Underinsured Motorist Benefits Not Available to Pedestrian
June 10, 2013
The insured business owner who purchased a commercial auto insurance policy brought an action seeking declaratory judgment that he was an insured entitled to recover underinsured motorist (UIM) benefits after being struck while walking in a crosswalk. This case is Vasquez v. American Fire and Casualty Company, 298 P.3d 94 (2013).
Vasquez, the president of Benchmark Construction, was injured when he was struck by an underinsured motorist while walking in a crosswalk on personal business. Vasquez made a claim for UIM coverage under the business auto policy of American Fire and Casualty that was issued to Benchmark. Vasquez was the president, majority owner, and an employee of Benchmark Construction. He purchased the commercial auto policy with Benchmark being the named insured. The auto policy provided liability coverage for five employees of Benchmark, including Vasquez, and underinsured motorist bodily injury coverage for five vehicles, including the Ford pickup that Vasquez owned in his own name.
American Fire and Casualty denied the UIM claim. Vasquez sued and the trial court ruled in favor of the insurer. This appeal followed.
The Court of Appeals noted that Washington law states that an insurer issuing liability coverage with respect to any motor vehicle registered or principally garaged in the state must provide UIM coverage for the protection of persons insured thereunder who are legally entitled to recover damages. Under the plain language of the statute, the court said, once it is determined that a person is an insured under the liability section of the policy, that person is also entitled to uninsured motorist coverage.
Vasquez contended that because the policy provided him with liability coverage in certain situations, he was entitled to UIM coverage. The court said that the auto policy listed Benchmark as the named insured and then made employees of Benchmark insureds while using a covered auto not owned, hired, or borrowed by the named insured. The insurer agreed that under these provisions, Vasquez had liability coverage as an employee when he was using a covered auto on Benchmark's business. However, the insurer pointed out that Vasquez was injured while walking in a crosswalk. He was not using a covered auto at the time of the accident and so, he was not an insured for liability purposes and not entitled to UIM coverage.
Vasquez argued that state law did not permit insurers to deny UIM coverage on the basis of restrictions contained in the liability provisions of the policy. He further argued that he, as the de facto purchaser of the Benchmark policy, likewise was entitled to unrestricted UIM coverage. The court of appeals did not agree. The court said that the policy's limiting phrases "while using" and "only to the extent of" are effective in making Vasquez an insured under the liability section of the policy only when the activity he was engaged in at the time of the injury fits within those limitations.
Vasquez also contended that he was a named insured by virtue of the fact that American Fire and Casualty paid his medical expenses under the auto med pay coverage. The court found this argument unpersuasive and said that, as evidence of contractual intent, the payment of medical expenses is too weak to support an inference that Vasquez was a named insured for liability coverage.
In summary, the court ruled that Vasquez was not a named insured and he was not an insured under the liability section of the policy. Therefore, Vasquez was not entitled to UIM coverage. The opinion of the trial court was affirmed.
Editor's Note: The Court of Appeals of Washington noted that the state offers "rocking chair" coverage in that the insured need not be occupying or using a particular vehicle to be eligible for UIM coverage. Court cases have declared that "UIM coverage is available if at the time of the injury the named insured was occupying a vehicle, on foot, on horseback, or while sitting in his rocking chair on his front porch". However, in this instance, Vasquez was not the named insured and he was not even an insured due to the limiting provisions in the policy. To be considered an insured, Vasquez had to be using a covered auto at the time of the accident and he was not; he was a pedestrian. The limiting phrases were found to be appropriate and applicable by the court in this instance.
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