Dennis H. Hagenow and Rosalee A. Hagenow v. American Family Mutual Insurance Company

IN THE SUPREME COURT OF IOWA
No. 12–2088
Filed May 2, 2014
DENNIS H. HAGENOW and ROSALEE A. HAGENOW,
Appellees,
vs.
AMERICAN FAMILY MUTUAL INSURANCE COMPANY,
Appellant.
Appeal from the Iowa District Court for Black Hawk County,
George L. Stigler, Judge.
An insurer seeks interlocutory review of a district court’s denial of
the insurer’s motion for summary judgment. REVERSED AND
REMANDED.
Scott K. Green of American Family Mutual Insurance,
West Des Moines, for appellant.
James W. Carney and George W. Appleby V of Carney & Appleby,
P.L.C., Des Moines, for appellee.
2
ZAGER, Justice.
Dennis and Rosalee Hagenow (Hagenows) brought this action to
recover uninsured motorist benefits from their insurer, American Family
Mutual Insurance Company (American Family). American Family moved
for summary judgment arguing the Hagenows were not entitled to
uninsured motorist benefits under their policy. The district court denied
American Family’s motion for summary judgment, and American Family
filed an application for interlocutory appeal, which we granted. For the
reasons set forth below, we reverse and remand.
I. Background Facts and Proceedings.
On November 10, 2008, Dennis Hagenow was stopped at a red
light at the intersection of University Avenue and Cedar Heights Drive in
Cedar Falls, Iowa, when his vehicle was rear-ended by a vehicle driven by
Betty Schmidt. Dennis suffered personal injuries, and his vehicle was
totaled. Schmidt was taken to the hospital and cited for failure to stop in
an assured clear distance.
In November 2010, the Hagenows filed an action alleging
negligence against Schmidt. Schmidt filed an answer denying the
Hagenows’ allegations and asserting the defense of sudden emergency.
Schmidt claimed to have suffered a transient ischemic attack or stroke
immediately before the accident with Dennis. The matter proceeded to a
jury trial. According to the judgment entered by the district court after
the trial, “[t]he jury returned a verdict that the defendant was not
negligent under any theories.” 1
At the time of the collision, American Family was the automobile
insurer of both the Hagenows and Schmidt. Schmidt’s automobile
1The judgment in favor of Schmidt was ultimately affirmed by us on further
review. See Hagenow v. Schmidt, 842 N.W.2d 661, 678 (Iowa 2014).
3
insurance policy had a personal injury liability limit of $300,000 per
person and a property damage liability limit of $100,000. The Hagenows’
policy included uninsured motorist coverage that provided American
Family would “pay compensatory damages for bodily injury which an
insured person is legally entitled to recover from the owner or operator of
an uninsured motor vehicle.”
The Hagenows filed an uninsured motorist claim under their
insurance policy. The Hagenows’ policy defined “an uninsured motor
vehicle” as a motor vehicle that was:
a. Not insured by a bodily injury liability bond or policy
at the time of the accident.
b. Insured at the time of the accident by a liability bond
or policy with bodily injury liability limits below the
minimum required by the financial responsibility law
of the state in which your insured car is principally
garaged.
c. A hit-and-run vehicle whose operator or owner is
unknown and which causes bodily injury to you or a
relative. Physical contact with a hit-and-run vehicle is
required.
d. Insured by a bodily injury liability bond or policy at
the time of the accident but the company denies
coverage or is or becomes insolvent within one year
after the accident.
American Family determined Schmidt’s vehicle was not an uninsured
motor vehicle under the Hagenows’ policy, so American Family denied
the claim.
In November 2010, the Hagenows filed this breach of contract
action against American Family. The Hagenows alleged American Family
breached the automobile insurance policy between the two by not paying
uninsured motorist benefits. American Family answered, denying the
4
Hagenows’ allegations and raising affirmative defenses, including that
Schmidt was not an “uninsured motorist” under the terms of their policy.
