United States Court of Appeals, Third Circuit
United States Court of Appeals, Third Circuit
United States Court of Appeals, Third Circuit
2d 1019
David Roeberg (argued), Frederick T. Haase, Jr., Roeberg & Associates, P.A.,
Wilmington, Del., for appellant Patrick J. O'Hanlon, etc.
Suit was brought against Hartford Accident and Indemnity Company, Insurance
Company of North America (INA), the appellant here, and Nationwide Mutual
Insurance Company. Nationwide insured the Ryan car. Hartford covered in one
policy four vehicles owned by Patrick J. O'Hanlon, father of Brian. INA had
provided to Patrick J. O'Hanlon an "umbrella policy"1 which included
automobile liability coverage and also a separate primary auto policy which
covered a pick-up truck owned by O'Hanlon. In the latter policy, the named
insured was designated as Coe Management Company, a trade name under
which O'Hanlon conducted business.
Nationwide paid its liability limit, $25,000. Recovery was sought under the
Uninsured Motorist (UM) coverage of the Nationwide policy. UM recovery
was also sought on the Hartford policy, the INA policy issued with Coe
Management as named insured and the INA umbrella policy. The Hartford
policy had $100,000/$300,000 ($100/$300) liability limits and it was asserted
that under Delaware law the insurer was required to offer UM coverage in this
amount, but had failed in its legal duty to do so.2 Reformation of the Hartford
policy to increase UM coverage to $100/$300 was sought. As to the INA Coe
Management policy, it was contended that although Delaware law required that
UM coverage be offered, INA did not make such coverage available.
Reformation of that policy was sought to include UM coverage therein. The
INA Coe Management policy had liability limits of $100/$300 and further
reformation of this policy was claimed so as to provide UM coverage in that
amount.
The INA umbrella policy provided UM coverage. Plaintiff asserted that this
policy likewise was required by Delaware law to provide UM coverage, and
consequently sought its reformation to UM limits of $300,000. This policy, as
written, provided UM coverage up to $35,000 after deduction of a "retained
limit". INA contended that because of payments made by other insurers, it
owed nothing. Plaintiff asserted, however, that in light of an ambiguity in the
UM coverage provisions of this policy INA owed at least the full $35,000.3
With respect to the issues surrounding the INA policies that are brought here by
appeal and cross-appeal, the district court first held that the INA Coe
Management policy which, as written, did not provide UM coverage but which
concededly should have so provided pursuant to Delaware law, was not a policy
having UM coverage that inured to the benefit of Brian O'Hanlon. Following
an evidentiary hearing, the district court also determined that the INA umbrella
policy was not a policy required by 10 Del.Code tit. 18, 3902 to provide UM
coverage. This rendered moot plaintiff's claim that that policy should be
reformed to provide UM coverage with $300,000 limits. Thereafter in an
unreported opinion, the court held that because of an ambiguity in the UM
coverage provisions contained in the INA umbrella policy, INA was required to
pay its full limit of $35,000 pursuant to the UM coverage contained in that
policy.4
11
12
1. Whether INA policy CAL 15 38 48, covering a 1973 GMC pick-up truck and
designating Coe Management Company as named insured was a policy whose
statutorily mandated UM coverage inures to the benefit of Brian O'Hanlon.
13
2. Whether INA policy XIM 30 82 80, i.e., the INA umbrella policy, which in
fact provides UM coverage, is a policy required by 10 Del.Code tit. 18, 3902
to contain UM coverage.5
3. Whether the "retained limit" as defined in INA's umbrella policy should be
14
I.
