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Filed 12/4/08; pub. order 1/5/09 (see
end of opn.)
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
FIRST APPELLATE DISTRICT
DIVISION ONE
|
MERCURY INSURANCE COMPANY,
Plaintiff, Cross-defendant and Respondent,
v.
DAVID DOUGLAS PEARSON,
Defendant, Cross-Complainant and Appellant. |
A119346
(Contra Costa
County
Super. Ct.
No. C06-01467)
|
David Douglas
Pearson was struck by an uninsured motorist while crossing an
intersection on foot. Pearson was listed as an additional driver under
an automobile insurance policy issued by the Mercury Insurance Company
(Mercury) to Pearson’s fiancée as the named insured. Asserting that the
uninsured motorist provisions of the policy did not cover Pearson for
injuries suffered in a pedestrian accident, Mercury denied coverage for
Pearson. Mercury sued Pearson for declaratory relief and Pearson
cross-claimed against Mercury and the insurance agents who procured the
policy. Following Mercury’s demurrer and motion for judgment on the
pleadings, the trial court granted judgment in favor of Mercury.
On appeal,
Pearson contends that (1) Mercury’s insurance policy is ambiguous and
created a reasonable expectation of coverage on his part, and (2) he
should be permitted to amend his cross-complaint to allege causes of
action against Mercury for vicarious liability and reformation of the
policy. Finding no merit in these contentions, we affirm.
I. BACKGROUND
On October 22, 2005, Pearson and his fiancée, Susan Hyung,
were struck by a speeding car driven by an uninsured motorist as they
attempted to walk across an intersection at a crosswalk. Hyung died
from her injuries and Pearson was badly injured. Pearson had purchased
an automobile insurance policy issued by Mercury (the policy) covering
Hyung and himself, which was in force at the time of the accident.
Hyung was designated as the “named insured” in the policy. The policy’s
declarations page listed Pearson and Hyung as “drivers,” and a
“Designated Persons Endorsement” to the policy specified that Pearson
was an additional person insured under the bodily injury coverage of the
policy.
Hyung’s heirs
made a claim under the uninsured motorist coverage of the policy.
Mercury paid its full per-person limit of $100,000 on the Hyung claim.
Pearson also made a claim for uninsured motorist benefits under the
policy. Mercury denied Pearson’s claim on the grounds that (1) the
uninsured motorist benefits under the policy only applied to “named
insureds” or their spouses, or to relatives living in their household,
unless the accident occurred “in or upon entering into or alighting from
an insured motor vehicle”; and (2) Pearson did not qualify for uninsured
motorist benefits because he was a pedestrian when the accident occurred
and was not Hyung’s spouse or her relative living in the same
household.
Mercury sued
Pearson for declaratory relief that Pearson was not entitled to
uninsured motorist benefits under the policy. Pearson cross-complained
against Mercury, insurance agent, Jim Schoensiegel, and Vicencia &
Buckley Insurance Services, Inc., an insurance agency (hereafter
Vicencia), alleging causes of action for declaratory relief and
reformation, breach of insurance contract, breach of the implied
covenant of good faith and fair dealing, professional negligence, and
breach of contract. Mercury demurred on the grounds that (1) as a
matter of law, the policy did not provide uninsured motorist coverage
for Pearson; (2) Pearson’s claim for breach of the implied covenant of
good faith and fair dealing also failed because there was no coverage
under the policy; and (3) Pearson’s causes of action for professional
negligence and breach of contract failed to state a claim against
Mercury.
The trial
court sustained Mercury’s demurrer without leave to amend. Because the
issue of coverage framed by its original complaint was still before the
court, Mercury followed its demurrer with a motion for judgment on the
pleadings, which was also granted. Pearson timely appealed from the
ensuing judgment against him and in favor of Mercury.
II. DISCUSSION
Pearson
contends that (1) ambiguities in the policy language and the Designated
Persons Endorsement show that his coverage was co-extensive with Hyung’s;
and (2) in the alternative, the judgment should be reversed to permit
him to proceed on theories of vicarious liability and/or reformation of
the policy.
A. Policy
Ambiguity
1.