In June 2012, American Family filed a motion for summary
judgment. First, American Family contended that Schmidt was not an
uninsured motorist under the definitions of the policy. Additionally,
American Family argued that to recover damages under the uninsured
motorist provision, the Hagenows must prove that they were “legally
entitled to recover from the owner or operator of an uninsured motor
vehicle.” American Family acknowledged Schmidt was covered and
defended Schmidt at the underlying civil jury trial which determined that
Schmidt was not liable for the Hagenows’ damages. Therefore, American
Family maintained, the Hagenows were not legally entitled to recover.
The Hagenows filed a resistance and cross-motion for summary
judgment. First, they argued they were legally entitled to recover
because the jury found Schmidt not liable on the basis of a legal excuse.
Next, while the Hagenows conceded Schmidt had automobile insurance
coverage at the time of the collision, they nevertheless insisted Schmidt’s
vehicle was uninsured under the terms of the Hagenows’ insurance
policy because American Family denied that the Hagenows’ uninsured
motorist coverage applied to sudden emergency defenses, like the one
raised by Schmidt.
In October, the district court conducted a hearing on American
Family’s motion for summary judgment. After the hearing, the district
court issued its ruling denying American Family’s motion for summary
judgment. The district court found that the “legally entitled to recover”
language in the policy was to be broadly construed. The district court
also found that “[t]he sole methodology of recovery for the Hagenows is
litigation to recover for their injuries.” The district court concluded that
5
under the facts of this case, the uninsured motorist provision found in
the Hagenows’ insurance policy did not bar their action against American
Family.
American Family timely filed an application for interlocutory
appeal, which we granted.
II. Standard of Review.
We review a district court’s decision to deny a motion for summary
judgment for correction of errors at law. Ranes v. Adams Labs., Inc., 778
N.W.2d 677, 685 (Iowa 2010). Summary judgment is appropriate “if the
pleadings, depositions, answers to interrogatories, and admissions on
file, together with the affidavits, if any, show that there is no genuine
issue as to any material fact and that the moving party is entitled to a
judgment as a matter of law.” Iowa R. Civ. P. 1.981(3). We view the
record in the light most favorable to the nonmoving party. Pitts v. Farm
Bureau Life Ins. Co., 818 N.W.2d 91, 96 (Iowa 2012).
III. Discussion.
There are two issues on appeal. The first is whether the district
court erred by concluding the Hagenows were “legally entitled to recover”
from American Family under the Hagenows’ uninsured motorist (UM)
provision. The second issue is whether Schmidt’s vehicle was “an
uninsured motor vehicle” under the Hagenows’ UM provisions.
Before separately addressing each issue, we recognize that our
fundamental task is to interpret the language of the insurance policy.
Am. Family Mut. Ins. Co. v. Petersen, 679 N.W.2d 571, 576 (Iowa 2004)
(explaining an automobile insurance policy is a contract and is governed
by rules applicable to contracts). “In doing so, ‘we strive to ascertain the
intent of the parties at the time the policy was sold.’ ” Id. (quoting
Ferguson v. Allied Mut. Ins. Co., 512 N.W.2d 296, 299 (Iowa 1994)). We
6
ordinarily determine the parties’ intent from the policy’s language, unless
the policy is ambiguous. Id. We have said “[a]n ambiguity exists when,
after application of our relevant rules of interpretation, a genuine
uncertainty results as to which of two or more meanings is proper.” Id.
We construe the policy provision in favor of the insured when the
provision is ambiguous. Id. With these principles in mind, we address
each issue.
A. Legally Entitled to Recover. On the first issue, American
Family argues a jury found Schmidt was not liable for the collision with
Dennis. Because the jury found Schmidt was not liable, American
Family insists the Hagenows are not legally entitled to recover. The
Hagenows respond that Schmidt was negligent but was absolved of
liability by her sudden emergency defense, a type of legal excuse. The
Hagenows argue Schmidt’s legal excuse does not affect their legal
entitlement to recover under the UM coverage.
We have said that UM coverage applies when four conditions are
met:
(1) the injured person is an insured under the insurance
policy provisions; (2) the injured person is “legally entitled to
recover damages from the owner or operator of an uninsured
motor vehicle;” (3) the injury to the insured was “caused by
accident;” and (4) the injury arose “out of the ownership,
maintenance, or use” of an uninsured motor vehicle.
