You can
search the entire site.
or go to the recent opinions, or the chronological or subject indices.
Jones v. Horace Mann Insurance Co. (5/16/97), 937 P 2d 1360
<![CDATA[
NOTICE: This opinion is subject to formal correction before
publication in the Pacific Reporter. Readers are requested to bring errors to
the attention of the Clerk of the Appellate Courts, 303 K Street, Anchorage,
Alaska 99501, phone (907) 264-0608, fax (907) 264- 0878.
THE SUPREME COURT OF THE STATE OF ALASKA
FRANK JONES, SR., as the )
natural parent and guardian ) Supreme Court No. S-7389
of FRANK JONES, JR., )
) Superior Court No.
Appellant, ) 3KN-94-257 CI
)
v. ) O P I N I O N
)
HORACE MANN INSURANCE COMPANY,) [No. 4821 - May 16, 1997]
a Florida Corporation, )
)
Appellee. )
______________________________)
Appeal from the Superior Court of the State of Alaska, Third
Judicial District, Kenai,
Charles K. Cranston, Judge.
Appearances: Richard G. Haggart, Maloney & Haggart,
Anchorage, for Appellant. Larry Z. Moser, Pletcher, Weinig, Moser & Merriner,
Anchorage, for Appellee.
Before: Compton, Chief Justice, Rabinowitz, Matthews,
Eastaugh, and Fabe, Justices.
RABINOWITZ, Justice.
I. INTRODUCTION
This appeal arises from the superior court's grant of summary
judgment in favor of Horace Mann Insurance Company. The superior court held
that a homeowner's policy issued by Horace Mann did not cover a snowmachine
accident, which occurred on a public road.
II. FACTS AND PROCEEDINGS
On November 24, 1991, Frank Jones, Jr. was struck by a
snowmachine operated by ten-year-old Christopher Chezik and sustained serious
injuries to his right leg. Chezik had been giving rides to friends on the
machine that day. The accident occurred on Ridgeway Road, a public road about
four-tenths of a mile from the Chezik home. Ridgeway Road is the access road to
Georges Drive, which abuts the Cheziks' property.
At the time the Cheziks purchased their home on Georges Drive,
they also purchased a homeowners' policy from Horace Mann Insurance Company.
Subsequent to the accident the Cheziks informed Horace Mann of the event. After
an investigation, Horace Mann notified the Cheziks that it declined coverage.
[Fn. 1]
Thereafter Frank Jones, Sr. sued the Cheziks on his son's
behalf. He sued Christopher Chezik for negligent operation of the snowmachine,
and the parents for negligent supervision of Christopher. The Cheziks settled
the lawsuit by paying $25,000 to Jones, assigning to him any claims they may
have had against Horace Mann or its agents, and permitting a judgment to be
entered against them. Following an uncontested damage presentation, the
judgment amount was determined to be $333,547.78.
Frank Jones, Sr. then sued Horace Mann and Curtis Bates, an
insurance broker, requesting specific performance and damages for negligence and
breach of contract. [Fn. 2] The Superior Court granted Horace Mann's subsequent
motion for summary judgment. The linchpin of the its ruling was its conclusion
that the homeowners' policy issued to the Cheziks did not cover the snowmachine
accident because it did not occur on "insured premises."
Frank Jones, Sr. now brings this appeal from the superior
court's grant of summary judgment in favor of Horace Mann.
III. DISCUSSION
A. Standard of Review
This court will uphold summary judgment if no issues of
material fact are in dispute and the moving party is entitled to judgment as a
matter of law. Bishop v. Municipality of Anchorage, 899 P.2d 149, 153 (Alaska
1995). Interpretation of contract language is a question of law, subject to de
novo review. Cox v. Progressive Casualty Ins. Co., 869 P.2d 467, 468 n.1
(Alaska 1994) (citations omitted). "This court interprets insurance contracts
by looking to the language of the disputed policy provisions, the language of
other provisions of the policy, and to relevant extrinsic evidence. In
addition, we also refer to case law interpreting similar provisions."[Fn. 3]
Id.