Relevant Policy Provisions
The relevant
provisions of the policy are as follows:
Under the
capitalized heading, “IMPORTANT NOTICE,” appearing on a separate page
immediately following the cover page of the policy, is the following
text: “Unless drivers residing with the Insured are NAMED in the
declarations, coverage may not be afforded. If you desire coverage for
drivers other than those shown, request your agent/broker to have your
policy amended to list the additional drivers.”
Parts I, II,
III, and IV of the policy provide coverage for defense and indemnity
with respect to third party bodily injury and property damage liability
claims (Part I), medical services (Part II), vehicular damage (Part
III), and damages caused by uninsured motorists (Part IV). Parts I, II,
and IV each contain separate clauses specifying the persons who are
insured under them, while Part III specifies the vehicles that it
covers. Under Part I, the persons insured include, with respect to
accidents involving automobiles listed in the policy, the named insured
or named insured’s spouse who resides with the named insured, persons
listed as drivers in the policy declarations, persons using an owned
automobile with the permission of the named insured, and persons
residing with the permissive user if related to him or her by blood,
marriage, or adoption. With respect to automobiles not listed in the
policy, Part I affords coverage to the named insured or named insured’s
spouse who resides with the named insured, and to relatives who reside
with the named insured and are listed as drivers in the policy
declarations.
Part II
affords medical expense coverage to the named insured, each relative of
the named insured who lives with the named insured and sustains bodily
injury while occupying a listed automobile or who, as a pedestrian,
sustains injury caused by a moving automobile, any other person injured
while occupying a listed automobile if driven by the named insured, a
relative who lives with the named insured, or a person driving with the
named insured’s permission.
The uninsured
motorist coverage provisions, contained in Part IV of the policy, state
that Mercury will “pay all sums which the insured . . . shall be legally
entitled to recover as damages from the owner, or operator of an
uninsured motor vehicle because of bodily injury, sustained by the
insured, caused by accident and arising out of the ownership,
maintenance or use of such uninsured motor vehicles.” Immediately below
the description of uninsured motorist coverage provided by the policy is
a list of definitions. The policy defines the unqualified term
“Insured” for purposes of Part IV to include (1) “the named insured and
the spouse of the named insured and while residents of the same
household, relatives of either while occupants of a motor vehicle or
otherwise”; and (2) any other person “while in or upon or entering into
or alighting from an insured motor vehicle.” This definition mirrors
statutory definitions required by Insurance Code section 11580.2.
The policy
also contained a Designated Persons Endorsement. This endorsement
listed Pearson as a “designated person,” and amended the definition of
“Persons Insured” in Part I of the policy to include “the person(s)
designated by name in this endorsement.” Immediately below the language
amending the policy, the endorsement includes the following four
sentences, each set apart in a separate paragraph: “It is agreed that
the designated person(s) resides with the ‘Named Insured,’ but is not a
‘relative’ as the words ‘Named Insured,’ and ‘relative’ are defined in
the policy. [¶] This policy does not provide coverage for any motor
vehicle owned by, or acquired from, or available for the regular use of,
a person(s) residing with the Named Insured unless such person(s) is
occupying a motor vehicle listed in the policy declarations. [¶] The
uninsured motorist coverage does not provide coverage for bodily injury
sustained by a resident of the same household as the Named Insured, who
is not a relative, unless such person(s) is occupying a motor vehicle
listed in the policy declarations. [¶] It is agreed the
designated person(s) is a resident of the same household as the Named
Insured, is not a relative, and is only provided coverage when operating
or occupying a motor vehicle listed in the policy declarations.”
(Italics added.) The endorsement contained a warning in capital
letters stating, “DO NOT SIGN THIS AGREEMENT UNTIL YOU READ AND
UNDERSTAND IT.” Just below the printed warning, Hyung was required to
write out by hand the words, “I have read and understand this document
and I do read English.” The endorsement was signed by Pearson as a
“resident driver” and by Hyung as the named insured.
2.
Analysis
Where a case
turns on the interpretation of an insurance policy, the court reviews
the policy’s terms under the ordinary rules of contract interpretation.