Id. at 575 n.1 (quoting Iowa Code § 516A.1 (2001)). The terms of the
Hagenows’ UM policy with American Family are consistent with these
conditions. The insured carries the burden under the “legally entitled to
recover” requirement to prove the uninsured motorist was liable and the
extent of the insured’s damages. Id. at 584 n.3. Therefore, the insured
may satisfy the “legally entitled to recover” condition by either obtaining
a valid judgment against the uninsured motorist, or by bringing an
7
action against the insurer. See id.; see also Leuchtenmacher v. Farm
Bureau Mut. Ins. Co., 461 N.W.2d 291, 294 (Iowa 1990) (concluding in an
underinsured-motorist-coverage (UIM) case that there was “nothing in
the language of [our UM and UIM statute]” suggesting that legal
entitlement to recovery “must be determined by a separate lawsuit”). We
have explained the insured need only “prove the damages he or she
would have been entitled to recover had a lawsuit against the
underinsured motorist been taken to judgment.” Waits v. United Fire &
Cas. Co., 572 N.W.2d 565, 574 (Iowa 1997). The same is true when the
motorist is an uninsured motorist.
The phrase “legally entitled to recover” contained in the Hagenows’
UM provision is taken from Iowa Code section 516A.1, which requires
that UM coverage must provide “for the protection of persons insured
under such policy who are legally entitled to recover damages from the
owner or operator of an uninsured motor vehicle.” Iowa Code § 516A.1
(2013) (emphasis added). We interpret the UM provision to be consistent
with the legislature’s intent in enacting the UM statute. See Otterberg v.
Farm Bureau Mut. Ins. Co., 696 N.W.2d 24, 31 (Iowa 2005) (concluding
claimant was not legally entitled to recover under either his UM coverage
or Iowa Code section 516A.1); Waits, 572 N.W.2d at 573 (explaining the
phrase “legally entitled to recover” in UIM coverage is interpreted to be
consistent with intent behind UIM statute); see also Wetherbee v. Econ.
Fire & Cas. Co., 508 N.W.2d 657, 659 (Iowa 1993) (“[A]n insurer cannot
offer underinsured motorist coverage more restrictive than that required
by the statute.”). In doing so, we interpret the phrase liberally, not
literally. Waits, 572 N.W.2d at 573.
We have never addressed the precise issue presented here. We
have, however, addressed other situations in which the insured sought to
8
recover UM or UIM benefits despite being “unable to recover from the
negligent tortfeasor.” See Otterberg, 696 N.W.2d at 29 (noting liberal
interpretation of “legally entitled to recover” has in several cases enabled
an insured to recover under UM coverage despite inability to recover from
the tortfeasor). In Leuchtenmacher, we held a judgment against the
underinsured tortfeasor was unnecessary to seek UIM benefits from an
insurer. 461 N.W.2d at 294.
In Waits, an insured motorist settled with an underinsured
motorist, then sought UIM benefits. 572 N.W.2d at 568. The insurer
resisted, arguing Waits was not legally entitled to recover because she
had given the underinsured motorist a release instead of giving a
covenant not to sue. Id. at 572. We rejected the insurer’s argument,
reasoning that Waits could still show the damages to which she would
have been entitled had a tort suit been pursued. Id. at 574.
In another case, we wrestled with the issue “whether an insured is
entitled to recover underinsured motorist benefits from her insurance
company when the insured has no right to bring an action in her own
name against the underinsured motorist.” Wetherbee, 508 N.W.2d at
658. After her husband James was killed in a car accident, Katherine
Wetherbee sought to recover loss-of-consortium damages under the
couples’ UIM coverage. Id. The insurer insisted that she was not legally
entitled to recover because only the administrator of James’s “estate
could bring an action for post-death loss of consortium.” Id. According
to the insurer, because Katherine was not the estate’s administrator—in
fact, no estate had been opened—she could not recover the damages. Id.
at 658–59.
