{
  "id": 720178,
  "name": "Manuel VIGIL, as guardian ad litem for Melissa Vigil, a minor child, and Kraig Vigil, a minor child, and Theresa Vigil, Plaintiffs-Appellees, v. CALIFORNIA CASUALTY INSURANCE COMPANY, Defendant-Appellant",
  "name_abbreviation": "Vigil v. California Casualty Insurance",
  "decision_date": "1991-05-14",
  "docket_number": "No. 18837",
  "first_page": "67",
  "last_page": "72",
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      "cite": "112 N.M. 67"
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      "cite": "811 P.2d 565"
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    "name": "Supreme Court of New Mexico"
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      "cite": "294 N.W.2d 141",
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          "parenthetical": "no distinction could be made for uninsured motorist coverage purposes on basis that family owned vehicles were insured under a single rather than multiple policies"
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      "case_ids": [
        1582455
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          "page": "330",
          "parenthetical": "\"The uninsured motorists protection covers the insured and the family members while riding in uninsured vehicles, while riding in commercial vehicles, while pedestrians or while rocking on the front porch.\""
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          "page": "103",
          "parenthetical": "\"The uninsured motorists protection covers the insured and the family members while riding in uninsured vehicles, while riding in commercial vehicles, while pedestrians or while rocking on the front porch.\""
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      "cite": "14 Ohio Misc. 23",
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      "reporter": "Ohio Misc.",
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          "parenthetical": "quoting Motorists Mut. Ins. Co. v. Bittler, 14 Ohio Misc. 23, 32-33, 235 N.E.2d 745, 751 (1968)"
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      "cite": "394 Mass. 450",
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          "parenthetical": "measure of parties' rights, and duties is found in their intention as expressed in their contract"
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    "date_added": "2019-08-29",
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    "judges": [
      "SOSA, C.J., and RANSOM, J., concur."
    ],
    "parties": [
      "Manuel VIGIL, as guardian ad litem for Melissa Vigil, a minor child, and Kraig Vigil, a minor child, and Theresa Vigil, Plaintiffs-Appellees, v. CALIFORNIA CASUALTY INSURANCE COMPANY, Defendant-Appellant."
    ],
    "opinions": [
      {
        "text": "OPINION\nMONTGOMERY, Justice.\nThe issue in this case is whether the individual medical payments coverages for two or more automobiles under one or more insurance policies may be \u201cstacked.\u201d The issue is not quite one of first impression, because we recently held in Sanchez v. Herrera, 109 N.M. 155, 783 P.2d 465 (1989), that the medical payments provisions under the separate policies in that case could not be stacked, based on an unambiguous exclusionary clause in each policy. In the present case \u2014 in which the policies lack an exclusionary clause \u2014 we reach the opposite result, based on the language of the policies and on well-accepted rules of construction applicable to cases of insurance-policy ambiguity. We thus affirm the trial court\u2019s judgment permitting both \u201cintra-policy\u201d and \u201cinter-policy\u201d stacking.\nI.\nEffective April 5, 1988, Manuel and Theresa Vigil renewed their two automobile insurance policies with California Casualty Insurance Company, insuring five vehicles. The first policy (# 1) insured a 1983 Toyota pickup, a 1981 Dodge Aries, and a 1978 Ford Fairmont. The second policy (# 2) insured a 1985 Chevrolet pickup and a 1982 Toyota pickup. Each policy provided $5,000 of medical payments coverage for \u201ceach person\u201d; that amount was shown on each policy\u2019s \u201cdeclarations page\u201d on the line for the \u201cvehicle number\u201d assigned to each vehicle, except that there was no med pay coverage on the 1982 Toyota pickup. Under the first policy, in other words, there were three medical payments coverages of $5,000 each, one associated with each vehicle; on the second policy there was one coverage of $5,000, associated with the Chevrolet pickup. The declarations page for each policy showed the amount of the premium charge for each medical payments coverage, as it did for each of the other coverages under the policy \u2014 liability for bodily injury and property damage, uninsured motorist, collision, comprehensive, etc.