ACUITY v. Estate of Michael Shimeta

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Justia Opinion Summary

The Supreme Court affirmed the judgment of the court of appeals reversing the decision of the circuit court granting declaratory judgment for Acuity, a mutual insurance company, in this insurance dispute arising from a fatal automobile accident, holding that the court of appeals did not err.

When Douglas Curley lost control of his vehicle and crossed the center line he hit another vehicle, killing Michael Shimeta and seriously injuring Terry Scherr. After Curley's insurer paid Shimeta's estate and Scherr $250,000 each both parties sought additional recovery under a policy that Acuity had issued to Shimeta before the accident. At issue was whether Acuity's underinsured motorist coverage entitled Shimeta's estate and Scherr to an additional $250,000 each from Acuity or whether the payments the parties received from Curley's insurer reduced their recovery to $0. The Supreme Court held that Acuity owed Shimeta's estate and Scherr $250,000 each, thus affirming the court of appeals.

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2023 WI 28 SUPREME COURT OF WISCONSIN CASE NO.: 2020AP189 COMPLETE TITLE: ACUITY, a Mutual Insurance Co., Plaintiff-Respondent-Petitioner, v. Estate of Michael Shimeta and Terry Scherr, Defendants-Appellants, Partners Mutual Insurance Co., Intervening Defendant. REVIEW OF DECISION OF THE COURT OF APPEALS Reported at 399 Wis. 2d 375, 965 N.W.2d 78 PDC No: 2021 WI App 64 - Published OPINION FILED: SUBMITTED ON BRIEFS: ORAL ARGUMENT: SOURCE OF APPEAL: COURT: COUNTY: JUDGE: April 7, 2023 September 30, 2022 Circuit Milwaukee Jeffrey A. Conen JUSTICES: KAROFSKY, J., delivered the majority opinion of the Court, in which ANN WALSH BRADLEY, ROGGENSACK, and DALLET, JJ., joined. ZIEGLER, C.J., filed a dissenting opinion, in which REBECCA GRASSL BRADLEY, J., joined. HAGEDORN, J., filed a dissenting opinion, in which REBECCA GRASSL BRADLEY, J., joined. NOT PARTICIPATING: ATTORNEYS: For the plaintiff-respondent-petitioner, there were briefs filed by Christine M. Rice, Nicole R. Radler, and Simpson & Deardorff, S.C., Milwaukee. There was an oral argument by Christine M. Rice. For the defendants-appellants, there was a brief filed by Brett A. Eckstein and Cannon & Dunphy, S.C., Brookfield. There was an oral argument by Brett A. Eckstein. An amicus curiae brief was filed by James A. Friedman, Daniel C.W. Narvey, and Godfrey & Kahn, S.C., Madison, for the Wisconsin Insurance Alliance. An amicus curiae brief was filed by Mark L. Thomsen, Lynn R. Laufenberg, and Gingras, Thomsen, & Wachs, LLP, Madison, for the Wisconsin Association for Justice. 2 2023 WI 28 NOTICE This opinion is subject to further editing and modification. The final version will appear in the bound volume of the official reports. No. 2020AP189 (L.C. No. 2019CV5402) STATE OF WISCONSIN : IN SUPREME COURT ACUITY, a Mutual Insurance Co., Plaintiff-Respondent-Petitioner, FILED v. APR 7, 2023 Estate of Michael Shimeta and Terry Scherr, Defendants-Appellants, Sheila T. Reiff Clerk of Supreme Court Partners Mutual Insurance Co., Intervening Defendant. KAROFSKY, J., delivered the majority opinion of the Court, in which ANN WALSH BRADLEY, ROGGENSACK, and DALLET, JJ., joined. ZIEGLER, C.J., filed a dissenting opinion, in which REBECCA GRASSL BRADLEY, J., joined. HAGEDORN, J., filed a dissenting opinion, in which REBECCA GRASSL BRADLEY, J., joined. REVIEW of a decision of the Court of Appeals. ¶1 JILL J. KAROFSKY, J. automobile accident that Affirmed. This case arises from a tragic occurred when Douglas Curley lost control of his vehicle, crossed the center line, and hit another vehicle, killing Michael passenger, Terry Scherr. Shimeta and seriously injuring his As a result of the accident, Curley's insurer each. paid Shimeta's estate (Shimeta) and No. 2020AP189 Scherr $250,000 Shimeta and Scherr sought additional recovery under a policy that Acuity had issued to Shimeta prior to the accident. The policy included underinsured motorist (UIM) coverage with a $500,000 limit for "each person" and a $500,000 limit for "each accident." At issue in this case is whether Acuity's UIM coverage entitles Shimeta and Scherr to an additional $250,000 each from Acuity, or whether the payments Shimeta and Scherr received from nothing. To policy's Curley's resolve reducing insurer this clause, reduced issue, which we must states their recovery interpret that "[t]he to the UIM limit of liability shall be reduced by all sums . . . [p]aid because of the bodily injury by or on behalf of persons . . . who may be legally responsible." ¶2 We conclude that the reducing clause operates on an individual basis to reduce the $500,000 "each person" limit of liability by the $250,000 payment that Shimeta and Scherr each received from Curley's insurer. Shimeta and Scherr $250,000 each. court of appeals' reversal of the Consequently, Acuity owes Accordingly, we affirm the circuit court's1 grant of declaratory judgment for Acuity. I. ¶3 BACKGROUND Michael Shimeta was tragically killed and Terry Scherr was severely injured on November 22, 2018 when Douglas Curley The Honorable Jeffrey A. Conen of the Milwaukee County Circuit Court presiding. 1 2 No. lost control of his pickup truck on Highway 10 2020AP189 in Portage County, crossed the center line, flipped in the air, and landed on top of Shimeta's Jeep. It is undisputed that Shimeta and Scherr's injuries met or exceeded $1 million in damages. ¶4 Curley insurance policy was insured issued by under Farmers an automobile Insurance liability Company. The policy provided coverage up to a $250,000 "per person" limit of liability, and a $500,000 "per accident" limit of liability. In accordance with this policy, Farmers paid Shimeta and Scherr $250,000 each. ¶5 Shimeta and Scherr were also covered under a UIM policy that Acuity issued to Shimeta. The policy's liability limits for for UIM coverage are $500,000 $500,000 for "each accident." "each person" and The policy includes a reducing clause that states: "[t]he limit of liability shall be reduced by all sums . . . [p]aid because of the bodily injury2 by or on behalf of persons . . . who may be legally responsible." ¶6 The parties do not dispute that Scherr were insured under the UIM policy. that Curley's truck defined by the policy. was an "underinsured both Shimeta and Nor do they dispute motor vehicle" as In dispute is whether Acuity must still pay $250,000 each to Shimeta and Scherr, or whether the $500,000 in combined payments from Farmers reduced Acuity's policy limits to zero. In Acuity's policy, defined terms are in bold font. terms are underlined in this opinion. 