Zel M. Fischer, Judge.
Owners Insurance Company appeals a summary judgment entered in favor of its policyholders Vicki Craig and Chris Craig that denied Owners the right to reduce the amount paid pursuant to its underinsured motorist ("UIM") coverage by the amount paid by the at-fault motorist's liability insurer. Because the policy at issue unambiguously provides for such set-off, the circuit court's judgment is reversed and the case is remanded.
Owners issued the Craigs a policy with UIM coverage.
The policy then contains "set-off" provisions:
This language clearly provides that Owners will pay the declarations' listed limit amount minus what is paid by the underinsured motorist's policy if damages exceed the declarations' listed limit amount, or damages minus what is paid by the underinsured motorist's policy if damages do not exceed the declarations' listed limit amount. As such, these provisions ensure Owners will never be obligated to pay the full amount the declarations list as the UIM "limit."
With this policy in place, Vicki was injured in an accident when her vehicle was struck by one driven by another motorist; she incurred damages exceeding $300,000. Because the at-fault motorist was insured under a Shelter Insurance policy with a liability limit of $50,000, Shelter Insurance paid the Craigs $50,000. The Craigs then turned to Owners, seeking $250,000, the declarations' listed UIM limit amount. Instead, Owners paid the Craigs $200,000, citing the set-off provisions that allowed them to deduct the $50,000 Shelter Insurance paid on behalf of the at-fault motorist. Owners then sought a declaratory judgment over the disputed $50,000, and both sides moved for summary judgment with a joint stipulation of facts. The circuit court ruled the policy was ambiguous and entered summary judgment in favor of the Craigs. Owners appealed and, pursuant to article V, § 10 of the Missouri Constitution, the case was transferred to this Court by certification of a dissenting judge after opinion by the court of appeals.
"Whether to grant summary judgment is an issue of law that this Court determines de novo." Seeck v. Geico Gen. Ins. Co., 212 S.W.3d 129, 132 (Mo. banc 2007). "The interpretation of an insurance policy is a question of law that this Court also determines de novo." Id.
Owners argues that the policy unambiguously provides for the $50,000 set-off, that the policy never promises to pay up to the full amount listed in the declarations but expressly states in the UIM endorsement that such amount is for reference purposes only, and that the declarations alone do not promise coverage. The Craigs argue the policy is ambiguous because, despite the language in the UIM endorsement, the declarations list $250,000 as the UIM limit and other portions of the policy reference the declarations as containing or describing the policy's limits of liability.
In the UIM context, this Court has previously held that an ambiguity exists when the policy contains both: (1) express language indicating the insurer will indeed pay up to the declarations' listed limit amount; and (2) set-off provisions ensuring the insurer will never be obligated to pay such amount. See Manner, 393 S.W.3d at 66; Ritchie, 307 S.W.3d at 140-41; Jones v. Mid-Century Ins. Co., 287 S.W.3d 687, 690-93 (Mo. banc 2009). The ambiguity arises from the fact that both statements cannot be true; either the insurer will sometimes pay up to the declarations listed limit, or the amount it will pay always will be limited by the amount paid by the underinsured motorist. Here, there is no such internal inconsistency or contradiction as, unlike in cases such as Jones, the policy contains no express language indicating the insurer will pay up to the declarations' listed limit amount. In fact, the "Limit of Liability" section in the UIM endorsement contains the opposite, stating the declarations' listed limit amount is "for reference purposes only" and "[u]nder no circumstances" will Owners have a duty to pay that entire amount. Essentially, this policy takes a form that this Court previously suggested would be enforceable:
Ritchie, 307 S.W.3d at 141 n.10.
While the Craigs point to the declarations' listed limit amount and other portions of the policy that make bare, general references to the declarations containing the limit of liability, the declarations "are introductory only and subject to refinement and definition in the body of the policy." Peters v. Farmers Ins. Co., 726 S.W.2d 749, 751 (Mo. banc 1987). The declarations "do not grant any coverage. The declarations state the policy's essential terms in an abbreviated form, and when the policy is read as a whole, it is clear that a reader must look elsewhere to determine the scope of coverage." Floyd-Tunnell v. Shelter Mut. Ins. Co., 439 S.W.3d 215,
The circuit court's judgment is reversed and the case is remanded.
Breckenridge, C.J., Stith, Wilson and Russell, JJ., concur; Draper, J., dissents in separate opinion filed.
George W. Draper III, Judge, dissenting.
I concur in the principal opinion's holding reaffirming the principle that insurance companies may issue policies with set-off provisions. However, I respectfully dissent because I would find that Owners Insurance Company's (hereinafter, "Owners") underinsured motorist coverage policy (hereinafter, "UIM") issued to Vicki and Chris Craig (hereinafter and collectively, "Insured") contained ambiguous provisions. Therefore, I would affirm the trial court's judgment.
Courts do not read provisions of an insurance contract in isolation but rather evaluate the entire policy as a whole. Manner v. Schiermeier, 393 S.W.3d 58, 65 (Mo. banc 2013). "Interpretation of an insurance policy and the determination of whether provisions are ambiguous are questions of law, subject to de novo review." Taylor v. Bar Plan Mut. Ins. Co., 457 S.W.3d 340, 344 (Mo. banc 2015). "In construing the terms of an insurance policy, this Court applies `the meaning which would be attached by an ordinary person of average understanding if purchasing insurance,' and resolves ambiguities in favor of the insured." Jones v. Mid-Century Ins. Co., 287 S.W.3d 687, 690 (Mo. banc 2009) (quoting Seeck v. Geico Gen. Ins. Co., 212 S.W.3d 129, 132 (Mo. banc 2007)). Additionally, "it is well-settled that where one section of an insurance policy promises coverage and another takes it away, the contract is ambiguous." Ritchie v. Allied Prop. & Cas. Ins. Co., 307 S.W.3d 132, 140-41 (Mo. banc 2009).
In this case, the principal opinion suggests Owners crafted a limitation of liability provision that this Court tacitly approved in Ritchie. See Ritchie, 307 S.W.3d at 141 n.10. Owners placed this set-off provision in its policy, which under any possible circumstance prevents Insured from recovering the full amount of the UIM policy limits. While a set-off provision may be used to prevent double recovery as explained in Jones, 287 S.W.3d at 693, I believe the principal opinion read the set-off provision in Owners' policy in isolation and failed to look at all of the provisions used in the UIM coverage policy.
In Owners' UIM policy language, there is an additional clause explaining its coverage.
Pursuant to the policy's liability for coverage, it states:
(Emphasis added). Additionally the declarations page indicates Insured contracted for UIM limits of up to $250,000 per person and up to $500,000 per occurrence.
While the "LIMIT OF LIABILITY" provision seeks to set off any amount of recovery from the policy limits stated on the declarations page, the "OTHER INSURANCE" provision clearly states that any coverage Owners provides is in excess of recovery from any other insurance provider. Allowing Owners to set off any recovered amount from Insured's policy limits ensures that Insured will never recover the full amount of the stated liability limits because there will always be some recovery from an underinsured motorist.
Here, Insured chose to pay for $250,000 per person and $500,000 per occurrence in UIM coverage, not $250,000 minus the amount recovered from the underinsured driver who caused more damage than the driver was insured to pay. Because Owners' policy appears in one section to provide any underinsurance coverage in excess of other coverage and another section prevents the full recovery of the declared policy limits without exception, there is an ambiguity. See Ritchie, 307 S.W.3d at 140-41;