SCOTT W. SKAVDAHL, United States Magistrate Judge.
This matter comes before the Court on cross-motions for summary judgment. The Court, having reviewed the motions and the parties' written submissions, having heard oral argument, and considering
This lawsuit involves a claim for uninsured motorist ("UM") benefits by Plaintiff Michael "Mickey" Garcia under a policy of insurance he purchased from Defendant Nationwide Mutual Insurance Company ("Nationwide"). The facts pertinent to the pending cross-motions are undisputed, and the Court's factual recitation is drawn primarily from the parties' agreed-upon undisputed facts.
On February 24, 2009, Garcia was injured in a motor vehicle collision with an uninsured motorist in Sweetwater County, Wyoming. Garcia sustained bodily injuries as a result of the collision that required medical treatment and rendered him unable to work for a period of time. Because Garcia was acting within the scope of his employment as a driver for A & C Driving Service LLC at the time of the collision, and because his employer had provided worker's compensation coverage for him, Garcia was eligible for the payment of worker's compensation benefits. The Wyoming Workers Compensation Division paid $5,434.28 in temporary total disability payments to Garcia and $34,264.73 in medical payments to Garcia or on his behalf. Although Garcia incurred a total of $69,447.08 in medical expenses as a result of the collision, all of Garcia's medical expenses were satisfied by the worker's compensation medical payments totaling $34,264.73.
At the time of the collision, Garcia was insured by Nationwide under a Nationwide automobile liability policy, policy number AACM0016904099-2. Garcia's policy included an uninsured motorist endorsement that provided uninsured motorist coverage with a per person limit of $250,000. Nationwide charged and collected a premium for that coverage from Garcia. Exclusion "B" of Garcia's uninsured motorist endorsement excludes coverage that would benefit any insurer under a workers' compensation law; however, that exclusion "does not apply to the Workers Compensation Division of the Wyoming State Treasurer's Office." (UM Endorsement at 2.) As a matter of policy, however, the State of Wyoming does not assert subrogation liens against payments made to injured workers under insurance policies that they have personally purchased. Accordingly, no worker's compensation lien is asserted against any recovery Garcia may receive from his uninsured motorist coverage in this case.
Nationwide's contractual obligation to provide UM benefits to Garcia is set forth in the three-page UM endorsement. The UM Endorsement of Garcia's policy provides:
(Id. at 1.) The "Limit of Liability" Section of the uninsured motorist endorsement contains two additional provisions that the parties assert are relevant to the issues now before the Court. The first provides:
(Id. at 2.) The second provision states:
(Id.)
In addition to these policy provisions, there are state regulations which are applicable
Id. at § 5 (emphasis added). Section 10 of the regulation provides:
Id. at § 10. It is behind the backdrop of these regulatory provisions and the contractual language that the issues are presented.
Summary judgment is appropriate when there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law. Fed. R.Civ.P. 56(a). Where, as here, the parties file cross-motions for summary judgment, the Court is "entitled to assume that no evidence needs to be considered other than that filed by the parties, but summary judgment is nevertheless inappropriate if disputes remain as to material facts." James Barlow Family Ltd. Partnership v. David M. Munson, Inc., 132 F.3d 1316, 1319 (10th Cir.1997), cert. denied, 523 U.S. 1048, 118 S.Ct. 1364, 140 L.Ed.2d 513 (1998).
As a federal court sitting in diversity, this Court applies the substantive law of the forum state. Because the policy was issued in Wyoming, both parties agree Wyoming law governs this dispute.
The sole issue before the Court is whether Nationwide is entitled to offset $39,699.01 in worker's compensation payments paid to or on behalf of Garcia from the amount of uninsured motorist benefits Nationwide owes Garcia under his UM policy. Nationwide asserts that the policy coverage at issue insures only against actual loss and does not encompass duplicate
"[P]arties have the right to embody in their [insurance] contract whatever lawful terms they wish, on the condition that the insurance agreement does not conflict with pertinent statutes or public policy." See Aaron v. State Farm Mut. Auto. Ins. Co., 34 P.3d 929, 932 (internal citations omitted). "It will not be supposed that the parties entered into a contract contemplating an act amounting to a violation of the law and [the contract] will be construed as intending something for which they had the power to contract." Tri-County Elec. Ass'n, Inc. v. City of Gillette, 584 P.2d 995, 1006 (Wyo.1978). "[I]f a contract can be performed legally, it will be presumed by the court that the parties intended a lawful mode of performance." Id. at 1005.
The Wyoming Insurance Department has promulgated the "Regulation Governing Uninsured Motorist Endorsements" which governs the terms of all uninsured motorist policies issued in the State of Wyoming. See Regulations, Wyoming Dept. of Insurance, ch. 23 §§ 1-10. In interpreting this regulation, the Court notes that "[t]he rules of statutory interpretation also apply to the interpretation of administrative rules and regulations." Powder River Basin Resource Council v.