In rejecting the insurer’s interpretation of the phrase, we opted for
an interpretation consistent with the legislature’s purpose in requiring
9
UIM coverage and its intent in using “legally entitled to recover.” See id.
at 661 (finding insurer’s interpretation inconsistent with the legislature’s
purpose and intent). The purpose of the UIM statute was, we explained,
to compensate “the victim of an underinsured motorist to the same
extent as if the underinsured motorist were adequately insured.” Id. at
660. We concluded the “only reasonable interpretation” of the phrase
was “that it means the insured must have suffered damages caused by
the fault of the underinsured motorist and be entitled to receive those
damages.” Id. at 661.
In Otterberg, we held an insured was not legally entitled to recover
UM benefits because the injuries sustained were covered under the
workers’ compensation system. See 696 N.W.2d at 31. We distinguished
Wait and Wetherbee, explaining that in those cases the “law provided for
an underlying claim, but the claim could not be enforced by the insured
under the particular circumstances.” Id. at 30. By contrast, Otterberg
never had a legal right to recovery against a coemployee. See id. Even
noting the liberal interpretation given to the phrase “legally entitled to
recover,” we said it could not “be stretched so far as to cover situations
when an insured could have never recovered from the uninsured
motorist because the law did not provide for any recovery.” Id.
In this case, the law provided a mechanism for the Hagenows to
pursue their underlying negligence claim. They filed a civil tort claim
against Schmidt, and after a period of discovery, proceeded to present
their claim through a jury trial. Unfortunately for the Hagenows, the
jury, applying principles of negligence and fault, found Schmidt was not
negligent. As American Family points out, despite the liberality with
which this court has interpreted the phrase “legally entitled to recover,”
the liability requirement has never been abandoned. Indeed, despite
10
rejecting the insurer’s attempts to avoid paying benefits in
Leuchtenmacher, Wetherbee, and Waits, it was recognized that the
insured’s entitlement to recovery depended on establishing the
underinsured motorist’s liability. See, e.g., Waits, 572 N.W.2d at 574
(noting Iowa Code section 516A.1 “requires the insured to prove the
damages he or she would have been entitled to recover” in a lawsuit);
Wetherbee, 508 N.W.2d at 661 (concluding “the insured must have
suffered damages caused by the fault of the underinsured motorist”);
Leuchtenmacher, 461 N.W.2d at 293 (noting the statute is written to
protect consumers and applies to a situation in which the insured is
entitled to recover but “the liability of the person legally responsible is
not insured” (citation and internal quotation marks omitted)).
Undaunted, the Hagenows point to a respected scholar on UM
insurance who they contend argues that tort immunities and other
limitations available to a tortfeasor should not prevent an insured from
recovering UM coverage from an insurer. Alan I. Widiss, Uninsured
Motorist Coverage: Observations on Litigating over When a Claimant Is
“Legally Entitled to Recover,” 68 Iowa L. Rev. 397, 426 (1983) [hereinafter
Widiss] (arguing a tort immunity or other limitation should not preclude
claims under UM coverage on the ground the insured “would not be
legally entitled to recover from the tortfeasor”); see also 1 Alan I. Widiss
& Jeffrey E. Thomas, Uninsured and Underinsured Motorist Insurance
§ 7.14, at 432 (3d rev. ed. 2005) [hereinafter Uninsured and Underinsured
Motorist Insurance] (making the same argument). According to the
Hagenows, Professor Widiss’s commentary supports their legal
entitlement to recovery of UM benefits in spite of Schmidt’s successful
sudden emergency defense.
11
Professor Widiss challenges insurers’ use of an uninsured
motorist’s tort-immunity defense in proceedings to recover UM benefits.
See Widiss, 68 Iowa L. Rev. at 426. He contends that the tort immunity
absolved only the tortfeasor from liability; the UM coverage is not related
to the tortfeasor, so the tort immunity should not affect whether the
insurer pays the UM benefit. Id. Professor Widiss argues further the
question whether a tort immunity can protect an insurer should be
resolved by balancing the public policy in favor of protecting victims of
uninsured drivers against the public policy interests behind tort
immunities. See id. at 426–27. Also, he points to the gradual abolition
of some tort immunities, which he argues indicates an increasing
concern for compensating tort victims. Id. at 427. Professor Widiss
concludes, “Determining the rights of an insured under the uninsured
motorist coverage in terms of whether the tortfeasor was negligent,
without regard to a tort immunity, is consistent with this trend.” Id. at
427 (emphasis added).
