E-Alert Case Updates

Clear Policy Language Prevails When Deciding Coverage Cases

Md. Auto. Ins. Fund v. John
No. 2028 (Md. Ct. Spec. App. 2011)
by Gregory L. Arbogast, Associate
Semmes, Bowen & Semmes (www.semmes.com)

In Maryland Automobile Insurance Fund v. John, the Court of Special Appeals interpreted the “clear policy language” of an automobile insurance policy and held that the Progressive American Insurance Company (“Progressive”) was not obligated to cover losses sustained in an automobile accident.

John arises out of an automobile insurance policy which Patricia Ashu (“Patricia”) purchased from Progressive. The case is complicated, however, because on May 4, 2005, Patricia passed away and her sister, Doreen Ashu (“Doreen”) continued using Patricia’s automobile. Two (2) days after Patricia’s death, Doreen notified Emmanuel Fomukong, an insurance agent for Progressive, of Patricia’s death and informed him that she would like to continue using the automobile under Patricia’s insurance policy. Mr. Fomukong informed Doreen that she could continue driving Patricia’s vehicle with continued coverage, provided that all of the necessary premiums were paid. Based on that representation, Doreen paid all of the required premiums, including a premium incurred when she renewed the policy, under Patricia’s name, on September 29, 2005.

On September 25, 2006, Doreen was involved in an automobile accident in which she collided with Charles John. Mr. John filed suit against Doreen claiming that her negligence caused him to sustain personal injuries. Progressive disclaimed coverage of the accident, so Mr. John amended his Complaint to add his own insurance carrier, the Maryland Automobile Insurance Fund (“MAIF”), as a defendant, pursuant to an uninsured motorist provision in his insurance policy. Mr. John then filed the instant declaratory judgment action to determine coverage.

The Court of Special Appeals held that Progressive did not owe coverage for the automobile accident. The Court relied upon the clear and unambiguous policy language in Patricia’s insurance policy with Progressive, which stated that, “[i]f a named insured dies, this policy will provide coverage until the end of the policy period for the legal representative of the named insured, while acting as such, and for persons covered under this policy on the date of the named insured’s death.” While Doreen was not the legal representative of the named insured, Patricia, she was covered under the policy on the date of Patricia’s death. The policy defined “insured” as a, “person residing in the same household as [the named insured], and related to [the named insured] by blood.” Doreen is Patricia’s sister who was living in her home on the date of Patricia’s death. Therefore, for the time immediately following Patricia’s death, Progressive covered Doreen.

Progressive, however, by the express terms of the policy ceased providing coverage to Doreen at the end of the policy term, which was September 29, 2005. Therefore, even though Doreen renewed the policy on September 29, 2005, since the renewal was under Patricia’s name and Patricia was deceased, Doreen was no longer covered. The policy language explicitly stated that Progressive will only provide coverage to a relative of a decedent, “until the end of the policy period.” Pursuant to those terms, Progressive only covered Doreen until September 29, 2005, the end of Patricia’s policy period. Therefore, since the accident occurred after September 29, 2005, the end of Patricia’s policy period, Progressive did not owe coverage for the accident. The Court found that it was immaterial that Progressive accepted Doreen’s renewal, and it declared that MAIF was obligated to cover the losses sustained in the accident.