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Roth v. Illinois Farmers Insurance Co.
State: Illinois
Court: 5th District Appellate
Docket No: 5-00-0308 Rel
Case Date: 08/07/2001
              NOTICE
Decision filed 08/07/01.  The text of this decision may be changed or corrected prior to the filing of a Petition for Rehearing or the disposition of the same.

NO. 5-00-0308

IN THE

APPELLATE COURT OF ILLINOIS

FIFTH DISTRICT


 
BRENDA ROTH, Independent)   Appeal from the
Administrator of the Estate of)   Circuit Court of
Angela Roth, Deceased,)   St. Clair County.
)
Plaintiff-Appellee,)
)
v.)   No. 99-MR-285
)
ILLINOIS FARMERS INSURANCE)
COMPANY,)   Honorable
)   John M. Goodwin, Jr.,
Defendant-Appellant.)   Judge, presiding.


PRESIDING JUSTICE CHAPMAN delivered the opinion of the court:

This is an appeal from an order granting a motion for summary judgment in adeclaratory judgment action brought to adjudicate the meaning of the language containedwithin an insurance policy of Illinois Farmers Insurance Company (defendant). The trialcourt found the underinsured-motorist clause in defendant's insurance policy ambiguous andawarded the plaintiff $200,000. The only issue in this dispute between the parties is whetherthe $100,000 per-person limit or the $300,000 per-occurrence limit of the underinsured-motorist coverage applies to the plaintiff's claims. We affirm.

I. FACTS

Angela Roth died as a result of injuries sustained in an automobile accident. Angelawas a passenger in a vehicle driven by Ryan Gebke. The accident occurred as a result of anapparent drag race instigated by the driver of the other vehicle, Darin Diesen. Darin Diesenwas at fault and was an underinsured motorist. At the time of the accident, the decedent,Angela Roth, was a 17-year-old minor and resided with her parents and eight brothers andsisters.

Defendant had issued an automobile insurance policy to Angela's parents. Thatpolicy provided coverage for Angela's injuries and subsequent death. The policy providedcoverage for insured persons, including the policyholder or any family member. The termsof the policy include both uninsured- and underinsured-motorist coverage. The partiesagreed that Angela Roth was covered under the policy, and they stipulated to the terms ofthat policy. The limits-of-liability clauses that are the source of contention between theparties provide as follows:

"The amounts shown in the Declarations are the limits of liability for UninsuredMotorist [sic] which apply subject to the following:

1. The uninsured(1) motorist bodily injury limit for 'each person' is the maximum wewill pay for all damages resulting from bodily injury sustained by one person in anyone accident or occurrence. Included in this limit, but not as a separate claim orclaims, are all the consequential damages sustained by other persons, such as loss ofservices, loss of support, loss of consortium, wrongful death, grief, sorrow[,] andemotional distress.

2. The uninsured motorist bodily injury limit for 'each occurrence' is the maximumamount we will pay for two or more persons for bodily injury sustained in any oneaccident or occurrence." (Emphasis in original.)

The terms of the underinsured-motorist benefits include $100,000 per person and $300,000per occurrence. The parties stipulated that the total damages sustained by Angela Roth andthe next of kin of Angela Roth under the Wrongful Death Act (740 ILCS 180/0.01 et seq.(West 1998)) exceed $300,000.

In settlement of the claims against him, Darin Diesen's liability carrier tendered thesum of $20,000, which represented Diesen's liability limits. Defendant has paid the plaintiff$80,000, which represents the difference between the per-person limit and the $20,000received on behalf of Darin Diesen.

The independent administrator of the estate of Angela Roth, Brenda Roth (plaintiff),made multiple claims under defendant's underinsured-motorist coverage, including a claimunder the Survival Act (755 ILCS 5/27-6 (West 1998)) for Angela's injuries sustained priorto her death and claims of Angela's next of kin under the Wrongful Death Act. Plaintiff firstargued that the policy required defendant to pay the $300,000 per-occurrence limit for theclaims since they were for two or more persons for "bodily injury" as defined in the policy. Alternatively, plaintiff argued that the terms and definitions in the underinsured-motorist-coverage section were latently and patently ambiguous. Defendant argued that the $100,000per-person limit applied because all claims arising out of Angela's injury and subsequentdeath should be considered one claim.

Plaintiff and defendant filed cross-motions for summary judgment. The trial courtgranted plaintiff's motion because it found defendant's underinsured-motorist clause ambiguous. The court denied defendant's motion for summary judgment. The trial courtentered judgment for plaintiff in the amount of $200,000, which represents the differencebetween the stipulated amounts paid by defendant and the $300,000 per-occurrence policylimit.

