{
  "id": 8564714,
  "name": "REBECCA SUMNER WOODS Executrix of the Estate of John C. Woods, Deceased v. NATIONWIDE MUTUAL INSURANCE COMPANY",
  "name_abbreviation": "Woods v. Nationwide Mutual Insurance",
  "decision_date": "1978-08-29",
  "docket_number": "No. 67",
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  "casebody": {
    "judges": [],
    "parties": [
      "REBECCA SUMNER WOODS Executrix of the Estate of John C. Woods, Deceased v. NATIONWIDE MUTUAL INSURANCE COMPANY"
    ],
    "opinions": [
      {
        "text": "SHARP, Chief Justice.\nCondition 4 of both the Spencer and Woods policies provides that the medical provisions of Part III \u201capply separately\u201d to each automobile insured therein. Relying upon this provision plaintiff contends that as to each policy she is entitled to treat the applicable limit on medical payments liability as applying to each car for which separate premiums have been paid, and to compute the amount recoverable by multiplying the respective liability limitation by the number of \u201cowned automobiles.\u201d Thus, she argues, she is entitled to payments of $1,000 for each of the three cars covered by the Spencer policy and $500 for each of the two cars named in the Woods policy, a total of $4,000. Conceding its liability for $1,000 and for $500 under the respective policies, defendant has paid plaintiff $1,500. She now seeks to recover the $2,500 she contends is still owing.\nThe general principles of construction employed to divine the meaning of an insurance contract are well summarized in Wachovia Bank & Trust Company v. Westchester Fire Insurance Company, 276 N.C. 348, 354-55, 172 S.E. 2d 518, 522-23 (1970), a case in which the parties argued contentions very similar to those of the parties in this case. As with all contracts, the goal of construction is to arrive at the intent of the parties when the policy was issued. Where a policy defines a term, that definition is to be used. If no definition is given, non-technical words are to be given their meaning in ordinary speech, unless the context clearly indicates another meaning was intended. The various terms of the policy are to be harmoniously construed, and if possible, every word and every provision is to be given effect. If, however, the meaning of words or the effect of provisions is uncertain or capable of several reasonable interpretations, the doubts will be resolved against the insurance company and in favor of the policyholder. Whereas, if the meaning of the policy is clear and only one reasonable interpretation exists, the courts must enforce the contract as written; they may not, under the guise of construing an ambiguous term, rewrite the contract or impose liabilities on the parties not bargained for and found therein. Plaintiff\u2019s appeal must be considered with these principles of construction in mind.\nIn its unpublished decision the Court of Appeals accepted the defendant\u2019s contention that this case is controlled by Wachovia Bank & Trust Company v. Westchester Fire Insurance Company, supra (hereinafter cited as Wachovia v. Insurance Co.) and concluded that \u201cthe judgment appealed from is consistent with the holding ... in that case. . . .\u201d Accordingly, it affirmed the trial court. Plaintiff apparently concedes the application of Wachovia v. Insurance Co. to the interpretation of the Spencer policy, but urges this Court to reconsider that opinion. She also contends that the policy provision construed in Wachovia v. Insurance Co. is entirely different from the one in the Woods policy under which she claims. We will consider each of these arguments in turn.\nAlthough the Spencer policy is practically identical with the one construed by this Court in Wachovia v. Insurance Co., a brief review of that case will demonstrate that it need not be 'reconsidered to resolve plaintiff\u2019s claim under the Spencer policy. In Wachovia v. Insurance Co. the plaintiff was the administrator of the estate of Herbert Barnes, the named insured to whom defendant Westchester Fire Insurance Company had issued a comprehensive automobile policy covering two vehicles, a Pontiac automobile and a Ford pickup truck. Separate premiums were paid for the coverage on each vehicle and both qualified as \u201cowned automobiles\u201d within the meaning of the policy. A provision of that policy purported to limit medical payments liability to $5,000, but it also included an \u201capply separately\u201d clause (Condition 4 in that policy too).