DocketNumber: 14 E.D. Appeal Docket 1999
Judges: Flaherty, Zappala, Cappy, Castille, Nigro, Newman, Saylor
Filed Date: 5/19/2000
Status: Precedential
Modified Date: 10/19/2024
OPINION
This appeal requires us to examine the nature and scope of a contractual arbitration provision in a policy of automobile insurance.
On August 14, 1992, an automobile owned and operated by Appellant, Carmen Borgia, Jr. (“Borgia”), was involved in an
On the date of the accident, Borgia was 27 years old and resided with his parents. His father owned two automobiles that were covered under a separate policy of insurance issued by Appellee, the Prudential Insurance Company (“Prudential”). Lacking UIM coverage under his own policy, Borgia filed a claim for such coverage under his parents’ policy. Prudential denied the claim on the grounds that, inter alia, Borgia was not a named insured, and his car was not a covered vehicle. Borgia was unwilling to accept Prudential’s determination.
On August 28,1995, Prudential filed a declaratory judgment action to resolve the dispute over whether Borgia was a “covered person” under the policy issued to his parents. That same day, Borgia filed a petition to appoint arbitrators and to compel arbitration. By order of November 7, 1995, the trial court (Bonavitacola, P.J.) granted Borgia’s petition and scheduled an arbitration hearing. Prudential, in its declaratory judgment action, filed a motion to stay arbitration. The trial court (O’Keefe, J.) denied the motion, and an arbitration hearing took place. The trial court subsequently denied Prudential’s motion for reconsideration of the order compelling arbitration (Bonavitacola, P.J.) and dismissed Prudential’s declaratory judgment action “without prejudice to be[ing] reopened when uninsured [sic] motorist provisions have been exhausted” (Moss, J.). On May 16, 1996, the arbitrators issued their report and award. By a vote of 2 to 1, they found that Borgia was entitled to recover UIM benefits under the Prudential policy in the amount of $87,500.
Prudential filed a petition to vacate the arbitration award and to reinstate the declaratory judgment action, averring
Prudential argued to the Superior Court that the trial court had erred in ordering the parties to proceed to arbitration without first resolving the threshold question of whether Borgia was entitled to demand arbitration. The Superior Court agreed, reasoning that, regardless of whether the alleged agreement called for statutory or common law arbitration, the trial court’s first task, upon being presented with a petition to compel arbitration, was to determine whether the parties had in fact agreed to arbitrate. The relevant inquiry, according to the Superior Court, was not simply whether the insurance policy contained an arbitration clause, but whether the party who had petitioned to compel arbitration was one who, under the terms of the contract, was entitled to enforce such clause. If the petitioner did not meet the requirements of the contract in that regard, the Superior Court explained, there was no agreement to arbitrate between the insurer and the petitioner, and, accordingly, no basis for sending the parties’ dispute to arbitration. The Superior Court emphasized that “the question of whether a particular party may enforce the arbitration agreement is for the trial court.”
The Prudential policy issued to Borgia’s parents stated, with regard to UIM benefits, that “[i]f we [Prudential] and a covered person disagree on policy coverages or amounts payable, either party may make a written demand for arbitration.” After examining other relevant provisions of the policy,
Borgia petitioned for allowance of appeal, arguing that the Superior Court, by reversing the arbitrators’ decision for an error of law, had exceeded the scope of review applicable to common law arbitration. We granted allowance of appeal limited to the issues of whether this matter is controlled by common law arbitration principles and, if so, whether the Superior Court exceeded the applicable scope of review when it determined that the question of whether Borgia was a “covered person” should not have been submitted to arbitration.
The general principles governing common law arbitration are well settled. Where one party makes application to compel arbitration, and the opposing party denies the existence of an agreement to arbitrate, the trial court “shall proceed summarily to determine the issue so raised.... ” 42 Pa.C.S. § 7304(a); see also 42 Pa.C.S. § 7342(a) (providing that specified sections of the Act, including Section 7304, shall be applicable to common law arbitration). In doing so, the trial court may not refuse an application to compel arbitration “on the ground that the controversy lacks merit or bona fides or on the ground that no fault or basis for the controversy sought to be arbitrated has been shown.” 42 Pa.C.S. § 7304(e). Once it has been determined that a substantive dispute is arbitrable, the arbitrators normally have the author
Borgia argues that if the Superior Court had properly applied these settled principles to the facts of the present case, it would not have reversed the judgments entered in his favor. Borgia reasons that, since the arbitration clause at issue provided for arbitration of disputes concerning “policy coverages,” his substantive dispute with Prudential was necessarily arbitrable, and the arbitrators were therefore authorized to decide all matters necessary to the resolution of that dispute. Whether Borgia was a covered person under his parents’ policy was, he contends, one of the matters — perhaps the essential matter — that had to be resolved in order to dispose of his claim. Borgia asserts that the arbitrators resolved the issue in his favor, and in doing so they did not deny Prudential a hearing, nor was the arbitration process
Borgia’s argument finds support in the substantial body of case law concerning contractual arbitration provisions. In the lead case of National Grange Mut. Ins. Co. v. Kuhn, 428 Pa. 179, 236 A.2d 758 (1968), the claimant, having sustained injury in a two-car collision, sought UM benefits under an insurance policy issued to the owner of the vehicle in which the claimant had been a passenger.