2 3 Those No. ¶7 Acuity filed an action for declaratory 2020AP189 judgment, asking the circuit court to find that Acuity was not obligated to pay Shimeta and Scherr any UIM benefits under its policy because $500,000 Shimeta from and Scherr Farmers. had The already circuit received court a total granted of Acuity's motion, reasoning that Acuity's $500,000 maximum limit for "each accident" was reduced to zero by Farmers' combined payments to Shimeta and Scherr. The court of appeals reversed, concluding that the reducing clause operates on an individual basis to reduce the limit of liability for "each person" by the payment that "each person" insured under the policy received. We agree with the court of appeals and conclude that the clause reduces the "each person" limit by the payments an individual insured received for his or her injuries. II. ¶8 ANALYSIS This case requires the court to interpret the language of an insurance policy, which presents a question of law that we review de novo. Mau v. N.D. Ins. Rsrv. Fund, 2001 WI 134, ¶12, 248 Wis. 2d 1031, 637 N.W.2d 45. ¶9 Analyzing Acuity's UIM policy requires us to put the disputed UIM policy language in context. To do so, we first provide a brief overview of the purpose of UIM coverage and the principles we use when interpreting UIM policies. Next, we review the UIM policy language at issue in this case. We then conclude that the policy's reducing clause, when read in the context of the whole policy, reduces the limit of liability for "each person" by the payments 4 received by each individual No. insured. limit 2020AP189 We further determine that the policy's "each accident" of liability serves as an additional backstop, establishing the maximum amount that Acuity will pay out for any one accident. A. ¶10 UIM Background As a general matter, the purpose of UIM coverage is to protect "persons insured under that coverage who are legally entitled to recover damages for bodily injury, death, sickness, or disease vehicles." from owners or operators of underinsured Wis. Stat. § 632.32(2)(d) (2019-20).3 motor This court has identified two approaches to UIM coverage, both of which are permissible under Wis. Stat. § 632.32(4m). Mut. Ins. N.W.2d 690. Co., 2006 WI 81, ¶¶24-27, Welin v. Am. Fam. 292 Wis. 2d 73, 717 Policies that follow the "separate fund" approach provide a set amount of coverage for the insured's damages that exceed party. the amount the insured recovers the responsible State Farm Mut. Auto. Ins. Co. v. Langridge, 2004 WI 113, ¶16, 275 Wis. 2d 35, 683 N.W.2d 75. the from "limits-to-limits" approach——like Policies that follow Acuity's policy——provide "a predetermined, fixed level of UIM recovery that is arrived at by combining payments from all sources" legally responsible for the insured's damages. end, Wis. Stat. Welin, 292 Wis. 2d 73, ¶49. § 632.32(5)(i) allows insurers to To that write UIM policies that "provide that the limits under the policy" shall All subsequent references to the Wisconsin Statutes are to the 2019-2020 version unless otherwise indicated. 3 5 No. 2020AP189 be reduced by "[a]mounts paid by or on behalf of any person or organization that may be legally responsible for the bodily injury or death for which the payment is made." ¶11 While our UIM cases provide a helpful framework for interpreting policy language, we pause to note that a UIM policy is a contract, and "[w]here the language of the policy is plain and unambiguous, we enforce it as written . . . . avoid rewriting contract Danbeck the obligations v. that the Mut. Ins. construction parties as a WI undertake." We language 2001 not imposing Wis. 2d 186, 629 N.W.2d 150 (internal citations omitted). policy Co., did and 245 the Fam. by ¶10, interpret Am. contract This is to 91, reasonable insured would understand it, and if the language is ambiguous, we construe it in favor of the insured. Id. With these principles in mind, we turn to the language of the contract at issue in this case. B. ¶12 We begin our Policy Language review examining the Declarations page. of the insurance policy by We next look to the UIM grant of coverage, then we examine the definition of "underinsured motor vehicle," and finally we analyze the Limits of Liability section, which contains the reducing clause at issue in this case. ¶13 The policy's Declarations page lists the types of coverage the policy provides, including "Underinsured Motorists" coverage Accident." for "$500,000 The Each Person" Declarations page and does "$500,000 not provide Each any additional information about "Underinsured Motorists" coverage 6 No. 2020AP189 or what "Each Person" or "Each Accident" mean, so we turn next to the Underinsured Motorists Coverage section in Part IV of the policy for further clarification. ¶14 The Underinsured Motorists Coverage section first includes the following grant of coverage: We [Acuity] will pay damages for bodily injury which an insured person is legally entitled to recover from the owner or operator of an underinsured motor vehicle. Bodily injury must be sustained by an insured person and must be caused by accident and result from the ownership, maintenance, or use of the underinsured motor vehicle. Acuity does not dispute that: (1) Shimeta and Scherr were legally entitled to recover at least $1 million in damages for bodily injury from Curley; (2) Shimeta and Scherr were both "insured persons" under Acuity's policy; and (3) Shimeta and Scherr sustained injuries that were caused by the accident. Having established that both Shimeta and Scherr meet the initial requirements set out in the grant of coverage, we next examine the policy's definition of "underinsured motor vehicle." ¶15 The policy defines "underinsured motor vehicle" as a vehicle covered by an insurance policy with a "limit for bodily injury liability" that is "less than the limit of liability for this coverage." "underinsured Acuity does not dispute that Curley operated an motor vehicle." Curley's automobile liability insurance provided coverage up to a $250,000 "per person" limit of liability and a $500,000 "per accident" limit of liability. 7 No. Under a split-limits policy4 like Curley's, "an 2020AP189 insured's objectively reasonable expectation is that the phrase 'limit for bodily injury liability' means tortfeasor's liability policy." the per person limit of a Filing v. Com. Union Midwest Ins. Co., 217 Wis. 2d 640, 650, 579 N.W.2d 65 (Ct. App. 1998). ¶16 Although underinsured, it Acuity does maintains that not dispute Shimeta and that Curley Scherr are is not entitled to recover under the policy because, under the Limits of Liability section, the $500,000 in combined payments they received from Farmers reduced the policy limits to zero. relevant portion of the Limits of Liability section is The as follows: Limits of Liability 1. The Limit of Liability shown in the Declarations for each person for Underinsured Motorists coverage is our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of bodily injury sustained by any one person in any one accident. Subject to this limit per person, the Limit of Liability shown in the Declarations for each accident for Underinsured Motorists coverage is our maximum limit of liability for all damages for bodily injury resulting from any one accident. This is the most we will pay regardless of the number of: a. Insured persons; b. Claims made; Policies with different per person and per accident limits are sometimes referred to as "split-limits" policies. See Folkman v. Quamme, 2003 WI 116, ¶7, 264 Wis. 2d 617, 665 N.W.2d 857. 4 8 No. 2020AP189 c. Vehicles or premiums shown in the Declarations; or d. Vehicles involved in the accident. 2. The limit of liability shall be reduced by all sums: a. Paid because of the bodily injury by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid under Part I – Liability; and b. Paid or payable because of the bodily injury under any of the following or similar law: (1) Workers' compensation law; or (2) Disability benefits law. ¶17 Paragraph 1 of this section defines the "each person" and "each accident" limits set out in the Declarations page, establishing that those limits are the maximum that Acuity will pay for any one person in an accident, and for any one accident, respectively. limit is Paragraph 1 also states that the "each accident" subject includes a liability" to the reducing will be "each clause person" providing reduced by limit. that payments Paragraph "the from limit those 2 of legally responsible for the insured's damages. ¶18 The parties agree that, under paragraph 1 and the limits set in the Declarations page, Acuity will never pay more than $500,000 to any individual insured for any one accident. Additionally there is agreement that Acuity will never pay more than $500,000 total for any one accident, regardless of the number of insureds. The parties' sole dispute reducing clause in paragraph 2. C. The Reducing Clause 9 is over the No. ¶19 related 2020AP189 The parties dispute the meaning of two separate, but parts