\nOn May 4,1988, one of the three vehicles insured under the first policy, the Ford Fairmont, was involved in an accident. Melissa Vigil \u2014 Manuel and Theresa\u2019s minor daughter \u2014 was driving the Ford at the time. She was pregnant with Kraig Vigil, and Theresa was a passenger in the vehicle. Each of the three Vigils \u2014 Melissa, Kraig and Theresa \u2014 sustained injuries and medical expenses in excess of $5,000. California Casualty paid $5,000 in medical expenses on behalf of each of the three Vigils, but it refused any further payments based on its interpretation of policy # 1 as providing medical payments coverage only with respect to a specific \u201coccupied\u201d vehicle (i.e., a ceiling of $5,000 per person on the Ford). Theresa and Manuel \u2014 the latter as guardian ad litem for Melissa and Kraig \u2014 then brought suit against California Casualty for a declaratory judgment that they were entitled to stack the medical payments coverages under both policies, so that there would be $20,000 of insurance available to defray the medical expenses of each of the three injured Vigils.\nAfter a bench trial, the trial court found in favor of the Vigils and issued a judgment declaring that they were entitled to stack the four medical payments coverages under the two policies. The court recited in its judgment: \u201cThe reasonable expectations of the Plaintiffs arising from purchasing the policies and paying four separate premiums for medical payments coverage was that they would be entitled to stack the four coverages in exchange for the payment of the four premiums.\u201d California Casualty appeals, contending that the ruling contravenes the policy language and our holding in Sanchez.\nII.\nIn Sanchez, we recognized that one of the considerations favoring stacking in the uninsured motorist coverage context is absent in the analogous, but different, context of medical payments coverage: There is no statute or public policy requiring stacking of medical payments coverages. 109 N.M. at 158, 783 P.2d at 468. Thus, we resolve the issues in this case by construing the language in the contracts between the parties, aided by principles of construction in the insurance policy setting. See id.; Vargas v. Pacific Nat\u2019l Life Assurance Co., 79 N.M. 152, 155, 441 P.2d 50, 53 (1968) (measure of parties' rights, and duties is found in their intention as expressed in their contract).\nIn each policy, California Casualty promises (under Part II, entitled \u201cExpenses for Medical Services\u201d and defining \u201cCoverage C \u2014 Medical Payments\u201d):\nTo pay all reasonable expenses incurred within two years 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:\nDivision 1. To or for the named insured and each relative who sustains bodily injury, sickness or disease, including death resulting therefrom, hereinafter called \u201cbodily injury,\u201d 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 a moving highway vehicle or trailer of any type while not occupying a motor vehicle.\nIt is undisputed that Theresa was a \u201cnamed insured\u201d and that Melissa and Kraig were relatives within the policy definitions. The policy defines \u201cowned automobile,\u201d in relevant part, as \u201ca private passenger, farm or utility automobile described in this policy for which a specific premium charge indicates that coverage is afforded[.]\u201d The Ford was described in the policy and a specific premium charge was assessed for the coverage. Therefore, because each of the three Vigils was \u201coccupying the owned automobile,\u201d it is clear that each had coverage under Part II of policy # 1 for his or her reasonable medical expenses incurred within two years from the date of the accident.\nThe next question \u2014 the critical question on this appeal \u2014 is the amount of such coverage. This question is not answered by the coverage provisions in Part II of the policy, or by any other provision in Part II, except the \u201cLimit of Liability\u201d clause. That clause reads:\nThe limit of liability for medical payments stated in the Declarations as applicable to \u201ceach person\u201d is the limit of the Company\u2019s liability for all expenses incurred by or on behalf of each person who sustains bodily injury as a result of any one accident.\nIt will be noted that this clause contains no reference to any vehicle listed in the Declarations and does not otherwise associate the amount of medical payments coverage (or any limitation thereon) with any particular automobile.\nWhen one looks to the Declarations page of policy # 1, one sees three amounts of medical payments coverage for \u201ceach person\u201d \u2014 $5,000, listed three times, for a total of $15,000. It is true that each $5,000 figure in the \u201cmedical payments\u201d column is located on a line preceded by the numeral \u201c1,\u201d \u201c2,\u201d or \u201c3.\u201d These numerals correspond with the designation of each of the three vehicles insured under the policy. A natural inference, therefore, is that each medical payments coverage amount is associated with one of the three vehicles. As just noted, however, the \u201cLimit of Liability\u201d clause does not make this inference express, and so one is left with the following question arising from the ambiguity created by the failure of the limitation clause to limit the coverage to a particular vehicle: Is the medical payments coverage amount limited to the single amount for the particular vehicle occupied by the insured at the time of the accident (as contended by California Casualty), or is the afforded coverage the total of the amounts for each person in the \u201cmedical payments\u201d column?