15
16
17
18
On the other hand, the application for the policy, 7 although listing Coe
Management Company as named insured, also notes that the insured is an
individual. The UM coverage endorsement which we must construe as part of
this policy, reads as though it were designed for use with a policy that covered a
natural person as named insured. The UM endorsement provided to us contains
a blank space in which the name of the named insured is to be inserted. If this
endorsement had been contained within the policy, obviously the name Coe
Management Company would have been inserted as the named insured. There
can be no question but that INA knew that this was a trade name synonymous
with Patrick J. O'Hanlon. The UM endorsement defined "Persons Insured", in
part, as "the Named Insured ... and, while residents of the same household, the
spouse and relatives of ... (the Named Insured.)"8
19
The district court is undoubtedly correct in its conclusion that Policy No. CAL
(commercial automobile liability) 15 38 48 issued to Coe Management
Company was never intended by either O'Hanlon or INA to apply to other than
business related risks. Under the liability features of this policy, Brian
O'Hanlon did not qualify as a person insured thereunder by being a relative of
the named insured living in the same household, as he did under UM coverage
endorsement that should have been a part of this policy. Basically, if Brian
were to achieve insured status under the Coe Management policy, that could
only result from his operation of an owned or hired automobile with the
permission of the named insured. However, if the description of named insured
in the UM coverage endorsement of the policy as Coe Management Company
is to be read as synonymous with Patrick J. O'Hanlon, then it is plain that Brian
O'Hanlon did in fact achieve status as a person insured under the UM
endorsement simply by being a relative of Patrick J. O'Hanlon residing in the
same household.
20
We believe that we are obliged to read the designation of the named insured in
the UM endorsement as a synonym for Patrick J. O'Hanlon, or at least as
though the UM endorsement had identified the named insured as "Patrick J.
O'Hanlon, trading as Coe Management Company."
21
The issue whether a policy that insures an individual under a trade name insures
the same person as would a policy issued to that person under his given name
has arisen most frequently with respect to non-owned or temporary substitute
automobile coverage.9
22
In Samples v. Georgia Mutual Insurance Co., 138 S.E.2d 463, 464, 110
Ga.App. 297 (Ga.App.1964), the plaintiff was driving a vehicle purchased by
her husband in the trade name under which he owned and operated a business.
The plantiff had procured a policy from the defendant in her own name, and
was driving the vehicle registered in her husband's trade name at a time when
her vehicle, which was covered by defendant's policy, was temporarily out of
commission. It is inferable that the vehicle registered in the trade name was not
insured; while operating it, plaintiff was involved in an accident. After
defending that suit, she brought an action against Georgia Mutual in an effort to
The court denied coverage. It pointed out that a trade name "is merely a name
assumed or used by a person recognized as a legal entity," and that "a judgment
against one in an assumed or trade name is a judgment against him as an
individual." Id. at 465. The court stated:
24 fact that the plaintiff's husband purchased this automobile in the name that he
The
used in doing business does not contradict the fact that he owned the automobile as
an individual.
Id.10
25
In Gabrelcik v. National Indemnity Co., 269 Minn. 445, 131 N.W.2d 534
(1964), the plaintiff insured her taxicab with defendant under a policy that
defined a temporary substitute automobile as "an automobile not owned by the
named insured or his spouse if a resident of the same household." Id. at 535.
The plaintiff's husband was in the used-car business and had in stock a Ford
automobile registered in the name of Frank's Used Cars, a trade name under
which plaintiff's husband conducted his business. While the taxi was
undergoing repair, plaintiff used the Ford in her taxi business. A passenger was
injured and plaintiff sought coverage under the temporary substitute coverage
of the policy issued to her by defendant. The court noted that an obvious
purpose of excluding temporary substitute coverage as to vehicles owned by the
spouse of the named insured residing in the same household "is to prevent the
same policy from being used to provide coverage for vehicles other than those
for which a premium was paid." Id.
26
The court also considered whether the vehicle registered in the name of Frank's
Used Cars was owned by the plaintiff's husband. It so held, stating:
27
We fail to see how the fact that plaintiff's spouse is the owner of the vehicle in
question is changed for insurance purposes by the manner in which it is
registered with the state. Whether the vehicle is registered in the husband's
name or in the name of the business which he owns and operates as a sole
proprietorship, the result is the same; namely, that this vehicle was owned by
the insured's spouse who resided in the same household.
