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ORDER MOLLOY, Chief Judge. I.INTRODUCTION On May 4, 2002, Gary Hanson was jogging on a road in Spokane when a driver negligently crossed the centerline and struck him. Stipulated Facts (Facts) ¶ 1. The driver paid his policy limits of $100,000 to Gary and/or Gail Hanson. Facts ¶ 2. Defendant Employers Mutual Casualty Co. (EMC) provided uninsured motorist coverage to P.H. Moller Co., Inc., the named insured and title owner of three vehicles. Facts ¶ 4. Gary and Gail Hanson were the sole shareholders of P.H. Moller Co., Inc., a Montana corporation doing business as Marathon Electric. Facts ¶ 3. An underinsured vehicle is an uninsured vehicle under the policy. Exh. C, Facts, Uninsured Motorists Coverage, at 3-4, ¶ F(3)(b). EMC had insured P.H. Moller for several years. Until January 30, 2000, the policy defined an insured as follows: B. Who Is An Insured 1. You. 2. If you are an individual, any âfamily member.â 3. Anyone else âoccupyingâ a covered âautoâ or temporary substitute for a covered âauto.â The covered âautoâ must be out of service because of its breakdown, repair, servicing, loss or destruction. 4. Anyone for damages he or she is entitled to recover because of âbodily injuryâ sustained by another âinsured.â Facts ¶ 6. The policy issued for the period January 30, 2000 â January 30, 2001 changed the definition of an insured: If the Named Insured is designated in the Declaration as: 1. An individual, then the following are âinsuredsâ: A. The named insured and any âfamily members.â B. Anyone else âoccupyingâ a covered âautoâ or a temporary substitute for a covered âauto.â The covered âautoâ must be out of service because of its breakdown, repair, servicing, âlossâ or destruction. C. Anyone for damages he or she is entitled to recover because of âbodily injuryâ sustained by another âinsured.â 2. A partnership, limited liability company, corporation or any other form of organization, then the following are âinsuredsâ: A. Anyone âoccupyingâ a covered âautoâ or a temporary substitute for a covered âauto.â The *1073 covered âautoâ must be out of service because of its breakdown, repair, servicing, âlossâ or destruction. B. Anyone for damages he or she is entitled to recover because of âbodily injuryâ sustained by another âinsured.â Facts ¶ 4. EMC did not notify Hansons of the change in definition. Facts ¶ 8. Plaintiffs contend EMC was required by M.C.A. § 33-15-1106 to notify them of a substantive change in their insurance contract, and that they are entitled to rely on the earlier definition because of EMCâs failure to do so. EMC responds that the change was not âon less favorable termsâ and therefore did not trigger any duty to inform. Nonetheless, EMC argues that Hansons are not âinsuredsâ under the earlier definition. In its Preliminary Pretrial Statement, Defendant states that it âdoes not contend that the 2001 revision of the policy which modified the definition of âWho Is An Insuredâ in the uninsured/un-derinsured motorist definition applies to this claim.â Defendantâs Preliminary Pretrial Statement (Dkt # 19) at 3. Therefore, I will address only the issue of whether the Hansons are âinsuredsâ under the UM endorsement as that term was defined up until 2001. Moreover, I will not address Plaintiffsâ argument regarding notice, as that claim is mooted by Defendantâs willingness to concede that the post-2001 definition does not apply. II. DISCUSSION A. Summary Judgment Standards Summary judgment is proper when no genuine issue of material fact exists and the moving party is entitled to a judgment as a matter of law. Fed.R.Civ.P. 56. The initial burden is on the moving party to establish that there is no genuine issue of material fact; once met, the burden shifts to the party opposing the motion to establish otherwise. Erker v. Kester, 296 Mont. 123 , 988 P.2d 1221, 1224 (1999). All reasonable inferences that might be drawn from the offered evidence must be drawn in favor of the party opposing summary judgment. Id. If there are no genuine issues of fact, the court must determine whether the moving party is entitled to judgment as a matter of law. Blain v. Stillwater Mining Co., 321 Mont. 403 , 92 P.3d 4, 6-7 (2004). B. Applicable Law Because this courtâs jurisdiction arises out of diversity, the law of Montana applies. Erie R.R. Co. v. Tompkins, 304 U.S. 64 , 58 S.Ct. 817 , 82 L.Ed. 1188 (1938). Under Montana law, the interpretation of insurance contracts is a question of law for the courts. Marie Deonier & Assoc. v. Paul Revere Life Ins. Co., 301 Mont. 347 , 9 P.3d 622, 630 (2000). The principles of interpretation to be applied are as follows: The language of the policy governs if it is clear and explicit. Ambiguities are construed against the insurer. Furthermore, exclusions from coverage will be narrowly and strictly construed because they are contrary to the fundamental protective purpose of an insurance policy- Id. The terms of an insurance policy must be interpreted according to their âusual, common sense meaning as viewed from the perspective of a reasonable consumer of insurance products.