An insurance policy is a contract. Insureds are obligated to read and understand their own insurance policy.
Right? Except no one reads an insurance policy. I’m not just taking about Joe Six Pack here. . I’m talking about you, my dear reader: You, me, all of us. Why? Because our busy
and lazy lives don’t afford us the time to do it. “Just give me the nutshell” is the mantra even insurance lawyers have in their personal lives.
The problem with this is that there are rare instances where reasonable people would expect insurance coverage but they don’t because they didn’t read their insurance policies. What do we do in these cases when we know that it is reasonable to expect coverage?
The Maryland Court of Appeals gave the wrong answer to this question in Stickley v. State Farm last month. In this case, the plaintiff was riding as a passenger in a car driven by her husband when her husband negligently drove into an intersection and was struck by another car. The accident killed the plaintiff’s husband and left her with serious injuries. At the time of the accident, the plaintiff and her spouse had a motor vehicle liability insurance policy with State Farm Mutual Automobile Insurance Company, and an umbrella policy with its subsidiary State Farm Fire and Casualty Company. No, I have no idea why they do it this way.
The umbrella policy contained a household exclusion, which denied payment of damages for bodily injury or personal injury resulting from the negligence of another insured household member. After the accident, the plaintiff filed a claim under both the motor vehicle liability policy and the umbrella policy. State Farm offered the plaintiff the full amount in liability coverage under the former, but denied the second claim due to the household exclusion. The plaintiff subsequently filed suit seeking to declare the household exclusion void.
Supporting her claim, the plaintiff cited Maryland Code § 19-504.1 of the Insurance Article that requires any insurer to offer its insured, under a policy or binder of private passenger motor vehicle liability insurance (“PPMVLI”), the same amount of liability coverage for both claims made by family members and nonfamily members. The plaintiff argued that the umbrella policy was a PPMVLI, and because State Farm never offered her and her husband equal coverage for family members, the household exclusion was void. Here, the court addressed two questions: (1) whether an umbrella policy that includes motor vehicle liability insurance constitutes a PPMVLI; and (2) whether the household exclusion violated public policy.
The court first examined the plain language of the phrase “policy or binder of private passenger motor vehicle liability insurance.” The court noted that PPMVLI refers to a specific type of motor vehicle liability insurance, whereas a personal liability umbrella policy covers a variety of losses. Thus, umbrella policies attach generally to the insured, whereas PPMVLI generally attach to the motor vehicle. In addition, the court stated that umbrella policies are a supplemental form of insurance distinguishable from primary policies including motor vehicle liability insurance or homeowner’s insurance. Because they are supplemental, umbrella policies only kick in once the primary policy has been exhausted. For example, if an automobile policy had a liability limit of $100,000, the umbrella policy would pick up after that point and cover for an additional amount.
Next, the court looked to the statutory context. Finding that the legislature used the term “motor vehicle liability insurance policy” in § 19-504 to discuss minimum liability coverage, the court determined that umbrella policies, which are supplemental and serve as an excess form of coverage, were by definition not “motor vehicle liability insurance polic[ies].” In addition, the legislature included § 19-504.1 within the subtitle “Motor Vehicle Insurance – Primary Coverage,” suggesting intent to address household exclusions in primary policies. The plaintiff contended that one of the uninsured motorist statutes in §§ 19-509, 510 referring to primary coverage has been interpreted to apply to umbrella policies, thus showing legislative intent to treat umbrella policies the same as motor vehicle liability insurance. However, the court rejected this argument, stating that the statute in question, § 19-509(h)(1), explicitly refers to policies that are different in kind from primary policies. In addition, the plaintiff also argued that where the legislature distinguished umbrella policies from primary motor vehicle policies in the uninsured motorist statute and chose not to do the same in the household exclusion statute, the latter must be read to include all motor vehicle policies, including umbrella policies. The court rejected this argument as well, explaining that a court “may neither add nor delete language so as to reflect an intent not evidenced in the plain and unambiguous language of the statute.” Finally, the court briefly noted that statutory interpretation requires the court to reach a conclusion that is consistent with common sense. In this case, common sense dictated that the umbrella policy differed from PPMVLI. As a result, the court determined that the umbrella policy was not a PPMVLI.
Next, the court turned to the second question, whether the exclusion in the umbrella policy was a violation of public policy. This is the court’s chance to do the right thing, right?
The court started by stating that parties are usually free to contract as they wish, except when a contractual provision violates public policy, in which case that provision becomes invalid. Here, the public policy with regards to household exclusions required the insurer to offer the same amount of insured liability coverage for both family members and nonfamily members in a PPMVLI. As a result, it would be a violation of public policy to enforce a household exclusion provision if the insurer did not make that offer. However, the court stated that the legislature did not intend to eliminate household exclusions in insurance disputes exceeding minimum coverage, but rather wanted to offer the insured an opportunity to purchase liability limits for family members as well.
Ultimately, the court decided to leave the issue up to the legislature, stating that it “will not invade the province of the General Assembly . . . no matter how just or fair we may think such a new law or public policy would be.” Of course, they do invade the province of the Maryland legislature but they pick and choose their spots and decided not to here.
I wrote Irwin Weiss, a real good plaintiff’s lawyer (and sometime defense lawyer) in Baltimore County whose opinion I seek out frequently on both legal and tactical issues. He gave me another path the court could have gone down. This is from his email:
This is from Liberty Mutual v. Ben Lewis Plumbing, 121 Md. App 467, 473 (1998):
In Twelve Knotts, supra, this Court quoted from Shepard v. Keystone Insurance Company, 743 F.Supp. 429, 432 (D.Md.1990), to the effect that:
It is the obligation of the insured to read and understand the terms of his insurance policy, unless the policy is so constructed that a reasonable man would not attempt to read it … If the terms of the policy are inconsistent with his desires, he is required to notify the insurer of the inconsistency and of his refusal to accept the condition.
The Twelve Knotts Court then pointed out that, though there were no Maryland cases requiring the result that the District Court had reached, nonetheless, it appeared to be the general rule:
[W]hen the insured accepts a policy, he accepts all of its stipulations, provided they are legal and not contrary to public policy. Where changes from the application appear in the delivered contract, under a more stringent doctrine, the insured has a duty to examine it promptly and notify the company immediately of his refusal to accept it. If such policy is accepted or is retained an unreasonable length of time, the insured is presumed to have ratified any changes therein and to have agreed to all of its terms.” Twelve Knotts, 87 Md.App. at 104, 589 A.2d 105 (quoting l2, J. Appleman, Insurance Law and Practice, § 7155).
The court obviously thinks this is a bad result. Why not jump on this precedent and the wisdom behind it and say no reasonable person would attempt to read the policy?
The full opinion can be found here.