Claimant appealed, requiring this Court to decide, for the first time, the scope of the arbitration contemplated by an arbitration clause in the UM provisions of an automobile insurance policy. “This question,” the Court reasoned, “must be decided in the light of the language of the ... policy affording the coverage.” Id. at 181, 236 A.2d at 759. The language of the arbitration clause in the Kuhn policy, with regard to both who could demand arbitration and what matters could be arbitrated, was very broad. The clause provided that, where the insurer and “any person making [a UM] claim” disagreed as to the claimant’s legal entitlement to damages or the amount owed, either party could demand arbitration of “the matter or matters upon which such person and the company do not agree____” Id. at 182, 236 A.2d at 759. Reasoning that “court proceedings should not be read into [an] agreement to arbitrate[,]” id. at 185, 236 A.2d at 760, and that any ambiguity should be resolved against the insurer as drafter, id., this Court interpreted the language quoted above as expressing the parties’ agreement to submit to arbitration any disputed “matter or matters” arising under the UM provisions of the policy. “The arbitration clause, in our view, indicates that the parties contemplated one method, and one method only, for the resolution of disputes under this coverage. That method was arbitration and all such disputes should be so decided.” Id. at 185, 236 A.2d at 761. Such a conclusion was not unfair to the. insurer, the Court explained, because “the policy language is the [insurer’s] and it may, if it so desires, alter that language to limit arbitration to only those issues it desires to be arbitrable.”
Although all of these cases involved coverage under the Uninsured Motorist Act, the fundamental principle set forth in those decisions — that where the parties have chosen arbitration as the forum for resolution of their disputes, they are
In Brennan, this Court addressed the scope of an arbitration clause in the UIM provisions of an automobile insurance policy. The issue in Brennan was whether the arbitrators, in concluding that the claimant was entitled to UIM benefits, had exceeded the scope of the common law arbitration authorized in the policy by considering a “setoff’ theory that the claimant had not raised. The arbitration clause in Brennan provided that “[i]f we and the covered person disagree whether that person is legally entitled to recover damages from the owners or operator of an underinsured motor vehicle, or do not agree as to the amount of damages, either party may make a written demand for arbitration.” Id. at 547-48, 574 A.2d at 582.
This Court interpreted the quoted language very broadly. Given such language, the Court explained, “[tjhere is no limit to the jurisdiction of the arbitrators over what issues may be submitted[,j and in fact the policy declares that all disputes between the insurance company and the insured will be arbitrated.” Id. at 549, 574 A.2d at 583. Because the parties’
Although the focus of this Court’s analysis in Brennan was on “what issues may be submitted” to arbitration, in Baverso v. State Farm Ins. Co., 407 Pa.Super. 164, 595 A.2d 176 (1991), the Superior Court relied on Brennan to decide an issue concerning who may submit issues to arbitration. In Baverso, the claimant demanded arbitration pursuant to a clause in a State Farm policy providing that, in the case of a disagreement as to whether “the insured” was “legally entitled to collect damages from the owner or driver of an uninsured motor vehicle,” or as to the amount of such damages, either “the insured” or State Farm could demand that the issue be decided by statutory arbitration. The Superior Court concluded that, “[wjhile the issue of whether appellant, Baverso, is an insured under the contract is seemingly a prerequisite to arbitration under State Farm’s policy, all issues under this type of arbitration clause [that is, one utilizing ‘the type of wording found in Brennan ’] must be determined by a panel of arbitrators.”