of the reducing clause: (1) "the limit of liability" and (2) "all sums . . . [p]aid because of the bodily injury." ¶20 Shimeta and Scherr argue that "the limit of liability" is the "each person" limit of liability. Alternatively, they argue that "the limit of liability" is ambiguous because it does not specify ambiguity which in favor Wis. 2d 186, ¶10. could refer limit to of applies, the and the insured. court See construes Danbeck, 245 Acuity argues that "the limit of liability" either the "each person" or "each accident" limit, "depending on the facts of the case," and in this case it is the "each accident" limit. ¶21 Regarding the phrase, "all sums . . . [p]aid because of the bodily injury . . ." Shimeta and Scherr argue that it means all sums paid because of the bodily injury suffered by the individual insured making the claim. Acuity argues that the phrase means all sums paid for all injuries suffered by any insureds injured in a single accident. ¶22 We agree with Shimeta and Scherr's interpretations and conclude that the reducing clause operates to reduce recovery on an individual basis. "each person" limit That is, the reducing clause reduces the for an insured 10 by all payments for the No. insured's injury. To explain why, we will 2020AP189 analyze the two phrases in turn.5 1. ¶23 "The Limit of Liability" We start with the phrase "the limit of liability." first inspection, this phrase appears to be ambiguous. policy has two called "Limits limits of liability——indeed, this On The section is of Liability," and paragraph 1 refers to the "each person" and "each accident" limit separately and in turn. But, unlike paragraph 1, the reducing clause does not specify whether "the limit of liability" refers to the "each person" limit or the "each accident" limit. Therefore, it is not immediately clear what "the limit of liability" means. ¶24 Ambiguity, as we have noted, is to be construed in favor of the insured. However, a phrase can seem ambiguous in isolation, unambiguous but become from the perspective of a reasonable insured when viewed within the context of a policy. See Badger Wis. 2d 61, Mut. Ins. Co. v. 647 N.W.2d 223. Schmitz, Here, 2002 there WI are 98, four ¶49, 255 possible interpretations of "limit of liability"——the phrase could mean: Although we analyze the two disputed phrases separately, we note that the phrases are interrelated and there are only two proposed readings of the clause as a whole. The first, favored by Shimeta and Scherr, is that the clause reduces the "each person" limit for an insured by all payments for the insured's injury. The second, favored by Acuity, is that the clause reduces the "each accident" limit by all payments made for all insureds' injuries. Neither party argues that the "each person" limit should be reduced by payments made on behalf of all insureds, or that the "each accident" limit should be reduced by payments made on behalf of just one insured. 5 11 No. 2020AP189 (1) both the "each person" and the "each accident" limit; (2) either the "each person" or the "each accident" limit depending on the facts of the case; (3) only the "each person" limit; or (4) only the "each accident" limit. four possible interpretations We analyze each of these and conclude that the phrase unambiguously refers to only the "each person" limit. ¶25 We first consider whether "the limit of liability" could mean both the "each person" and the "each accident" limit. In doing so we immediately see that "the limit of liability" (emphasis added) is phrased in the singular, rather than plural. The "common and ordinary meaning" of the singular term "the limit of liability" is one particular limit, rather than more than one. See Danbeck, 245 Wis. 2d 186, ¶10, ("The words of an insurance policy are given their common and ordinary meaning"); see also Filing, 217 Wis. 2d at 650 (holding that an unspecified "limit for bodily injury liability" in an Underinsured Motorist definition referred to the "per person" limit, rather than both limits). would From a reasonable insured's point of view, the limit refer to a singular limit of "each person" or "each accident," not both. ¶26 If Acuity meant to refer to more than one limit, it could use the word "limits," as it did in the title of the section ("Limits § 632.32(5)(i), clauses in of which their UIM Liability"). authorizes policies, 12 Wisconsin insurers also uses to the use Stat. reducing plural form No. "limits."6 2020AP189 Because Acuity did not refer to the plural form "limits," an insured is likely to understand that the reducing clause is referring to only one limit. ¶27 We next consider whether "the limit of liability" in the reducing clause refers to either the "each person" limit or "each accident" limit depending on the facts of the case. Acuity argues, "[w]hen there is more than one injured insured, paragraph 1 dictates that the 'limit of liability' to be reduced is the each accident limit." But neither paragraph 1 nor the reducing clause actually say that the limit of liability to be reduced changes depending on the number of injured insureds, and Acuity has not pointed us to anywhere else in the policy that does so.7 Wisconsin Stat. § 632.32(5)(i) states that "A policy may provide that the limits under the policy for uninsured motorist coverage or underinsured motorist coverage for bodily injury or death resulting from any one accident shall be reduced by any of the following that apply" (emphasis added). 6 The dissenting opinions assert that paragraph 1 of the Limits of Liability section establishes that the "limit of liability" is used in the singular to denote the most Acuity will pay depending on the number of insureds and chosen coverages. See Chief Justice Ziegler's dissent, ¶50; Justice Hagedorn's dissent, ¶61. But paragraph 1 does not do so——as stated previously, paragraph 1 uses "limit of liability" in the singular to describe the each person and each accident limit separately and in turn. Paragraph 1 simply sets out the rules we all agree on: (1) the each person "Limit of Liability" is the "maximum limit of liability . . . arising out of bodily injury sustained by any one person in any one accident," and (2) the each accident "Limit of Liability" is the "maximum limit of liability for all damages for bodily injury resulting from any one accident." Paragraph 1 reinforces that there are two limits of liability and does not answer the relevant question: which "limit of liability" is the reducing clause referring to? 7 13 No. ¶28 unclear Given how the a language reasonable of the insured reducing would 2020AP189 clause, understand it that is "the limit" is different depending on the facts of the case, much less figure out how the facts of a determine which limit would be reduced. particular case would As we have reasoned in previous UIM cases, "reducing clauses must be crystal clear in the context of the whole policy. Otherwise, insureds are not likely to understand what they are purchasing." Ins. Co., 255 Wis. 2d 61, ¶46. Badger Mut. There may, of course, be some variation in recovery depending on the facts of a particular case, but if the insurer intends for the coverage rules and definitions to vary, the insurer must make the rules governing that variation clear in its policy language so that the insured understands what coverage he or she is actually purchasing. See id. ¶29 the Because the term "limit of liability" is undefined in policy, Hirschhorn v. it is given its plain and Auto-Owners Ins. Co., 2012 Wis. 2d 761, 809 N.W.2d 529. ordinary WI 20, meaning. ¶28, 338 The reducing clause refers to "the limit" as opposed to "either limit" or "a limit," and it does not indicate in any way that the limit may vary. common, ordinary meaning of "the limit" that a reasonable is Therefore, the one single, particular limit. ¶30 Having decided insured would understand "the