2022 UT App 80

THE UTAH COURT OF APPEALS

KEVIN MUIR,

Appellant,

v.

CINCINNATI INSURANCE COMPANY,

Appellee.

Opinion

No. 20210289-CA

Filed June 24, 2022

Fourth District Court, Provo Department

The Honorable Christine S. Johnson

No. 200400938

Michael J. Petro, Leah Jordana Aston, Eva Marie 

Brady, and Lindsey Brinton Harris, Attorneys for

Appellant

Vincent J. Velardo and Katia K. Conrad, 

Attorneys for Appellee

JUDGE MICHELE M. CHRISTIANSEN FORSTER authored this Opinion, 

in which JUDGES GREGORY K. ORME and RYAN M. HARRIS

concurred.

CHRISTIANSEN FORSTER, Judge:

¶1 After sustaining injuries in an automobile accident, Kevin 

Muir made a claim for underinsured motorist benefits, but his 

insurance company denied the claim because Muir had 

previously made fraudulent statements in an effort to obtain

personal injury protection benefits related to the same accident. 

Muir sued the insurance company, and the district court 

dismissed Muir’s lawsuit on summary judgment. Muir appeals, 

and we affirm.
Muir v. Cincinnati Ins. Co.

20210289-CA 2 2022 UT App 80

BACKGROUND

¶2 Muir is listed as a “covered driver” under an auto 

insurance policy (the Policy) issued to him by Cincinnati

Insurance Company (Cincinnati). The Policy provided several 

types of coverage, including liability, personal injury protection 

(PIP), uninsured/underinsured motorist (UIM), and collision.

¶3 In 2017, Muir was riding as a passenger in a vehicle that 

was rear-ended by another vehicle. Muir suffered injuries and 

received $25,000 in damages from each of the two drivers’ 

insurance companies—amounts that represented the policy limits 

of those policies. Cincinnati also paid out PIP benefits to Muir 

under the Policy.

¶4 In connection with his PIP claim, Muir “stated that he was 

not working due to the injuries he sustained,” but this statement 

was false: Muir was, in fact, “working as a self-employed truck 

driver.” As a result of his false statement, Muir “was charged 

criminally with insurance fraud and entered ‘no contest’ pleas to 

reduced Class A misdemeanors.”

¶5 Muir subsequently made a demand for UIM benefits under 

the Policy. However, Cincinnati denied coverage, relying on the 

Policy’s fraud exclusion, which reads, “‘We’ do not provide 

coverage for any ‘covered person’ who has made fraudulent 

statements or engaged in fraudulent conduct in connection with 

any accident or loss for which coverage is sought under this 

policy.”

¶6 Following this denial, Muir sued Cincinnati for breach of 

contract and breach of the duty of good faith and fair dealing. The 

parties filed cross-motions for summary judgment on the 

question of whether the Policy’s fraud exclusion precluded Muir’s 

claim for UIM benefits.

¶7 The district court granted Cincinnati’s motion and denied 

Muir’s. Muir appeals.
Muir v. Cincinnati Ins. Co.

20210289-CA 3 2022 UT App 80

ISSUE AND STANDARD OF REVIEW

¶8 Muir argues that the district court erred in granting 

Cincinnati’s motion for summary judgment. “We review the 

district court’s grant of summary judgment for correctness and 

accord no deference to its conclusions of law.” Gardiner v. 

Anderson, 2018 UT App 167, ¶ 14, 436 P.3d 237 (quotation 

simplified).

ANALYSIS

¶9 Muir urges us to determine that the Policy’s fraud 

exclusion is ambiguous and to construe the ambiguity in his favor. 

“An insurance policy is merely a contract between the insured 

and the insurer and is construed pursuant to the same rules 

applied to ordinary contracts.” Alf v. State Farm Fire & Cas. Co., 850 

P.2d 1272, 1274 (Utah 1993). “An insurer may exclude from 

coverage certain losses by using language which clearly and 

unmistakably communicates to the insured the specific 

circumstances under which the expected coverage will not be 

provided.” Id. at 1275 (quotation simplified). “If a policy is 

ambiguous, doubt is resolved against the insurer. However, if a 

policy is not ambiguous, no presumption in favor of the insured 

arises and the policy language is construed according to its usual 

and ordinary meaning.” Id. at 1274 (quotation simplified).