\nBarnes died from injuries received in a head-on collision with another vehicle while he was driving the \u201cnamed\u201d Pontiac. In a suit on the medical payment provisions of the policy the plaintiff, Barnes\u2019 executor, argued that the \u201capply separately\u201d language could reasonably be construed as creating two independent, identical contracts for each vehicle for which separate premiums had been paid, and that the limitation provision applied separately to claims under each of these contracts. Had Barnes had two separate policies identical to the one issued by that defendant, he would have qualified under Division 1 of each of those contracts for medical payments coverage, thus the plaintiff there sought to aggregate, or \u201cstack,\u201d the limitation provisions so as to render the defendant liable for the sum of the medical payments protection provided by each hypothetical policy. This Court rejected the independent contract construction on the facts of that case.\nThe faulty reasoning underlying plaintiff\u2019s claim under the Spencer policy can best be demonstrated by assuming, arguendo, that in Wachovia v. Insurance Co. this Court had adopted the construction of the \u201capply separately\u201d clause put forward by the plaintiff in that case, that is, that the \u201capply separately\u201d provision created independent identical contracts for each car for which separate premiums had been paid. On the facts in this case Cynthia Woods was neither the \u201cnamed insured\u201d nor his relative. She was, however, operating the Volkswagen, with the permission of the \u201cnamed insured.\u201d Further, the Volkswagen, by virute of the separate premiums paid, was an \u201cowned automobile\u201d within the meaning of the Spencer policy.\nUnder Division 2, subsection (a) of this contract, defendant agreed to extend medical payments coverage to nonrelatives of the \u201cnamed insured\u201d for bodily injury \u201ccaused by accident, while occupying the owned automobile\u201d with the permission of the \u201cnamed insured.\u201d (Emphasis added.) Thus, the coverage extended by this provision is explicitly limited to that purchased for the \u201cowned automobile\u201d occupied at the time of collision. One cannot construe this language to mean that nonrelatives receive protection by virtue of the premiums paid for the other vehicles mentioned in the policy which were not occupied by the injured party. There is nothing ambiguous about this language; it ties coverage to specific vehicles. Plaintiff, therefore, is not entitled to collect additional payments under the Spencer policy.\nWachovia v. Insurance Co. has no application to plaintiff\u2019s claim under the Spencer policy. Had Spencer obtained three separate, identical insurance policies for each of his vehicles, still claimant could recover medical payment expenses only under the Volkswagen policy up to the applicable limit of $1,000. She could not qualify for coverage under the policies issued for the other cars for the simple reason she could occupy only one owned automobile at a time. Hence, no issue of limitation would arise as to those claims. Plaintiff here has overlooked this distinction between qualifying for coverage under a policy in the first instance, and being bound by subsequent limitations imposed upon the coverage extended.\nCynthia Woods\u2019 relationship to the \u201cnamed insured\u201d in the two policies involved here is quite different, and different policy provisions bear upon her right to medical payments. As a member of the \u201cnamed insured\u2019s\u201d family within the meaning of the Woods policy (Part III, Coverage G, Division 1), Cynthia Woods was entitled to medical payments for bodily injury \u201ccaused by accident while occupying or being struck by an automobile.\u201d (Emphasis added.) Clearly, this provision does not tie coverage for her medical payments to a specific vehicle.\nSince the medical payments coverage purchased for each of Woods\u2019 two vehicles also extended medical coverage to a family member accidentally injured while occupying a non-owned automobile, it would be impossible to attribute liability for medical payments coverage to either car to the exclusion of the other. Obviously, each premium which was paid for medical coverage under the Woods policy bought the same protection with respect to accidental injuries sustained by a family member while occupying a non-owned automobile. Where coverages derived from two separate premiums overlap so completely, and where the provisions of the policy are said to \u201capply separately\u201d to each vehicle insured, the policyholder may reasonably conclude that his double payment of premiums provides double coverage. Otherwise, he would receive no consideration for his second premium.\n\u201cThe test in construing the language of the contract [an insurance policy] is not what the insurer intended the words to mean, but what a reasonable person in the position of the insured would have understood them to mean.