II. ANALYSIS

Plaintiff and defendant agree that claims arising out of the injury to, and death of,Angela Roth are covered by the underinsured-motorist portion of defendant's policy. However, the parties disagree as to whether plaintiff's claims are subject to the per-personlimit of $100,000 or the per-occurrence limit of $300,000. Plaintiff argues that the terms ofthe policy clearly place her claims within the per-occurrence limit. Alternatively, plaintiffargues that the wording of the policy is ambiguous as to whether the separate claims arisingout of the injury to, and death of, Angela Roth are subject to the per-occurrence limit or theper-person limit.

The construction of an insurance policy is a question of law subject to de novoreview. McKinney v. Allstate Insurance Co., 188 Ill. 2d 493, 722 N.E.2d 1125 (1999). Ourprimary objective in construing the language of a policy is to ascertain and give effect to theintentions of the parties as expressed in their agreement. American States Insurance Co. v.Koloms, 177 Ill. 2d 473, 479, 687 N.E.2d 72, 75 (1997). If the terms of the policy are clearand unambiguous, they must be given their plain and ordinary meaning. Outboard MarineCorp. v. Liberty Mutual Insurance Co., 154 Ill. 2d 90, 108, 607 N.E.2d 1204, 1212 (1992). However, if the terms are susceptible to more than one meaning, they are consideredambiguous and will be construed strictly against the insurer, which drafted the policy.Koloms, 177 Ill. 2d at 479, 687 N.E.2d at 75 (1997). Courts will not strain to find anambiguity in an insurance policy where none exists. United States Fire Insurance Co. v.Schnackenberg, 88 Ill. 2d 1, 5, 429 N.E.2d 1203, 1205 (1981).

Plaintiff contends that the per-occurrence limit of the underinsured-motorist coverageis triggered by her claims for Angela's personal injuries under the Survival Act and theseparate claim of Angela's parents and siblings under the Wrongful Death Act for the lossoccasioned by Angela's death. Plaintiff argues these are two different claims that trigger theper-occurrence limit of the underinsured-motorist coverage because they are claims forbodily injury "for two or more persons."

Plaintiff focuses on the definition of "bodily injury" provided in the policy as supportfor her reading of the per-occurrence limitation. Bodily injury is defined in the policy asmeaning "injury to the body, sickness, disease[,] or death of any person." Thus, plaintiffargues that the per-occurrence limit applies anytime two or more persons have a claim forinjury to the body or death of "any person" sustained in any one accident. Plaintiff contendsthat because there are two separate claims, one by Angela's estate for injuries sustained byAngela in the accident and one by Angela's parents and siblings for her wrongful death,there are two or more persons who have a claim for injury to the body, and death, of anyperson. Finally, plaintiff argues, because the insurance policy does not make its per-occurrence limit subject to the terms of the per-person limit, it is not necessary to interpretthe per-occurrence coverage with reference to the terms of the per-person coverage.

Defendant argues that the per-occurrence limit should never be reached because ofthe terms and definitions of the per-person clause and that, therefore, any supposedambiguity in the per-occurrence limit is irrelevant. Defendant argues that the per-personlimitation includes the consequential damages sustained by other persons, such as loss ofservices, loss of support, loss of consortium, wrongful death, grief, sorrow, and emotionaldistress. Defendant argues that such language has been held by the Illinois Supreme Courtto mean that only one person was injured and that such language is unambiguous. See McKinney v. Allstate Insurance Co., 188 Ill. 2d 493, 722 N.E.2d 1125 (1999). Defendantnotes that in McKinney the court examined language restricting the per-person limits toinclude damages sustained by anyone else as a result of that bodily injury and held that suchlanguage unambiguously limited all claims to the single per-person limit.

Defendant's reliance on McKinney is misplaced. Although in McKinney the IllinoisSupreme Court did address an insurance policy's per-person limit and its effect on theplaintiff's survival claim and wrongful-death claims, the language of the insurance policyin that case is not the language of the insurance policy at bar. The language of the limits-of-liability clauses at issue in McKinney provided as follows:

"1. 'each person' is the maximum that we will pay for damages arising out of bodilyinjury to one person in any one motor vehicle accident, including damages sustainedby anyone else as a result of that bodily injury.

2. 'each accident' is the maximum we will pay for damages arising out of bodilyinjury to two or more persons in any one motor vehicle accident. This limit is subjectto the limit for 'each person.' " McKinney, 188 Ill. 2d at 495, 722 N.E.2d at 1126.

The limits-of-liability clauses of defendant's policy provide as follows:

"1. The uninsured motorist bodily injury limit for 'each person' is the maximum wewill pay for all damages resulting from bodily injury sustained by one person in anyone accident or occurrence. Included in this limit, but not as a separate claim orclaims, are all the consequential damages sustained by other persons, such as loss ofservices, loss of support, loss of consortium, wrongful death, grief, sorrow[,] andemotional distress.