The Hagenows’ reading of Professor Widiss’s commentary is flawed
for at least two reasons. First, the sudden emergency defense is not a
type of immunity, but rather a distinct defense that, if proved, excuses
the alleged tortfeasor from liability. Compare Vasconez v. Mills, 651
N.W.2d 48, 54 (Iowa 2002) (explaining the fact finder may excuse an
alleged tortfeasor’s violation of statutory law if the alleged tortfeasor
proves he or she was confronted with an unforeseen emergency), with W.
Page Keeton, et al., Prosser and Keeton on The Law of Torts § 131, at
1032 (5th ed. 1984) (“An immunity is a freedom from suit or liability.”).
Unlike immunity defenses, which for policy reasons prevent a protected
party from being held liable, the sudden emergency defense recognizes
the difficulty a person has considering reasonable alternatives when
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confronted by an unforeseen emergency and therefore modifies the
standard of care. Compare Hook v. Trevino, 839 N.W.2d 434, 445 (Iowa
2013) (declining to extend state volunteer’s immunity to the state after
considering policy consequences, among other considerations); Turner v.
Turner, 304 N.W.2d 786, 787–89 (Iowa 1981) (abrogating absolute
parental immunity for negligence after considering “the values which that
doctrine purports to foster”), with Vasconez, 651 N.W.2d at 54
(explaining the rationale of the sudden emergency defense); Jones v.
Blair, 387 N.W.2d 349, 352 (Iowa 1986) (noting a person acting in an
emergency “is not held to the same standard of care as one who has had
time to reflect”). Thus, the Hagenows’ argument misses the mark as a
definitional matter.
Furthermore, though Professor Widiss is critical of immunity
defenses, he accepts that the uninsured motorist must be negligent for
the insurer to pay UM benefits. A broader review of his work confirms
his focused critique is not directed at defenses that challenge the merits
of the insured’s negligence case. For instance, in a well-known treatise,
Professor Widiss declares that “[t]he language ‘legally entitled to recover’
is undoubtedly intended to mean that a claimant is only entitled to
indemnification for injuries resulting from the tortious conduct of an
[uninsured] motorist.” 3 Uninsured and Underinsured Motorist Insurance
§ 34.1, at 168 (footnotes omitted). The treatise also counsels that the
right to recover UM benefits is “contingent on the insured being legally
entitled to recovery because the injuries were caused by the negligent
operation of” a vehicle. 1 Uninsured and Underinsured Motorist Insurance
§ 7.2, at 363 (emphasis added).
Notably, insurers’ use of other types of defenses to liability goes
unchallenged by Professor Widiss and other leading commentators.
13
Although Widiss’s treatise questions the overall fairness of the
contributory negligence defense, in light of the widespread adoption of
comparative fault, it does not quibble with the defense’s use by insurers
in states where the defense is available. See id. § 7.4, at 378–81. In
addition, Widiss does not challenge insurers’ use of an available workers’
compensation system, so long as the insured is compensated by workers’
compensation. See 3 Uninsured and Underinsured Motorist Insurance
§ 34.2, at 178–79.
Noting that comparative fault has replaced contributory negligence,
another well-known treatise approves of insurers using comparative fault
as a defense to paying UM benefits because “the purpose of uninsured
. . . motorist insurance is to put the claimant in the same position the
claimant would have been had the tortfeasor been adequately insured.”
6 Jeffrey E. Thomas & Christopher J. Robinette, New Appleman on
Insurance Law Library Edition § 65.03[2], at 65-65 (2013) [hereinafter
New Appleman]; see Rodman v. State Farm Mut. Auto. Ins. Co., 208
N.W.2d 903, 909 (Iowa 1973) (explaining the purpose of the UM statute
is to provide the insured the same protection he or she would have had if
the tortfeasor had been minimally insured). Hence, “because the
tortfeasor would be entitled to raise the defense and obtain a reduction
in damages, it is appropriate for the insurer to receive the same benefit.”