\nThis question can be answered in (at least) two ways: by applying the contractual language to other situations that could easily arise under the wording of the policy, and by resorting to settled principles of insurance-policy construction. Approaching the question in the first of these ways, we ask: Suppose the insured was not occupying an \u201cowned automobile\u201d at the time of the accident, but rather was occupying a non-owned automobile with the owner\u2019s permission (under Division 1(b)) or was not occupying any motor vehicle at all (under Division 1(c))? There is no question that the insured would have medical payments coverage in either of those situations, but in what amount? Looking at the declarations page, one could not associate the amounts in the \u201cmedical payments\u201d column with any particular vehicle or vehicles, because the three vehicles described in the policy would be irrelevant. In each of the hypothesized situations, the insured either would be occupying a vehicle not described in the policy or would not be occupying any vehicle at all. The only reasonable conclusion is that the amount of medical payments coverage would be the total listed in the \u201cmedical payments\u201d column, namely, $15,000. In other words, in those two hypothesized situations, the intra-policy coverages for medical payments clearly would be stacked.\nWe see no reason to construe the policy as requiring a different result when the insured is occupying his or her own vehicle, described in the policy. As we said in Sanchez, \u201cBecause most people would expect to carry their maximum amount of coverage while inside an insured car, the preclusion of medical payments recovery would, like with uninsured motorist coverage, frustrate the insured\u2019s legitimate expectations.\u201d 109 N.M. at 160, 783 P.2d at 470. The policy is at least ambiguous in the situation when the insured is occupying an owned vehicle insured under the policy; and ordinary principles of insurance law require the policy to be construed in favor of the insured. See, e.g., id. at 159, 783 P.2d at 469.\nIn Sanchez, we likened medical payments insurance to uninsured motorist coverage, which, we said, \u201cfollow[sj the person, leading to the same incongruities, and the same frustration of the insured\u2019s expectations.\u201d Id. at 160, 783 P.2d at 470 (emphasis added). See also 8A J.A. Appleman & J. Appleman, Insurance Law and Practice \u00a7 4902, at 225 (1981) (medical payments indorsement \u201cis closely akin to a personal accident policy\u201d); R. Keeton & A. Widiss, Insurance Law \u00a7 5.9, at 584 (1988) (medical payments coverage \u201cis a first-party, no-fault insurance coverage\u201d). In this respect, med pay coverage is \u201climited personal accident insurance\u201d which, like uninsured motorist coverage (and subject to any explicit policy limitations or exclusions), applies if at the time of the accident the insured \u201cwas occupying the [automobile] described in his policy or was on foot, or on horseback, or while sitting in his rocking chair on his front porch or while occupying a non-owned automobile * * Cardin v. Royal Ins. Co. of America, 394 Mass. 450, 452, 476 N.E.2d 200, 202 (1985) (quoting Motorists Mut. Ins. Co. v. Bittler, 14 Ohio Misc. 23, 32-33, 235 N.E.2d 745, 751 (1968)); accord Chavez v. State Farm Mut. Automobile Ins. Co., 87 N.M. 327, 330, 533 P.2d 100, 103 (1975) (\"The uninsured motorists protection covers the insured and the family members while riding in uninsured vehicles, while riding in commercial vehicles, while pedestrians or while rocking on the front porch.\u201d). Unless the policy explicitly provides otherwise, there is no particular relationship between the insurance benefits available to the insured and the automobile or other vehicle involved in the accident. If the insured incurs medical expenses as the result of an accident which occurs in one of the situations contemplated by the coverage clause, the insured is entitled to benefits under the policy, and the amount of those benefits is not limited by the happenstance that the accident does or does not occur in a particular way or with reference to a particular vehicle.\nMany courts around the country have already allowed stacking of medical payments coverage in various circumstances. See generally Annotation, Combining or \u201cStacking\" Medical Payment Provisions of Automobile Liability Policy or Policies Issued by One or More Insurers to One Insured, 29 A.L.R.4th 49 (1984); 8A Appleman, supra, \u00a7 4902.55. The authors of the Appleman treatise observe:\nSince actuarial computations demonstrate that the true cost of such coverage [medical payments] is nominal, and a separate premium is paid upon each contract, it is quite surprising that the carriers do not voluntarily, and cheerfully, permit a stacking of such coverage\nThis is a fairer result, to all parties, than [refusing to permit stacking] * * *. [T]he most equitable result seems to be to permit a stacking of benefits without awarding duplicate benefits.