28
Id. at 536.
29
30
31
The judgment in favor of INA on plaintiff's claim under the policy issued with
Coe Management Company as named insured is reversed. Plaintiff is entitled to
In O'Hanlon II, 457 F.Supp. 961, supra, the district court held that INA's
umbrella policy was not a policy required by 10 Del.Code tit. 18, 3902 to
contain UM coverage. Hence, the court dismissed plaintiff's claim that this
policy should be reformed to increase UM coverage to limits of $300,000.
33
Plaintiff correctly notes that an objective of subsection (b) of section 3902 was
to provide a purchaser of insurance with the opportunity to protect himself from
the risk posed by an uninsured driver to the extent of his liability limits or
$300,000, whichever is less.13
34
35
Policies such as the INA umbrella policy under consideration here, with respect
to their automobile coverages, would not exist but for underlying primary auto
policies to which they provide excess liability insurance. Primary insurance
policies in Delaware, by their very existence, provide insureds with all of the
benefits accorded under section 3902. To place umbrella policies within the
ambit of section 3902 would be to apply that section to require UM coverage in
addition to that provided by primary policies. We do not believe that section
3902 can be so read, and hold that it is not applicable to policies that provide
excess liability insurance.15
III.
36
There is no dispute that the UM coverage contained in the INA umbrella policy
is applicable to Brian O'Hanlon. The UM coverage in that policy is entitled
"Coverage B" and the pertinent portions of the coverage clause as well as of the
definition of "retained limit" are set forth in note 3, supra.16
37
The district court held, and it is not argued to the contrary here, that the amount
37
The district court held, and it is not argued to the contrary here, that the amount
of the retained limit in this case is $75,000. This sum is the aggregate of the
$25,000 that Nationwide paid on its liability coverage, the $10,000 Nationwide
paid under its UM coverage, and the liability limit of $10,000 each on the four
separate UM coverages contained in the Hartford policy.17
38
INA's interpretation of this language requires that the amount of the retained
limit be ascertained, here $75,000, and that this amount be deducted from
$35,000, with the result that the company is liable only for the difference. Such
an application of the policy terms would result in no payment.18
39
Plaintiff's interpretation requires that, first the total loss or damage suffered by
the insured be ascertained: Second, the amount of the retained limit is to be
calculated. Following these steps, the amount of the retained limit is deducted
from the total loss leaving INA to pay the difference up to $35,000.
40
41
One cannot read the UM provisions of the umbrella policy without coming to
the conclusion that INA is promising to pay, under some circumstances, up to
$35,000 in UM coverage. Conversely, under INA's view of the policy, it would
never pay more than $25,000.
42
This is because the policy states two alternative sums as the retained limit. One
is the gross amount of other UM and liability insurance payable to the insured.
The other is "the minimum amount specified by the financial responsibility
laws of the state in which the accident shall occur." The latter amount as
specified by Delaware law is $10,000. This sum is the minimum to be deducted
and would be deducted even if not paid.
43
We doubt that there is any ambiguity with respect to the issues before us
concerning INA's UM umbrella policy coverage, and we think INA has
misconstrued its own policy. It seems clear that the INA has agreed to pay, up
to a maximum of $35,000, "all sums ... which the INSURED ... shall be legally
entitled to recover as damages from the owner or operation of an uninsured
automobile" after the retained limit is deducted from the damages to which the
insured is legally entitled. The retained limit is then defined as the total of other
insurance payable or the minimum limit specified by the applicable financial
This, it seems to us, requires: first, that the total damages of the insured be
ascertained; second, that the retained limit be calculated; and third, that the
retained limit be deducted from the total damages leaving INA to pay the
difference, if any, but not to exceed $35,000.
45
46
47
Even if we are incorrect, and the intent of the draftsman was as INA asserts,
then we are clear that the policy is ambiguous and that ambiguity must be
resolved against the insurer.
IV.