B. The Cheziks' Homeowners' Insurance Policy Does Not Cover the
Snowmachine Accident.
1. The accident did not occur on insured premises.
Horace Mann denied coverage because in its opinion the
accident did not occur on the "insured premises." The following policy
provisions are relevant to resolution of this issue:
Coverage L - Personal Liability - We pay, up to our limit, all
sums for which an insured is liable by law because of bodily injury or property
damage caused by an occurrence to which this coverage applies. We will defend a
suit seeking damages if the suit resulted from bodily injury or property damage
not excluded under this coverage. . . .
. . . .
INCIDENTAL LIABILITY COVERAGES
. . . .
5. Motorized Vehicles - We pay for the bodily injury or the
property damage which:
a. occurs on the insured premises and is a result of the
ownership, maintenance, use, loading or unloading of:
1) a motorized vehicle if it is not subject to motor
vehicleregistration because of its type or use; or
2) a recreational motor vehicle;
b. results from:
. . .
3) a motorized vehicle which is designed only for use
off public roads and which is used mainly to service the insured premises. . .
.[ [Fn. 4]]
DEFINITIONS
. . . .
b. Under Coverages L and M, insured premises also includes:
. . .
6) premises used by you in connection with the
described location;
7) all access ways immediately adjoining the insured
premises. . . .
Jones contends that Ridgeway Road is an access way and that
the situs of the accident on Ridgeway Road immediately adjoins the Cheziks'
insured premises. More particularly, Jones argues the accident site was an
"insured premises"because it is "immediately adjacent"to land used by the
Cheziks in connection with their home. [Fn. 5] Charles Chezik testified that
the Chezik family used the land immediately adjacent to the scene of the
accident for snowmobiling. Jones notes that "it is uncontested that Chezik's
testimony and diagram show the Chezik family used the area immediately adjacent
to the accident site on Ridgeway Road for snow machining and that such use
occurred as a result of recreational snow machine rides initiated at the
Chezik's home and returning to [it]." (Emphasis added.)
Horace Mann asserts that the situs of the accident, some four-
tenths of a mile from the Cheziks' residence, does not fall within the policy
definition of "insured premises." It argues the accident is excluded because it
did not happen on the Cheziks' property, or on any adjacent premise used by the
Cheziks in connection with their property, or on an access way immediately
adjoining the insured premises.
In rejecting Jones's contentions the superior court stated,
"While the policy contains no express geographical limit on the expansive
definition of the insured premises, . . . plaintiffs' reasonable expectations
would have included such a limit."[Fn. 6] Having studied the provisions in
question and the relevant case law, we hold that the superior court correctly
interpreted and applied the relevant policy provisions in concluding the
accident did not occur on "insured premises."
In United States Fire Insurance Co. v. Schnackenberg, 429
N.E.2d 1203, 1207 (Ill. 1981), the Illinois Supreme Court was called upon to
interpret the phrase "ways immediately adjoining"the insured premises. The
court found that "[i]f [Schnackenberg's] interpretation of the coverage clause
were adopted, the insured premises definition would be rendered meaningless
for there would be no geographical limit to coverage and liability for conduct
which originated on the premises and could be said to be incidental thereto."
Therefore the Supreme Court of Illinois concluded that a bicycle accident which
occurred on a public road two and one half blocks from the insured's dwelling
was not covered. Id.
The Schnackenberg court quoted with approval an annotation on
premises liability:
"It is generally agreed that the term adjacent means near or
close to ; that the term adjoining, although more restrictive than the term
adjacent, has often been loosely used interchangeably with it; but that when
the word immediately modifies adjacent or adjoining, definite contact is
meant, allowing no intervening space. In the application of these definitions,
the courts have held injuries on sidewalks bounding the particularly described
property to be covered by the policy, except when there is a clear indication to
the contrary. And although there is authority to the contrary, a policy
purporting to cover certain named premises and ways immediately adjoining
covers injury on the street bounding the premises, that is, injury sustained
within the roadway directly in front of the property." Annot., 23 A.L.R.3d
1230, 1232-33 (1969).
