Saturday, May 17, 2008

SUM Not Triggered -- Comparison of Combined Single Limit to Split Limits

SUM – TRIGGER – STAY OF SUM ARBITRATION
Matter of Automobile Ins. Co. of Hartford v. Ray
(2nd Dept., decided 5/13/2008)

I feel like it's math class and we're doing word problems every time I review a SUM trigger question or case. There's nothing new in this Second Department decision, but it's a good review of SUM (Supplementary Uninsured Motorists a/k/a underinsured motorists) coverage trigger rules when comparing a combined single limit (CSL) policy to a split limits policy.

Question:

Ray, Roberts and Gigante were occupants of Gigante's vehicle, which was insured by AICH s/h/a (sued herein as) Travelers under a PAP (personal auto policy) with a $300,000 CSL (combined single limit) for both BI (bodily injury) and PD (property damage). The Gigante PAP also afforded $300,000 in SUM coverage per person/per accident.

The Gigante vehicle collided with a vehicle being driven by Woods (the tortfeasor), which was insured under a PAP with split BI liability limits of $100,000 per person/$300,000 per accident. That policy afforded PD liability coverage in addition to the BI limits (probably $50,000 or $100,000 per accident, although the decision does not say).

The tortfeasor's insurer paid $100,000 to Ray, $100,000 to Roberts, and $100,000 to Gigante, exhausting its BI liability limits. Ray made a claim for and then demanded arbitration of what she contended was $200,000 in available SUM coverage - the difference between the $300K Gigante PAP CSL and the $100K she had received from the tortfeasor's PAP insurer.

Is there a SUM trigger?

Answer:

No, said the Second Department, REVERSING the lower court's denial of AICH's petition to permanently stay Ray's SUM arbitration.

Since the Gigante policy's $300K CSL includes PD, the $300K per accident BI liability limits of the tortfeasor's policy were not less than the BI liability limits of Gigante policy.

In a multiple-victim accident, the Gigante policy would provide a total of $300K in coverage for BI less any amount payable for PD. By contrast, the tortfeasor's policy would provide $300K for BI plus any amount payable for property damage. Thus, the tortfeasor is not underinsured for purposes of Insurance Law § 3420(f)(2)(A).

Therefore, $300,000 BI/PD CSL < $100,000 BI person/$300,000 BI accident/$100,000 PD accident. No SUM trigger.

1 comment:

Vin P. said...

What if the insured's limits were CSL 300 but did not include P.D. (provided separately). Since the insured limit was still the same as the tortfeasor and not greater, would the result be same under the strict facial per-accident comparison?