Opinion ID: 1778482
Heading Depth: 1
Heading Rank: 6

Heading: Did the Trial Court Err in Granting Summary Judgment on the Issue of the Limit of Medical Payments Coverage Under the Policy?

Text: ¶ 36. Cossitt argues that the trial court erred in determining as a matter of law that the policy in question was unambiguous and provided only $1,000.00 in medical payments. The policy contains three different coverages for medical expenses: Coverage C-Medical Payments, Coverage C-1-Major Medical Payments, and Coverage C-2-AUTO-Matic Payments. Coverage C-Medical Payments specifically provides that the limit of liability for that coverage of medical expenses is stated in the declaration page. Cossitt's declaration page stated she had a $1,000.00 medical limit. Cossitt asserts, though, that the policy is ambiguous. Coverage C-1 Major Medical Payments provides for payment of medical expenses incurred up to $5,000.00 and is subject only to limits of liability of $1,000.00 for funeral expenses and $5,000.00 for all other expenses. Because Coverage C-1-Major Medical Payments does not state that it is limited to the limits of liability set forth in the declarations page and does provide limits of $5,000.00, Cossitt asserts that she is entitled to the $5,000.00 liability limits under Coverage C-1. She argues that at the very least the policy is ambiguous. Cossitt notes that the Court has held that any ambiguities in insurance provisions are to be construed in favor of the injured insured motorist. Atlanta Cas. Co. v. Payne. 603 So.2d 343, 346 (Miss.1992)(citing Commercial Union Ins. Co. v. Dairyland Ins. Co., 584 So.2d 405, 408 (Miss.1991)). ¶ 37. In support of her position, Cossitt also refers the Court to Government Employees Ins. Co. v. Brown, 446 So.2d 1002 (Miss.1984). Brown concerned an issue certified by the Fifth Circuit as to whether the language contained in the limits of liability clause in the uninsured motorist provisions of an automobile policy was sufficiently clear and unambiguous to prevent the stacking of uninsured motorist coverage where separate premiums were charged for more than one vehicle under a single policy. Id. at 1003. The policy contained a provision limiting liability for uninsured motorist coverage to the amount stated in the declarations page as applicable to each person ($10,000.00), regardless of the number of automobiles to which the policy applied. Id. at 1004-05. The declarations page, however, described three vehicles owned by the parties and covered under the single policy with separate premiums charged for each automobile. Id. at 1005. ¶ 38. The Court held that the policy language under the limits of liability clause, when read together with the declarations page, was ambiguous and void. [W]hile the language within the `limits of liability' clause is clear and unambiguous as to what is intended, when read together with the declaration sheet it becomes unclear and ambiguous. Id. at 1006. Cossitt argues the limits of liability clause contained in Coverage C-1-Major Medical Payments conflicts with the declaration page. Secondly, the declarations page itself is ambiguous, given that it does not differentiate between Coverages C, C-1 and C-2, but only states that Medical coverage is limited to $1,000.00. ¶ 39. Alfa argues that Cossitt ignores the language in the initial paragraph of Coverage C-1 which makes the agreement subject to all of the provisions of Coverage C .... Included under Coverage C is the limits of liability which clearly states that such limits are as stated on the declaration page. In this case, the limits of med-pay benefits on the declaration page is $1,000.00. ¶ 40. Alfa's argument seems to be a stretch. If the limit of all of the coverages listed in the policy is what is on the declaration page, then it would be quite pointless to put more limiting language in the policy under Coverage C-1. Furthermore, the limiting language Alfa refers to is surrounded by language that negates the $1,000.00 limit argument. Specifically, the full sentence states, [t]o pay the medical expenses as defined and set forth under Coverage C incurred up to but not exceeding $5,000, to or for each person who sustains bodily injury in any one accident, subject to all the provisions of Coverage C, and subject to the limits of liability as hereinafter set forth. (emphasis added). To say that Coverage C-1 is subject to the liability in the declaration page as required by Coverage C when it clearly says it is subject to the limits of liability as hereinafter set forth is nonsensical. Had the declarations page stated that Cossitt was subject to Coverage C med-pay benefits, there would be no conflict. The policy, however, states only medical limits of $1,000 for the premium listed. There is no indication of how they arrived at this limit in terms of which coverage Cossitt had. In fact the declarations page states that [t]he limit of the Company's liability against each such coverage shall be as stated herein subject to all terms of the policy having reference thereto. (emphasis added) There may very well be proof that the agent told Cossitt that if she was paying a certain premium she would only be entitled to Coverage C, however, that is not in the record. At the very least there is a genuine issue of material fact as to whether Alfa is liable for $5,000 coverage, and the trial court erred by granting summary judgment on this point. The trial court is reversed on this point, and this issue is remanded for a trial on the merits.
¶ 41. The trial court ordered Alfa to pay Cossitt the sum of $1,000. On remand from Cossitt I, Cossitt had claimed she was entitled to an award of prejudgment interest on the medical benefits to which she was entitled to recover. Cossitt submits that the refusal to grant interest is reversible error. ¶ 42. In support of her position, Cossitt cites the general rule that in actions for breach of a contract of insurance, the insured is entitled to prejudgment interest on the amount of benefits which were withheld by the insurer after payment was due. State Farm Mut. Auto. Ins. Co. v. Bishop, 329 So.2d 670, 673 (Miss.1976). The only exception to this rule applies when the amount due the insured is uncertain or unliquidated. Cossitt claims that this exception does not apply since Alfa admits owing the sum of $1,000 as of November 1,1985. ¶ 43. Alfa asserts that Cossitt is not entitled to prejudgment interest based on Simpson v. State Farm Fire and Casualty Co., 564 So.2d 1374, 1381 (Miss.1990). Alfa appears to have the supporting law in Simpson. There, the Court held that [t]he insured must include a proper demand or request for prejudgment interest, including from when it is allegedly due, in the pleadings. Id. at 1380-81 (citing Maryland Cas. Co. v. Legg, 247 So.2d 812 (Miss.1971)) (emphasis added). Because Cossitt's Answer and Counterclaim failed to include such a demand, Alfa asserts that the trial court did not err in its award to Cossitt. Cossitt makes no response to this argument in her Reply Brief. (Cossitt did claim she was entitled to prejudgment interest in her attempt to amend her answer. However, the trial court denied her motion based on this Court's limited inquiry on remand.) ¶ 44. Cossitt's request for prejudgment interest is not in the pleadings. Therefore, she is not entitled to such an award per this Court's holding in Simpson. Accordingly, the trial court's denial of prejudgment interest is affirmed.