Id. at 1206.
If Jones's arguments were accepted, there would be no "logical
geographical limit"to coverage under the homeowners' policy. See id. at 1206-
07 ("If bicycle riding 2 1/2 blocks away from the insured premises is a use
incidental to those premises because it originated there, it is just as
incidental if the rider is 2 1/2 miles or any greater distance from home."). A
number of courts have accepted the Schnackenberg rationale. See, e.g. Herzog v.
National American Ins. Co., 465 P.2d 841, 844 (Cal. 1970) (homeowner's policy
that disclaimed liability for accidents "away from the premises or the ways
immediately adjoining"did not cover an accident on a freeway, three to five
miles from the insured's premises); Safeco Ins. Co. v. Brimie, 516 N.E.2d 577,
581 (Ill. App. 1987) (homeowner's policy did not cover accident occurring on
school grounds on which insured regularly rode where accident site was separated
from residence by playground, public street, and fence); Farm Bureau Mut. Ins.
Co. v. Sandbulte, 302 N.W.2d 104, 109 (Iowa 1981) (for policies with the "ways
immediately adjoining"language, claims arising from accidents "on ways not
actually contiguous to or touching the insured premises have been uniformly
held, as a matter of law, to be excluded from coverage"). Cf.Huggins v.
Yoshiwara, 465 P.2d 845, 846 (Cal. 1970) (homeowner's policy that provides
coverage for automobile accidents in certain limited instances does not become a
motor vehicle insurance policy).
Based on the terms of the Horace Mann policy and the reasoning
of these authorities, we agree with the superior court's ruling that the
accident did not occur on insured premises. A construction of the relevant
provisions that included coverage for an accident occurring on a public road,
four-tenths of a mile from the Cheziks' residence, would be contrary to the
intent and reasonable expectations of both the insurer and the insured. Land
used by the Cheziks on a snowmachine four-tenths of a mile from their residence
cannot be reasonably viewed as "premises used . . . in connection with"their
property. As the Herzog court stated:
While we agree that the phrase "ways immediately adjoining"is
somewhat imprecise, we do not believe that it is so ambiguous as to defy
reasonable construction in the context of a particular case. Such construction
in the instant case leads us to conclude without hesitation that the accident in
question, which took place on [a freeway], occurred "away from the premises [of
the insured] or the ways immediately adjoining . . . ." Thus, coverage of that
accident is not provided by the policy.
Herzog v. National Am. Ins. Co., 465 P.2d at 844 (citations and footnotes
omitted).
2. The snowmachine was not used mainly to service the
Chezik residence.
Jones next contends that because the snowmachine was used
mainly to service the insured premises, coverage exists since there is no
geographical limitation on the policy's coverage of such use. Jones relies on
Section 5(b)(3) of the Incidental Liability Coverage section of the Horace Mann
policy which states:
5. Motorized Vehicles - We pay for bodily injury or the property
damage which:
. . .
b. results from:
. . .
3) a motorized vehicle which is designed only for use off public
roads and which is used mainly to service the insured premises[.]
Jones further notes that Charles Chezik testified that servicing the
premises includes giving snowmachine rides and that the snowmachine was used at
least once to haul a Christmas tree to the residence. [Fn. 7]
In rejecting this theory of coverage, the superior court found
"that the snowmobile was not used 'mainly to service the insured premises'
because neither the plain meaning of the phrase nor the reasonable expectation
of the insured party could lead to such a conclusion." In our view the superior
court correctly analyzed this issue and properly concluded that summary judgment
should be granted to Horace Mann on this theory of coverage.