Section 5(b) of the Regulation Governing Uninsured Motorist Endorsements provides:
Regulations, Wyoming Dept. of Insurance, ch. 23 § 5(b).
In contrast to Section 5(b), and contained within the same "Regulation Governing Uninsured Motorist Endorsements" stands Section 10, a general "catch-all" provision that provides as follows:
Id. at § 10. Nationwide reads Section 10 to "trump" the more specific language of Section 5(b), relying on the magic words
Section 5(b) prohibits Nationwide, in all instances, from requiring a reduction in uninsured motorist benefits payable under the policy as a result of worker's compensation benefits. Because the Court declines to read Section 10 of the uninsured motorist insurance regulations to render Section (5)(b) meaningless, the Court also declines to read Section 10 to allow Nationwide to accomplish through general exclusionary language that which it is prohibited from doing through an explicit set-off. Accordingly, even if the UM Endorsement allowed a set-off for the worker's compensation benefits at issue, such a set-off would violate Wyoming public policy as evidenced by Section 5(b) of the Regulation Governing Uninsured Motorist Endorsements, and would therefore be invalid and unenforceable as a matter of Wyoming law.
Because the Court will not suppose the parties entered into a insurance contract that violates Wyoming's insurance regulations, the Court must next consider whether the contractual provisions at issue can be construed as intending something for which the parties had the legal power to contract. Tri-County Elec. Ass'n, Inc. v. City of Gillette, 584 P.2d at 1006. Accordingly, the Court, having rejected Nationwide's interpretation of the UM Endorsement as being contrary to law, next construes the terms of the UM Endorsement to determine whether the contract can be given a lawful construction.
"Under Wyoming law, interpretation of an insurance contract is a question for the court to resolve as a matter of law." Marathon Ashland Pipe Line LLC v. Maryland Cas. Co., 243 F.3d 1232 (10th Cir.2001) (quoting State ex rel. Farmers Ins. Exch. v. District Court of the Ninth Judicial Dist., 844 P.2d 1099, 1102 (Wyo. 1993)) (internal quotation marks omitted). When interpreting an insurance policy under Wyoming law, the Wyoming Supreme Court has set forth several key principles for courts to follow. State ex rel. Farmers Ins. Exch., 844 P.2d at 1101-02 (quoting Commercial Union Ins. Co. v. Stamper, 732 P.2d 534, 539 (Wyo.1987)). First, the words of the contract are to be given their "common and ordinary meaning," and must not be tortured to create an ambiguity. Id. at 1101. Second, the primary consideration in interpreting an insurance policy is the parties' intention, which should be ascertained, to the extent possible, from
Garcia's uninsured motorist endorsement requires Defendant to "pay compensatory damages which an `insured' is legally entitled to recover from the owner or operator of an `uninsured motor vehicle' because of `bodily injury'...." (UM Endorsement at 1.) The parties agree that Garcia is an "insured," that he sustained "bodily injury" in the collision, that the other vehicle involved in the collision was an "uninsured motor vehicle," and that he is "legally entitled to recover [damages] from the owner or operator of the uninsured motor vehicle." The critical provisions for purposes of the issue now before the Court are the following:
(Id. at 2.) Both parties argue that this policy language is clear and unambiguous; however, not surprisingly, each has reached a different conclusion as to what the policy clearly and unambiguously provides.
"The language of an insurance policy is ambiguous if it is capable of more than one reasonable interpretation." Doctors' Co. v. Insurance Corp. of America, 864 P.2d 1018, 1024 (Wyo.1993). Ambiguity in a contract is not created by the subsequent disagreement between the parties regarding the meaning of a contract. Colorado Cas. Ins. Co. v. Sammons, 157 P.3d 460, 465 (Wyo.2007). Instead, "[a] contract is ambiguous if indefiniteness of expression or double meaning obscure the parties' intent." Id. (quoting Cathcart v. State Farm Mut. Auto. Ins. Co., 2005 WY 154, ¶ 18, 123 P.3d 579, 587 (Wyo.2005)). "If the meaning of a provision in a contract is not readily apparent, the court may resort to competent evidence of extraneous circumstances to determine the parties' intent." Id. Whether there is ambiguity within the four corners of the contract is a question of law. Martin v. Farmers Ins. Exchange, 894 P.2d 618, 620 (Wyo.1995).
