2010 Wi app 17
court of appeals of
published opinion
Case No.: |
2009AP894 |
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Complete Title of Case: |
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Opinion Filed: |
December 22, 2009 |
Submitted on Briefs: |
December 1, 2009 |
Oral Argument: |
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JUDGES: |
Curley, P.J., Fine and Kessler, JJ. |
Concurred: |
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Dissented: |
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Appellant |
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ATTORNEYS: |
On behalf of the plaintiffs-appellants, the cause was
submitted on the briefs of Kevin R. Martin of |
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Respondent |
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ATTORNEYS: |
On behalf of the defendant-respondent, the cause was
submitted on the brief of Werner Scherr and Jean-Marie Feedham of Gonzalez Saggio & Harlan LLP,
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2010 WI App 17
COURT OF APPEALS DECISION DATED AND FILED December 22, 2009 Clerk of Court of Appeals |
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NOTICE |
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This opinion is subject to further editing. If published, the official version will appear in the bound volume of the Official Reports. A party may file with the Supreme Court a petition to review an adverse decision by the Court of Appeals. See Wis. Stat. § 808.10 and Rule 809.62. |
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Appeal No. |
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STATE OF |
IN COURT OF APPEALS |
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Estate of Plaintiffs-Appellants, Estate of Representative and Estate of Plaintiffs, United Healthcare of Wisconsin, Inc., Involuntary-Plaintiff, v. The Auto Club Group Insurance Company, Defendant-Respondent. |
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APPEAL
from an order of the circuit court for
Before
¶1 FINE, J.
I.
¶2
¶3 This action was brought against Auto Club Group Insurance by
¶4 The circuit court granted summary judgment to Auto Club Group Insurance in a written order that did four things: (1) it dismissed the claims against Auto Club Group Insurance by Stys; (2) it dismissed the claims against Auto Club Group Insurance by James Kucza; (3) it dismissed the claims against Auto Club Group Insurance by Kenneth Kucza; and (4) it withheld a decision on whether to dismiss the claims against Auto Club Group Insurance by Mrs. Kucza’s estate. The notice of appeal that brings this matter before us is on behalf of “Jean Stys, James Kucza and Kenneth Kucza” and asserts that it appeals the circuit court’s order “which granted [Auto Club Group Insurance]’s motion for summary judgment and dismissed the appellants’ claims.”
¶5 We recite the operative documents at length because the
parties have blurred the distinctions between the individual claims of
¶6 The circuit court correctly granted summary judgment to Auto
Club Group Insurance dismissing the claims of
II.
¶7 A party is entitled to summary judgment if “there is no
genuine issue as to any material fact” and that party “is entitled to a
judgment as a matter of law.” Wis. Stat. Rule 802.08(2). We review de novo a circuit court’s
summary-judgment decision, and apply the governing standards “just as the trial
court applied those standards.” Green Spring Farms v. Kersten, 136
315–317, 401 N.W.2d 816, 820–821 (1987). The facts
material to this appeal are not disputed, and the appeal requires an analysis
of the Auto Club Group policy. This,
too, is subject to our de novo
review. See Ruenger v. Soodsma, 2005
WI App 79, ¶8, 281
¶8 We construe and apply language in insurance policies as that
language “would be understood by a reasonable person in the position of the
insured.” American Family Mut. Ins. Co. v.
American Girl, Inc., 2004 WI 2, ¶23, 268
¶9 The policy’s underinsured-motorist-coverage part promises to “pay compensatory damages which an insured person is legally entitled to recover from the owner or operator of an underinsured motor vehicle because of bodily injury: 1. sustained by an insured person; and 2. caused by an accident.” (Bolding in original; formatting altered.) No one here disputes that: (1) Raymond Kucza is an “insured person”; (2) he sustained “bodily injury”; “caused by an accident”; (3) Crouse was the “owner or operator of an underinsured motor vehicle” when she ran into Raymond Kucza; and (4) Raymond Kucza’s adult children are “legally entitled to recover” from Crouse for the loss of society and companionship they suffered as a result of the accident she caused. Fatal to their claims here, however, is that none of the adult children is an “insured person” under the policy, and thus the underinsured-motorist-coverage provision does not apply to them. Simply put, the Auto Club Group is only obligated to “pay compensatory damages which an insured person is legally entitled to recover.” (Emphasis added.)
¶10 The underinsured-motorist-coverage part of the Auto Club Group
policy defines, as material here, an “insured person” as “any resident relative.” (Bolding in
original.) Also as material here, the
policy defines “resident relative” as “a person who is related to you by blood
… who lives and is physically present in your household at the time of the
accident.” Although
¶11 Bruflat v. Prudential Property & Casualty Insurance Company,
2000 WI App 69, 233
¶12 Bruflat does not apply here because there, as Bruflat
notes, the issue was not coverage as
it is here, but, rather, who was entitled to receive payment of a covered
loss.