Although the term "service"is not defined in the policy, it
has been defined as meaning "to repair or provide maintenance for." Nationwide
Mut. Ins. Co. v. Prevatte, 423 S.E.2d 90, 93 (N.C. App. 1992) (citing The Meriam
Webster Dictionary (3d ed. 1968)). Study of the record reveals an absence of
any genuine issue of material fact concerning whether or not the snowmachine was
used mainly to service the insured premises. Apart from one isolated instance
of hauling wood and one Christmas tree hauling, it is undisputed that the
vehicle was used for recreational purposes. We agree with Horace Mann that it
is unreasonable to interpret the term "used mainly for service of the insured
premises"as including recreational use of a snowmachine. Thus the Cheziks had
no reasonable expectation of coverage based upon section 5(b)(3) of the
Incidental Liability section of the Horace Mann policy.
Jones further argues that the accident is covered under this
provision because Horace Mann has waived any right to argue that the vehicle was
not used "mainly to service the insured premises." Jones asserts that this
defense was waived because Horace Mann failed to raise it in its original
"denial of coverage letter"to the Cheziks.
An insurer must give the insured "such notice of its intention
to deny liability and of its refusal to defend as will give the insured a
reasonable time to protect himself." Sauer v. Home Indem. Co., 841 P.2d 176,
182 (Alaska 1992) (quoting 7C John A. Appleman, Insurance Law and Practice
4686 (1979)). This notice must also "provide a reasonable explanation of the
basis in the insurance policy in relation to the facts or applicable law for
denial of a claim." Id. (quoting AS 21.36.125). Notice is necessary to avoid
prejudice to the insured "which may result from delays in the insured
undertaking its own defense or from delays in gathering evidence essential to
successfully challenge the denial of coverage or a defense." Id. (citation
omitted). "Thus, an insurance company which wrongfully refuses to defend is
liable for the judgment which ensues even though the facts may ultimately
demonstrate that no indemnity is due." Id. at 184 (citation omitted). Jones
contends that Horace Mann failed to state all bases for denial and thus waived
them.
As the superior court noted, twenty-seven days after the
accident Horace Mann sent a denial letter that "put plaintiffs on notice of the
grounds for denial and did not hinder them in gathering evidence to challenge
the denial of coverage."[Fn. 8] The instant case is thus distinguishable from
Sauer, where the plaintiff did not learn of the insurance company's denial of
coverage until nearly five years after the event. Sauer, 841 P.2d at 179. In
that case, the lack of any communication precluded the insurance company from
arguing that coverage under the policy did not exist once a judgment had been
entered. Id. at 183. Here, the insurance company determined that coverage did
not extend to the Cheziks' claim and so informed them. See also Intel Corp. v.
Hartford Acc. & Indem. Co., 952 F.2d 1551, 1559 (9th Cir. 1991) (waiver not
found where there was no evidence that insurance company attempted to mislead or
prejudice insured by belated announcement of a new ground for denying
liability); Waller v. Truck Ins. Exchange, 900 P.2d 619, 636 (Cal. 1995) (only
one state, out of the thirty-four to have considered the issue, has held that an
insurer waives coverage defenses not stated in its initial denial letter; the
overwhelming majority do not term this a waiver). Thus we conclude the superior
court correctly ruled in the factual context of this case that Horace Mann did
not waive the defense that the snowmachine was not used "mainly to service the
insured premises."
3. Medical payments coverage does not extend to this
accident under the Horace Mann policy.
Jones argues that regardless of where the accident occurred,
the medical payment provisions of the policy obligated Horace Mann to pay Jones'
medical expenses. This policy provision states:
Coverage M - Medical Payments to Others - Wepay the necessary
medical expenses if they are incurred or medically determined within three years
from the date of an accident causing bodily injury covered by this policy. . . .
This applies only to:
. . .
2. a person away from the insured premises if the bodily injury:
. . .
b. is caused by an activity of the insured[.]
