Vogelin v. American Family Mutual Insurance

213 P.3d 1216, 346 Or. 490, 2009 Ore. LEXIS 42
CourtOregon Supreme Court
DecidedJuly 16, 2009
DocketCC0502-01571; CA A132051; SC S056655
StatusPublished
Cited by11 cases

This text of 213 P.3d 1216 (Vogelin v. American Family Mutual Insurance) 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
Vogelin v. American Family Mutual Insurance, 213 P.3d 1216, 346 Or. 490, 2009 Ore. LEXIS 42 (Or. 2009).

Opinion

*492 WALTERS, J.

In this insurance breach-of-contract case, we decide how a liability payment that plaintiff recovered from a tort-feasor affects her recovery of underinsured motorist (UIM) benefits under her own insurance policy. We conclude that the relevant Oregon statutes permitted defendant — plaintiffs insurer — to calculate plaintiffs UIM benefit by subtracting the tortfeasor’s liability payment from the uninsured motorist (UM) liability limit of plaintiffs policy, instead of by subtracting that payment from the amount of plaintiffs total damages.

The facts are undisputed. Plaintiff, who had purchased an automobile insurance policy from defendant, was injured in an automobile collision in 2003 and sustained damages exceeding $300,000. The driver who collided with plaintiff and injured her had liability insurance with a liability limit of $25,000; the driver’s insurance carrier paid that amount to plaintiff. Because the driver’s liability payment was not sufficient to pay the full amount of plaintiffs damages, plaintiff made a claim against defendant for UIM benefits; the UM liability limit under her own policy was $100,000. The parties discussed various settlement amounts but did not come to an agreement.

Plaintiff filed this action against defendant in 2005 for breach of contract, arguing that ORS 742.504 establishes the minimum policy terms for UM and UIM insurance coverage. Plaintiff contended that, as interpreted by this court in Bergmann v. Hutton, 337 Or 596, 101 P3d 353 (2004), ORS 742.504(7)(c) requires insurers to pay their insureds the total amount of the damages that they incur, less any amount paid by or on behalf of a tortfeasor, up to the insured’s UM liability limit. Plaintiff argued that ORS 742.502(2)(a), which mandates UIM coverage, must be read consistently with ORS 742.504(7)(c), and compels the same result. Thus, plaintiff asserted, although the policy that she had purchased from defendant purportedly provided that the tortfeasor’s $25,000 liability payment would be deducted from her UM liability limit ($100,000), Oregon law required that that payment should be deducted from the total amount of her damages (which exceeded $300,000). Because the resulting figure *493 exceeded her policy’s $100,000 UM liability limit, plaintiff reasoned that she was entitled to receive her full UIM benefit from defendant. Defendant responded that ORS 742.502(2)(a), rather than ORS 742.504(7)(c), controlled, and that, under defendant’s interpretation of that former statute, the tortfeasor’s payment ($25,000) must be deducted from the amount of the policy’s UM limit in plaintiffs policy ($100,000), rather than from plaintiffs damages. It followed, in defendant’s view, that its obligation to plaintiff was limited to $75,000.

The trial court agreed with defendant and, after a jury returned a damages finding of $304,035.70, entered judgment for plaintiff in the amount of $75,000, plus attorney fees and costs. The Court of Appeals affirmed. Vogelin v. American Family Mutual Ins. Co., 221 Or App 558, 191 P3d 687 (2008). We allowed plaintiffs petition for review to answer this question of statutory interpretation — a question left open in Mid-Century Ins. Co. v. Perkins, 344 Or 196, 179 P3d 633 (2008), modified on recons, 345 Or 373, 195 P3d 59 (2008).

We begin our analysis with ORS 742.504(7)(c), because it is central to an understanding of the parties’ arguments. The parties agree that ORS 742.504 sets out the minimum required UM and UIM benefit provisions for all automobile insurance policies issued in Oregon. ORS 742.504; ORS 742.502(4). 1 ORS 742.504(7)(c) sets out the mandatory provisions regarding calculation of UM and UIM benefits and provides:

“Any amount payable under the terms of this coverage because of bodily injury sustained in an accident by a person who is an insured under this coverage shall be reduced by:
“(A) All sums paid on account of the bodily injury by or on behalf of the owner or operator of the uninsured vehicle * * *, including all sums paid under the bodily injury liability coverage of the policy; and
*494 “(B) The amount paid and the present value of all amounts payable on account of the bodily injury under any workers’ compensation law, disability benefits law or any similar law.”

(Emphasis added.)

In Bergmann, 337 Or 596, this court considered the question whether, under ORS 742.504(7)(c)(B), the amount of UIM benefits that an insured was entitled to receive from an insurer was (1) the amount of the insured’s damages reduced by workers’ compensation benefits; or (2) the amount of the insured’s UM liability limit reduced by workers’ compensation benefits. 2 To make that determination, the court construed the meaning of the words in the introductory phrase italicized above, “[a]ny amount payable under the terms of this coverage.” Id. at 602-07. The court distinguished the term “coverage” from the term “policy” — a term that the legislature did not use in the statutory text at issue — and explained that the former was a broad term encompassing “the universe of people, vehicles, and events that trigger the insurer’s obligation to pay under the policy,” whereas the latter referred to “the specific contract between the insurer and the insured[.]” Id. at 604. The court noted that an insurance policy includes limits on the insurer’s liability, but insurance “coverage” does not. Id. The court therefore concluded that the phrase “[a]ny amount payable under the terms of this coverage” in ORS 742.504(7)(c) meant

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Cite This Page — Counsel Stack

Bluebook (online)
213 P.3d 1216, 346 Or. 490, 2009 Ore. LEXIS 42, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vogelin-v-american-family-mutual-insurance-or-2009.