â Dakota Fire Ins. Co. v. Oie, 291 Mont. 486 , 968 P.2d 1126, 1129 (1998). Although doubts in coverage are construed strictly against the insurer, the court will not rewrite the terms of a policy, but will enforce the terms as written. Generali-U.S. Branch v. Alexander, 320 Mont. 450 , 87 P.3d 1000, 1004 (2004). An ambiguity exists when a contract taken as a whole is reasonably subject to two different interpretations. Jacobsen v. Farmers *1074 Union Mut. Ins. Co., 320 Mont. 375 , 87 P.3d 995, 997-98 (2004) (citation omitted). III. Applying Montana Law to Han-sonsâ Contract Plaintiffs advance several arguments as to why âyouâ must include Gary Hanson, some of which overlap. Their primary argument relies on a federal case out of this district interpreting Montana law. Hager v. American West Insur. Co., 732 F.Supp. 1072, 1075 (D.Mont.1989). A second argument is that âyouâ must include the shareholders of a close corporation because a contrary interpretation would result in an illusion of coverage, and Montana requires an insured to provide something of value for premiums paid by an insured. A third argument is that because Defendant interpreted âyouâ under the med-pay portion of this contract to include Gary Hanson, it must interpret âyouâ under the UM/UIM endorsement similarly. Moreover, if EMC interprets âyouâ in two different ways, it has created an ambiguity that must be construed in favor of the insured. A. Hager : âYou or Any Family Memberâ Plaintiffs rely heavily on Hager v. American West Insur. Co., 732 F.Supp. 1072, 1075 (D.Mont.1989), in which the court held that Colleen Hager, a minority shareholder in a closely held family corporation, was an additional insured under the corporationâs uninsured motorist coverage. The policy defined an insured as âYou or any family member.â Judge Hatfield concluded, âWhere an automobile liability policy containing the âfamily memberâ terminology has been issued to a closely held corporation, it is entirely legitimate to conclude the readily identifiable officers and shareholders of that corporate entity fall within the purview of that terminology.â Id. at 1075 . The court explained that this conclusion was consistent with the public policy manifest in the Montana uninsured motorist statute, M.C.A. § 33-23-201, as well as with the rule that ambiguities in an insurance policy must be construed in favor of the insured. Id. âThe ambiguity in the subject policy is created by utilization of the term âfamily memberâ in a policy issued to a closely held corporation.â Id. Importantly, the Hager definition of insured was âYou or any family member.â Because a corporation cannot have family members, the court found the definition ambiguous. Here, in contrast, the definition is: 1. You. 2. If you are an individual, any family member. The Hager definition was ambiguous because it included family members regardless of whether the named insured was a corporation or an individual. Here, that ambiguity is absent. Moreover, the phrase, âIf you are an individualâ emphasizes that âyouâ may not be an individual. Defendants observe that Hager has never been cited by the Montana Supreme Court, except in dissent, Lierboe v. State Farm Mut. Ins. Co., 316 Mont. 382 , 73 P.3d 800, 804 (2003), and argue that it therefore offers no âdefinitive ruling on the precise issue.â Def. Brf. Supporting Motion for Sum. Jdgmnt., at 12. It also cites numerous cases from other jurisdictions, which it contends have refused to follow the Hager rule, i.e., that shareholders of an insured corporation are entitled to UM or UIM coverage under the corporationâs automobile liability polices. While some courts have construed Hager as establishing that rule, others have discerned a different rule: that the class of insureds covered by a UM/UIM policy cannot be smaller than the class of insureds covered by the liability portion of the policy. See, e.g., Georgeson v. Fidelity & Guaranty Insur. Co., 48 F.Supp.2d 1262 , 1265 *1075 (D.Mont.1998). Under this rule, the court must look to the liability