Jones argues that "the injuries to Frank Jones, Jr. were caused by the
activity of Christopher Chezik and therefore are covered under the medical
payment liability coverage without regard to the location where the injury
occurred." Horace Mann counters that the operative language in this provision
is the phrase "an accident causing bodily injury covered by this policy." They
contend that "[i]f the bodily injury suffered by Frank Jones, Jr., is not
covered by this policy, then the medical payments provision does not come into
effect." In our opinion this argument has merit. Since we upheld the superior
court's ruling that the accident in question did not take place on "insured
premises"as that term is defined in paragraphs 7(b)(6) and b(7) of the Horace
Mann policy, we find no error in the superior court's rejection of Jones' claim
for medical payments coverage. [Fn. 9]
4. The Chezik policy excludes negligent entrustment and
supervision claims.
Jones contends that, under AS 21.36.235, [Fn. 10] the
provisions of the renewed Horace Mann homeowners' policy do not apply, as the
law requires notice to the insured of all changes in coverage. The renewal
policy reads in relevant part:
EXCLUSIONS THAT APPLY TO COVERAGES L AND M
This policy does not apply to bodily injury or property damage
which results directly or indirectly from:
. . .
3. the ownership, operation, maintenance, use, occupancy,
renting, loaning, entrusting, supervision, loading or unloading of motorized
vehicles . . . owned or operated by or rented or loaned to an insured.
The original language stated in relevant part:
This policy does not apply to liability:
. . .
c. resulting from the ownership, maintenance, use, loading or unloading by
an insured of motorized vehicles . . . except as provided under Incidental
Liability and Medical Payments Coverages[.]
We conclude that it is unnecessary to construe AS 21.36.235. As the
superior court correctly observed, the original policy issued by Horace Mann
also restricts coverage.
The superior court, persuaded by the reasoning of Farmers
Insurance Group of Oregon v. Nelsen, 715 P.2d 492 (Or. App. 1986), concluded
that a "claim of negligent supervision is subject to the restrictions
surrounding coverage of the underlying accident." In Nelsen, the court held
that a policy insures "not against theories of liability, but against liability
for certain injuries or damage and that injuries caused by motor vehicles off
the premises of the insured are not covered by a homeowners's policy." Id. at
494 (citations omitted). Thus the superior court reasoned, "Because the policy
does not cover the accident itself, a change in the legal theory of liability
does not give rise to coverage."
The superior court further observed that "[b]ecause an insured
party contracts for coverage of certain types of accidents and injuries, the
reasoning in Nelsen is more compelling"under the reasonable expectations
approach to interpreting insurance contracts. We agree. Further support is
supplied by the Ninth Circuit's construction of Alaska law. That court
concluded that it was proper to deny negligent entrustment recovery where an
aircraft exclusion in a homeowner's policy otherwise precluded recovery; to do
otherwise would ignore the "clear language"of the clause. Allstate Ins. Co. v.
Ellison, 757 F.2d 1042, 1045 (9th Cir. 1985). We therefore hold that the
superior court properly granted summary judgment as to this theory of liability.
[Fn. 11]
IV. CONCLUSION
The superior court's grant of summary judgment in favor of
Horace Mann is AFFIRMED.
FOOTNOTES
Footnote 1:
On December 19, 1991, Ted Webber, of Horace Mann, wrote to Charles
Chezik stating in relevant part:
As I had indicated previously there is no coverage for
ownership, maintenance, use, loading or unloading of a snowmobile type
recreational motor vehicle while used off the insured premises.
Footnote 2:
Bates is not a party to this appeal because the claims against him
were dismissed by stipulation of the parties.
Footnote 3:
Generally, the obligations of insurers are determined by the terms
of the policy at issue. Bering Strait Sch. Dist. v. RLI Ins. Co., 873 P.2d
1292, 1294-95 (Alaska 1994). The following rules of construction also apply:
Insurance contracts are contracts of adhesion, and as
such "will be construed according to the principle of reasonable expectations.
" The reasonable expectation doctrine has been stated as follows:
The objectively reasonable expectations of applicants
and intended beneficiaries regarding the terms of insurance contracts will be
honored even though painstaking study of the policy provisions would have
negated those expectations.