\nId. at 278-79.\nThe court below, in entering its declaratory judgment in favor of the Vigils, focused on the fact that a separate premium charge was assessed for each medical payments coverage under the two policies, thereby giving rise to reasonable expectations on the part of the Vigils that their four med pay coverages would be stacked. The court relied on the analogy in the uninsured motorist field provided by Lopez v. Foundation Reserve Ins. Co., 98 N.M. 166, 646 P.2d 1230 (1982), in which we held that uninsured motorist benefits under a single policy insuring more than one vehicle could be stacked (i.e., we upheld \u201cintra-policy\u201d stacking), based in part on the fulfillment this result accorded to the insured\u2019s reasonable expectations arising from payment of multiple premiums. Id. at 170-71, 646 P.2d at 1234-35. Many of the courts that have permitted stacking of medical payments coverages have done so on the rationale that separate premiums for separate coverages entitle the insured to the benefit of what he or she has paid for. See, e.g., Annotation, supra, 29 A.L.R.4th at 76-77, 83-84. We gave considerable weight to this factor in Sanchez, 109 N.M. at 159-60, 783 P.2d at 469-70, even though we rejected stacking in that case based on an unambiguous policy exclusion.\nWhile we do not retreat from anything we have said in the uninsured motorist field or, in Sanchez, in the medical payments field, we do not rest our holding in this case primarily on the ground that separate premiums were charged for the separate medical payments coverages. Most automobile insurance involves the assessment of separate premium charges on the individual items of coverage provided by the policy. Premiums are computed and stated separately, in other words and for example, on each bodily injury and property damage liability coverage (depending, inter alia, on liability limits, number and ages of drivers, etc.), on each uninsured motorist coverage (depending on number of vehicles and liability amounts), on each collision or comprehensive coverage (depending on number and values of vehicles, amounts of deductibles, etc.), and the like. A particular insured may or may not have expectations based on the premiums he or she has paid, and those expectations may or may not be reasonable in a particular case. In the present case, we hold that intra-policy stacking was available based on the wording of the policy and the kind of insurance at issue, as well as on what the trial court found were the reasonable expectations of the insured.\nIII.\nWe turn now to inter-policy stacking. At first blush, the coverage clause in policy # 2 appears not to be applicable. Theresa, Melissa, and Kraig Vigil were not occupying a non-owned automobile, as contemplated by coverage sub-clause (b), because the Ford was owned by a named insured and (if principally operated by a resident of the household \u2014 e.g., Melissa) was not being operated by a named insured at the time of the accident. Nor were the Vigils \u201cnot occupying a motor vehicle\u201d as contemplated by sub-clause (c); they were occupying the Ford. Arguably, under sub-clause (a), they were not occupying an \u201cowned automobile\u201d either, because the Ford is not listed on the declarations page \u2014 is not \u201cdescribed in this policy\u201d\u2014 policy #2.\nBut we think it would be a silly result to hold that the insurer could escape liability for stacked medical payments coverage by the simple expedient of issuing a separate policy for each insured vehicle. The policy at issue here \u2014 policy # 2 \u2014 provides in sub-clause (a) that medical payments coverage exists when a named insured or a relative sustains bodily injury in an accident \u201cwhile occupying the owned automobile[.]\u201d \u201cOwned automobile\u201d is defined as an \u201cautomobile described in this policy for which a specific premium charge indicates that coverage is afforded[.]\u201d The declarations page indicates that a specific premium charge was assessed for the medical payments coverage under policy #2; the only question is whether the Ford was described \u201cin this policy.\u201d We think it does no violence to the intention of the parties to hold, and we do hold, that \u201cthis policy\u201d refers to both policy # 1 and policy # 2, since, substantively and to all intents and purposes, they constitute the same policy.\nOnly one policy form was offered into evidence at the trial in this case. The record is not clear on whether that document was an attachment to the declarations page for either policy # 1 or policy # 2, or was a form or specimen policy obtained from California Casualty, or was otherwise provided to the court for purposes of the trial. The record is clear, however, that the terms of \u201cthe policy\u201d were identical for both policy # 1 and policy #2.