2. The uninsured motorist bodily injury limit for 'each occurrence' is the maximumamount we will pay for two or more persons for bodily injury sustained in any oneaccident or occurrence." (Emphasis omitted.)

The language at issue in McKinney is significantly different than the language in defendant'spolicy. Defendant's use of the word "for" in its per-occurrence clause and Allstate's use ofthe word "to" in the per-occurrence clause at issue in McKinney is a significant differencein the use of language that gives different meaning and effect to each clause. Whendefendant's definition of bodily injury is included in the per-occurrence clause, the clauseprovides benefits "for" two or more persons "for" injury or death of "any person." InMcKinney, Allstate's use of the word "to" in its per-occurrence limitation resulted in aninterpretation of the policy that provided payment for bodily injury "to" two or more personsinjured in any one accident.

When defendant's policy is examined as a whole, it is possible for plaintiff's claimsto fit into either the per-person clause or the per-occurrence clause as each is applicable tothe separate claims asserted. It is clear that the language "the maximum amount we will payfor two or more persons for bodily injury sustained in any one accident or occurrence"(emphasis added; original emphasis omitted) is applicable to the separate claims asserted byplaintiff. The survival claim asserted by Angela Roth's estate for Angela's predeath injuriesand the wrongful-death claim asserted by her parents and siblings for Angela's resultingdeath qualify under the terms as two or more persons seeking payment for bodily injury(injury to the body of Angela Roth and the death of Angela Roth) sustained in any oneaccident.

Defendant contends that the per-occurrence clause should not be read in isolation; rather, it asks that we read the entire policy as a whole. However, defendant also contendsthat we should not reach the issue of the interpretation of the per-occurrence clause becauseit need not be reached after a proper examination of the per-person clause. We are not toread the provisions of an insurance policy in isolation, but we are required to read theprovisions of a contract in light of each other to determine whether an ambiguity exists.Douglas v. Allied American Insurance, 312 Ill. App. 3d 535, 727 N.E.2d 376 (2000). Insurance policy provisions should be read in context, not in isolation. Economy PreferredInsurance Co. v. Ingold, 302 Ill. App. 3d 360, 707 N.E.2d 983 (1998).

In examining defendant's policy as a whole and the relation of its provisions to eachother, we think it significant that the per-occurrence clause in defendant's policy did notexpressly make its underinsured-motorist coverage subject to the per-person limit, althoughin the bodily injury liability portion of its policy, the per-occurrence clause is subject to theper-person limit. The presence of such language in one provision and its absence in anotherprovision within the same policy is significant in that it suggests an intention by the drafterto provide broader coverage in those situations where the language is absent. The absenceof such language serves to distinguish McKinney, because the language in the Allstate policyin McKinney made the "each accident" limitation expressly subject to the limit for "eachperson."

Defendant argues that because the per-person clause defines the coverage, there is noambiguity. We disagree. Because we find that both the per-person clause and the per-occurrence clause define coverage applicable to the claims asserted by plaintiff, the policyis ambiguous. Defendant would require the reader of the policy, particularly upon readingthe "Limits of Coverage" section of the policy, to stop at the first clause of that section andnot proceed to number two, the next clause of the same section, simply because number oneis applicable. However, the second clause, number two under the same section, also appliesto the claims asserted in this case. It is unreasonable to ask the reader of an insurance policyto stop reading at the first instance of coverage and to deny any subsequent provisions ofcoverage that may also apply. This is particularly so when neither clause indicates that theapplication of one demands that the other be forfeited. Where one provision, when readwith others, becomes ambiguous, the contract must be construed to favor the insured. McDonald v. Prudential Property & Casualty Co., 304 Ill. App. 3d 422, 710 N.E.2d 556(1999).

III. CONCLUSION

Both the per-person clause and per-occurrence clause in the insurance policy's limitsof coverage apply to the claims asserted by plaintiff. Because neither clause provides thatthe application of one excludes the application of the other, the result is confusion to aninsured whose claims fall within both, and the policy is ambiguous. Ambiguous terms inan insurance policy generally are construed strictly against the drafter of the policy and infavor of coverage, because the insurer is the drafter of the policy and could have drafted theambiguous provision clearly and specifically. Smith v. Allstate Insurance Co., 312 Ill. App.3d 246, 726 N.E.2d 1 (1999).

For the foregoing reasons, we find defendant's insurance policy ambiguous, and weaffirm the judgment of the circuit court.

Affirmed.

WELCH and HOPKINS, JJ., concur.

 

1. The underinsured-motorist-coverage rider states, "[A]ll the terms and conditions ofPart II-Uninsured Motorist Coverage apply to Underinsured Motorist Coverage."

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