portion of the policy, which here defines an insured as being, essentially, anyone using one of the three vehicles owned by the corporation. Exh. C, Facts, at 2, ¶ A(1). The definition of âinsuredâ for purposes of UM/UIM coverage is the named insured (âyouâ), any family members if the named insured is an individual, anyone in a covered auto (or temporary substitute of the covered auto is out of repair), or anyone with a claim for damages arising from bodily injury to another insured. If âyouâ is interpreted as the corporation, then the only persons covered under the UM/UIM policy are persons who are injured while in one of the vehicles owned by the corporation. Thus, under both the liability and UM portions of the policy, anyone in a vehicle owned by the corporation would be covered. This interpretation of Hager , therefore, does not force the conclusion that the Hansons are covered. Whether Hager stands for the rule that a policy issued to a close corporation is ambiguous if it refers to family members, or for the rule that the class of insureds covered for liability must be coextensive with the class covered for damages from uninsured motorists, it is sufficiently distinguishable from this case to render it unpersuasive. B. Reasonable Expectations Plaintiffs also argue that a corporation cannot be covered under an UM/UIM endorsement, because uninsured coverage applies only to bodily injury, which a corporation cannot suffer. Under the doctrine of âreasonable expectations,â they argue that the policy must be interpreted so as to cover the Hansons, because a reasonable consumer would expect such coverage. The reasonable expectations doctrine provides that the objectively reasonable expectations of insurance purchasers about the terms of their policies should be honored even if a painstaking study of the policy would negate those expectations. Transamerica Ins. Co. v. Royle, 202 Mont. 173 , 656 P.2d 820, 824 (1983); American Family Mut. Ins. Co. v. Livengood, 292 Mont. 244 , 970 P.2d 1054, 1059 (1998). An insurance contract is to be interpreted from the viewpoint of a consumer with average intelligence, with no training in law or insurance. Leibrand v. National Farmers Union Property & Casualty Co., 272 Mont. 1 , 898 P.2d 1220, 1225 (1995). Plaintiffs argue that the Hansonsâ purchase of UM/UIM coverage indicates their expectation that the âbodily injuryâ covered by that provision would be their bodily injury, not the corporationâs. At the very least, they argue, it creates ambiguity in the contract. âAny ambiguity in an insurance policy must be construed in favor of the insured, and in favor of extending coverage.â Mitchell v. State Farm Ins. Co., 315 Mont. 281 , 68 P.3d 703, 709 (2003). As a general rule, the Montana Supreme Court has consistently held that âan insurer may not place in an insurance policy a provision that defeats coverage for which the insurer has received valuable consideration.â Ruckdaschel v. State Farm Mutual Auto. Ins. Co., 285 Mont. 395 , 948 P.2d 700, 702 (1997); Bennett v. State Farm Mut. Auto. Ins. Co., 261 Mont. 386 , 862 P.2d 1146 (1993). More specifically, âan insurer is not allowed to deny coverage for which it has received valuable consideration.â Ruckdaschel, 948 P.2d at 702 . If the Hansons have been paying premiums for UM/UIM coverage through then-close corporation, Montana public policy requires that they be receiving coverage under that portion of the policy. Had either of the Hansons been in a company-owned vehicle when they were injured, *1076 they would have been insured under the UM/UIM endorsement. It is Gary Hansonâs status as a pedestrian at the time of his injury that takes him out of the policy coverage. Therefore, if it is legitimate for the insurer to provide UM/UIM coverage to occupants of covered vehicles only, and not to pedestrians, then the Hansons arguably received the value of their reasonable expectations. Underinsured motorist coverage is âpersonal and portableâ under Montana law. Mitchell v. State Farm, 315 Mont. 281 , 68 P.3d 703, 712 (2003). The purpose of the uninsured motorist insurance statute is âto protect completely, those willing to accept its protection, from all harm, whatever their status passenger, driver, pedestrian at the time of injury, produced by uninsured motorists. The only restrictions are that the plaintiff must be an insured, the defendant motorist uninsured, and that plaintiff be legally entitled to recover.