\u201d Marriott Financial Services, Inc. v. Capitol Funds, Inc., 288 N.C. 122, 143, 217 S.E. 2d 551, 565 (1975). The natural construction of the language of the Woods policy is that when a member of the insured\u2019s family is injured in an automobile accident, and the insured has paid medical bills in excess of the coverage provided for each insured automobile, he is entitled to stack or aggregate the medical payments coverage for which he qualifies up to the limit for each car on which he has paid a premium.\nIn reaching the conclusion that plaintiff is entitled to the benefit of the medical coverage provided for each vehicle named in the Woods policy we are not unmindful of its limitation of liability provision, which states that the insurer\u2019s liability for one accident shall not exceed $500 per person. This language, when read in conjunction with the \u201capply separately\u201d clause, becomes ambiguous. As pointed out above, this ambiguity is particularly evident when a \u201cDivision 1\u201d beneficiary sustains injuries while occupying a non-owned automobile. Suppose, for example, that the named insured had purchased medical payments coverage in varying amounts for multiple vehicles named in a single policy. In such a case it would be impossible to determine the applicable limitation when, as here, the family member is injured while occupying a non-owned vehicle and neither of the owned vehicles is involved. Absent express language in the policy that the \u201cper accident\u201d limitation applies without regard to the number of vehicles covered by the policy, the ambiguity must be resolved against the insurer, who drew up the contract. Duke v. Mutual Life Ins. Co., 286 N.C. 244, 210 S.E. 2d 187 (1974). Since it is stipulated that plaintiff has complied with all the conditions precedent to recovery under the Woods policy, we therefore hold that she is entitled to collect medical payments for each car on which her testate paid premiums.\nThis holding does not conflict with the result in Wachovia v. Insurance Co. Although in that case we also analyzed the extent of coverage under \u201cDivision 1\u201d provision relating to members of the \u201cnamed insured\u2019s\u201d family, the language in that contract (identical to Division 1 of the Spencer policy) differs markedly from that employed in the Woods policy. In rejecting the plaintiff\u2019s argument in Wachovia v. Insurance Co. that the \u201capply separately\u201d clause should be construed as creating independent contracts for the vehicles for which separate premiums had been paid, we specifically distinguished cases from five other jurisdictions which had allowed the \u201cstacking\u201d of medical payments claims under policies whose coverage \u201cwas afforded to the policyholder and members of his family \u2018while occupying or through being struck by an automobile.\u2019 \u201d 276 N.C. at 360, 172 S.E. 2d at 526. See Kansas City Fire and Marine Ins. Co. v. Epperson, 234 Ark. 1100, 356 S.W. 2d 613 (1962); Government Employers Ins. Co. v. Sweet, 186 So. 2d 95 (Fla. App. 1965); Travelers Indemnity Co. v. Watson, 111 Ga. App. 98, 140 S.E. 2d 505 (1965); Southwestern Fire and Casualty Co. v. Atkins, 346 S.W. 2d 892 (Tex. Civ. App. 1961); Central Surety and Indemnity Corp. v. Elder, 204 Va. 192, 129 S.E. 2d 651 (1963). The basis for distinguishing the policy involved in Wachovia v. Insurance Co. from those construed by the other courts was that in the latter, there was \u201c \u2018no way to relate coverage to either\u2019 automobile of the policyholder. . . .\u201d Id. at 360, 172 S.E. 2d at 526. By contrast, the terms of the policy in Wachovia v. Insurance Co. tied coverage to the specific car which the injured family member was occupying at the time of the accident. When, as in the Woods policy, no such limitation appears in Division 1 of the policy being construed, the reasoning of the courts in the cases cited above is persuasive.\nThe judgment of the Court of Appeals affirming the judgment of the Superior Court that \u201cplaintiff recover nothing from defendant in his action\u201d is affirmed as it relates to the claim under the Spencer policy; it is reversed as it relates to the claim under the Woods policy. This cause will be remanded to the Superior Court of Guilford County, High Point Division, for the entry of judgment that plaintiff recover of defendant the additional sum of $500, plus interest and costs.\nAffirmed in part;\nReversed in part.",
        "type": "majority",
        "author": "SHARP, Chief Justice."
      }
    ],
    "attorneys": [
      "Bencini, Wyatt, Early & Harris by William E. Wheeler for plaintiff-appellant.",
      "Young, Moore, Henderson & Alvis by B. T. Henderson II and Joseph C. Moore III; Robert R. Gardner, of Counsel, for defendant appellees."