¶13 Appellants contend, however, that they should be able to
recover their loss-of-society-and-companionship claims under the
underinsured-motorist- coverage part of the Auto Club Group policy because they
argue that a limits-of-liability provision in the policy makes the coverage
ambiguous, and ambiguous policies must be applied in favor of coverage. See
Folkman v. Quamme, 2003
WI 116, ¶13, 264
The Limits of Liability for Uninsured Motorists Coverage and the Limits of Liability for Underinsured Motorists coverage are shown on the Declaration Certificate.
The Limit of Liability for each person is the maximum Limit of Liability for all damages due to bodily injury to any insured person in any one accident including any claim of other persons for damages for care and loss of services and society, wrongful death, and survivor actions and derivative damages arising out of bodily injury. Subject to this limit for each person, the Limit of Liability for each accident is the maximum Limit of Liability for all damages due to bodily injury resulting from any one accident including any claims of other persons for damages for care and loss of services and society, wrongful death and survivor actions and derivative damages arising out of the bodily injury.
(Bolding in original, italics added.) Appellants contend that the italicized language’s reference to “other persons” (rather than “insured persons”) means that the policy is ambiguous because at the very least it envisions persons other than “insured persons” recovering under the policy’s underinsured-motorist coverage. We disagree.
¶14 Appellants have pointed us to no law that permits a
limits-of-liability provision to trump an insuring agreement, which, as we have
seen, is the pivot on which an insurer’s liability must turn. See American Girl, 2004 WI 2, ¶24, 268
Wis. 2d at 32, 673 N.W.2d at 73 (If the insuring agreement makes it “clear
that the policy was not intended to cover the claim asserted, the analysis ends
there.”). We have found, however, an
analogous situation where an appellate court would not permit a
limits-of-liability provision to “negate the specific provisions defining
coverage.” Southeast Atlantic Cargo
Operators, Inc. v. First State Ins. Co., 398 S.E.2d 264, 266 (
¶15 The insured in Southeast Atlantic Cargo Operators
had primary coverage from an insurer that was declared insolvent.
¶16 Here, the Auto Club Group insuring agreement only promises
coverage for what “insured persons” could recover from an underinsured
motorist, and, as we have seen,
¶17 Finally, the appellants also argue that unless they can recover
under the policy’s underinsured-motorist coverage, the policy would be
“illusory.” A policy’s coverage is
illusory when there are “no circumstances” where an insured can collect. Kaun v. Industrial Fire & Cas. Ins. Co., 148
¶18 We affirm the circuit court’s dismissal of the individual
claims asserted by
By the Court.—Order affirmed.
[1]
[2]
[3] Indeed, the appellants concede that they “have never contended that the children are ‘insureds’ under the policy.” (Italics omitted.) They do argue, however, that the Estate of Raymond S. Kucza is an “insured” under the policy, but, as we have seen, the written order from which this appeal was taken did not address the scope of the estate’s recovery; it only dismissed the individual claims asserted against Auto Club Group by Raymond Kucza’s adult children, and it is that dismissal that we affirm.
[4]
(1) An action for wrongful death may be brought by the personal representative of the deceased person or by the person to whom the amount recovered belongs.
(2) If the deceased leaves surviving a spouse, and minor children under 18 years of age with whose support the deceased was legally charged, the court before whom the action is pending, or if no action is pending, any court of record, in recognition of the duty and responsibility of a parent to support minor children, shall determine the amount, if any, to be set aside for the protection of such children after considering the age of such children, the amount involved, the capacity and integrity of the surviving spouse, and any other facts or information it may have or receive, and such amount may be impressed by creation of an appropriate lien in favor of such children or otherwise protected as circumstances may warrant, but such amount shall not be in excess of 50% of the net amount received after deduction of costs of collection. If there are no such surviving minor children, the amount recovered shall belong and be paid to the spouse of the deceased; if no spouse survives, to the deceased’s lineal heirs as determined by s. 852.01; if no lineal heirs survive, to the deceased’s brothers and sisters. If any such relative dies before judgment in the action, the relative next in order shall be entitled to recover for the wrongful death. A surviving nonresident alien spouse and minor children shall be entitled to the benefits of this section. In cases subject to s. 102.29 this subsection shall apply only to the surviving spouse’s interest in the amount recovered. If the amount allocated to any child under this subsection is less than $10,000, s. 807.10 may be applied. Every settlement in wrongful death cases in which the deceased leaves minor children under 18 years of age shall be void unless approved by a court of record authorized to act hereunder.
Section 895.04(2) was amended by 2009 Wis. Act 28, § 3269 to add coverage for domestic partners.