Opinion ID: 2607677
Heading Depth: 1
Heading Rank: 6

Heading: stacking of medical payments provisions

Text: Sanchez also appeals the district court's summary judgment in favor of State Farm on the issue of stacking. Stacking involves adding the maximum coverage under one policy to the maximum of a second policy until the insured's damages are fully compensated or his or her combined policy limits are exhausted. See Lopez v. Foundation Reserve Ins. Co., 98 N.M. 166, 168, 646 P.2d 1230, 1232 (1982). Sanchez argues that he should be able to add the coverage provided by each of five policies carried with State Farm on separate family vehicles for total medical coverage of $21,000.00. State Farm paid out $5,000.00 on the truck in which the accident occurred, but argues that each of the other policies clearly restrict coverage to only that vehicle, owned by the insured, that is listed on that particular policy. The district court held the policies were unambiguous, and, because the policies precluded stacking, the court granted summary judgment for State Farm. We affirm. The question of whether medical payments provisions in insurance policies should be stacked has not previously been considered in New Mexico. In a series of opinions, however, this court has addressed the issue of stacking uninsured motorist benefits under automobile policies. Lopez, 98 N.M. 166, 646 P.2d 1230 (stacking of uninsured motorist coverage not precluded by the policy terms and should be allowed); Schmick v. State Farm Mut. Ins. Co., 103 N.M. 216, 704 P.2d 1092 (1985) (New Mexico's statute mandating uninsured motorist coverage was intended to cover accidents with underinsured motorists as well); Jimenez v. Foundation Reserve Ins. Co., 107 N.M. 322, 757 P.2d 792 (1988) (stacking should be allowed pursuant to New Mexico's statute even when the insurance contract clearly precludes stacking). State Farm argues these cases are distinguishable from the present issue because the legislature mandated uninsured motorist coverage in NMSA 1978, Section 66-5-301(B), whereas medical coverage exists only by virtue of contracts freely entered into between the insured and State Farm. We agree, and find that our prior decisions concerning stacking are not directly analogous to the present case, because of the strong public policy in New Mexico regarding uninsured motorist coverage. We thus resort to traditional methods of contract interpretation to assist our resolution of this issue. This court has established two principles for analyzing stacking questions, and both are applicable in the absence of a statute. First, an insurance company may have a duty specifically to exclude stacking if the policy as a whole encourages the insured to expect coverage. Lopez, 98 N.M. at 168, 646 P.2d at 1232. Second, such exclusionary provisions will be enforced only if they are both unambiguous and not in conflict with statutory public policy. Jimenez, 107 N.M. at 324, 757 P.2d at 794. Therefore, in this case a failure by State Farm to exclude the stacking of medical payments could make the contract ambiguous as a matter of law, requiring reversal. The relevant portions of the insurance policy at issue state: We will pay for medical expenses for bodily injury sustained by: 1. a. the first person named in the declarations; b. his or her spouse; and c. their relatives. These persons have to sustain the bodily injury: a. while they operate or occupy a vehicle covered under the liability section... . [Emphasis in original.] Further, the liability section of each policy purchased by Sanchez provides: We will: 1. pay damages which an insured becomes legally liable to pay because of: a. bodily injury to others, and b. damage to or destruction of property, including loss of its use, caused by accident resulting from the ownership, maintenance or use of your car. . .. [Emphasis in original.] Your car, as defined by the policy, is the vehicle described on the Declarations Page of each policy. The declarations page of each policy owned by Sanchez lists only one vehicle  the sole vehicle insured by that policy. Additionally, each policy contains an exclusionary clause, as follows: THERE IS NO COVERAGE: 4. FOR MEDICAL EXPENSES FOR BODILY INJURY: a. SUSTAINED WHILE OCCUPYING OR THROUGH BEING STRUCK BY A VEHICLE OWNED BY YOU, YOUR SPOUSE, OR ANY RELATIVE, WHICH IS NOT INSURED UNDER THIS COVERAGE; ... . [Emphasis added.] We examine this language for ambiguity and to determine whether it specifically rejects stacking.