Thursday, February 8, 2018

Judge Gelb Addresses Issue of Apparent First Impression Relative to Umbrella Policy

In the case of Charles v. USAA, No. 7106 - CV - 2016 (C.P. Luz. Co. March 3, 2017 Gelb, J.), Judge Lesa Gelb of the Luzerne County Court of Common Pleas ruled in favor of the carrier in a declaratory judgment action filed by a Plaintiff seeking a decision regarding the applicability of a personal umbrella policy to wrongful death claims arising out of a motor vehicle accident as asserted by the children of decedent, Janice Lewis, against her husband (deceased), the owner of the policy.

According to the Opinion, the decedent, Janice Lewis, was a passenger in a vehicle driven by her husband, Kenneth Lewis, when that vehicle was involved in an accident with another vehicle.  Both Janice and Kenneth Lewis were fatally injured in the accident.

At the time of his death, Kenneth Lewis was insured by USAA  through automobile, homeowners, and personal umbrella insurance policies.  The Plaintiffs submitted various claims to USAA for consideration.

USAA agreed to tender the limits under the automobile insurance policy.

However, USAA advised that it would not extend benefits for the death of Janice Lewis under the personal umbrella policy of Kenneth Lewis.  The carrier pointed to an Exclusion in the umbrella policy for the bodily or personal injury of any insured under the policy.  The Plaintiffs argued that none of the wrongful death beneficiaries were "insureds" under the umbrella policy and that they were, therefore, not subject to the Exclusion and should be entitled to recover under that policy.

The issue came before the court on cross motions for summary judgment.

After reviewing applicable Pennsylvania law concerning the construction of insurance policy contracts as applied to the provisions at issue in this case, Judge Gelb ruled that the language of the umbrella policy, including the definition of "bodily injury" and the relevant Exclusion against recovery by insureds, when reviewed in conjunction with the nature of the Pennsylvania Wrongful Death Statute, compelled her decision to uphold the carrier's denial of coverage.

More specifically, the court noted that the covered bodily injury in this case, as per the policy provisions, is that of the decedent, Janice Lewis, who was an insured under the umbrella policy.  Therefore, under the clear and unambiguous language of the umbrella policy, the Exclusion against coverage for bodily injury incurred by an insured was applicable to preclude coverage under the facts presented.

Judge Lesa Gelb
Luzerne County
Judge Gelb also noted that, under Pennsylvania law, while a wrongful death action is not derivative of the decedent's rights, it is derivative of the decedent's injuries.  Accordingly, the court reiterated that it followed that, as the wrongful death action in this matter arose out of a bodily injury occurring to an insured, coverage for the same under the umbrella policy was precluded by the Exclusion noted.

The court also dealt with an apparent issue of first impression raised by the Plaintiffs.  The Plaintiffs alleged that the Lewis's children suffered emotional harm resulting from their mother's death, which is a recoverable element of damages pursuant to the Wrongful Death Statute, which claim allegedly should serve to trigger coverage under the umbrella policy.

However, Judge Gelb noted that the Plaintiffs did not allege any physical injury to the children from which the emotional harm allegedly manifested.  It was emphasized that the protections of the umbrella policy required a physical injury in order to trigger coverage and the only physical injury or injuries at issue in this case were those of the deceased mother, who as an insured, was excluded from coverage under the personal umbrella policy.

As such, the court granted the carrier's motion for summary judgment and denied the Plaintiff's motion for summary judgment.

Anyone wishing to review this decision by Judge Gelb may click this LINK.

No comments:

Post a Comment