With respect to the first provision, which states that Nationwide will not duplicate payments "for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible," Nationwide contends that the worker's compensation payments were payments "made by or on behalf of persons or organizations who may be legally responsible" within the meaning of the policy. Nationwide further contends that the payment of benefits for medical bills and lost wages already covered by worker's compensation would constitute a "duplicate payment" to Garcia in contravention of this provision. In contrast, Garcia contends that the phrase
The meaning of the phrase "who may be legally responsible" is not immediately apparent to the Court. On the one hand, Nationwide's reading has some logical appeal. The Wyoming Workers Compensation Division was "legally responsible" pursuant to a contract with Garcia's employer, to provide benefits to an employee such as Garcia injured in the course of his employment. Certainly, the Wyoming Workers Compensation Division did not assume the obligations to pay Garcia's medical and lost wage claims gratuitously.
Wyo. Stat. § 31-10-104 (emphasis added). The additional modifying language "for the bodily injury or death" makes clear that the type of legal responsibility provided for in the statute refers to legal responsibility for injuries arising from tort liability, as opposed to legal responsibility for damages resulting from contractual obligation. In the absence of similar modifying language, the UM Endorsement's use of the phrase "legally responsible" has no clear and unambiguous meaning. Does the policy intend to prohibit duplication of payments made by entities legally responsible for the insured's injuries (i.e., the tortfeasor, an insurer, or a third-party with comparative fault), or to payments made by entities legally responsible for the damages sustained by insured (i.e., as here, a worker's compensation insurer who is contractually liable for payment of a covered employee's damages)? The Court finds the indefiniteness and double meaning of the phrase "persons or entities legally responsible" obscures the parties' intent, and the provision is therefore ambiguous. Because this Court must construe the policy in harmony with the applicable insurance regulations as well as in favor of the insured, the Court finds that this provision does not require a set-off for benefits Garcia received from the Wyoming Worker's Compensation Division.
The second relevant provision contained in the UM Endorsement provides that an
The provision, on its face, indicates that Garcia is not entitled to damages in excess of damages sustained. Garcia's medical bills and lost wage claims are damages that were sustained as a result of his collision with an underinsured motorist. In seeking to recover them in this action, Garcia is not seeking compensation from Nationwide in excess of damages sustained, but rather, he is seeking compensation reflecting the full amount of damages he sustained, without regard to whether payment was made for the same or some component of those damages by a collateral source.
Notably, there would be no "double recovery" in this case but for the decision by the Wyoming Workers Compensation Division not to assert its right of subrogation. Nationwide seems to concede, as it must under the policy language, that it would be obligated to reimburse the Wyoming Workers Compensation Division for the amounts it paid in worker's compensation benefits to Mr. Garcia. Accordingly, to the extent there is any "windfall" in this case, it is a windfall resulting entirely from the voluntary decision of the Wyoming Workers Compensation Division choosing to forego its valid subrogation claim. Further, as Plaintiff's counsel suggested at oral argument, in focusing on whether the Wyoming Workers Compensation Division may (or may not, as is apparently the case in this instance) assert its subrogation rights, the Court may be putting the cart in front of the horse. Any subrogation lien that could potentially be asserted against Mr. Garcia's recovery necessarily would not arise until Mr. Garcia has, in fact, recovered damages. Although the Court is mindful that an inflexible chronological focus ignores the practical realities of how these claims are litigated in the real world, the Court is not at all convinced it should concern itself with the amount of subrogation sought in each case, a result that goes hand-in-hand with the approach urged by Nationwide.
The Court finds that the UM Endorsement does not clearly and unambiguously require consideration of funds paid by a collateral source when calculating the "damages sustained" by Garcia. Instead, the policy may be read to limit Garcia's damages to those damages sustained, without regard to whether a collateral source for payment of some of those funds will assert a right of subrogation to recover separately from the insured.
Having determined that both of the relevant provisions are ambiguous, the Court applies the Wyoming rules regarding construction of an insurance contract. As set forth above, where the terms of an insurance policy are ambiguous, the contract must be construed liberally in favor of the insured and strictly against the insurer. Aaron v. State Farm Mut. Auto. Ins. Co., 34 P.3d 929, 933 (Wyo.2001) (quoting State ex rel. Farmers Ins. Exch., 844 P.2d at 1101 and Stamper, 732 P.2d at 539). Additionally,
WHEREFORE, for the reasons set forth above, the Court finds that Nationwide's interpretation of the relevant UM Endorsement's provisions would be contrary to Section 5(b) of the Regulation Governing Uninsured Motorist Endorsements. In addition, to the extent the policy provisions can be read to allow two reasonable constructions, the Court strictly construes the policy against Nationwide and adopts the interpretation which does not violate applicable insurance regulations. Accordingly, the Court finds, as a matter of law, that Nationwide is not entitled to a set-off in the amount of $39,699.01 for the workers compensation's benefits received by or on behalf of Garcia. Plaintiff's motion for partial summary judgment is therefore