Opinion ID: 2308373
Heading Depth: 2
Heading Rank: 1

Heading: Do the Patriot and Dairyland Policies Cover the Asserted Claims?

Text: [¶ 10] Hylie and Carla Hall are undisputedly included as insured parties under each of the Patriot and Dairyland policies. The only question presented is whether the Patriot or Dairyland policy exclusions apply to prevent coverage in the circumstances of this case. [¶ 11] In construing insurance policies, exclusions are disfavored, and we construe them strictly against the insurer. Patrons Oxford Ins. Co. v. Harris, 2006 ME 72, ¶ 7, 905 A.2d 819, 824. We have upheld policy exclusions similar to the Dairyland and Patriot exclusions against arguments that the exclusions violated insurance statutes, e.g., 24-A M.R.S. § 2902 (Supp.1986); [4] 24-A M.R.S.A. § 2902-A (1990 & Supp.1992), repealed by P.L.1993, ch. 69, § 1 (effective Oct. 13, 1993), or were against public policy. See Cash v. Green Mountain Ins. Co., 644 A.2d 456, 457-58 (Me.1994) (holding that an exclusion from coverage of other-owned vehicles does not violate an established rule of law or tend to harm the interests of society); Bear v. U.S. Fidelity & Guaranty Co., 519 A.2d 180, 181-82 (Me.1986) (holding that an exclusion of coverage for any injury `sustained by any person . . . [w]hile occupying, or when struck by, any vehicle owned by you . . . which is not insured for this coverage under this policy,' is not against public policy); Gross v. Green Mountain Ins. Co., 506 A.2d 1139, 1141-42 (Me.1986) (upholding the clear and unambiguous language of an exclusion from coverage for `bodily injury sustained by any person . . . [w]hile occupying, or when struck by, any motor vehicle owned by you . . . which is not insured for this coverage under this policy' and holding that the exclusion did not violate the uninsured vehicle statute and was not against public policy) (emphasis in original). [¶ 12] The United States Court of Appeals for the First Circuit construed a policy similar to those at issue in the present case, when a policy exclusion unambiguously precluded coverage for the surviving spouse of a man killed in an automobile accident while occupying a vehicle not covered by the policy. Maurice v. State Farm Mut. Auto. Ins. Co., 235 F.3d 7, 9-10 (1st Cir.2000). There, the First Circuit held that the applicability of an exclusion was nose-on-the-face plain when the exclusion provided that THERE IS NO COVERAGE . . . FOR BODILY INJURY TO AN INSURED . . . WHILE OCCUPYING A MOTOR VEHICLE OWNED BY YOU [OR] YOUR SPOUSE . . . IF IT IS NOT INSURED FOR THIS COVERAGE UNDER THIS POLICY. Id. at 9-10 (emphasis in original). [¶ 13] To evaluate whether the Halls' policy exclusions apply, we interpret each policy's language. If an exclusion in a policy is ambiguous, we interpret it strictly against the insurer. Patrons Oxford Ins. Co., 2006 ME 72, ¶ 7, 905 A.2d at 824.
[¶ 14] The Patriot policy provides uninsured and underinsured vehicle coverage for bodily injury suffered in an accident with an uninsured or underinsured vehicle: We will 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: 1. Sustained by an insured; and 2. Caused by an accident. The policy excludes from its uninsured and underinsured vehicle coverage, however, any damages for an injury suffered by the insured while using a vehicle that is registered to the insured but not covered by the Patriot policy: EXCLUSIONS A. We do not provide Uninsured Motorists Coverage for bodily injury sustained: 1. By an insured while occupying, or when struck by, any motor vehicle owned by that insured which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle. 2. By any family member while occupying, or when struck by, any motor vehicle you own which is insured for this coverage on a primary basis under any other policy. For purposes of the Patriot uninsured or underinsured vehicle policy, insured includes [y]ou or any `family member.' The term you in the policy includes both: 1. The named insured shown in the Declarations; and 2. The spouse if a resident of the same household. [¶ 15] The language of this policy's exclusion prohibits recovery when an insured suffers bodily injury while occupying a motor vehicle that is owned by the insured but is not covered by the policy. According to the policy's clear language, the exclusion applies to bodily injury sustained by an insured, a term that includes the defined term you, while occupying a vehicle owned by the insured that is not covered by the same policy. As spouses sharing a residence, both Hylie Hall and Carla Hall were included in the definition of you. The exclusion applies, therefore, if either spouse was injured while occupying a vehicle, owned by either of them, that was not insured by the Patriot policy. Here, Hylie Hall  an insured  occupied a motorcycle he owned that was not insured by the Patriot policy. Like the exclusions construed in Gross, 506 A.2d at 1141, and Maurice, 235 F.3d at 9-10, the exclusion in the Patriot policy unambiguously applies in the circumstances of this case, and Carla Hall is not entitled to underinsured vehicle coverage pursuant to this policy.