\nFor all that appears in the record, the declarations page for policy # 2 was simply a continuation of the declarations page for policy # 1 \u2014 as if the computer had simply run off on another page the coverages provided for the Chevrolet and the 1982 Toyota. The two policies have the same named insureds, the same insurer, the same effective date, the same bodily injury and property damage liability limits \u2014 in fact, they appear the same in all material respects except that the vehicles insured under each are different and one of the policies, #2, lists a bank as a lienor or lessor. In light of the identical provisions of the two policies, we think that a fair reading of the phrase \u201cdescribed in this policy\u201d is \u201cdescribed in these policies,\u201d referring to the policies issued by the same insurer, to the same insureds, on the same date, for essentially the same coverages on their five vehicles. An alternative, and equally fair, reading of \u201cthis policy\u201d is that it refers to both policy # 1 and policy # 2 as a \u201ccombination policy,\u201d providing the Vigils\u2019 automobile insurance on those five vehicles. See State Farm Mut. Automobile Ins. Co. v. Castaneda, 339 So.2d 679, 681 (Fla.App.1976) (where three policies issued on different automobiles to same insured by same insurer provided medical payments coverage, policies would be read and construed with reference to each other, and therefore stacked); cf. Bradley v. Mid-Century Ins. Co., 409 Mich. 1, 45, 294 N.W.2d 141, 155 (1980) (no distinction could be made for uninsured motorist coverage purposes on basis that family owned vehicles were insured under a single rather than multiple policies).\nAs indicated, we believe this construction does no violence to the parties\u2019 intent. Had the three injured Vigils been occupants of a non-owned vehicle with the owner\u2019s consent, or had they not occupied any vehicle at all but had been struck by a vehicle, both policies clearly would have afforded coverage. And, had the operator of the Ford been Theresa rather than Melissa, there could well have been coverage under both policies (under sub-clause (a) in policy # 1 and under subclause (b) in policy # 2). It seems highly doubtful that the premium for the med pay coverage under policy # 2 was computed on the basis that coverage would be provided in all cases except when the insureds were occupying another of their owned vehicles, insured by the same company but under a different policy, and operated by someone other than the named insured. In this situation \u2014 to fall back on the \u201creasonable expectations\u201d theory \u2014 the Vigils would have been more than reasonable in assuming that the premium paid for med pay coverage on the Chevrolet afforded them coverage in all of these situations, not just the ones that might be found applicable by piecing the policy wording together in a highly literal and perhaps overly technical way.\nThe judgment of the district court is affirmed.\nIT IS SO ORDERED.\nSOSA, C.J., and RANSOM, J., concur.\n. Coverage is also afforded, under Division 2 immediately following Division 1 as quoted in the text, to other persons besides the named insured and his or her relatives in certain circumstances. Division 2 is not relevant to this appeal.\n. As is obvious, we regard the policy\u2019s use of the definite article \"the\u201d in the phrase, \u201cwhile occupying the owned automobile,\u201d as unimportant. The word \"the\" is part of the insurer\u2019s printed form; the form could just as easily have used the indefinite article \"an,\u201d or the phrase could have been worded \"while occupying one of the owned automobiles.\"\n. The policy defines \"non-owned automobile\u201d as \"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, except that a private passenger, farm or utility automobile, or a trailer used therewith, owned by, or principally operated by a resident of the named insured\u2019s household and insured in the Company, shall be considered a non-owned automobile while operated by the named insured!?]\u201d\n. See the definition of \"non-owned automobile\" supra note 3.\n. Under policy # 2, the Vigils obtained collision and comprehensive insurance, whereas such coverage was omitted for the other four vehicles. It appears, therefore, that a reason for this \"separate\" policy might have been that the bank had a lien on the Chevrolet.\n. This \u2014 coverage under sub-clause (b) in policy #2 \u2014 assumes that the Ford might have been principally operated by a resident of the named insured\u2019s household, such as Melissa, under the definition of \u201cnon-owned automobile,\u201d supra note 3.",
        "type": "majority",
        "author": "MONTGOMERY, Justice."
      }
    ],
    "attorneys": [
      "James E. Thomson, Santa Fe, for defendant-appellant.",
      "Berardinelli & Associates, David J. Berardinelli, Santa Fe, for plaintiffs-appellees."
    ],
    "corrections": "",
    "head_matter": "811 P.2d 565\nManuel VIGIL, as guardian ad litem for Melissa Vigil, a minor child, and Kraig Vigil, a minor child, and Theresa Vigil, Plaintiffs-Appellees, v. CALIFORNIA CASUALTY INSURANCE COMPANY, Defendant-Appellant.\nNo. 18837.\nSupreme Court of New Mexico.\nMay 14, 1991.\nJames E. Thomson, Santa Fe, for defendant-appellant.\nBerardinelli & Associates, David J. Berardinelli, Santa Fe, for plaintiffs-appellees."
  },
  "file_name": "0067-01",
  "first_page_order": 101,
  "last_page_order": 106
}