48
For the reasons set forth in this opinion, the judgment of the district court in
favor of INA on plaintiff's claim under policy No. CAL 15 38 48, designating
Coe Management Company as named insured, is reversed and remanded for
proceedings not inconsistent with this opinion. The district court is directed to
enter a judgment in the amount of $10,000 in favor of plaintiff pursuant to this
policy and to conduct further proceedings to resolve the question whether the
UM limits of this policy should be reformed to provide UM coverage with a
limit of $100/$300.
49
The judgment of the district court in the amount of $25,000 in favor of the
plaintiff against INA on plaintiff's claim under the UM coverage features of its
Personal Catastrophe Policy No. XIM 30 82 80 is affirmed.19
50
51
I agree with the majority that the district court was correct in holding that 10
Del.Code tit. 18, 3902 does not require that INA's umbrella policy contain
UM coverage. Further, I agree with the majority that the district court was
correct in holding that INA owed O'Hanlon $35,000, not $10,000, under the
UM provision in the umbrella policy. However, I diverge from the majority
when it reverses the judgment in favor of INA on O'Hanlon's claim under the
CAL policy issued to Coe Management Co.
52
I believe, as does the majority, that the district court was correct when it
concluded that the CAL policy issued by INA was never intended by either
O'Hanlon or INA to apply to other than business-related risks. However, I
cannot agree with the majority's apparent prediction that the Delaware state
courts would view each policy issued in a trade name for commercial purposes
as if it were issued in an individual's given name.
53
In reaching this conclusion, the majority reasons that "(t)o do otherwise would,
as a general principle, frustrate the unambiguous underwriting intent underlying
the usual definitions of non-owned and temporary substitute automobiles." I
disagree. I believe that the majority's reliance on the cases arising under nonowned and temporary substitute coverage is misplaced. The policies under
review in those cases contain a clause providing for temporary substitute
coverage when the vehicle described in the policy is temporarily out of service
and another is used in its place. These policies exclude from temporary
substitute coverage any vehicle owned by the named insured or his or her
spouse. When an insured uses a car registered in his or her spouse's trade name,
the court will equate the trade name with the spouse's given name in order to
effectuate the intent of the parties and to prevent an insured from obtaining
coverage for vehicles other than those for which he or she has paid a premium.
See, e.g., Gabrelcik v. National Indemnity Co., 269 Minn. 445, 131 N.W. 534,
535 (1964).
54
In this case, however, the majority applies this doctrine in order to achieve a
result that is admittedly contrary to the intent of both parties, and that requires
INA to provide coverage for nonbusiness-related risks, for which O'Hanlon has
never paid INA a premium. This result is directly contrary to the rationale
underlying the cases on which the majority relies. Therefore, I would affirm the
district court's holding that Brian O'Hanlon would not have been covered under
the CAL policy even if INA had provided the required UM coverage.
Honorable H. Curtis Meanor, United States District Judge for the District of
We have called this policy an "umbrella policy" for want of a better brief
description. INA entitles it a Personal Catastrophe Plan. To call it an excess
policy would not be accurate, for it provides some primary coverage for
liabilities not arising out of automobile accidents, e.g., libel and slander. With
respect to automobile liability insurance it is primarily an excess policy, but
does provide some primary auto insurance. For example, most primary auto
policies carry a geographical limitation to the continental United States and
Canada. The umbrella policy contains no such limitation and would provide
primary auto coverage outside the continental United States and Canada
the Company agrees to pay all sums up to $35,000 less the amount of the
RETAINED LIMIT which the INSURED or his legal representative shall be
legally entitled to recover as damages from the owner or operator of an
uninsured automobile ..., provided:
(1) the Company's liability hereunder shall be only in excess of the RETAINED
LIMIT, ...