(Bank of the West v. Superior Court (1992) 2 Cal.4th 1254,
1264.) If the policy language is clear and explicit, it governs. (Ibid.)
If the policy terms are ambiguous or uncertain, the court must attempt
to determine whether coverage is consistent with the insured’s
objectively reasonable expectations. (Id. at p. 1265.) If this
rule does not resolve the ambiguity, it must be resolved against the
insurer. (Ibid.)
In
determining whether an ambiguity exists, the words of the policy must be
interpreted according to the plain meaning that a layman would
ordinarily attach to them. (Reserve Insurance Co. v. Pisciotta
(1982) 30 Cal.3d 800, 807.) Policy language is ambiguous when it
reasonably may be interpreted in two or more ways. (Waller v.
Truck Ins. Exchange, Inc. (1995) 11 Cal.4th 1, 18.) “Courts will
not adopt a strained or absurd interpretation in order to create an
ambiguity where none exists.” (Reserve Insurance Co. v. Pisciotta,
at p. 807.) Moreover, the language must be interpreted in the context
of the policy as a whole, and in light of the circumstances of the
case. It cannot be deemed to be ambiguous in the abstract. (Bank of
the West v. Superior Court, supra, 2 Cal.4th at p. 1265.)
Pearson
argues that the “Important Notice” at the front of the policy created an
expectation that the coverage afforded to additional drivers named in
the declarations page would be coextensive with that afforded to the
named insured. In Pearson’s view, the fact that the uninsured motorist
provisions do not in fact provide coextensive coverage for additional
drivers merely creates an ambiguity or conflict in the policy’s terms
that must be resolved in favor of coverage. The Designated Persons
Endorsement, according to Pearson, may be construed either as surplusage
or an ineffective waiver of the additional uninsured motorist coverage
provided due to the ambiguity created by the “Important Notice” placed
at the front of the policy.
At the
outset, we reject Pearson’s claim that the “Important Notice,” read in
combination with the uninsured motorist provisions, creates an ambiguity
about the extent of uninsured motorist coverage for additional drivers.
Construed according to its plain meaning, the “Important Notice” is
simply a courtesy warning to the policyholder that drivers
residing with the named insured who are not listed on the declarations
page are not necessarily afforded the same coverage under the policy as
additional drivers who are listed in the declarations
page. The word “drivers” appears three times in the notice. This
notice simply warns policyholders of the fact that the liability
provisions of the policy—the only provisions that apply exclusively to
drivers—apply differently to potential drivers who reside with
the named insured, depending on whether such persons are or are not
listed as additional drivers in the declarations page.
The notice cannot reasonably be construed as a promise that,
notwithstanding the actual language of the policy, a driver named in the
declarations automatically receives the same coverage as the named
insured for every type of loss, liability, or accident covered by the
policy.
The
Designated Persons Endorsement further undermines Pearson’s position
that the policy is ambiguous. The endorsement is clear and explicit
that the uninsured motorist coverage would not provide coverage for
bodily injury sustained by Pearson unless he was occupying a motor
vehicle listed in the policy declarations, and that he had no coverage
under any portion of the policy unless he was operating or occupying a
motor vehicle listed in the declarations. He signed the endorsement, as
did Hyung, and the endorsement contained a warning in capitalized
lettering not to sign it “until you read and understand it.”
With respect
to the issue of whether Pearson was covered for bodily injuries he
sustained when struck by an uninsured motorist while crossing a street
on foot, we find no ambiguity in the policy. The policy’s uninsured
motorist provisions mirror the statutory definitions authorized by
Insurance Code section 11580.2 and any asserted ambiguity in them may
not be construed against Mercury. (Interinsurance Exchange v.
Marquez (1981) 116 Cal.App.3d 652, 656.)
The trial
court properly sustained Mercury’s demurrer and granted its motion for
judgment on the pleadings based on the theory that the Mercury policy
did not as a matter of law afford coverage for Pearson’s injuries. We
turn now to the issue of whether Pearson should nonetheless have leave
to amend his cross-complaint to plead causes of action not based on the
premise that the written policy issued to him provided coverage for his
injuries.