limit of liability" to refer to one particular limit of liability, rather than both limits or either limit, the next question is whether the phrase unambiguously refers to the 14 No. 2020AP189 "each person" limit, the "each accident" limit, or whether the phrase is ambiguous. We conclude that a reasonable insured would understand "the limit of liability" to unambiguously refer to the "each person" limit. ¶31 person" Reading "the limit of liability" to mean the "each limit harmonizes the reducing underinsured motor vehicle definition. clause and the The policy defines an underinsured motor vehicle as one whose "limit for bodily injury liability is . . . less than the limit of liability for this coverage." Both the definition and the reducing clause refer to "the limit of liability," and both compare the insured's limit of liability with the limit of the responsible party——the definition compares each limit in order to determine whether there is coverage, and the reducing clause compares each limit in order to determine the amount of recovery. clearly refers to limit, or both. in the UIM the each person limit, Neither section the each accident Importantly, Acuity concedes that the "limit" definition refers to the "each person" limit of liability——otherwise, Curley would not be underinsured as his policy had equal "each accident" limits and lower "each person" limits than Acuity's policy. ¶32 An insured would reasonably expect "the referred to in both sections to mean the same limit. sections referred to different understandably confused. limits, an insured limit" If these would be It makes little sense that a vehicle could be "underinsured" when its policy limits are compared to Acuity's UIM policy limits in 15 the definitions section, yet No. 2020AP189 treated as equally insured when those same limits are compared in the reducing clause.8 insured would reasonably In the absence of more specificity, an expect that when similar terms are similarly used to compare policy limits, those terms refer to the same limit. Therefore, we read the reducing clause's "limit of liability" to mean the "each person" limit, consistent with the UIM definition and consistent with what a reasonable insured would expect.9 Justice Hagedorn's dissent claims we put "too much stock" in harmonizing the underinsured motor vehicle definition with the reducing clause. See Justice Hagedorn's dissent, ¶70. However, it is well established that when the same or similar language is used in a contract or insurance policy, the language should be applied consistently. See Day v. Allstate Indem. Co., 2011 WI 24, ¶57, 332 Wis. 2d 571, 798 N.W.2d 199 (explaining that the insurer's proposed definition of a term is "inconsistent with how the term is used in the context of another policy provision"). Although both sections as a whole may perform different functions, they both use the same phrase, "limit of liability," in answering the same question——how do the insured's limits of liability compare with those of the responsible party? A reasonable insured would read these phrases consistently. 8 Similarly, Chief Justice Ziegler's dissent asserts that by interpreting the phrases consistently, we are creating a "requirement that a vehicle qualifying as 'underinsured' automatically means the insured receives payment." See Chief Justice Ziegler's dissent, ¶50. We implement no such requirement. There will still be situations in which an underinsured vehicle may not automatically qualify the insured for payment——when the insured's recovery is reduced by payments received from other sources, for instance. This interpretation is also consistent with Filing v. Com. Union Midwest Ins. Co., 217 Wis. 2d 640, 579 N.W.2d 65 (Ct. App. 1998), in which the court of appeals interpreted a UIM policy's underinsured motor vehicle definition. Like the court of appeals in Filing, which determined that the "limit for bodily injury liability" referenced in the definition was the 9 16 ¶33 The dissenting opinions' reading of No. 2020AP189 the reducing clause as referring to the maximum amount that Acuity will pay depending on the number of insureds and nature of the coverage is a logical way that an insurance policy could work. However, the language of this particular policy does not connect the dots. At best, the dissenting opinions provide us with an alternative reasonable interpretation of "limit of liability." When policy language is "susceptible to more than one reasonable interpretation," it is ambiguous. ¶10. Danbeck, 245 Wis. 2d 186, Ambiguity is resolved in favor of the insured, id., so the result is the same regardless. 2. ¶34 "All Sums Paid Because of the Bodily Injury" We now turn to the second disputed phrase in the reducing clause and conclude that "all sums . . . [p]aid because of the bodily injury" means payments made because of the bodily injury suffered by the individual insured, rather than aggregate payments for all bodily injuries suffered by all insureds. The clause states that the limit shall be reduced "by all sums" "[p]aid because of the bodily injury by or on behalf of persons or organizations who may be legally responsible." glance, "by immediately injury." all sums" qualified appears by the to be phrase expansive, "because of At first but it is the bodily The policy defines "bodily injury" as "bodily injury tortfeasor's "per person limit," we read the policy "from the perspective of what the insured as an individual, not insureds as a whole, could recover from the tortfeasor's liability carrier," and similarly conclude that the reducing clause refers to the "each person" limit. See Filing, 217 Wis. 2d at 649. 17 No. 2020AP189 to or sickness, disease or death of a person" (emphasis added). This definition uses the singular——referring to one person—— rather than the plural, which would encompass multiple injured people. Although (despite the singular phrasing) "bodily injury" does appear to be used elsewhere in the policy to refer to injuries suffered by multiple insureds,10 the reducing clause further uses an additional singular term, "the bodily injury" (as opposed to, for example "bodily injuries" or "any bodily injury"). Based on the singular word choice in the reducing clause, we conclude that "all sums . . . [p]aid because of the bodily injury" means all sums paid because of the bodily injury to a singular insured.11 ¶35 Like with the phrase "limit of liability," if we were to accept that an insured could also read "the bodily injury" broadly so insureds, that then it the referred phrase to would any be injury sustained ambiguous. We by all construe ambiguous language in favor of the insured, so the result here would be the same. ¶36 Danbeck, 245 Wis. 2d 186, ¶10. When reading the reducing clause as a whole, the most reasonable interpretation is that the "each person" limit shall Paragraph 1 of the Limits of Liability section defines the each accident limit as the "maximum limit of liability for all damages for bodily injury resulting from any one accident." 10 We are not the first state high court to come to this conclusion. See, e.g., Buell v. Am. Universal Ins. Co., 224 Conn. 766, 771, 621 A.2d 262 (1993) (determining that "the" bodily injury in a reducing clause "refers only to the claimant's bodily injury and not to the bodily injury of others"). 11 18 No. 2020AP189 be reduced by payments made because of the bodily injury to the insured making the claim. This reading does not make the "each accident" limit superfluous. The "each accident" limit remains a cap on what Acuity itself will ever pay for bodily injury resulting from any one accident. Here, Acuity will pay no more than that $500,000 limit. III. ¶37 CONCLUSION We affirm the court of appeals because we agree that the policy's reducing clause operates on an individual basis to reduce the "each person" limit of liability by the payment each insured individually received from Curley's insurance. By the Court.