The policy sets forth a definition of retained limit which in pertinent part states:
With respect to coverage B, the Company's liability shall be only for loss in
excess of the INSURED'S RETAINED LIMIT defined as the greater of:
(1) the total amount of insurance payable to the INSURED under other
Uninsured Motorists, ... or Auto Liability insurance; or
(2) the minimum amount specified by the financial responsibility laws of the
state in which the accident shall occur; and then up to an amount not exceeding
$35,000 as the result of any one accident, provided, such liability shall be
reduced by the amount of the RETAINED LIMIT.
4
Other issues were decided by the district court. However, their recitation is not
necessary to show the origination of the questions presented by the present
appeals
It is conceded that the UM endorsement supplied in the record is the one that
INA would have used to provide the statutorily required UM coverage, for it is
the only approved form INA had at the time. We do not know if a different
form is now in use regarding UM coverage in connection with commercial
vehicle policies
10
To the same effect is Kelly v. Craig, 263 F.Supp. 570 (W.D.Mo.1967), which
relied on Samples v. Georgia Mutual Ins. Co., supra
11
12
13
For aid in interpreting section 3902 on this issue the district court held an
evidentiary hearing. See O'Hanlon II, 45 F.Supp. 961. Evidence was taken from
a professor of law with expertise in the field of uninsured motorists' coverage
and an INA employee versed in the history and extent of coverage of umbrella
policies. No attack has been made upon the propriety of holding such a hearing
in order to obtain "legislative facts" and, while we imply no criticism of it, we
find that we need not consider the evidence thus adduced in order to resolve the
issue whether UM coverage was mandated in the umbrella policy by section
3902
14
Our result is in accord with Trinity Universal Ins. Co. v. Metzger, 360 So.2d
960 (Ala.1978). Contra, Aetna Cas. & Sur. Co. v. Green, 327 So.2d 65
(Fla.Dist.Ct.App.), cert. denied, 336 So.2d 1179 (Fla.1976)
16
It is clear and not disputed that the vehicle with which Ryan engaged in a drag
race was an uninsured vehicle within the meaning of this policy. See O'Hanlon
I, 439 F.Supp. at 379. The definition of "insured" set forth in the policy
includes Brian O'Hanlon
17
INA contended below, at one point, that the retained limit should include as
amounts payable the increased limits of the Hartford UM coverage to
$100/$300 that the plaintiff alleged the Hartford policy should have provided.
That assertion has not been pressed on appeal
18
INA has in fact paid $10,000 to plaintiff under the UM coverage of its umbrella
policy. We deduce that this payment was made following payment by
Nationwide of its $25,000 liability limit, and before the judicial rulings which
led to the payments by Nationwide and Hartford under their UM coverages.
INA has not sought recoupment of this $10,000 and its payment is why the
district court entered judgment against INA for $25,000 not $35,000 under its
umbrella policy UM coverage
19
In view of the extent of Brian O'Hanlon's injuries it is clear that the addition of
$10,000 under the UM coverage of the Coe Management policy will not
increase the retained limit to such extent as would render INA's UM obligation
under the umbrella policy less than $35,000
Further, we doubt, but cannot be certain, that an increase of the retained limit by
a further addition in the amount of $90,000 pursuant to reformation of the Coe
Management policy or in the amount of Hartford's payment made in settlement
of its reformation dispute, or both, would alter INA's liability for the full
$35,000 available to appellant under the umbrella policy's UM coverage. We
recognize, however, the possibility that the retained limit could be affected to
an extent sufficient to modify, in whole or in part, INA's liability under the UM
provisions of its umbrella policy.
We affirm the district court's judgment on the umbrella policy with the notation
that if INA is ultimately entitled to any reduction of its umbrella UM liability as
a result of reformation of the Coe Management policy, either with or without
addition of the Hartford settlement amount, that reduction can be credited
against the judgment on the Coe Management policy as reformed.
We are not directing the district court to permit INA to advance the argument
that the Hartford settlement amount should be added to the retained limit. But
in fairness, since we are remanding for disposition the claim that the Coe
Management policy should be reformed, we are authorizing the district court,
in its discretion, to permit INA to press this argument.