â Guiberson v. Hartford Casualty Ins. Co., 217 Mont. 279 , 704 P.2d 68, 74 (1985) (citing Jacobson v. Implement Dealers Mutual Ins. Co., 196 Mont. 542 , 640 P.2d 908, 911 (1982)). These cases establish the proposition that Montana public policy supports a broad interpretation of uninsured motorist coverage. Nonetheless, the statute does not require that such coverage be sold irrespective of an auto insurance policy. In other words, UIM coverage is neither so personal nor so portable that insurers must sell it to individuals who are not buying auto insurance policies. I think, therefore, that as long as it is legal for an insurer to sell an automobile liability policy to a corporation, which is the named insured, it is legal'for the insurer to limit the class of covered individuals to those who are occupying covered vehicles at the time they are injured. I do not think Montanaâs policy favoring underinsured motorist coverage is defeated by allowing an insurer to provide UIM coverage for occupants of corporate-owned vehicles only, and not for pedestrians. Thus, the clear language of the insurance contract rebuts Plaintiffsâ reasonable expectations argument, which is not saved by resort to policy arguments. C. âYouâ Under the Medical Payments Endorsement The more difficult issue is Plaintiffsâ last argument, presented by the fact that EMC paid Hanson as an insured under the med-pay endorsement, which defines an insured as: 1. You while âoccupyingâ or, while a pedestrian, when struck by any âauto.â 2. If you are an individual, any âfamily memberâ while occupyingâ or, while a pedestrian, when struck by any âauto.â 3. Anyone else âoccupyingâ a covered âautoâ or a temporary substitute for a covered âauto.â The covered âautoâ must be out of service because of its breakdown, repair, servicing, âlossâ or destruction. EMC paid Hanson $15,000 in medical payments under this endorsement â $5,000 from each of P.H. Mollerâs three policies, Plaintiffs contend that EMC cannot reasonably interpret âyouâ in the med-pay definition to include Hanson individually without applying the same definition to the UM/UIM definition. The Defendantâs argument is that the med-pay endorsement was ambiguous because it could not reasonably be understood to apply to a corporation because of the language modifying âyou.â Recognizing this ambiguity, and in light of the rule that ambiguities must be resolved in favor of coverage, Defendant opted to pay Hanson under the medical payments endorsement. *1077 EMC correctly notes that the âyouâ in the med-pay definition is ambiguously modified by language that can only apply to a person, and never to a corporation, while the âyouâ in the UIM definition stands alone. Therefore, it argues, it paid Hanson under the med-pay because of that additional language; because it is lacking in the UIM definition, it should not have to pay. Construction of words and phrases within an insurance policy must attempt to reconcile all parts of the insurance contract. Holeman, 961 P.2d at 119. An ambiguity exists when âthe contract taken as a whole in its wording or phraseology is reasonably subject to two different interpretations.â Id. (citing Canal Ins. v. Bunday, 249 Mont. 100 , 813 P.2d 974 (1991)). EMC has created an ambiguity by its interpretation of âyouâ in the med-pay provision as being Gary Hanson individually, which directly conflicts with its interpretation of âyouâ in the underinsured provision as being P.H. Moller Co., Inc. Because ambiguities in insurance contracts must be construed against the insurer, and in favor of coverage, âyouâ must be consistently interpreted in this policy as including the sole shareholders of P.H. Moller Co., Inc., Gary and Gail Hanson. Therefore, because of the ambiguity created by EMCâs interpretation of the insurance contract, Gary Hanson is an âinsuredâ under the UIM coverage of the EMC policy. IV. CONCLUSION Taken on its own, the uninsured motorist definition of who is covered is unambiguous, and legitimately excludes coverage of individuals who are not in covered autos at the time they are injured. But the insurance policy must be read as a whole. The medical payments definition of who is covered implicitly recognizes that âyouâ is an individual, while the uninsured motorist definition can be interpreted as referring to the corporate âyouâ only. Such an ambiguity must be construed in favor of coverage. Accordingly, IT IS HEREBY ORDERED that Plaintiffsâ Motion for Summary Judgment (Dkt.# 12) is GRANTED, and Defendantsâ Motion for Summary Judgment (Dkt.# 10) is DENIED. The Clerk is directed to notify the parties accordingly.
Case Information
- Court
- D. Mont.
- Decision Date
- September 22, 2004
- Status
- Precedential