New Appleman § 65.03[2], at 65-65. Thus, although Professor Widiss
pointedly challenges insurers’ use of immunity defenses, he and other
leading commentators do not question insurers’ use of other defenses to
negligence in deciding whether an insured is legally entitled to recover.
On the contrary, it is accepted that “[a]n insurer may assert as defenses
to a claim under [uninsured] coverage the nonnegligence of the
14
uninsured.” 9 Steven Plitt, et al., Couch on Insurance 3d § 123:16, at
123-58 (rev. ed. 2008).
High courts in other states hold defenses aimed at negating an
element of the negligence claim are part of the determination whether an
insured is legally entitled to recover. See, e.g., Ex parte Mason, 982
So. 2d 520, 521 (Ala. 2007) (rejecting insurer’s use of statute of
limitations defense but stating “the uninsured motorist’s substantive
defenses are available to the insurer”); Williams v. State Farm Mut. Auto.
Ins. Co., 641 A.2d 783, 787 (Conn. 1994) (“Whether the uninsured
motorist was legally liable must be determined in light of any substantive
defenses that would have been available to the uninsured motorist.”);
Stemple v. Md. Cas. Co., 144 P.3d 1273, 1275–76 (Kan. 2006) (explaining
insurer can use “the substantive defenses that would have been available
to the uninsured motorist” (citation and internal quotation marks
omitted)); Brown v. Lumbermens Mut. Cas. Co., 204 S.E.2d 829, 834 (N.C.
1974) (“Any defense available to the uninsured tort-feasor should be
available to the insurer.”); Snyder v. Am. Family Ins. Co., 871 N.E.2d 574,
581 (Ohio 2007) (observing that insurers should have the same defenses
available to them as the allegedly negligent uninsured motorist); Vega v.
Farmers Ins. Co. of Or., 918 P.2d 95, 102–04 (Or. 1996) (explaining
possible reasonable interpretations of the phrase “legally entitled to
recover” and holding it requires the insured to prove elements of
negligence and overcome defenses). Even a case cited by Professor
Widiss for its criticism of immunity defenses and relied on by the
Hagenows interprets the phrase “legally entitled to recover” to mean “that
the claimant must be able to prove the elements of her claim necessary
to entitle her to recover damages.” Allstate Ins. Co. v. Elkins, 396 N.E.2d
528, 531 (Ill. 1979); Widiss, 68 Iowa L. Rev. at 425; see also Karlson v.
15
City of Okla. City, 711 P.2d 72, 74–75 (Okla. 1985) (rejecting use of
governmental immunity defense by insurer while noting requirement that
insured establish uninsured motorist’s fault); accord 3 Uninsured and
Underinsured Motorist Insurance § 34.2, at 175. Many courts and leading
commentators agree the determination whether an insured is legally
entitled to recover includes considering the defenses available to the
uninsured motorist. It follows that if an uninsured motorist is not
negligent, because a defense negated an element of the negligence claim
or otherwise, then the insured motorist is not legally entitled to recover
UM benefits from the insurer.
At the underlying civil trial, Schmidt asserted the defense of
sudden emergency, contending that although she pled guilty to violating
a traffic ordinance in connection with the collision with Dennis, she was
not liable because she suffered a stroke prior to the collision. The Iowa
State Bar Association Civil Jury Instruction 600.75, captioned “Sudden
Emergency,” which is to be used “in conjunction with an instruction on
legal excuse where a statutory violation is claimed,” provides:
A sudden emergency is an unforeseen combination of
circumstances that calls for immediate action or a sudden
or unexpected occasion for action. A driver of a vehicle
who, through no fault of [his] [her] own, is placed in a
sudden emergency, is not chargeable with negligence if the
driver exercises that degree of care which a reasonably
careful person would have exercised under the same or
similar circumstances.
Iowa State Bar Ass’n, Iowa Civil Jury Instruction 600.75 & cmt. (2012)
(emphasis added). The Iowa bar association instruction on legal excuse
provides:
(Name) claims that if you find that [he] [she] violated the law
in the operation of [his] [her] vehicle, [he] [she] had a legal
excuse for doing so because (excuse) and, therefore, is not
negligent. “Legal excuse” means that someone seeks to avoid
16
the consequences of [his] [her] conduct by justifying acts
which would otherwise be considered negligent. The burden
is upon (name) to establish as a legal excuse:
1. Anything that would make complying with the
law impossible.
