Opinion ID: 171597
Heading Depth: 3
Heading Rank: 1

Heading: Aggregate Limits

Text: Section 10-4-710(2)(b) provided: A complying policy may provide that all benefits set forth in section 10-4-706(1)(b) to (1)(e) and in this section are subject to an aggregate limit of two hundred thousand dollars payable on account of injury to or death of any one person as a result of any one accident arising out of the use or operation of a motor vehicle. The district court found that the policies, through PIP endorsements, both expressly contemplate and clearly establish $200,000 aggregate caps. App. at 797. The district court noted that the endorsements contain charts of available PIP coverage with DELUXE PIP AGGREGATE LIMIT$200,000 per person indicated at the top of the charts. Id. Based on this, the district court found that the policies contained aggregate limits. In their appeal, Mr. Reffel, Mr. Persichitte, and Mr. Whitehead argue that because the limit only applies on a per person basis, and not on a per person, per accident basis, the limit does not comply with the statute. Consequently, they conclude the limit is unenforceable. Additionally, they argue that § 10-4-710(2)(b) only applies to complying policies. They contend that the present policies are non-complying policies based on their treatment of rehabilitation benefits, deductibles, and co-insurance.
Plaintiffs acknowledge that the PIP endorsements contain the language AGGREGATE LIMIT$200,000 per person and reference an accident, but contend that there is not a sufficient connection between these references to satisfy § 10-4-710(2)(b). We disagree. The reference to an accident appears in conjunction with a list of what PIP benefits will be paid. Similarly, a provision titled Limits of Liability contains the statement our liability for [PIP] benefits for bodily injury sustained by an eligible injured person in one motor vehicle accident is limited as follows.... App. at 478. These references make clear that the monetary cap applies per person and per accident.
Section 10-4-703(2) defined a complying policy as: a policy of insurance which provides the coverages and is subject to the terms and conditions required by this part 7, and is certified by the insurer and the insurer has filed a certification with the commissioner that such policy, contract, or endorsement conforms to Colorado law and any rules or regulations promulgated by the commissioner. Part 7 required coverages for liability, and PIP medical expenses, rehabilitation, wage loss, essential services, and death benefits. Zahner v. Am. Family Mut. Ins. Co., 179 P.3d 98, 102 (Colo.Ct.App. 2007). If a policy provides these coverages, it is a complying policy. Id. Here, plaintiffs contend that portions of their policies do not provide the coverages required by Part 7. They point to provisions that: (1) prevent excess rehabilitation benefits from covering medical expenses; and (2) reduce the maximum of payable benefits by the amount of deductibles and co-insurance. Even if we were to assume that plaintiffs are correct in their reading of the policies, this argument alone does not change the aggregate limits set forth in the policies. If a policy does not provide these minimum coverages required by the CAARA, the policies would be reformed to provide those minimum coverages. Colby v. Progressive Cas. Ins. Co., 928 P.2d 1298, 1300 n. 1 (Colo.1996) (also noting that the CAARA is incorporated into every automobile insurance policy). Reformation of the policy only alters the defective portion to comply with the CAARA, leaving the remainder unchanged. Stickley v. State Farm Mut. Auto. Ins. Co., 505 F.3d 1070, 1080 (10th Cir.2007) ([W]hen an insurance policy is found to violate CAARA, only the defective portion of the policy is reformed to comply with CAARA. It does not wipe the slate clean and give the insured the fullest amount of benefits available for every category possible.). As a result, a policy that initially contained aggregate limits, but is later reformed, continues to contain aggregate limits after reformation. See Clark v. State Farm Mut. Auto. Ins. Co., 433 F.3d 703, 711 (10th Cir.2005) (Thus, we agree with the district court that the ... policy's $200,000 aggregate limit applies to benefits under the reformed policy.).