    ],
    "corrections": "",
    "head_matter": "REBECCA SUMNER WOODS Executrix of the Estate of John C. Woods, Deceased v. NATIONWIDE MUTUAL INSURANCE COMPANY\nNo. 67\n(Filed 29 August 1978)\n1. Insurance \u00a7 6.1\u2014 construction of policy\nWhere an insurance policy defines a term, that definition is to be used in construing the policy; if no definition is given, nontechnical words are to be given their meaning in ordinary speech, unless the context clearly indicates another meaning was intended.\n2. Insurance \u00a7 6.1\u2014 construction of policy\nThe various terms of an insurance policy are to be harmoniously construed, and if possible, every word and every provision is to be given effect. If, however, the meaning of words or the effect of provisions is uncertain or capable of several reasonable interpretations, the doubts will be resolved against the insurance company and in favor of the policyholder, but if the meaning of the policy is clear and only one reasonable interpretation exists, the courts must enforce the contract as written.\n3. Insurance \u00a7 68.8\u2014 family automobile policy \u2014 three automobiles \u2014 injury to nonrelative driving owned automobile \u2014 medical payments provision \u2014 recovery only for occupied vehicle\nWhere a family automobile policy covering three automobiles provided medical payments coverage for nonrelatives of the named insured for bodily injury \u201ccaused by accident, while occupying the owned automobile\u201d with the permission of the named insured, a nonrelative who was injured while driving an \u201cowned automobile\u201d was not entitled to recover the $1,000 medical payments limit for each automobile for which separate premiums had been paid but could recover only up to the $1,000 limit for the owned automobile she occupied at the time of the collision, notwithstanding the policy contained a clause stating that the terms thereof \u201capply separately\u201d to each automobile insured therein.\n4. Insurance \u00a7 68.8\u2014 family automobile policy \u2014 two automobiles \u2014 injury to family member \u2014medical payments provision \u2014recovery for each insured automobile\nWhere a family automobile policy covering two automobiles provided medical payments coverage to the named insured and his relatives for bodily injury \u201ccaused by accident while occupying or being struck by an automobile,\u201d and the policy provided that the terms thereof \u201capply separately\u201d to each automobile insured therein, an insured who paid medical bills for a family member injured in an automobile accident in excess of the $500 coverage provided for each insured automobile was entitled to stack or aggregate the medical payments coverage for which he qualified up to the $500 limit for each car on which he paid a premium, notwithstanding the policy also provided that the insurer\u2019s liability for one accident was limited to $500 per person.\nON petition for discretionary review of the decision of the Court of Appeals (reported without published opinion in 31 N.C. App. 156, 228 S.E. 2d 785 (1976)), which affirmed the judgment in favor of defendant entered by Long, J., at the 16 February 1976 Session of GUILFORD Superior Court. Docketed and argued as case No. 42 at the Spring Term 1977.\nPlaintiff\u2019s intestate, John C. Woods (Mr. Woods), instituted this action on 26 January 1974 to recover sums allegedly due him under the medical payment provisions of two separate family automobile policies issued by defendant, Nationwide Insurance Company. Mr. Woods died on 6 August 1975, and on 15 September 1975 his executrix, Rebecca Sumner Woods, was substituted as plaintiff in this action. The facts in the case were stipulated. The questions before the Court involved the proper interpretation of the medical payment provisions of defendant\u2019s two policies.\nOn 27 April 1973 Mr. Woods\u2019 daughter, Cynthia Woods, was severely injured while she was driving a Volkswagen automobile belonging to Harold Lee Spencer (Spencer). In consequence Mr. Woods incurred hospital, medical, and other related expenses for his daughter in an amount in excess of $4,000. The Volkswagen was one of three automobiles owned by Spencer, all of which were covered by Family Automobile and Comprehensive Liability Policy No. 61B 323-248 (Spencer policy) issued to him by defendant. Mr. Woods was the \u201cnamed insured\u201d in Family Automobile and Comprehensive Liability Policy No. 61B 130-165 (Woods policy) issued to him by defendant. This policy covered two automobiles owned by Mr. Woods.\nAt the time of Miss Woods\u2019 accident both the Spencer policy and the Woods policy were in full force and effect and both \u201cnamed insureds\u201d had performed all the conditions of their respective policies. As executrix of Mr. Woods\u2019 estate, plaintiff sues to recover from defendant the sum of $4,000 \u2014$3,000 under the medical payments provision of the Spencer policy and $1,000 under the Woods policy.\nThe declarations page of the Spencer policy shows various coverages for the three different automobiles, including the 1961 Volkswagen in which Miss Woods was injured. The first paragraph of this page provides: \u201cThe insurance afforded is only with respect to such of the following coverages for the indicated automobile for which a specific premium is shown. The limit of the Company\u2019s liability under each such coverage and for the indicated automobile shall be as stated herein, subject to all the terms of this policy having reference thereto.\u201d\nThe coverage with which we are concerned is \u201cMedical Payments each Person.\u201d Following this designation there are two columns for each vehicle. The first column is headed \u201cLimits of Liability\u201d and the second column is headed \u201cPremiums.