flatly against public policy.” Id. Short concluded that “both spouses are accountable and bound by their contractual agreements in the same manner as any other two insureds would be.” Id. at 591.

¶ 10 The Court of Civil Appeals misapplied Short by requiring that the insureds be joint insureds and joint tenants before coverage could be denied. Joint tenancy was not required. The trial court was correct in denying Husband’s motion for a new trial on his contract claim for policy benefits.

III. USAA’s Action in Tort for Fraud Entitled It to Seek Damages to Compensate for Expenses it Incurred in Investigating the Fire and Paying the Mortgage Holder.

¶ 11 In addition to denying the claim for fire loss, USAA filed this action to recover [301]*301sums it expended in investigating the fire and in paying the mortgage holder. USAA’s action was a tort action for fraud. It was not based on the contract provision which allows USAA to deny the claim in cases of concealment or fraud. Specifically, the fraud action was based on false statements concerning the cause of the fire and on claims Husband submitted to USAA which it claimed were inflated, false, and a misrepresentation of the true amount of damage. The jury found for USAA in its fraud action.

¶ 12 The Court of Civil Appeals has failed to appreciate that USAA did not file this lawsuit in order to deny the claim for policy benefits, contract provisions allowed it to do so. It is therefore irrelevant whether the insurance contract provided for recovery of investigation expenses and payment to the mortgage holder.

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United Services Automobile Ass'n v. McCants
1997 OK 73 (Supreme Court of Oklahoma, 1997)

Cite This Page — Counsel Stack

Bluebook (online)
1997 OK 73, 944 P.2d 298, 1997 WL 338560, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-services-automobile-assn-v-mccants-okla-1997.