Court Opinion

ID: 9537649
Source: CourtListenerOpinion
Date Created: 2023-08-07 07:20:57.137457+00
Date Added: 2024-06-11T14:56:52.384179
License: Public Domain

ROSSMAN, P. J.,
dissenting.
As the majority so correctly observes, the outcome of this case is dependent on the meaning of the policy, construed in its entirety. The majority then reaches a predetermined result by construing provisions of the policy without regard to their context. Plaintiffs UM coverage provision states plaintiffs obligation
“[t]o pay all sums which the insured or his legal representative shall be legally entitled to recover as damages from the owner or operator of an uninsured motor vehicle because of bodily injury, sickness or disease, including death resulting therefrom, herein after called ‘bodily injury,’ sustained by the insured, caused by accident and arising out of the ownership, maintenance or use of such uninsured motor vehicle
The limit of liability stated in the Declarations section of the policy is $25,000 per person and $50,000 per accident. Read together with the limit of liability declarations, the policy’s UM coverage thus requires payment for all bodily injury, sickness, disease or death, up to the policy monetary limit of $50,000.
The UM portion of the policy also contains these limitations:
“(a) The limit of liability stated in the Declaration as applicable to ‘each person’ is the limit of the Company’s liability for all damages, including damages for care or loss of services, because of bodily injury sustained by one person as the result of any one accident and, subject to the above provision respecting each person, the limit of liability as stated in the *173Declarations as applicable to ‘each accident’ is the total limit of the Company’s liability for all damages, including damages for care or loss of services, because of bodily injury sustained by two or more persons as the result of any one accident.
“(b) Any loss payable under the terms of this coverage to or for any person shall be reduced by:
“(1) the amount paid and the present value of all amounts payable to him under any workers’ compensation law, exclusive of non-occupational disability benefits.” (Emphasis supplied.)
The majority notes sagely:
“Subsection (a) is followed by subsection (b) which provides for reduction of the ‘loss payable’ for covered damage under the policy. The fact that the two clauses are part of the ‘limits of liability’ provision of the policy suggests that the two provisions should be read together.” 123 Or App at 170.
Perhaps if the majority had understood the quoted provisions, it would have realized that, despite the fact that sub-paragraphs (a) and (b) are together in the same “limits of liability” section, they deal with separate policy limit issues entirely. Because it did not, it erroneously concludes that subparagraph (b) is somehow subject to paragraph (a), and that, when “read together,” the limitations of both subpara-graphs must be read to describe monetary limits stated in the policy declarations. Reading the provisions, either together or separately, it readily is apparent to me that they discuss different types of “limits” altogether. The first subpara-graph, which refers to “the limit of liability stated in the Declarations,” is clearly a reference to the monetary policy limits of $25,000 and $50,000, and explains how those limits operate in the context of an accident involving two or more persons. The second subparagraph, which is the disputed provision, deals with an entirely different subject matter. It does not describe policy monetary limits, which the preceding paragraph clearly identified as the “limits of liability stated in the Declarations.” Rather, it talks about “any loss payable under the terms of this coverage.” “This coverage” is UM coverage. “Loss payable” refers to all those losses described in the first paragraph quoted in this opinion as being within UM coverage. If the parties had intended that the offset apply to the monetary limits set forth in the declarations, they *174should have stated so, by using language similar to that used in subparagraph (a).
It is apparent to me that “loss payable under the terms of this coverage” refers to a loss covered by the terms of the policy, rather than to a dollar limit stated in the policy declarations. Because defendants’ covered losses are far in excess of any workers’ compensation benefits that they have obtained, as well as in excess of UM policy limits, they are entitled to full UM policy limits.
The rationale of the majority would appear to be that, despite the clear language of the policy, plaintiff could not possibly have intended to provide greater coverage than that required by statute, ORS 742.504(7)(c). Whether the policy provides greater coverage than the statute is not our concern, when, as here, the policy language is clear and permits only one interpretation.
The majority is wrong for another reason. Its interpretation of both the policy and the statute is contrary to the compelling public policy that, in the absence of clear legislative direction, there should be no setting off of recoveries against UM limits if there would be no double recovery. See Monaco v. U.S. Fidelity & Guar., 275 Or 183, 187, 550 P2d 422 (1976); Amer. Motorist Ins. v. Thompson, 253 Or 76, 79, 453 P2d 164 (1969); Peterson v. State Farm Ins. Co., 238 Or 106, 111-15, 393 P2d 651 (1964).
The insured pays premiums for UM benefits up to a certain amount, if adequate compensation is not available from another source. If the driver at fault is adequately insured, then the limits of the UM coverage are irrelevant. If, as here, the driver at fault is not insured, then an offset for compensation from another source is a windfall to the insurer, who has received premiums in exchange for the promise to compensate the insured. As between the insurer and the insured, public policy dictates that the insured recover under the terms of the UM coverage without any deduction for workers’ compensation benefits, so long as there is no double recovery.
Workers’ compensation benefits do not compensate for noneconomic loss. An insured who has paid premiums to insure against noneconomic damages should be entitled to *175receive what he has paid for. Under plaintiffs’ and the majority’s interpretation, when workers’ compensation benefits exceed UM policy limits, the injured party is entitled to nothing for noneconomic damages.
The majority has put the saddle on the wrong horse. Its result permits a windfall to the insurance industry simply because defendants have received a small bit of compensation for the tragic consequences of their severe injuries. The basic purpose of uninsured motorist coverage is to provide protection for the policy holder against the risk of inadequate compensation for injuries or death caused by the negligence of a financially irresponsible motorist. The legislative purpose in making such coverage compulsory was to place the injured policy-holder in the same position as if the tortfeasor had been insured. Peterson v. State Farm Ins. Co., supra, 238 Or at 111-12. The majority’s interpretation of the insurance policy and ORS 742.504(7) fails to honor that public policy.
For all these reasons, I dissent.
De Muniz and Leeson, JJ., join in this dissent.