—The decision affirmed. 19 of the court of appeals is No. ¶38 dissent ANNETTE because KINGSLAND the ZIEGLER, majority C.J. reads 2020AP189.akz (dissenting). Acuity's policy as I no reasonable insured would, creating coverage out of thin air that was never agreed upon. Acuity's UIM insurance policy is simple. Acuity agrees to pay up to a certain limit in the event its insured is injured in an accident with a driver whose vehicle is underinsured: up to $500,000 per $500,000 for any one accident. person, but no more than This is one among five limits, each listed in the "Limits of Liability" section of Acuity's policy. The per person and per accident limits work together as one collective limit to Acuity's liability. reduced "by all sums" paid by or on But this limit is behalf of the legally responsible party (the "tortfeasor") so the insured does not receive duplicate payments. Because the insureds in this case received from the tortfeasor a combined amount equal to Acuity's limit, the insureds received exactly the amount they would have gotten from Acuity if the tortfeasor had no insurance at all, and Acuity's liability is reduced to zero. ¶39 But the majority complicates Simple as that. this simple policy. Though Acuity's policy discusses the per person and per accident limits collectively as one singular "limit of liability," the majority reads them separately, ignoring the organization of the "Limits of Liability" section. structure and The majority then continues to overcomplicate Acuity's policy, imposing an atextual requirement that a vehicle qualifying as "underinsured" means the insured will receive payment under Acuity's policy in 1 No. every instance. 2020AP189.akz This is not how Acuity's policy operates. I respectfully dissent. I ¶40 "We interpret the provisions of an insurance policy using the same principles applicable to contracts generally." Kemper Independence Ins. Co. v. Islami, 2021 WI 53, ¶16, 397 Wis. 2d 394, 959 N.W.2d 912. "Where the language of a contract is unambiguous and the parties' intentions can be ascertained from the face of the contract, we give effect to the words they employed." Steadfast Ins. Co. v. Greenwich Ins. Co., 2019 WI 6, ¶21, 385 Wis. 2d 213, 922 N.W.2d 71. policy is plain and unambiguous, "Where the language of the we enforce it as written, without resort to rules of construction or principles in case law." Fontana Builders, Inc. v. Assurance Co. of Am., 2016 WI 52, ¶37, 369 Wis. 2d 495, 882 N.W.2d 398 (quoting Danbeck v. Am. Fam. Mut. Ins. Co., 2001 WI 91, ¶10, 245 language in Wis. 2d 186, 629 N.W.2d 150). ¶41 We isolation. clause must read policy context, not in "Sometimes it is necessary to look beyond a single or sentence agreement." Wis. 2d 617, to Folkman 665 capture v. the Quamme, N.W.2d 857. This policy's organization and structure. essence 2003 may WI of an 116, require insurance ¶21, 264 examining a Gohde v. MSI Ins. Co., 2004 WI App 69, ¶12, 272 Wis. 2d 313, 679 N.W.2d 835 ("We first look at the organization and structure of the policy."); Remiszewski v. Am. Fam. Ins. Co., 2004 WI App 175, ¶24, 276 Wis. 2d 167, 687 N.W.2d 809 ("We further conclude that neither 2 No. 2020AP189.akz the structure and organization of American Family's policy, nor any provision therein, renders the reducing clause contextually ambiguous."). ¶42 The entire "Limits of Liability" section from Acuity's policy, including the reducing clause, is reproduced below: Limits of Liability 1. The Limit of Liability shown in the Declarations for each person for Underinsured Motorists coverage is our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of bodily injury sustained by any one person in any one accident. Subject to this limit for each person, the Limit of Liability shown in the Declarations for each accident for Underinsured Motorists coverage is our maximum limit of liability for all damages for bodily injury resulting from any one accident. This is the most we will pay regardless of the number of: 2. a. Insured persons; b. Claims made; c. Vehicles or premiums Declarations; or d. Vehicles involved in the accident. shown in the The limit of liability shall be reduced by all sums: a. Paid because of the bodily injury by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid under Part I – Liability; and b. Paid or payable because of the bodily injury under any of the following or similar law: (1) Workers' compensation law; or 3 No. (2) 2020AP189.akz Disability benefits law. 3. No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and Part I – Liability, Part II – Expenses for Medical Services or Part III – Uninsured Motorists coverage provided by this policy. 4. We will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible. 5. We will not make a duplicate payment to the extent amounts are paid or payable because of the bodily injury under any of the following or similar law: a. Workers' compensation law; or b. Disability benefits law. Accounting for the structure and organization of the entire "Limits of Liability" section in Acuity's UIM policy, it becomes clear that the reducing clause reduces both the per person limit and the per accident limit. ¶43 The section is contains five paragraphs. labeled "Limits of Liability" and Each paragraph in some way limits Acuity's liability to the insured. The first paragraph does so with reference to the per person and per accident limits; the second paragraph being the reducing clause; and the last three limit liability for various forms of duplicate payments. Each one of these paragraphs thus operates as a limit to Acuity's liability, explaining "Limits." Each paragraph counts as one individual "limit of liability." why the section title uses the plural This also explains why the reducing clause states 4 No. 2020AP189.akz "[t]he limit of liability," in the singular, "shall be reduced." It is because everything described in the first paragraph is one singular "limit of liability" for purposes of the "Limits of Liability" section. ¶44 Paragraph Immediately person after limit followed by and the 1.'s the the own language subparagraph per accident statement, "This confirms this reading. describing both the limit, is there the is most per a break we will pay . . . ." The break indicates that "the most [Acuity] will pay" everything is subparagraph: described in the preceding both the per person limit and per accident limit, which the policy describes collectively. Together, they form one singular "limit of liability" listed among other limits in the "Limits of Liability" section. Because the per person limit and per accident limit constitute one "limit of liability," the reducing clause requires that both of them be reduced "by all sums" "[p]aid because of the bodily injury." II ¶45 Nowhere does the majority grapple with the "Limits of Liability" section's structure and organization. Its analysis never even acknowledges the fact that the "Limits of Liability" section contains three additional paragraphs after the reducing clause. This leads the majority to instead rely on a myopic reading of the policy that in no way reflects how a reasonable insured would understand it. ¶46 insureds' The majority distorts Acuity's policy to maximize the recovery beyond what 5 was bargained for. After No. 2020AP189.akz incorrectly concluding that the reducing clause reduces either the per person or the person accident limit, but not both, the majority determines that "the limit" in "the limit of liability" must be the same both in the reducing underinsured motor vehicle definition. clause and in Majority op., ¶31. the The majority reasons, "It makes little sense that a vehicle could be 'underinsured' when its policy limits are compared to Acuity's UIM policy limits in the definitions section, yet treated as equally insured when reducing clause." ¶47 those same limits are compared in the Id., ¶32. The majority conflates status as "underinsured" with the need for payment.1 vehicle is Under Acuity's policy, a tortfeasor's "underinsured" when the associated liability insurance policy's limit is "[l]ess than the limit of liability for this coverage." mean the UIM A vehicle being "underinsured" does not policyholder payment from his insurer. policy provides less automatically must receive some All it means is that the tortfeasor's coverage than the insured's policy. Whether the tortfeasor's policy will ultimately pay the same amount as an insured would receive under his own UIM policy is a different comparison, question it may entirely. appear After that there a limits-to-limits is some set of circumstances where a tortfeasor's policy limit will not provide the same amount of coverage as the insured's UIM policy. But, as is the case here, the insured may still receive from the Justice Hagedorn also identifies this error, a criticism on which I expand here. See Justice Hagedorn's dissent, ¶¶7071. 