Wilbert v. Harleysville Mutual Insurance

385 A.2d 987, 254 Pa. Super. 217, 1978 Pa. Super. LEXIS 2662
CourtSuperior Court of Pennsylvania
DecidedApril 13, 1978
Docket140
StatusPublished
Cited by26 cases

This text of 385 A.2d 987 (Wilbert v. Harleysville Mutual Insurance) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wilbert v. Harleysville Mutual Insurance, 385 A.2d 987, 254 Pa. Super. 217, 1978 Pa. Super. LEXIS 2662 (Pa. Ct. App. 1978).

Opinions

SPAETH, Judge:

On July 29, 1972, Judith T. Wilbert, operating an automobile registered in her name, was involved in an accident with an automobile driven by an uninsured motorist. Three Wilbert children were with their mother; mother and children were all injured.

On the date of the accident a family combination automobile policy was in effect, issued by The Harleysville Mutual [220]*220Insurance Company to Edward J. Wilbert, husband of Judith. Mr. and Mrs. Wilbert filed a claim under the uninsured motorist coverage clause of the policy, individually and on behalf of their three children. Harleysville denied coverage on the ground that the automobile owned and operated by Mrs. Wilbert was not listed in or insured by the policy, and that the claim was therefore barred by the following provision:

Exclusions. This policy does not apply under Part IV
[“Protection Against Uninsured Motorists”]:
(a) to bodily injury to an insured while occupying an automobile (other than an insured automobile) owned by the named insured or a relative, or through being struck by such an automobile;

The Wilberts petitioned the lower court for declaratory judgment,1 arguing that the exclusion was in violation of the Uninsured Motorist Act2 and of the rules and regulations adopted and promulgated by the Insurance Commissioner pursuant to the Act. The lower court agreed and granted the petition, thereby holding that the Wilberts were entitled to coverage. Harleysville filed this appeal. We affirm.3

-1-

Harleysville is correct that the Wilberts are not entitled to coverage under the policy as issued. To repeat the exclusion (with interpolations):

This policy does not apply .
[221]*221(a) to bodily injury to an insured [Judith Wilbert and the children] while occupying an automobile (other than an insured automobile) owned by the named insured
[Edward Wilbert] or a relative [Judith Wilbert] . . .

Here Judith and the children were occupying an automobile that had both of the characteristics of an automobile not covered by the policy: first, it was an automobile “other than an insured automobile,” i. e., it was not named in the policy; and second, it was an automobile “owned by a relative [of the named insured],” i. e., by Judith, Edward’s wife.

-2-

The foregoing, however, does not end the matter, for it is necessary to ask: As issued, was Harleysville’s policy valid?

The rules and regulations adopted and promulgated by the Commissioner provide:

The extent of the coverage which shall be offered as “uninsured motorist coverage” shall be at least that coverage contained in the sample form attached hereto as Exhibit C and made a part of this regulation, which is the national standard form for this insurance.
31 Pa.Code § 63.2 (emphasis added).

The sample form referred to provides:

This endorsement does not apply:
(b) to bodily injury to an insured while occupying an automobile (other than an insured automobile) owned by a named insured or any relative resident in the same household, or through being struck by such an automobile, but this exclusion does not apply to the principal named insured or his relatives while occupying or if struck by an automobile owned by an insured named in the schedule or his relatives;
Id., Exhibit C at 184 (emphasis added).

[222]*222It will be observed that Harleysville omitted the emphasized clause from its policy. This omission, however, is not by itself enough to show that the policy is invalid. Even though the policy does not exactly match the Commissioner’s sample form, if the policy as applied to this case nevertheless has the same effect as the form, it should not be held in violation of the regulations under which the form was promulgated.

It is arguable that under the terms of the Commissioner’s sample form Judith and the children are excluded — as they are excluded under Harleysville’s policy. The argument might go as follows:

The Commissioner’s sample form consists of two clauses, the first clause being an exclusion, the second clause being an exclusion from that exclusion. Under the first clause Judith and the children are excluded, for they were occupying an automobile “other than an insured automobile”, and “owned by . any relative [of the named insured].” The question is therefore whether under the second clause coverage is restored to Judith and the children.

The second clause, with interpolations, reads as follows: “[The exclusion of the first clause] does not apply to the principal named insured [Edward] or his relatives [Judith and the children] while occupying ... an automobile owned by an insured named in the schedule or his relatives.” Here the automobile was owned by Judith. Is she “an insured named in the schedule”? If she is, the terms of the second clause have been met, and coverage is restored. If she is not, the terms of the second clause have not been met, and coverage is not restored.

There is no point in pretending that the meaning of the term, “an insured named in the schedule,” is clear. However, it seems likely that by it the Commissioner meant to refer to a “designated insured.” This is suggested by comparing the Commissioner’s sample form with the more commonly used form, which provides that uninsured motorist coverage does not apply:

[223]*223(b) to bodily injury to an insured while occupying a highway vehicle (other than an insured highway vehicle) owned by the named insured, any designated insured or any relative resident in the same household as the named or designated insured or through being struck by such a vehicle but this exclusion does not apply to the named insured or his relatives while occupying or if struck by a highway vehicle owned by a designated insured or his relatives.

See P. Pretzel, Uninsured Motorists 30-32 (1972). Furthermore, in the definitional section of the Commissioner’s form it is said:

“insured” means:
(1) the named insured as stated in the policy . and any person designated as named insured in the schedule
31 Pa.Code § 63.2, Exh. C, at 182 (emphasis added).

If this reasoning is accepted, it follows that Judith and the children are excluded under the Commissioner’s sample form. They are excluded under the first clause. The second clause, with interpolations, reads: “[The exclusion of the first clause] does not apply to the principal named insured [Edward] or his relatives [Judith and the children] while occupying ... an automobile owned by an insured named in the schedule [which is to be construed as meaning by a designated insured ] or his relatives.” Judith was not a “designated insured”.

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Wilbert v. Harleysville Mutual Insurance
385 A.2d 987 (Superior Court of Pennsylvania, 1978)

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Bluebook (online)
385 A.2d 987, 254 Pa. Super. 217, 1978 Pa. Super. LEXIS 2662, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wilbert-v-harleysville-mutual-insurance-pasuperct-1978.