¶10 “We construe insurance contracts by considering their 

meaning to a person of ordinary intelligence and understanding, 

viewing the matter fairly and reasonably, in accordance with the 

usual and natural meaning of the words, and in the light of 

existing circumstances, including the purpose of the policy.” 

Doctors’ Co. v. Drezga, 2009 UT 60, ¶ 12, 218 P.3d 598 (quotation 

simplified). “Ambiguity exists if a provision of a contract is 

capable of more than one reasonable interpretation because of 

uncertain meanings of terms, missing terms, or other facial 

deficiencies.” Id. (quotation simplified). If the contract is capable 

of more than one reasonable interpretation, then it cannot be 
Muir v. Cincinnati Ins. Co.

20210289-CA 4 2022 UT App 80

interpreted as a matter of law. Brady v. Park, 2019 UT 16, ¶¶ 53–

56, 445 P.3d 395. “However, policy terms are not necessarily 

ambiguous simply because one party seeks to endow them with a 

different interpretation according to his or her own interests.” Alf, 

850 P.2d at 1274–75.

¶11 As stated, the Policy contains a fraud exclusion that bars 

coverage when a claimant makes a fraudulent statement in 

connection with any accident or loss for which coverage is sought. 

Muir acknowledges that he made fraudulent statements in 

securing PIP benefits in connection with the accident in question

but argues that those fraudulent statements should not negate his 

claim for UIM benefits. Muir asserts that the Policy’s fraud 

exclusion is ambiguous because the Policy itself provides for 

multiple types of coverage. Because the word “coverage” is 

undefined, he asserts, the fraud exclusion could reasonably be 

read in two different ways: (1) it could be read to preclude all 

types of coverage under the Policy when fraud is committed, or 

(2) it could be “read so as to preclude just the specific type of 

coverage the insured was in fact seeking” at the time they “made 

the fraudulent misrepresentation.”

¶12 However, we do not agree that the second interpretation is 

a reasonable reading of the Policy language. The fraud exclusion 

is contained in the “General Provisions” section of the Policy, not 

within any specific coverage provision, so the exclusion is at least 

potentially applicable to all types of coverage provided by the 

Policy. Moreover, the Policy explicitly excludes a “covered 

person” from receiving coverage if the covered person “made 

fraudulent statements or engaged in fraudulent conduct in 

connection with any accident or loss for which coverage is sought 

under [the Policy].” (Emphasis added.) The inclusion of the word 

“accident” in this clause links the misrepresentation to the 

accident in question, not just to the coverage sought, and makes 

Muir’s preferred reading of the provision unreasonable, 

especially given Muir’s admission that his “fraudulent conduct 

was indeed ‘connected’ to the accident” at issue.
Muir v. Cincinnati Ins. Co.

20210289-CA 5 2022 UT App 80

¶13 The inclusion of the word “accident” also makes this case 

distinguishable from Flores v. Allstate Insurance Co., 819 So. 2d 740 

(Fla. 2002), on which Muir heavily relies. The fraud exclusion at 

issue in Flores, which the Florida Supreme Court determined to be 

ambiguous, read, “Allstate will not provide coverage for any loss

which occurs in connection with any material misrepresentation, 

fraud, or concealment of material facts.” Id. at 743 (quotation 

simplified). Since different types of coverage concern different 

types of losses, this language could reasonably be interpreted “as 

affecting coverage only in connection with the subsection or 

element of the claim to which the material misrepresentation or 

fraud relates.” Id. at 750. On the other hand, since a single accident 

can encompass all types of coverage, the use of the word 

“accident” in the fraud exclusion at issue here makes a similar 

reading of the Policy unreasonable.

¶14 The accident for which Muir sought UIM coverage is the 

same accident for which he made fraudulent statements in 

seeking PIP coverage. And the Policy precludes coverage sought 

in connection with any accident for which a covered person has 

made fraudulent statements. We therefore agree with the district 

court’s determination that Cincinnati was, as a matter of law,

within its rights under the Policy to deny Muir’s claim for UIM 

coverage.

CONCLUSION

¶15 The district court correctly interpreted the Policy’s fraud 

exclusion to preclude all benefits related to a particular accident

when fraudulent statements were made in connection with that 

accident. Accordingly, the court did not err in granting 

Cincinnati’s motion for summary judgment and denying Muir’s. 

We therefore affirm.