In order to determine the reasonable expectations of the
parties,
we look to the language of the disputed policy
provisions, the language of other provisions of the insurance policy, and to
relevant extrinsic evidence. In addition, we refer to case law interpreting
similar provisions.
Id. at 1294-95 (citations omitted).
Footnote 4:
The terms "Motor Vehicle,""Motorized Vehicle,"and "Recreational
Motor Vehicle"as used in the Horace Mann policy are defined as follows:
9. Motor vehicle means a motorized vehicle, a trailer or a
semi-trailer, and all attached machinery or equipment, if:
a. it is subject to motor vehicleregistration; or
b. it is designed for use on public roads.
10. Motorized Vehicle means a self-propelled land or
amphibious vehicle regardless of method of surface contact. This includes parts
and equipment.
. . . .
14. Recreational Motor Vehicle means a motorized vehicle, a
trailer or attached equipment that is designed or is used for leisure time
activities and which is not a motor vehicle.
Footnote 5:
Jones states the argument as follows: "If the land immediately next
to Ridgeway Road constitutes an insured premises, because of its use in
connection with the Cheziks' residence, then access-ways immediately adjacent to
such land are also insured."
Footnote 6:
In Herzog v. National Am. Ins. Co., 465 P.2d 841, 843 (Cal. 1970),
the court said:
The reasonable expectations of the insured in a homeowner's
policy--as additionally manifested in the type of information sought upon
application for such a policy and the relatively small premiums charged--clearly
do not contemplate coverage for automobile- related accidents which occur beyond
this limited area. Nor do the reasonable expectations of the insured
contemplate that his homeowner's policy will provide such extended automobile
coverage; other insurance, with a premium commensurate to the increased risks,
is available for that purpose, and, as in the case at bench, is customarily
obtained by the homeowner.
From the foregoing it clearly appears that neither the intent
of the parties nor their reasonable expectations contemplate that the personal
liability provisions of a homeowner's policy should provide coverage for
automobile accidents occurring away from the immediate vicinity of the home.
Thus, any construction of the policy which would provide such extended coverage
would be contrary to the intent and reasonable expectations of both insurer and
insured.
Footnote 7:
Carol Chezik further testified the snowmachine was used on one
occasion to haul wood to the residence.
Footnote 8:
For the text of the letter see note 1, supra.
Footnote 9:
In regard to Jones's argument that Horace Mann waived all other
defenses to medical payments coverage, the superior court correctly determined
that
[c]oncerning Jones argument that Horace Mann waived the right
to raise any other defenses to this suit which were not stated in its "denial of
coverage"letter, this Court finds that argument moot in that all other theories
of coverage require the accident to have occurred "on the insured premises." In
other words, other defenses potentially affected by the waiver theory would only
be asserted if the Court determined that the accident occurred "on the insured
premises." Since the Court determined that the accident did not occur on the
insured premises, the potential waiver of other arguments is moot.
Footnote 10:
AS 21.36.235 provides:
Notice of premium or coverage changes upon renewal. (a)
Except as provided in AS 21.36.305, if the renewal premium is increased more
than 10 percent for a reason other than an increase in coverage or exposure
base, or if after renewal there will be a material restriction or reduction in
coverage not specifically requested by the insured, written notice shall be
mailed to the insured and to the agent or broker of record as required by AS
21.36.260.
(1) at least 20 days before expiration of a personal
insurance policy; or
(2) at least 45 days before expiration of a business or
commercial policy.
(b) If notice before expiration of the policy is not
given as required by (a) of this section, the existing policy shall continue
until the insurer provides notice for the time period required by (a) of this
section for that policy.
(c) This section does not apply to workers' compensation
insurance.
Footnote 11:
Given our discrete holdings in section III.B.1, 2, and 3 of this
opinion, it is unnecessary to address the remaining arguments advanced by the
parties in this appeal.
]]>
