Opinion ID: 2203952
Heading Depth: 1
Heading Rank: 1

Heading: Please Read Your Policy

Text: The premium for the subject policy would be less than the cost of a more conventional liability policy because of curtailed risks and of fewer insured losses. Any assured, therefore, would be fairly chargeable with heed to the practical axiom that one receives only in proportion to the amount he pays. The policy is calculated to accommodate holders in the less endowed financial group, parents whose children have become sui juris and persons in general who do not, or who find rare occasion to, lend their cars. None of these potential customers is normally obligated to purchase any liability insurance. It is understandable that the availability of such a policy might serve to augment the number of the assured. It is likewise foreseeable that the policy could effect a diversion from the more extensive coverage of present policyholders who for their own more adequate protection and from concern for the public weal might otherwise be prone to retain the broader insurance. Such speculations must attend an empirical answer. In this case it becomes the statutory duty of this Court to:    determine whether or not the reasons assigned by the commissioner are valid   . R.S. c. 60, § 6, as amended. The administrative authority of the defendant as an executive officer is restricted to requisite fact finding and to needful regulation delimited within the policy, standard and rule affirmatively established for his guidance by the Legislature.    Its authority is no less nor more than the legislative body has given it   . Kovack v. Licensing Board, Me., 173 A.2d 554, 556, The Constitution as a continuously operative charter of government does not demand the impossible or the impracticable. It does not require that Congress find for itself every fact upon which it desires to base legislative action or that it make for itself detailed determinations which it has declared to be prerequisite to the application of the legislative policy to particular facts and circumstances impossible for Congress itself properly to investigate. The essentials of the legislative function are the determination of the legislative policy and its formulation and promulgation as a defined and binding rule of conduct   . These essentials are preserved when Congress has specified the basic conditions of fact upon whose existence or occurrence, ascertained from relevant data by a designated administrative agency, it directs that its statutory command shall be effective. It is no objection that the determination of facts and the inferences to be drawn from them in the light of the statutory standards and declaration of policy call for the exercise of judgment, and for the formulation of subsidiary administrative policy within the prescribed statutory framework   . Yakus v. United States, 321 U.S. 414, 424, 64 S.Ct. 660, 667, 88 L.Ed. 834. It has been a consistent tradition of our decided cases that one who enters a relation evidenced by a writing is bound by its terms in the absence of very exceptional circumstances of a voiding equitable nature. The law of contracts, sales, the parol evidence rule, etc. attest to that truth. Watkins Medical Co. v. Stahl, 117 Me. 190, 191, 103 A. 70; Peterson Co. v. Parrott, 129 Me. 381, 382, 152 A. 313; Dutch v. Gamage, 120 Me. 305, 308, 113 A. 785; Spaulding v. American Realty Co., 121 Me. 493, 497; Lavoie v. City of Auburn, 128 Me. 412, 413, 148 A. 143 (caveat emptor). Latter day social legislation has done much as in labor laws and in investment security acts to equalize the trading position of persons otherwise less advantaged to negotiate at arms' length with their better positioned fellows. However, the law has not been characteristically paternalistic. The Legislature in its praiseworthy measure to protect policyholders and the public from misleading liability policies and from those capable of a construction which is unfair intended a quantified censorship. Yet the Legislature has expressedly assumed no mission to require broad liability coverage or any. Purchasers of liability insurance are left uninhibited in their selective judgment of amount and kind of available insurance. The Legislature has exercised its police power to prevent the use in this State of any perceptibly guileful or delusive or illusory policy and of any policy logically and demonstrably susceptive to an interpretation or construction inequitably thwarting or frustrating the assured or the public. The Legislature has not relieved policyholders from the pains and consequences of reading and choosing such policies as are not reprehensibly misleading or amenable to unfair construction. Such policyholders must continue to be presumed by the ordinary rules of law to know the contents of their policies whether the policies are read or not. Watkins Medical Co. v. Stahl, 117 Me. 190, 191, 103 A. 70. It is quite true that the Legislature must have been aware that all too many insurance policies are not read and are not easy to read intelligibly. The Legislature concerned itself only with the specific evils which it listed. It was not monitoring comprehensible forthright policies for any breadth, depth and multiplicity of coverage beyond what the expressed meeting of the minds of the freely contracting insured and insurer might negotiate. The plaintiff in its contest of the rulings and 20 detailed specifications of the defendant set forth earlier in this opinion readily affirms that its proposed policy with the endorsement is designedly restricted in coverage and directs attention to the cautionary limitation imprinted in red by the plaintiff on the obverse cover of the policy. Plainiff generally concedes that the coverage of the policy is as the defendant describes it. Plaintiff comments that broader coverage as to protected personnel and as to risk may be had by the insured as desired for an enhanced premium. Defendant's statement in specification 5 is objectively true and plaintiff's disagreement with it is incorrect. The insured is protected with expressed exceptions while operating a non-owned automobile and for negligent operation of a motor vehicle. Insured does not receive the broader coverage against negligent maintenance of his car and against certain negligence apart from operation. Medical payments coverage is plain if not plenary. The scope of the coverage afforded by the policy is comparatively narrow. The Legislature has not ordained any greater coverage or any coverage at all. In the instant case this Court is not to prescribe a policy. We judge the validity of the reasons which the defendant assigned for his disapproval of the policy in issue. The disapproval of the defendant must be an exercise of sound discretion. In its response to defendant's 6th and 7th objections to the policy plaintiff acknowledges that there is at least technical justification for the Commissioner's censure. Plaintiff's assurance that despite a persisting nebulous element it would recognize and honor a sort of joint ownership in insured wife and husband is commendable but does not constitute a firm legal commitment. The policy requires confirmatory clarification conclusively presuming a non-owning and insured spouse of an owner to be an owner. A definition of the term, motor vehicle, as the defendant insists in specification 11 is at least preferable and facile. Dissatisfaction of the defendant as to the definition of operation in specification 16 and specifically as to the phrase, to physically control and regulate is warranted and the ambiguity should be dispelled. The external red warning upon the policy runs in part as follows: It protects the individuals, named in the policy, against liability due to their operation of an automobile  . (Italics ours.) But the policy internally contains coverage exclusions, inter alia: (g) to bodily injury to (1) the spouse or any parent, son or daughter of the insured,   . The exclusion (g) withholds coverage against bodily injuries to any son or daughter emancipated or adult at the time of an accident. (Anno. 122 A.L.R. 1355) The policy obviously does not fully protect the individuals, named in the policy, against liability due to their operation of an automobile as implied so conspicuously and notably in the warning which hints of no reservation. The red caution requires becoming modification in its language to square with the reality of the liability coverage. The defendant in his more comprehensive disapprobation of the policy has in principle protested such shortcoming. It is our opinion that the reasons assigned by the defendant are accordingly valid in part and invalid in part. R.S. c. 60, Sec. 6, as amended: Rule 80B, M.R.C.P., 155 Me. 592. Policy disapproval applicable to the warning and specifications of disapproval numbered 6, 7, 11 and 16 are determined to be valid and are sustained. Appeal denied.