No UM/UIM Coverage if Responsible Party is Insured

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Why Did the Obvious Go to an Appeal?

Juan Brambila appealed an order granting summary judgment in favor of Great West Casualty Company (“Great West”) in Great West’s action for a declaratory judgment determining the viability of Brambila’s uninsured-motorist claim. The appeal presents an issue of first impression concerning the availability of uninsured-motorist coverage when an insured would-be tortfeasor denies liability. In Great West Casualty Company v. Juan Brambila and Port To Port, Inc., Juan Brambila, No. 1-21-0939, 2022 IL App (1st) 210939, Court of Appeals of Illinois, First District, Fifth Division (May 27, 2022) the Court of Appeals resolved the dispute with logic and common sense.

FACTS

Brambila sought compensation via two different avenues:

FIRST: an uninsured/underinsured motorist (UM/UIM) claim with Great West.

SECOND: In addition to his attempt to recover from Great West, Brambila also filed a common-law negligence action against Grygorcewicz’s estate. 

Great West moved for summary judgment, arguing that Grygorcewicz did not meet the definition of “uninsured motorist” because he was in fact insured at the time of the accident and Great West asserted that Grygorcewicz’s estate’s act-of-God defense merely denied liability and was not the same as his insurer denying coverage.

ANALYSIS

If Grygorcewicz is found not liable, his insurance policies clearly and unambiguously foreclose the availability of UM coverage in this case.

For two reasons, Brambila’s injuries in this case are not covered by these UM provisions.

FIRST, it is undisputed that Grygorcewicz was insured at the time of the accident. 

The denial of liability is not a denial of coverage. Because Grygorcewicz was insured at the time of the accident and his insurer has not denied coverage.

SECOND, an act-of-God defense alleging that the victim’s injuries were caused by an unforeseeable event that is beyond the power of human intervention to prevent negates this causation element and absolves the alleged tortfeasor of liability.

The only impediment to Brambila recovering from Grygorcewicz’s estate would be the lack of liability.

Because Grygorcewicz’s estate’s denial of liability does not have the effect of rendering Grygorcewicz an uninsured motorist for the purposes of UM coverage, the circuit court’s order granting Great West’s motion for summary judgment was affirmed.

ZALMA OPINION

It’s a no win situation for the plaintiff Brambila who was faced with an insured allegedly responsible party who claims no liability because he was not negligent and he was insured. A waste of court time.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, is available at http://www.zalma.com and [email protected].

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