A New Mexico Federal Magistrate Judge ruled on June 25 that a spouse’s loss of consortium claim alleged “bodily injury” separate from that sustained by her husband, who had been killed by USAA’s insured in an auto accident. As a result, the policy’s $200,000 per accident limit—rather than the $100,000 per person limit—was applicable to the claims.
The crucial question before the Court was whether the policy’s definition of “bodily injury” was broad enough to encompass damages suffered by an individual not personally involved in the auto accident. The definition provided:
“Bodily Injury” means bodily harm, sickness, disease or death.
“Bodily Injury” does not include mental injuries such as emotional distress, mental anguish, humiliation, mental distress or any similar injury unless it arises out of physical injury to some person (emphasis added).”
Judge Stephen Yarbrough acknowledged that the definition differed from the phrase’s plain and ordinary meaning—stating “[c]ommon sense, and the ordinary meaning of these terms, would dictate that because only Mr. Calderon was involved in the auto accident, there was only one bodily injury.” Ultimately, however, the phrase’s plain and ordinary meaning must yield to the definition of “bodily injury” USAA expressly provided in the policy.
USAA argued that construing a spouse’s loss of consortium claim as an independent “bodily injury” “render[s] without meaning the distinction between ‘each person’ and ‘each accident’ in the policy.” The Court disagreed—stating that if the spouse had been physically injured in the same auto accident there would be no question that each would be entitled to $100,000 in coverage. Moreover, to the extent that USAA observed tension between the definition and other portions of the policy, any resulting ambiguity would require liberal construction of in favor of the insured (and coverage). The Court acknowledged that the availability of a single $100,000 limit may have been USAA’s intent, but “this unexpressed intent must give way to the clear language in the contract.”
This is a memorandum opinion authored by a federal magistrate judge. It does not provide controlling precedent but does suggest a careful review of policy language before restricting consortium claims to the single, per occurrence limit available for the bodily injury from which they derive.
USAA Cas. Ins. Co. v. Calderon, No. CV 18-588 SCY/KK, 2019 WL 2602557, (D.N.M. June 25, 2019).