In the case before us, the issue to be decided is whether, under the terms of the arbitration clause in Part 5 of the Prudential policy, Borgia’s claim to the status of a “covered person” who may demand arbitration is, in itself, arbitrable. As noted earlier, the arbitration clause provides that “if [Prudential] and a covered person disagree on policy coverages or amounts payable, either party may make a written demand for arbitration” (emphasis added). Prudential contends that, pursuant to this language, a determination that the claimant is a covered person must precede arbitration of coverage disputes. Such a requirement is not apparent from the language of the arbitration clause, however. The quoted phrase does not draw a clear distinction between parties who are entitled to invoke arbitration and matters which may be arbitrated, and a common-sense interpretation suggests that
In sum, the Prudential policy, insofar as it attempts to limit the right to demand arbitration to a certain class of claimants, is ambiguous. Pursuant to Kuhn and Brennan, such ambigui
Such an outcome inflicts no injustice on Prudential. This is not a case in which the party who challenges the arbitration award (Prudential) contends that it was not a party to the arbitration agreement. See Martin, 436 Pa. at 377, 260 A.2d at 805 (rejecting the insurer’s argument that Goldstein v. Int’l L.G.W.U., 328 Pa. 385, 196 A. 43 (1938), holding that one who denied being a party to an arbitration agreement was entitled to a judicial determination of the question, was applicable to the case at bar, it being undisputed that the insurer was a party to such an agreement); cf. Gaslin, Inc. v. L.G.C. Exports, Inc. (Appeal of Figueroa), 334 Pa.Super. 132, 144 n. 8, 482 A.2d 1117, 1124 n. 8 (1984) (stating that “[i]f Figueroa was not a party to the franchise agreement that contained the arbitration provision, then he did not consent to arbitrate this dispute and the award against him was improper”), superseded by statute on other grounds as stated in Beriker v. Permagrain Products, Inc., 347 Pa.Super. 102, 500 A.2d 178 (1985). To the contrary, Prudential was not merely a party to, but was the drafter of, the arbitration agreement. Having chosen common law arbitration as the forum for resolution of coverage disputes, Prudential is bound by the narrow scope of
Accordingly, we conclude that where, as here, an insurer has drafted the UIM provisions of a policy to provide, without exception, for common law arbitration of “coverage disputes” between the insurer and a “covered person,” it is for the arbitrators to decide whether a particular claimant is a “covered person,” and their decision in the matter will not be reversed for an error of law. We therefore reverse the order of the Superior Court which vacated the judgments entered on the arbitration award.
. The policy issued to Borgia's parents does not define the term “covered person.” Part 5 of the policy explains that, if the policyholder has purchased UIM coverage, Prudential “will pay up to our limit of liability for bodily injury that is covered under this part when an insured (whether or not occupying a car) is struck by an underinsured motor vehicle.” As for who is an insured, the policy provides, inter alia, that the policyholder and “resident relatives” are insured while using the policyholder's car, a "substitute car,” or a "non-owned car.” A "substitute car” is one which the policyholder has borrowed temporarily. to replace a covered car that is being repaired or replaced; it cannot be a car that is owned by the policyholder or a household resident. A "non-owned” car includes rental cars, and the policy specifies that such a car must be used with its owner's permission and in the manner intended by the owner. Prudential concedes, and the Superior Court acknowledged, that Borgia was a resident relative in his parents' household. Nevertheless, the court agreed with Prudential's assertion that Borgia was not entitled to UIM benefits because his accident occurred while he was driving a vehicle that could not be deemed either a substitute car or a non-owned car under the policy.
. On appeal, Prudential argues that Borgia conceded, in both the trial court and the Superior Court, that Prudential had the right to appellate review of the order compelling arbitration. We have determined that this is not the case. In addition, Borgia argues that counsel for Prudential, at arbitration, conceded that it was for the arbitrators to decide the coverage dispute. There would appear to be some merit to this contention, as Prudential’s attorney stated to the arbitrators; "If what you’re saying ... is, is it for the panel of arbitrators to resolve the coverage dispute between plaintiff and defendant, I am conceding that
. Act of April 25, 1927, P.L. 381, No. 248, as amended, 5 P.S. §§ 161-179. The Act of 1927 was repealed by the JARA Continuation Act of 1980, Act of October 5, 1980, P.L. 693, No. 142, 501(c), effective in 60 days.
. Act of July 9, 1976, P.L. 586, No. 142, § 2, as amended, Oct. 5, 1980, P.L. 693, No. 142, § 501(a); Act of Dec. 20, 1982, P.L. 1409, no. 326, art. II, § 201.
. In contrast, a party may seek vacation of a statutory arbitration award on any of the various grounds set forth at Section 7314(a)(1) of the Judicial Code, including the lack of an agreement to arbitrate. 42 Pa.C.S. § 7314(a)(l)(v); see, e.g., Patton v. Hanover Ins. Co., 417 Pa.Super. 351, 612 A.2d 517 (1992) (quashing an appeal from an order granting claimant's petition to compel arbitration, and noting that the trial court could address the existence of an arbitration agreement if the insurer petitioned to vacate the resulting award pursuant to Section 7314(a)(l)(v)). Section 7314 is not among the provisions of the Act that have been made applicable to common law arbitration via Section 7342(a).