B. Vicarious
Liability and Reformation
Pearson concedes that he made no request for leave to amend his
cross-complaint in the trial court, and failed to show in what manner he
could have amended his pleading to state a viable cause of action
against Mercury. He argues, correctly, that he is entitled to make such
a showing for the first time on appeal, in reliance on the following
language from Performance Plastering v. Richmond American Homes of
California (2007) 153 Cal.App.4th 659 at pages 667–668: “A trial
court’s order sustaining a demurrer without leave to amend is reviewable
for abuse of discretion ‘even though no request to amend [the] pleading
was made.’ (Code Civ. Proc., § 472c, subd. (a).) While it is the
plaintiff’s burden to show ‘that the trial court abused its discretion’
and ‘show in what manner he can amend his complaint and how that
amendment will change the legal effect of his pleading’ [citation], a
plaintiff can make ‘such a showing . . . for the first time to the
reviewing court’ [citation].”
Pearson
maintains that the allegations of his cross-complaint are either
sufficient as is to state causes of action for vicarious liability and
reformation, or can be amended to state such causes of action.
With regard
to vicarious liability, Pearson’s cross-complaint alleged that in the
event the policy did not afford coverage for his injuries, agent
Schoensiegel and broker Vicencia were dual agents and that Mercury
should therefore be held vicariously liable to him for their negligent
failure to procure the coverage that he had requested, i.e., individual
coverage for injuries to him caused by an uninsured motorist that was
coextensive with the coverage afforded to Hyung. If the mere allegation
of dual agency is insufficient to establish Mercury’s vicarious
liability, Pearson states that he can further allege that (1) Vicencia
and Schoensiegel advertised to the public that they represent Mercury;
(2) their advertising was approved by Mercury, which allows brokers to
use its name and logo; (3) they are monitored and supervised by Mercury;
and (4) Mercury lists Vicencia on its Internet Web site. Pearson points
out that similar facts were held sufficient to impose vicarious
liability on Mercury for illegal fees charged by its broker-agents.
(See Krumme v. Mercury Ins. Co. (2004) 123 Cal.App.4th 924,
946.) Pearson also proposes to allege that Mercury prohibits its agents
and brokers from showing exemplar policies to prospective insureds and
that Vicencia and Schoensiegel arbitrarily selected Hyung as the named
insured without disclosing that he and Hyung would not be receiving
equal coverage under the policy, as requested.
In our view,
Pearson’s cross-complaint, if amended as proposed, would not state a
viable cause of action for vicarious liability against Mercury. First,
Pearson makes no claim that Vicencia and Schoensiegel exclusively
represented Mercury.
If an insurance agent is the agent for several companies, and either
selects the company with which to place the insurance or picks an
insurer at the insured’s direction, the insurance agent is the agent of
the insured, not the insurer. (Eddy v. Sharp (1988) 199
Cal.App.3d 858, 865.) Even if Vicencia and Schoensiegel were dual
agents, any alleged negligence on their part in procuring the insurance
Pearson requested was committed, as a matter of law, in their capacities
as Pearson’s agent. (See Troost v. Estate of DeBoer (1984)
155 Cal.App.3d 289, 298.)
Second, the
insurance policy provides that “[b]y acceptance of this policy the named
insured agrees that . . . this policy embodies all agreements existing
between himself and the company or any of its agents relating to this
insurance.” The policy further provides that an agent’s oral statements
do not change the terms of the policy. As discussed earlier, the
Designated Persons Endorsement signed by Pearson and Hyung went to great
lengths to ensure that Pearson understood his coverage was not
coextensive with Hyung’s. To the extent that Pearson alleges negligent
misrepresentations by Vicencia and Schoensiegel about that fact, Mercury
could not as a matter of law have authorized or ratified such
misrepresentations in light of the policy’s integration clause and
Designated Persons Endorsement. (See Everett v. State Farm General
Ins. Co. (2008) 162 Cal.App.4th 649, 662–663.)