2. Anything over which the driver has no control
which places [his] [her] vehicle in a position
contrary to the law.
3. Failure to obey the law when the driver is
confronted with sudden emergency not of [his]
[her] own making.
4. An excuse or exception provided by the law.
If you find that (name) has violated the law as
submitted to you in other instructions, and that [he] [she]
has established a legal excuse for doing so under any one of
the four definitions set forth above, then you should find that
(name) was not negligent for violating the particular law
involved.
Id. 600.74 (emphasis added). 2
The sudden emergency instruction “is merely an expression of the
reasonably prudent person standard of care.” Weiss v. Bal, 501 N.W.2d
478, 481 (Iowa 1993). Therefore, a driver confronted with an emergency
must still exercise reasonable care. Bannon v. Pfiffner, 333 N.W.2d 464,
470 (Iowa 1983). The decision whether a person has exercised
reasonable care during an emergency is typically for the jury. See id.
Having been given instructions similar to the uniform instructions, the
jury in the negligence case between the Hagenows and Schmidt
concluded Schmidt exercised reasonable care under the circumstances.
After the trial, in response to the question on the verdict form, “ ‘Was the
2We noted in Hagenow v. Schmidt that “[t]he Restatement (Third) of Torts:
Liability for Physical and Emotional Harm includes a separate section for disability—
which does not require advanced awareness or a rapid response.” 842 N.W.2d at 676.
We observed that section 11(b) on sudden incapacitation best fit the facts of the
underlying negligence action. See id.; see also Restatement (Third) of Torts: Liab. for
Physical & Emotional Harm § 11(b), at 130 (2010). Schmidt, however, did not request a
jury instruction based on that provision. See Hagenow, 842 N.W.2d at 677.
17
defendant, Betty Schmidt, at fault?,’ ” the jury answered “ ‘no.’ ”
Hagenow v. Schmidt, 842 N.W.2d 661, 669 (Iowa 2014).
Proof of the uninsured motorist’s liability is an element that must
be established by the insured to recover UM benefits. See Petersen, 679
N.W.2d at 584 n.3 (explaining an insured establishes he or she is legally
entitled to recover by proving the uninsured motorist’s liability and
damages). Permitting the Hagenows to recover UM benefits when they
were unable to show Schmidt’s fault would be inconsistent with the
purpose of UM insurance. See Rodman, 208 N.W.2d at 909 (“It is plain
the legislature intended to assure protection to an insured against
motorists whose liability to the insured is not covered.”). Because the
jury found Schmidt was not at fault for the collision with Dennis, we hold
the Hagenows are not legally entitled to recover UM benefits from
American Family.
B. Uninsured Motor Vehicle. Even if we were to conclude the
Hagenows were legally entitled to recover, the Hagenows would still have
the burden of showing that Schmidt was an “uninsured motorist” as
defined under their insurance policy. See Wetherbee, 508 N.W.2d at 660
(observing that in addition to being legally entitled to recover, the insured
must satisfy the insurance policy’s other terms and conditions). The
Hagenows concede there is only one provision in their UM policy under
which Schmidt’s vehicle could have been defined as uninsured. Under
that provision, an uninsured motor vehicle is one that is “[i]nsured by a
bodily injury liability bond or policy at the time of the accident but the
company denies coverage.” The Hagenows argue Schmidt’s vehicle,
which was undisputedly covered by liability insurance at the time of the
accident, was uninsured under this provision.
18
We acknowledge American Family’s capacity as both Schmidt’s
liability insurer and the Hagenows’ UM carrier adds a unique wrinkle to
the interpretative exercise. However, for our analysis, we must separate
the two different legal capacities involving American Family and the
respective insurance policies. American Family, in its capacity as
Schmidt’s liability insurer, is best thought of as a distinct liability
insurer. The Hagenows argue that by refusing to pay UM benefits under
their policy, American Family has made Schmidt’s vehicle into an
uninsured motor vehicle for purposes of the UM policy.