. Until 1984, UM coverage was governed by the Uninsured Motorist Act, Act of August 14, 1963, P.L. 909, § 1 (codified as amended at 40 P.S. § 2000) (the "UM Act”), which provided that automobile liability policies must include UM coverage. 40 P.S. § 2000(a); Davis v. Government Employees Ins. Co., 500 Pa. 84, 86, 454 A.2d 973, 973 (1982). In 1984, the legislature enacted the Motor Vehicle Financial Responsibility Law, Act of February 12, 1984 (No. 11), § 8(c) (codified as amended at 75 Pa.C.S. §§ 1701-1799.7) (the "MVFRL”), which required insurers to provide UIM as well as UM protection. 75 Pa.C.S. § 1731; Hackenberg v. Southeastern Pa. Transp. Auth., 526 Pa. 358, 361, 586 A.2d 879, 880 (1991). Under the 1990 amendments to the MVFRL, insurers were required to offer UM and UIM coverage, but the purchase of such coverage was optional. 75 Pa.C.S. § 1731(a); Hall v. Amica Mut. Ins. Co., 538 Pa. 337, 348 n. 2, 648 A.2d 755, 761 n. 2 (1994). The UM Act has not been repealed, although it has been supplanted in some respects by the MVFRL. Hackenberg, 526 Pa. at 363 n. 4, 586 A.2d at 881 n. 4, See generally James R. Ronca et al„ Pennsylvania Motor Vehicle Insurance,: An Analysis of the Financial Responsibility Law § 5.1, at 91. Arbitration is not mandated by the UM Act, see Hiller v. Allstate Ins. Co., 300 Pa.Super. 149, 151 n. 1, 446 A.2d 273, 274 n. 1 (1982), or the MVFRL, see Johnson v. Pennsylvania Nat’l Ins. Cos., 527 Pa. 504, 507, 594 A.2d 296, 298 (1991).
. The policy provided for arbitration pursuant to the mies of the American Arbitration Association and, in addition, expressed the parties’ agreement to be bound by the arbitration award. Such phrases
. As the Superior Court subsequently observed, although arbitration was not required by the UM Act, see footnote 6, UM clauses ordinarily provided for arbitration, and in fact the national standard form included a broad arbitration clause. Hiller, 300 Pa.Super. at 151 n. 1, 446 A.2d at 274 n. 1.
. Taylor was decided by a full Court, with three justices dissenting and one justice concurring in the result. The dissenters agreed that "under our [prior] decisions . .., either party could have required [the] issue to be decided by an arbitrator.” Id. at 26, 252 A.2d at 620 (Roberts, J., dissenting) (emphasis in original). Neither party had done so, however, and the dissenters saw no basis on which the Court could "demand enforcement of a provision which neither party wishes to utilize.” Id. at 27, 252 A.2dat621.
. In this respect, the present case is distinguishable from Baverso. The policy in Baverso provided for the arbitration of disagreements concerning the insured’s legal entitlement to collect damages from the oivner or operator of an underinsured motor vehicle, or the amount of such damages. Arguably, such language limits the scope of arbitration to issues arising from the claimant’s underlying tort action against the owner or operator of the other vehicle, and does not encompass a disagreement as to whether the claimant was in fact "an insured.” The policy in the present case, in contrast, utilizes the broader, less specific term “policy coverages” to define the scope of arbitration, and that phrase is fairly read to encompass the claimant's asserted status as a "covered person.” Whether the Superior Court in Baverso improperly extended this Courfs holding in Brennan is a question that is not before us in this case. Notably, the approach to UIM arbitration provisions taken by this Court in Brennan is, in itself, broader than that of most other jurisdictions. See National Union Fire Ins. Co. v. Reynolds, 77 Hawai’i 490, 493, 889 P.2d 67, 70 (App.1995) (citing A.S. Klein, Annotation, What Issues Are Arbitrable Under Arbitration Provision of Uninsured Motorist Insurance, 29 A.L.R.3d (1970), which addresses UIM as well as UM coverage). In addition, federal courts applying Pennsylvania case law have noted that the Superior Court has interpreted Brennan broadly. See, e.g., McAlister v. Sentry Ins. Co., 958 F.2d 550, 553-54 (3 rd Cir.1992) (concluding that, where a policy provided that either the insurer or "the insured” could demand arbitration of disagreements as to whether the "insured” was legally entitled to recover damages from the owner or driver of an underinsured motor vehicle, it was for the arbitrators to determine whether the claimant was “an insured”); Continental Cas. Co. v. Gezon, 1994 WL 236458 (E.D.Pa.1994) (same, with regard to UM coverage).