1 6 No. 2020AP189.akz tortfeasor the same amount he would have received under his own UIM policy even if the tortfeasor's policy limit is "[l]ess than the limit of liability for" the insured's UIM coverage. The majority rather, equates insurance with payment even where such payment is unnecessary.2 ¶48 The correct result is straightforward. Acuity's liability is limited to $500,000 for any one insured, but no more $500,000 for any one accident. caused "bodily policy. Each $500,000. insurer injury" insured's The injuries a liability had $500,000 per accident. received to only two A singular, tragic accident people damages were from caused limit of insured under their injuries exceed tortfeasor whose by a $250,000 per Acuity's person and Thus, both of the insureds in this case $250,000 because total payments reached the tortfeasor's per accident limit. Under Acuity's policy, because the per reducing clause treats the person and per accident limits as one collective "limit of liability," they are both reduced. because Both insureds received a combined total of $500,000 of a single accident, so the per accident limit is reduced to zero, meaning there is no coverage remaining for this accident. The majority adds more confusion by attempting to ease this concern with the fact that payment may still be unnecessary "when the insured's recovery is reduced by payments received from other sources." Majority op., ¶32 n.8. Following the majority's logic, no payment is necessary when the insured receives a full recovery from the tortfeasor plus "other sources," but payment is somehow required when the insured receives the same amount from the tortfeasor alone. Again, no reasonable insured would understand Acuity's policy to operate this way. 2 7 No. ¶49 2020AP189.akz The fact that the tortfeasor's per person limit caused his vehicle to qualify as "underinsured" under Acuity's policy does not change this result. The vehicle was underinsured because, due to Acuity's limits-to-limits comparison approach, it was possible that the insureds might not receive an amount equivalent to the amount they would have received under Acuity's UIM policy. If one insured suffered more than $250,000 in damages and the other suffered less, this would mean that the insured with more damages would recover less from the tortfeasor than he would from Acuity under its UIM policy. In this situation, the tortfeasor's vehicle would be underinsured, and payment by Acuity would be necessary. tortfeasor's insureds the liability same insurance amount the It is possible that the would insureds not have would paid receive the under Acuity's policy, but that is not the case here, so payment by Acuity is not necessary. There is no need to read in confusion to reach this sensible result. III ¶50 per Acuity's policy is simple and straightforward. accident and per person limits operate together as The one collective "limit of liability" to establish the most Acuity might pay. Because the reducing clause reduces "the limit of liability" "by all sums" paid to the insureds by the tortfeasor, each component part of that collective limit likewise reduces. In this case, the insureds received from the tortfeasor the exact amount they would have under Acuity has no remaining liability. 8 Acuity's policy, meaning But the majority eschews No. 2020AP189.akz this simple reading in favor of a complex one that no reasonable insured would requirement automatically understand. that means a It vehicle the also unwittingly qualifying insured receives as creates a "underinsured" payment. This is simply not how Acuity's policy operates. ¶51 For the foregoing reasons, I respectfully dissent. ¶52 I am authorized to state that Justice REBECCA GRASSL BRADLEY joins this dissent. 9 No. ¶53 BRIAN unfortunate HAGEDORN, passing, J. Michael (dissenting). Shimeta motorist (UIM) coverage from Acuity. agreed to $500,000 pay per accident. claims person, up to but no a Before purchased his underinsured In that policy, Acuity maximum more 2020AP189.bh limit than of liability: $500,000 total per The operative language and design of these policies is standard. And basic logic tells us that the per accident limit will reduce the amount individuals can recover in multiperson accidents. In practice, this means that the recovery for any individual under Shimeta's policy with Acuity may not be the full $500,000 if multiple insureds are injured. Everyone agrees that this is how the policy works. ¶54 The UIM policy also has a standard reducing clause. The whole concept of this kind of UIM coverage combined with a reducing clause is for an insured to obtain "a predetermined, fixed level of UIM recovery that is arrived at by combining payments" "from all legally responsible sources." Fam. Mut. Ins. Co., 2006 WI 81, ¶49-50, 292 N.W.2d 690 (quoting another source). In Welin v. Am. Wis. 2d 73, 717 other words, the insured has agreed to be paid a specific amount——first from other legally responsible parties, with any remaining amounts due coming from Acuity. So the reducing clause functions consistent with the rest of the policy. ¶55 But the majority somehow finds that payments from the tortfeasor's insurer should count as a reduction against only the per person complexity where limit. none In is so found, 1 doing, the leading it majority to creates misread the No. policy. 2020AP189.bh In the end, the insureds here do not receive a fixed level of UIM recovery arrived at by combining payments from all legally responsible sources. Shimeta's policy accident. This may be good for Shimeta's estate and his injured passenger, but promises Instead, they receive double what it is not as a what total the payout policy for any provides. one I respectfully dissent.1 I. ¶56 THE POLICY We begin with the policy language.2 The declarations page of the policy summarizes the coverage Shimeta purchased. Multiple coverages are listed in the standard way, as providing a certain payout for "Each Person" and a second amount for "Each Occurrence" or "Each Accident." For example, Shimeta purchased uninsured motorist coverage for bodily injury in the amount of $500,000 per person and $500,000 per accident. And as relevant here, the UIM coverage is "$500,000 Each Person" and "$500,000 Each Accident." I understand Chief Justice Ziegler's dissent to make largely the same arguments I present here, and therefore I substantially agree with it. 1 Because insurance policies are contracts, our primary goal in interpreting them is "to give effect to the intentions of the parties." Wadzinski v. Auto-Owners Ins. Co., 2012 WI 75, ¶11, 342 Wis. 2d 311, 818 N.W.2d 819. "The parties' intentions are presumed to be expressed in the language of the policy." Id. We therefore begin the inquiry with the policy's language. See, e.g., Secura Ins. v. Lyme St. Croix Forest Co., LLC, 2018 WI 103, ¶17, 384 Wis. 2d 282, 918 N.W.2d 885. "Generally, we interpret a policy's terms as they would be understood from the perspective of a reasonable person in the position of the insured." Id. 2 2 No. ¶57 comes 2020AP189.bh The relevant policy language in the UIM endorsement under the bolded3 heading "Limits of Liability" and provides in relevant part: 1. The Limit of Liability shown in the Declarations for each person for Underinsured Motorists coverage is our maximum limit of liability for all damages, including damages for care, loss of service or death, arising out of bodily injury sustained by any one person in any one accident. Subject to this limit for each person, the Limit of Liability shown in the Declarations for each accident for Underinsured Motorists coverage is our maximum limit of liability for all damages for bodily injury resulting from any one accident. This is the most we will pay regardless of the number of: a. Insured persons; b. Claims made; c. Vehicles or Declarations; or premiums shown in the d. Vehicles involved in the accident. 