Walker v. Commercial Union Insurance Co.

879 S.W.2d 596, 1994 Mo. App. LEXIS 690, 1994 WL 144978
CourtMissouri Court of Appeals
DecidedApril 26, 1994
DocketNo. 64211
StatusPublished

This text of 879 S.W.2d 596 (Walker v. Commercial Union Insurance Co.) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Walker v. Commercial Union Insurance Co., 879 S.W.2d 596, 1994 Mo. App. LEXIS 690, 1994 WL 144978 (Mo. Ct. App. 1994).

Opinion

REINHARD, Judge.

Plaintiff appeals the trial court’s dismissal of a count in his petition for vexatious refusal to pay. We reverse and remand.

Plaintiff is an automobile driver injured when the automobile he was driving was struck by an uninsured motor vehicle. Defendant is plaintiffs insurance company, which had issued an automobile insurance policy to plaintiffs father covering his father’s automobile. The policy included uninsured motorist coverage (pursuant to § 303.-030.5, RSMo 1986), as well as so-called “medical payments” and property damage coverages. A1 premiums were paid and the policy was in force at the time of the accident. As a listed driver of the car, plaintiff was covered by the policy.

On March 25, 1992, plaintiff was driving his father’s insured automobile when the car was struck by that of an uninsured motorist, Wanda Hill. Plaintiff alleges he was proceeding through an intersection when Hill faded to stop at a red light and struck plaintiffs father’s car.

Plaintiff alleges that on November 3, 1992, he made a written demand on defendant under the uninsured motorist provision of the policy for $8,000 as a compromise settlement for plaintiff’s injuries and damages arising from the accident. He further claims that on December 1, 1992, an agent of defendant informed plaintiff that defendant had evaluated plaintiffs uninsured motorist claim at $6,000.- Defendant also informed plaintiff that defendant would claim the right under the policy to “set off” against the $6,000 the sum of $2,065.30 for plaintiffs medical bills which were covered and had been paid under the “medical payments” provision of the policy.

On December 2, 1992, plaintiff requested defendant supply him with a copy of the policy detailing any provisions allowing such a “set off” of medical payments against the uninsured motorist claim. Defendant provided a copy of the policy on February 4, 1993. Plaintiff asserts no such provision exists in that policy.

On March 8, 1993, plaintiff filed a two-count petition in the circuit court. Count I was a breach of contract claim under the uninsured motorist clause of the policy for damages resulting from personal injury caused by the negligence of the uninsured motorist in running the red light. Count II was a claim, pursuant to §§ 375.296 and 375.-420, RSMo 1986, for vexatious refusal to pay anything on the uninsured motorist claim,1 [598]*598even though defendant had already agreed to a value of $6,000 on the claim.

Defendant filed a motion to dismiss Count II for failure to state a claim upon which relief can be granted in that “[plaintiff] has failed to allege ... that the fault of the alleged uninsured motorist ... has been adjudicated or otherwise shown that he is legally entitled to recover against [the uninsured motorist].” The trial court sustained the motion. The court also made a determination pursuant to Rule 74.01 that there was no just reason for delay in appealing the dismissal.

When considering a motion to dismiss for failure to state a claim upon which relief can be granted, we must interpret the pleading broadly, treating all facts alleged as true and construing all allegations favorably to plaintiff. Lowrey v. Horvath, 689 S.W.2d 625, 626 (Mo. banc 1985).

In his sole point on appeal, plaintiff contends the trial court erred in dismissing Count II of his petition in that a plaintiff need not obtain an adjudication against an uninsured motorist as a prerequisite to a suit for vexatious refusal to pay under uninsured motorist coverage.

Defendant relies on Craig v. Iowa Kemper Mut. Ins. Co., 565 S.W.2d 716 (Mo.App.1978), in which the Western District addressed the very question at issue in the instant case. In Craig, two policyholders brought a claim against their insurer for vexatious refusal to pay under the uninsured motorist provision of their automobile insurance policy. The trial court denied the claim and the Western District affirmed that denial. The court stated:

The obligation of [insurer] to pay $10,000 to [policyholders] ... did not accrue merely because they proved a loss but only after the damage was adjudicated to result from the legal liability of the uninsured motorist. Thus, the claim of [policyholders] did not become a loss under the policy within the terms of § 375.420 — and so payable directly from the insurer to the insured — until the legal cause for the injury first was fixed on the uninsured motorist. Only then did the claim become a loss under the policy, and so, ex contractu — in this case, when final judgment was entered on the verdict of December 20, 1972 against [the uninsured motorist].
... In consonance with explicated principles, the claim on the uninsured motorist coverage of the policy did not accrue to the [policyholders] against [insurer] until the judgment against [uninsured motorist] became final on January 19, 1973. Then for the first time the [policyholders] became insureds under the uninsured motorist provision of the policy within the meaning of § 375.420. Only then did their claim become a loss upon a policy — ex contrac-tu — entitled to payment by [insurer] without reasonable delay. (Emphasis original).2

Id. at 720-22.

Subsequent to the decision in Craig, our supreme court, in Oates v. Safeco Insurance Company of America, 583 S.W.2d 713, stated:

To recover under an uninsured motorist policy, the insured does not need an unsatisfied judgment against the uninsured motorist, but has the burden of proving (1) that the other motorist was uninsured, (2) that the other motorist is legally liable to the insured, and (3) the amount of damages. The second element set out is equivalent to the statutory and contractual requirement that the insured be “legally entitled to recover.” (Citations omitted).

Id. at 715.

The Oates court continued:
We interpret the words “legally entitled to recover” to mean simply that the plaintiff must be able to establish fault on the part of the uninsured motorist which gives rise to damages and prove the extent of those damages.... [We] hold that this phrase refers to fault on the part of the uninsured motorist.

[599]*599Id. at 716, (quoting Reese v. Preferred Risk Mutual Insurance Co., 457 S.W.2d 205, 208 (Mo.App.1970)).

The court in Oates further stated:

[T]he insured is “legally entitled to recover” if his action is not barred by a substantive limitation at the time the action is brought against the uninsured motorist carrier and he can show (1) causal negligence or fault on the part of the uninsured motorist, (2) the absence of contributory negligence where submitted, and (8) resulting damage to himself. (Citations omitted)

Oates, 583 S.W.2d at 716-717.

Oates

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Related

Lowrey v. Horvath
689 S.W.2d 625 (Supreme Court of Missouri, 1985)
Reese v. Preferred Risk Mutual Insurance Company
457 S.W.2d 205 (Missouri Court of Appeals, 1970)
Cobb v. State Security Insurance Co.
576 S.W.2d 726 (Supreme Court of Missouri, 1979)
Craig v. Iowa Kemper Mutual Insurance Co.
565 S.W.2d 716 (Missouri Court of Appeals, 1978)
Oates v. Safeco Insurance Co. of America
583 S.W.2d 713 (Supreme Court of Missouri, 1979)
Shafer v. Automobile Club Inter-Insurance Exchange
778 S.W.2d 395 (Missouri Court of Appeals, 1989)
State ex rel. Safeco National Insurance Co. of America v. Rauch
849 S.W.2d 632 (Missouri Court of Appeals, 1993)
Thomas v. American Casualty Insurance Co.
871 S.W.2d 460 (Missouri Court of Appeals, 1993)

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Bluebook (online)
879 S.W.2d 596, 1994 Mo. App. LEXIS 690, 1994 WL 144978, Counsel Stack Legal Research, https://law.counselstack.com/opinion/walker-v-commercial-union-insurance-co-moctapp-1994.