Zervas v. USAA Gen. Indem. Co.

370 F. Supp. 3d 1169
CourtDistrict Court, D. Nevada
DecidedFebruary 27, 2019
DocketCase No.: 2:18-cv-00051-JAD-GWF
StatusPublished
Cited by2 cases

This text of 370 F. Supp. 3d 1169 (Zervas v. USAA Gen. Indem. Co.) is published on Counsel Stack Legal Research, covering District Court, D. Nevada primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Zervas v. USAA Gen. Indem. Co., 370 F. Supp. 3d 1169 (D. Nev. 2019).

Opinion

Jennifer A. Dorsey, U.S. District Judge

Emily Zervas was severely injured as a passenger in a motorcycle accident caused by an uninsured driver, and her loss exceeded the $500,000 combined limits of the three uninsured-motorist (UM) policies that covered the accident. Geico and State Farm each paid out their $100,000 policy limits. But defendant USAA tendered just *117160% of its $300,000 limit, so Zervas sues for breach of contract and declaratory relief, seeking the remainder of the USAA coverage.

USAA moves for summary judgment. It acknowledges that its $300,000 policy makes up 60% of the $500,000 in available coverage, but it contends that the "other insurance" clause in its policy sets its coverage obligation at 60% of its own policy limit-for a total of just $180,000. Because USAA's other-insurance clause conflicts with the allocation provisions in the other applicable policies, Nevada law requires me to disregard USAA's formula and instead prorate Zervas's loss among the insurers based on their share of the aggregate policy limits, making USAA responsible for 3/5 of the $500,000 covered loss, or $300,000. I therefore deny USAA's motion for summary judgment and instead grant summary judgment in favor of Zervas on her breach-of-contract and declaratory-relief claims. And with good cause appearing, I grant Zervas's motion to amend her complaint to add a bad-faith claim.

Discussion

I. USAA's summary-judgment motion [ECF No. 14]

Like many insurance disputes involving multiple polices, this case turns on the interplay between clauses in the applicable policies that dictate who pays how much when several policies provide benefits for a covered loss. Known in insurance-industry speak as "other insurance" provisions, these ubiquitous clauses "seek to limit the insurer's obligations in the event that there is another policy [i.e., other insurance] that covers the same risk."1 USAA seeks to do just that here. The policy it sold to Zervas's mother affords $300,000 per person in UM coverage. But because Zervas's loss is also covered by two other $100,000 policies issued by Geico and State Farm,2 USAA seeks to limit its obligation to a fraction of its own $300,000 policy, instead of a fraction of the aggregated three policies ($500,000).

A. When there's a conflict among applicable policies' allocation methods, the court must prorate the loss based on the aggregate policy limits.

Difficulties arise when a loss is covered by several policies and each provides a different method of allocating benefits. Courts have developed several approaches to address this type of conflict. Nevada has adopted3 the rule articulated by the Oregon Supreme Court in Lamb-Weston, Inc. v. Oregon Automobile Insurance Co.4 Under the Lamb-Weston rule, "when 'other insurance' clauses cannot be reconciled,"5 they are all deemed void,6 and the court must apply a simple proration formula: prorating the insured's loss by the ratio *1172that each policy's limit bears to the sum of all the applicable limits (up to each policy's limit). This rule "avoids arbitrariness in the selection of conflicting clauses," "discourages litigation between insurers, and ... provide[s] a basis for a uniformity of result."7

If the other-insurance clause in Zervas's mother's USAA policy conflicts with the other-insurance language in the State Farm or Geico policy here, Nevada law requires me to apply the Lamb-Weston rule, disregard USAA's other-insurance provision, and hold USAA responsible for its pro rata share of the loss based on the aggregate $500,000 in coverage. Before I can conclude that this rule applies, however, I must first determine whether the allocation methods in the policies are consistent or contradictory.

B. The allocation method in USAA's other-insurance clause conflicts with those in the State Farm and Geico policies.

Looking at the coverage that Zervas is entitled to under these policies, it is clear that one affords primary coverage and the other two afford excess coverage. "Primary insurance coverage is provided when, under the terms of the policy, liability attaches immediately upon the happening of an occurrence that gives rise to liability, as opposed to excess or secondary coverage, which attaches only after a predetermined amount of primary coverage has been exhausted."8 Although neither USAA nor Zervas addresses this primary-excess distinction, proper characterization of the various insurers' coverage is the first step to understanding the three policies' other-insurance clauses.

Because the accident involved a motorcycle insured by its owner's Geico policy, that policy provided Zervas primary UM coverage.9 Geico's other-insurance clause contains customary proration language that states that Geico's proportion of responsibility will be the ratio of its policy limit to the sum of all applicable limits-in this case, $100,000 out of $500,000, or 20%.10 Geico tendered its full $100,000 for this accident.

Zervas's father had a State Farm policy that also covered this accident. That policy provides primary UM coverage only if a person covered by the policy is injured while "occupying" a car owned by the policyholder.11 Because the motorcycle Zervas was riding wasn't owned by her father, the State Farm policy affords Zervas excess coverage. That policy also contains customary language that prorates State Farm's excess coverage with other applicable excess-insurance providers.12 State Farm calculates *1173its proportion of responsibility as the ratio of its policy limit to the sum of all applicable excess-policy limits.

Zervas's mother held the USAA policy at issue. Like the State Farm policy, USAA's provides only excess coverage for this accident because Zervas was injured in a vehicle not owned by her mother, the policyholder.13 This policy also contains an other-insurance clause that prorates USAA's share based on the total excess coverage available under all policies:

On an excess basis, we will pay only our share of the loss that must be paid under insurance providing coverage on a [sic] excess basis. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability for coverage provided on a [sic] excess basis .14

Because the total available excess coverage is $400,000 (State Farm's $100,000 + USAA's $300,000), USAA's share under this provision would be $300,000/$400,000 or 3/4, and State Farm's share is $100,000.15 State Farm tendered its $100,000.

But USAA paid just $180,000, not 3/4 of the $400,000 in available excess coverage (which works out to $300,000).

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Bluebook (online)
370 F. Supp. 3d 1169, Counsel Stack Legal Research, https://law.counselstack.com/opinion/zervas-v-usaa-gen-indem-co-nvd-2019.