Pearson also
contends that he either has stated or can state a cause of action for
reformation based on mutual mistake or mistake by one party that is
known or suspected by the other party. The only allegation concerning
reformation in the cross-complaint states in relevant part: “[T]o the
extent that the written terms of the policy may be read to exclude
[Pearson’s] entitlement to uninsured motorist benefits . . . , said
terms do not comport with the express intent of the parties and the
course of dealings of the parties, and should, therefore, be reformed.”
We do not find that single, conclusory allegation sufficient to state a
cause of action for reformation based on mistake. Pearson must be able
to allege facts showing that he and Mercury agreed to coverage terms
providing him with the same uninsured motorist coverage as Hyung, and
that he thereafter accepted the policy issued to him by Mercury under
the mistaken belief that it provided such coverage. (See Lemoge
Electric v. County of San Mateo (1956) 46 Cal.2d 659, 663–664;
Genuser v. Ocean Acc. etc. Corp. (1941) 42 Cal.App.2d 673, 675.)
On its face,
the “Designated Persons Endorsement” signed by Pearson and Hyung negates
any claim for reformation by Pearson. That endorsement stated clearly
and explicitly that Pearson would not have the same uninsured motorist
coverage under the policy as Hyung. Although there is case law holding
that the fact that a party seeking reformation has read the contract
does not prevent a court from finding that it was executed under a
mistake (Hess v. Ford Motor Co. (2002) 27 Cal.4th 516, 529), the
equitable remedy of reformation is not available for a mistake of fact
that is caused by the neglect of a legal duty. (Civ. Code, § 1577.)
Here, Pearson alleged in his cross-complaint that he was the prime mover
in obtaining the subject insurance policy—the person who initially
sought “coverage benefits for himself and his vehicles,” who
communicated his intentions and needs to Vicencia and Schoensiegel, who
corresponded with them about the policy, and who actually paid for the
policy.
As between Hyung and Pearson, it was Pearson who assumed the
responsibility for this transaction at every step. But notwithstanding
Pearson’s professed belief that he was purchasing the same coverage for
himself as Hyung’s, he nonetheless accepted the policy without question
despite being presented with an endorsement advising him in clear and
explicit language that the policy did not in fact afford him the same
coverage as Hyung. The endorsement contained a warning in capitalized
letters stating, “DO NOT SIGN THIS AGREEMENT UNTIL YOU READ AND
UNDERSTAND IT.” In our view, these facts—which cannot be pleaded out of
existence—show that either Pearson was not actually concerned about
whether he was covered when not occupying a covered vehicle, or that he
violated a legal duty by ignoring a prominently displayed legal warning
and signing the agreement when he had not in fact read or understood
it. In either case, we find that Pearson would not be entitled to
reformation as a matter of law.
For these
reasons, we hold that the trial court did not abuse its discretion in
denying Pearson leave to amend his cross-complaint.
III. DISPOSITION
The judgment
in favor of Mercury is affirmed.
_________________________
Margulies, J.
We concur:
_________________________
Marchiano, P.J.
_________________________
Swager, J.
CERTIFIED FOR PUBLICATION
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
FIRST APPELLATE DISTRICT
DIVISION ONE
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MERCURY INSURANCE COMPANY,
Plaintiff, Cross-defendant and Respondent,
v.
DAVID DOUGLAS PEARSON,
Defendant, Cross-complainant and Appellant. |
A119346
(Contra Costa
County
Super. Ct.
No. C06-01467)
ORDER CERTIFYING OPINION FOR PUBLICATION
[NO CHANGE IN JUDGMENT] |
|
|
|
THE COURT:
The opinion in the above-entitled
matter filed on December 4, 2008, was not certified for publication in
the Official Reports. After the court’s review of requests under
California Rules of Court, rule 8.1120, and good cause established under
rule 8.1105, it is hereby ordered that the opinion should be published
in the Official Reports.
___________________________
Margulies, Acting P. J.
Trial Court: Contra
Costa County Superior Court
Trial Judge: Hon.
Judith S. Craddick
Counsel:
Law Offices of Ball &
Yorke, Allen R. Ball and Esther R. Sorkin for Defendant,
Cross-complainant and Appellant.
Hager & Dowling, John
V. Hager and Holly C. Blackwell for Plaintiff, Cross-defendant and
Respondent.

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