[¶ 16] The parties do not dispute that Hylie Hall would be entitled to coverage pursuant to this policy if the tortfeasor were underinsured. Hylie Hall was occupying the motorcycle insured by his Dairyland policy  not some other vehicle owned by him or his wife  when he was involved in the accident. The exclusion in the policy does not, therefore, apply to him, and coverage is available if the tortfeasor is underinsured. We will be able to determine whether the tortfeasor was underinsured only after we ascertain how much underinsured vehicle coverage was available to the Halls in the aggregate. See 24-A M.R.S. § 2902(1) (2005); [5] Connolly v. Royal Globe Ins. Co., 455 A.2d 932, 935 (Me.1983). Accordingly, we examine Carla Hall's Dairyland policy to determine whether it provides coverage that must be aggregated.
[¶ 17] Carla Hall's Dairyland Plain Talk Motorcycle Policy provides uninsured or underinsured vehicle coverage for bodily injuries sustained in an accident with an uninsured or underinsured vehicle: We promise to pay damages you're legally entitled to receive from the owner or operator of an uninsured motor vehicle because of bodily injury. (Emphasis in original.) The policy covers bodily injury, including loss of services, sickness, disease or death which results from the injury, caused by a motor vehicle accident and suffered by you. (Emphasis in original.) [¶ 18] The Dairyland policy contains the following exclusion, however: Anyone occupying a motor vehicle owned by you or furnished by your regular use and not insured under this insurance isn't protected by this insurance. (Emphasis in original.) Throughout the policy, the term you is defined to include both the person named on the declarations page and that person's husband or wife if a resident of the same household. [¶ 19] The exclusion in this policy applies to anyone occupying a vehicle that you own, but which is not insured under the policy. Although the definition of you includes both the named insured and a spouse residing in the same household, the exclusion explicitly states that it applies to anyone occupying the vehicle, not to you as an insured, as in the Patriot policy. The policy does not define the term anyone. [¶ 20] Viewed one way, the term anyone would be interpreted to mean any individual occupant of the vehicle. Because Carla Hall was not an individual occupant of the vehicle, the exclusion would not apply to her. Under a competing view, anyone would be interpreted to include the plural you defined in the 12 policy  that is, the named insured and the spouse sharing the insured's residence. Following this interpretation, Carla Hall would be deemed to have occupied the vehicle because she and Hylie Hall would be considered as a single you for purposes of the policy. [¶ 21] Because there are two ways to interpret the policy, it is ambiguous and must be interpreted strictly against Dairyland. See Patrons Oxford Ins. Co., 2006 ME 72, ¶ 7, 905 A.2d at 824. The term anyone is not defined in the policy, and therefore the term must take its ordinary meaning, especially in the context of a Plain Talk policy. See Found. for Blood Research v. St. Paul Marine & Fire Ins. Co., 1999 ME 87, ¶ 12, 730 A.2d 175, 180. Anyone is generally understood to mean, any person indiscriminately: ANYBODY. WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY 97 (2002). The term is in the singular and signifies, in the context of the policy, any person occupying a vehicle owned by Carla or Hylie Hall who is not insured by the policy. Carla Hall was not a person occupying the vehicle. Accordingly, she is not a person to whom the policy exclusion applies. The policy therefore provides coverage if Carla Hall can demonstrate that she suffered a bodily injury within the meaning of the policy. [¶ 22] Generally, a person alleging loss of consortium is not considered to have alleged a bodily injury. Gillchrest v. Brown, 532 A.2d 692, 693 (Me.1987). Rather, loss of consortium is an injury that is understood to derive from the bodily injury of another. Id. The Dairyland policy, however, specifically defines bodily injury more broadly than the common understanding of the term to include loss of services . . . suffered by you. The term loss of services is equivalent to loss of consortium and is therefore included as a type of loss that is compensable under the Wrongful Death Act. [6] See Pelletier v. Fort Kent Golf Club, 662 A.2d 220, 224 (Me. 1995) (stating that a spouse may recover for loss of consortium when there is an actual loss of services or affection). In these circumstances, the policy's express terms include Carla Hall's alleged injury as a form of bodily injury. Carla Hall is, therefore, entitled to coverage under her own Dairyland policy if the tortfeasor is underinsured.