We believe the Hagenows’ policy is susceptible of only one
reasonable interpretation. In the Hagenows’ policy, the terms “[w]e, us,
and our” refer to American Family in its capacity as the Hagenows’ UM
insurer. Under the liability coverage section of the Hagenows’ insurance
policy, for example, the policy states, “We will pay compensatory
damages . . . .” It also explains, “We will defend any suit . . . .” Also,
their UM policy provides, “We will pay compensatory damages for bodily
injury which an insured person is legally entitled to recover from the
owner or operator of an uninsured motor vehicle.”
In the definition of an “uninsured motor vehicle” in the Hagenows’
policy, however, the denial of coverage is made by “the company.” We
have said “[a] cardinal rule of contract interpretation is that the use of
substantially different language in provisions of a contract must have
been intentional and must be recognized by a reviewing court.”
Greenfield v. Cincinnati Ins. Co., 737 N.W.2d 112, 120 (Iowa 2007). Thus,
the Hagenows’ UM policy draws a clear distinction between its capacity
as their UM insurer—by using “[w]e, us, [or] our”—and other liability
insurers, or in this case, American Family in its capacity as Schmidt’s
liability insurer—by using “the company.”
19
And this makes sense. The determination whether an allegedly
negligent motorist is covered by insurance turns on the terms and
conditions of that allegedly negligent motorist’s liability insurance policy,
which in many cases will be provided by another insurance company.
American Family, acting as the Hagenows’ insurer, plays no role in
deciding whether another motorist is insured under the terms of that
motorist’s policy. In other words, acting as the Hagenows’ UM insurer,
American Family’s denial that the UM benefits must be paid to the
Hagenows under the UM policy has no effect on whether Schmidt’s
vehicle was uninsured for purposes of the UM policy. The determination
whether the allegedly uninsured motorist is covered by insurance is
made by that person’s insurance company, “[t]he company.”
To be more concrete, “the company” in the Hagenows’ UM policy
refers in this case to American Family in its capacity as Schmidt’s
liability insurer. In acting as Schmidt’s liability insurer, American
Family obviously had to decide whether to cover Schmidt’s liability
according to the terms and conditions of Schmidt’s liability policy. Had
American Family, in its capacity as Schmidt’s liability insurer, denied her
coverage, then Schmidt’s vehicle would have been, for purposes of the
Hagenows’ policy, uninsured.
But American Family did not deny Schmidt was covered by
insurance; it denied she was liable for the accident with Dennis and
raised an affirmative defense. Interpreting nearly identical policy
language in Petersen, we explained UM coverage applied when the vehicle
was “insured but the insurer denies coverage.” 679 N.W.2d at 580. It
was clear, we said, these “provisions contemplate coverage to include
situations . . . when the victim could not recover under the tortfeasor’s
liability policy due to an exclusion.” Id. Presumably finding no exclusion
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with which to deny her coverage, American Family denied Schmidt’s
liability and defended her in the negligence case with the Hagenows, as it
was contractually obligated to do.
Neither American Family’s defense of Schmidt in one capacity, nor
American Family’s denial she was an uninsured motorist in another
capacity, transformed Schmidt into an uninsured motorist. Because
American Family, acting as Schmidt’s insurer, covered Schmidt, she was
not an uninsured motorist for purposes of the Hagenows’ UM coverage.
Therefore, even if the Hagenows had been legally entitled to recover, they
could not satisfy the terms of their UM policy entitling them to benefits.
The Hagenows have not met their burden that they are legally entitled to
recover damages from the owner or operator of an uninsured motor
vehicle.
IV. Conclusion.
We conclude the district court erred by denying American Family’s
motion for summary judgment. The Hagenows were not “legally entitled
to recover” under Iowa Code section 516A.1 or their UM policy. In
addition, Schmidt’s vehicle was not an uninsured motor vehicle under
the terms of the Hagenows’ UM provision. Accordingly, the district court
is reversed, and the matter is remanded to the district court for entry of
judgment in favor of American Family.
REVERSED AND REMANDED.