2. The limit of liability shall be reduced by all sums: a. Paid because of the bodily injury by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid under Part I – Liability; and b. Paid or payable because of the bodily injury under any of the following or similar law: (1) Workers' compensation law; or (2) Disability benefits law. Following our style guide, bolded terms in the policy are underlined in this dissent. 3 3 No. ¶58 section Several uses observations the phrase are "limit in of order. 2020AP189.bh This liability" entire throughout. Paragraph 1 uses that phrase four times, and refers back to the amount itemized in the declarations. the most an insurer will pay, The policy explains that called the "maximum limit of liability," will turn on the policy coverages purchased and the number of insureds entitled to payment for a single accident. One limit is purchased. Acuity by the "each person" coverage amount And the "each accident" limit is the maximum limit will accident." governed pay for bodily injury "resulting from any one This means that when two or more persons are injured in one accident, the "each accident" limit could, depending on the policy purchased, operate as a cap that limits the recovery for any one insured. And if that wasn't plain enough——because that pattern is how this whole policy operates——the paragraph doubles down and declares that no matter how many insured persons are injured, claims are made, or vehicles are involved or covered, the per accident limit is "the most we will pay regardless." ¶59 This UIM coverage, then, works together as a seamless, integrated, perfectly understandable whole. If this were a $100,000 per person, $300,000 per accident policy, for example, the per person limit might be the more commonly limit, and the per accident limit reached less often. applicable But this is a $500,000 per person and $500,000 per accident policy. So here, the per accident limit may come into play more often than a policy with a different mix of coverages. 4 While the coverage No. 2020AP189.bh purchased and nature of an accident will dictate how the math works, the policy will always have a definitive maximum limit of liability——a dollar figure that serves as a cap on Acuity's liability. This limit need not be one or the other. For example, in this $500,000 per person and per accident policy, where one insured is injured in the same accident, the "limit of liability" is $500,000. There's no need to choose between the two limits. The point is, there will always be a fixed dollar amount is that the most Acuity will pay, however it is calculated. ¶60 This can be seen in a straightforward way in the same page of the policy as the "Limits of Liability" section. UIM policy provides that other applicable could likewise reduce the amount owed. insurance The coverage Under paragraph 3 of the "Other Insurance" section, the policy says its obligation to pay primary or liability" excess under coverage the will policy. In extend other to "our words, limit the of policy understands there will always be a fixed dollar "limit"——phrased in the singular——that will be owed to the insured. Whether that limit will be established by the per person limit or the per accident limit will again depend on the coverages purchased and the number of insureds that are injured in any one accident. ¶61 Turning to the reducing clause in paragraph 2 of the "Limits of Liability" section, it too employs the same language as paragraph 1. It refers to the "limit of liability." already know what that phrase means: And we it is the most Acuity will pay, whether determined by the per person or per accident limit 5 No. 2020AP189.bh (or both if identical), depending on the chosen coverages and number of injured persons. And the reducing clause says that this limit "shall be reduced by all sums" paid by someone or some entity "who may be legally responsible"——like the tortfeasor who caused the accident in this case.4 ¶62 Applying the policy is straightforward. The reducing clause operates to reduce Acuity's liability under its policy, whatever that limit might be. In this case, the tortfeasor's insurer paid $500,000 in combined payments to Shimeta's estate and the passenger in his car; both are insureds under the policy seeking coverage for bodily injury resulting from one accident. And since Acuity agreed to pay no more than $500,000 for any one accident under the terms of this particular policy, Acuity's "limit of liability" is reduced per the reducing clause to zero. ¶63 this. A reasonable insured would not be confused by any of It is exactly how this UIM policy is designed to work. Shimeta bargained and paid for this precise level of coverage. Once again, the whole point of this type of "limits-to-limits" UIM policy is to "put the insured in the same position he or she would have occupied had the tortfeasor's liability limits been the same as the UIM limits purchased by the insured."5 Welin, The policy further says that it shall be reduced by anything paid or payable under workers compensation law, disability benefits law, or any similar law. 4 If the tortfeasor in this case had the liability limits Shimeta purchased——$500,000 per person and $500,000 per accident——then Shimeta and his passenger would have received the same thing they were given here: $500,000 total. That's why Shimeta's estate already received exactly what he originally bargained for. 5 6 No. 292 Wis. 2d 73, ¶26. The policy self-consciously 2020AP189.bh offers "a predetermined, fixed level of UIM recovery that is arrived at by combining payments from all sources." Id., ¶49. The reducing clause ensures that the insureds receive only the fixed sum they bargained for. Nothing more, nothing less. It does this by promising to pay up to the limit of liability, minus payments from other responsible parties or under other relevant laws providing compensation.6 II. ¶64 THE MAJORITY'S MISTAKES The majority, however, misses all of this and designs a more generous insurance policy than the one Shimeta bargained for. The majority begins its analysis of the reducing clause by rightly focusing on the phrase "limit of liability." op., ¶23. with the stumped. But instead of interpreting that phrase consistent rest of the policy, the majority proclaims itself So it hypothesizes four possibilities for what it could mean. refer to: Majority The majority reasons "Limit of liability" could "(1) both the 'each person' and the 'each accident' limit; (2) either the 'each person' or the 'each accident' limit depending on the facts of the case; (3) only the 'each person' limit; or (4) only the 'each accident' limit." Id., ¶24. In fact, the policy provides that Acuity "will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons . . . who may be legally responsible." The majority's conclusion results in exactly the type of duplicate payment the policy prohibits. 