\u201d In these two columns under each automobile appear, respectively, \u201c$1,000\u201d and \u201cINCL.\u201d The letters \u201cINCL\u201d appear in the Premiums column for each automobile and for every coverage provided. The insured paid a separate premium for each type of coverage for each automobile but the amount is not specified. The complaint simply alleges that the amount of premiums paid for the medical payments coverage was \u201cunknown.\u201d\nSubsequent provisions of the Spencer policy pertinent to this appeal are the following:\n\u201cNationwide Mutual Insurance Company agrees with the Insured, named in the declarations made a part hereof, in consideration of the payment of the premium and in reliance upon the statements in the declarations and subject to the limits of liability, exclusions, conditions and other terms of this policy:\n* * *\n\u201cPart III-Expenses for Medical Services\n\u201cCoverage G \u2014 Medical Payments \u2014 Automobile\n\u201cTo pay all reasonable expenses incurred within one year from the date of accident for necessary medical, surgical, X-ray and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services:\n\u201cDivision 1 \u2014 to or for the Named Insured and each relative who sustains bodily injury, sickness or disease, including death resulting therefrom, hereinafter called \u2018bodily injury,\u2019 caused by accident,\n(a) while occupying the owned automobile,\n(b) while occupying a non-owned automobile, but only if such person has, or reasonably believes he has, the permission of the owner to use the automobile and the use is within the scope of such permission, or\n(c) through being struck by an automobile or by a trailer of any type;\n\u201cDivision 2 \u2014 to or for any other person who sustains bodily injury caused by accident, while occupying\n(a) the owned automobile, while being used by the Named Insured, by any resident of the same household or by any other person with the permission of the Nam- \u2022 ed Insured; or . . .\n* * *\n\u201cDefinitions\n\u201c \u2018Owned automobile\u2019 means\n(a) a private passenger, farm or utility automobile described in this policy for which a specific premium charge indicates that coverage is afforded, . . .\n* * *\n\u201c \u2018Non-owned automobile\u2019 means an automobile or trailer not owned by or furnished for the regular use of either the Named Insured or any relative, other than a temporary substitute automobile;\n* * *\n\u201cLimit of Liability\n\u201cThe limit of liability for medical payments stated in the declarations as applicable to \u2018each person\u2019 is the limit of the Company\u2019s liability for all expenses incurred by or on behalf of each person who sustains bodily injury, sickness or disease as the result of any one accident.\n* * *\n\u201cConditions\n* * H=\n\u201c4. Two or More Automobiles (Coverages A, B, C, D, E and G)\n\u201cWhen two or more automobiles are insured hereunder, the terms of this policy shall apply separately to each. . . .\u201d\nUnder the schedule of coverages, the Spencer policy provides for \u201ccoverage G \u2014 medical payments \u2014 $1,000 each person.\u201d\nThe declaration page of the Woods policy, which covers Mr. Woods\u2019 two vehicles, varies from the Spencer policy as to the vehicles covered and the amount of the coverage. With reference to \u201cautomobile medical payments, each person,\u201d this page shows that separate premiums were paid for this type of coverage on each of the two vehicles, with a limit of liability on each vehicle of $500 for each person.\nTo recover on the Woods policy plaintiff relies upon the following provisions:\n\u201cPart III \u2014 Expenses For Medical Services\n\u201cCoverage G \u2014 Medical Payments \u2014 Automobile\n\u201cTo pay all reasonable expenses incurred within one year from the date of accident for necessary medical, surgical, X-ray and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services:\n\u201cDivision 1 \u2014 to or for the Named Insured and each relative who sustains bodily injury, sickness or disease, including death resulting therefrom, hereinafter called \u2018bodily injury,\u2019 caused by accident, while occupying or through being struck by an automobile;\n* * *\n\u201cLimit of Liability\n\u201cThe limit of liability for medical payments stated in the declarations as applicable to \u2018each person\u2019 is the limit of the Company\u2019s liability for all expenses incurred by or on behalf of each person who sustains bodily injury, sickness or disease as the result of any one accident.\n* * *\n\u201cConditions\n\u201c4. Two or More Automobiles (Coverages A, B, C, D, E, and G)\n\u201cWhen two or more automobiles are insured hereunder, the terms of this policy shall apply separately to each. . . .\u201d\nDefendant has admitted liability to plaintiff under the Spencer policy for the payment of $1,000 and under the Woods policy for $500. These amounts have been paid to the plaintiff without prejudice to the plaintiff\u2019s right to maintain this action. Plaintiff brought this suit to compel payment of an additional $2,000 under the Spencer policy and an additional $500 under the Woods policy.\nThe trial judge heard the case without a jury, found the facts, which were undisputed, and adjudged that plaintiff is entitled to recover nothing from defendant. On appeal the Court of Appeals affirmed, and we allowed certiorari.\nBencini, Wyatt, Early & Harris by William E. Wheeler for plaintiff-appellant.\nYoung, Moore, Henderson & Alvis by B. T. Henderson II and Joseph C. Moore III; Robert R. Gardner, of Counsel, for defendant appellees."
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