Barnes v. State Farm Mutual Automobile Insurance Company

Filing 34

ORDER denying 26 Plaintiff's Motion for Summary Judgment; granting 26 Defendant's Motion for Summary Judgment. Signed by Honorable Robin J. Cauthron on 11/23/15. (lg)

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF OKLAHOMA
DAWN BARNES, an individual,
Plaintiff,
v.
STATE FARM MUTUAL
AUTOMOBILE INSURANCE
COMPANY, a foreign insurance
company,
Defendant.

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No. CIV-15-25-C

MEMORANDUM OPINION AND ORDER
Before the Court is Defendant’s Motion for Summary Judgment (Dkt. No. 26), filed
on October 1, 2015. Plaintiff has responded and filed a cross-motion for summary judgment
(Dkt. No. 27). The motions are now at issue.
I. BACKGROUND
Plaintiff was injured in an automobile accident on August 27, 2013, when operating
her 2004 Nissan Maxima. The Nissan was insured by State Farm Mutual Automobile
Insurance Company (“State Farm”) which provided for Medical Payments Coverage
(“MPC”) with limits of $10,000. Plaintiff made a claim under the policy, and Defendant
State Farm paid Plaintiff the policy limit of $10,000. Plaintiff also owned another vehicle,
a 2011 Hyundai Sonata, insured by State Farm at the time of the accident. The Hyundai
policy provided for MPC with limits of $100,000. Plaintiff made a claim to recover MPC
under the Hyundai Policy, which Defendant State Farm denied. Plaintiff argues she is
entitled to recover under the Hyundai policy due to the language of the “Other Medical

Payment Coverage” provision within the Nissan policy. Plaintiff argues that the provision
gave her the reasonable expectation that she would be covered under the Hyundai policy no
matter which vehicle she was in. Plaintiff does not wish to “stack” the MPCs but rather
recover the higher of the two policies. Plaintiff is seeking payment of $57,607.42, the
remaining balance of her medical bills. Defendant refutes this argument.
II. STANDARD OF REVIEW
Summary judgment is properly granted if the movant shows that no genuine dispute
as to any material fact exists and that the movant “is entitled to judgment as a matter of law.”
Fed. R. Civ. P. 56(a). A fact is material if it affects the disposition of the substantive claim.
Anderson v. Liberty Lobby, Inc., 477 U.S. 247, 248 (1986). The party seeking summary
judgment bears the initial burden of demonstrating the basis for its motion and of identifying
those portions of “the pleadings, depositions, answers to interrogatories, and admissions on
file, together with the affidavits, if any,” that demonstrate the absence of a genuine issue of
material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986) (internal quotations
omitted). If the movant satisfactorily demonstrates an absence of genuine issue of material
fact with respect to a dispositive issue for which the non-moving party will bear the burden
of proof at trial, the non-movant must then “go beyond the pleadings and . . . designate
‘specific facts showing that there is a genuine issue for trial.’” Id. at 324 (quoting
Fed. R. Civ. P. 56(e)). These specific facts may be shown “by any of the kinds of evidentiary
materials listed in Rule 56(c), except the mere pleadings themselves.” Id. Such evidentiary
materials include affidavits, deposition transcripts, or specific exhibits. Thomas v. Wichita
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Coca-Cola Bottling Co., 968 F.2d 1022, 1024 (10th Cir. 1992). When considering a motion
for summary judgment, a court must view the evidence and draw reasonable inferences
therefrom in the light most favorable to the nonmoving party. Matsushita Elec. Indus. Co.,
Ltd. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986).
III. ANALYSIS
The outcome of both Motions for Summary Judgment hinge on the interpretation of
the “Other Medical Payments Coverage” provision in the Nissan’s policy. This Court must
consider whether the contract’s verbiage weighs in favor of the insurer or insured. Due to
the adhesive nature of insurance contracts, different rules of construction have traditionally
applied. Max True Plastering Co. v. U.S. Fidelity and Guar. Co., 1996 OK 28, ¶ 8, 912 P.2d
861, 865.
For instance: 1) ambiguities are construed most strongly against the insurer;
2) in cases of doubt, words of inclusion are liberally applied in favor of the
insured and words of exclusion are strictly construed against the insurer; 3) an
interpretation which makes a contract fair and reasonable is selected over that
which yields a harsh or unreasonable result; 4) insurance contracts are
construed to give effect to the parties’ intentions; 5) the scope of an agreement
is not determined in a vacuum, but instead with reference to extrinsic
circumstances; and 6) words are given effect according to their ordinary or
popular meaning.
Id. (footnotes omitted). Courts will not interfere with a contract absent “fraud, duress, undue
influence or mistake.” Bilbrey v. Cingular Wireless, L.L.C., 2007 OK 54, ¶ 9, 164 P.3d 131,
134. When a contract is unambiguous the Court looks to the four corners of the contract to
determine the meaning. Lewis v. Sac & Fox Tribe of Oklahoma Hous. Auth., 1994 OK 20,
¶ 27, 896 P.2d 503, 514.
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The reasonable expectation doctrine applies in Oklahoma when contract language is
ambiguous or when there are exclusions in the contract that are masked by technical or
obscure language. Max True Plastering Co., 1996 OK 28, ¶ 23, 912 P.2d at 869. The
doctrine stands on the premise that an insurer’s and the insured’s reasonable expectations of
the insurance contract should be honored. Id. In this case, Plaintiff argues that the “Other
Medical Payments Coverage” provision in the Nissan policy gave her the reasonable
expectation that she would be covered under the Hyundai policy. The language of the policy
reads:
2.

If medical payments coverage provided by this policy and one or more
other vehicle policies issued to you or any resident relative by one or
more of the State Farm Companies apply to the same bodily injury,
then:
a.

the Medical Payments Coverage limits of such policies shall not
be added together to determine the most that may be paid; and

b.

the maximum amount that may be paid from all such policies
combined is the single highest applicable limit provided by any
one of the policies. We may choose one or more policies from
which to make payment.

In this case, Defendant argues that the word “applies,” in the title of the “If Other
Medical Payments Coverage or Similar Vehicle Insurance Applies” provision, makes it clear
that the clause does not simply address any other MPCs, but only addresses other MPCs that
actually apply. The word apply, taking it’s plain and ordinary meaning, means to be
“applicable or relevant.” http://dictionary.reference.com/browse/apply (last visited Nov. 17,
2015). Plaintiff conceded that she has no claim under the Hyundai policy itself. In order for

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Plaintiff to recover under the Hyundai’s policy, Plaintiff would need to have been occupying:
(1) her car, (2) a newly acquired car, (3) a temporary or substitute car, or (4) a non-owned
car. Under the Hyundai’s policy, she was not occupying any of these four; therefore the
Hyundai’s policy is not applicable (i.e., does not apply). Under the “Other Medical
Payments Coverage” section of the Nissan’s policy, the provision is only relevant when
another insurance policy applies. By its plain language, this provision is triggered only upon
proof of the existence of another applicable insurance policy. Since Plaintiff has given no
evidence of another policy that applies, she is not entitled to recover under the “Other
Medical Payments Coverage” provision and specifically under the Hyundai policy.
IV. CONCLUSION
Accordingly, Plaintiff’s Motion for Summary Judgment (Dkt. No. 27) is DENIED,
and Defendant’s Motion for Summary Judgment (Dkt. No. 26) is GRANTED.
IT IS SO ORDERED this 23rd day of November, 2015.

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