6 7 No. ¶65 2020AP189.bh The majority first rejects the idea that both limits are referred to because the reducing clause uses the singular "limit of liability." Id., ¶¶25-26. Moving on to option two, the majority explains that it can't be right either because "neither paragraph 1 nor the reducing clause actually say that the limit of liability to be reduced changes depending on the number of injured insureds." Paragraph 1 immediately Id., ¶27. preceding the Except that it does. reducing clause uses "limit of liability" in the singular for both, and explicitly says that the "maximum limit of liability for all damages . . . resulting from any one accident" supersedes the per person limit. The per accident limit is the maximum Acuity "will pay regardless of the number of . . . Insured persons" who are injured and entitled to recovery. ¶66 The majority then postulates a reasonable insured is simply not going to understand which limit applies. op., ¶28. I suppose it's true that few insureds truly grasp how their policies work. reading Majority material for Insurance policies tend not to be evening most people. But this isn't science, and a reasonable insured wouldn't be confused. rocket Shimeta bargained for a maximum recovery defined as $500,000 per person, and at most, $500,000 per accident regardless of the number of injured persons. The entire policy issued to Shimeta, including standard liability insurance, uninsured motorist coverage, and the UIM endorsement contain the same structure. Under the majority's logic, reasonable people just can't understand what it means for a policy to have a maximum dollar limit (the "limit 8 No. 2020AP189.bh of liability") that can vary depending on coverages purchased and the facts of a case. ¶67 since The the majority "limit singular, it of can compounds its liability" in only refer to errors the "one by positing that reducing clause is particular limit of liability, rather than both limits or either limit." Id., ¶30. It then concludes we must choose the "each person" limit because that harmonizes the definition underinsured motor vehicles. with Id., ¶31. the definition of Since caselaw, rather than a definition in the policy, establishes that a vehicle is underinsured, the majority concludes we must read it the same way. Id., ¶32. Finally, the majority misconstrues the policy further by saying that because the reducing clause uses the phrase "the bodily injury" in the singular, it should be understood as reducing payments only for a singular insured's per person coverage. liability" or "the Any other proposed reading of "limit of bodily injury" would be ambiguous, the majority reasons, and therefore read in favor of the insured. Id., ¶¶33, 35. ¶68 None of this correct. First, neither basic grammar nor logic dictate that because "limit of liability" is used in the singular, only one of the two possible limits must be referred to. Rather, the policy is consistent that there will always be a maximum dollar limit to Acuity's liability depending on the coverages purchased for per person and per accident, and depending on the facts of the case. 9 No. ¶69 2020AP189.bh Second, the majority's emphasis on "the bodily injury" is likewise atextual. The policy always uses "bodily injury" in the singular and bolded. This is because "bodily injury" is a defined term in the policy referring to a type of damage that triggers liability and coverage. The policy does the same thing with type "property damage"——another of damage covered in the policy and is separately defined. throughout insured the persons rest are of the policy, injured, the even may be Both here and where phrase always bolded and used in the singular. that two "bodily or more injury" is The majority's emphasis on the definite article "the" does not transform this standard definition-invoking language into a clue that the reducing clause is meant to operate in a way totally divorced from the entire operation of this fixed coverage UIM policy. ¶70 Finally, the majority puts too much stock in the fact that whether underinsurance is triggered looks only to the per person limit. Acuity agrees based on a court of appeals decision that the tortfeasor's limit should be compared with the policy's per person limit for purposes of answering the initial question of whether the policy is triggered. See Filing v. Com. Union Midwest Ins. Co., 217 Wis. 2d 640, 649-50, 579 N.W.2d 65 (Ct. App. 1998) (holding that the tortfeasor's liability limits should be compared with the per person limits under the policy). But that means little here. The reasoning of the court of appeals in Filing rested less on a careful interpretation of the language than on its sense that the insured expected potential coverage apart from how many are injured in an accident. 10 Id. No. It also discussed the many "absurd results" 2020AP189.bh that occasioned by interpreting the policy the other way. & n.3. would be Id. at 647 While I am not suggesting the outcome was incorrect, Filing has little to say analytically about the question presented here. ¶71 Whether different Acuity question must pay altogether and from triggered in the first instance. in what whether amount UIM is coverage a is To determine if any portion of the coverage is reduced, we must look to the relevant policy language. And as we've explained, paragraph 1——directly before the reducing clause in paragraph 2——specifically references both limits. "[A] reasonable reducing clause section of in the insured [paragraph UIM 2] would of endorsement understand the Limit qualifies of the that the Liability insurer's obligation to pay the maximum limit of liability as described in . . . [paragraph 1]." ¶23, 281 Wis. 2d 228, Ruenger v. Soodsma, 2005 WI App 79, 695 N.W.2d 840. Thus, whether UIM coverage is triggered in the first instance isn't doing the analytical work the majority thinks it is. III. ¶72 satisfy While insurers can draft policies moving forward that the misinterprets state. CONCLUSION majority's today perplexity, will impact the language current policies the majority across the The majority misses the mark by trying to figure out which limit the phrase "limit of liability" in the reducing clause applies to. The answer 11 is apparent: The policy No. consistently limit, a describes "limit of itself as liability," having which one could 2020AP189.bh maximum be dollar triggered by either of the two limits depending on the coverages purchased and the facts of the case. that Acuity's liability And the reducing clause provides limit must be reduced when other responsible parties provide compensation. ¶73 Here, Shimeta purchased UIM coverage in the amount of $500,000 per person and $500,000 per accident. An unfortunate accident occurred, his injured, both Shimeta's estate leaving insureds and his Shimeta under the injured from the tortfeasor's insurance. dead and policy. passenger passenger Collectively, received $500,000 The reducing clause requires that this $500,000 be deducted from Acuity's limit of liability, which under these facts and this coverage is $500,000 for this one accident. Therefore, the predetermined, fixed sum Shimeta bargained for was paid out, and Acuity has no further liability under the policy. ¶74 I respectfully dissent. I am authorized to state that Justice REBECCA GRASSL BRADLEY joins this dissent. 12 No. 1 2020AP189.bh
Primary Holding

The Supreme Court affirmed the court of appeals' opinion reversing the decision of the circuit court granting declaratory judgment for Acuity in this insurance dispute arising from a fatal automobile accident, holding that the court of appeals did not err.


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