The Colorado Court of Appeals issued its opinion in Hansen v. American Family Mutual Insurance Co. on Thursday, December 19, 2013.
Personal Injury—Insurance Policy—Underinsured Motorist Coverage—Ambiguity—CRS § 10-3-1115—Covered Benefit.
Claimant was injured while riding as a passenger in her boyfriend’s vehicle. After settling a claim with the boyfriend’s insurer for policy limits, she pursued an underinsured motorist (UIM) claim with American Family Mutual Insurance Company. American Family denied the claim because claimant did not reside with the named insureds (her parents). Claimant filed an action against American Family, asserting a breach of contract claim, common law claim, and statutory claim.The trial court entered judgment in favor of claimant on her statutory claim and awarded her attorney fees and costs. Claimant filed a motion to amend the judgment and requested that the court award a statutory penalty of two times the covered benefit, or $150,000. The trial court granted claimant’s motion.
On appeal, American Family argued that the trial court erred in concluding that the insurance policy was ambiguous and by referring its construction to the jury. The Court of Appeals disagreed. American Family prepared and delivered to claimant a lien holder statement, which created an ambiguity in the insurance policy as to the identity of the named insured, because it was inconsistent with the declaration pages maintained by the insurance company. Therefore, the trial court did not err in reaching this conclusion.
American Family also argued that because claimant’s claim for coverage under the policy was “fairly debatable,” it cannot be found to have unreasonably delayed or denied payment of a benefit under the statutory claim as a matter of law. The Court disagreed. The policy was arguably unambiguous as to the named insured, so American Family was not entitled to judgment as a matter of law on claimant’s statutory claim.
Furthermore, the court did not err in awarding claimant two times the covered benefit. According to CRS § 10-3-1115, the award to be made to the prevailing claimant is not the damages suffered by the claimant caused by the delay in the payment of the benefit; rather, it is two times the covered benefit that was unreasonably delayed or denied. There is no dispute that the covered benefit under the reformed policy was $75,000. Therefore, claimant correctly received $150,000. The judgment was affirmed.
Summary and full case available here.