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Cramer v. National Casualty Co.

United States District Court, D. South Carolina, Orangeburg Division

June 7, 2016

Margaret Cramer, Plaintiff,
National Casualty Company, Defendant.


         Plaintiff Margaret Cramer (“Plaintiff”) filed this declaratory judgment action against Defendant National Casualty Company (“Defendant”), seeking a declaration by the court that Plaintiff is entitled to underinsured motorist coverage from Defendant. (ECF No. 1-1 at 10 ¶ 36.)

         This matter is before the court on a motion by Plaintiff for summary judgment pursuant to Fed.R.Civ.P. 56 (“Plaintiff’s Motion”). (ECF No. 45.) Defendant opposes Plaintiff’s Motion, and filed a motion for summary judgment (“Defendant’s Motion”) asserting that the court should find that Plaintiff does not qualify as an “insured” under the policy. (ECF No. 55.) The court GRANTS Plaintiff’s Motion and DENIES Defendant’s Motion.


         St. Matthews is a non-emergency medical transport company that transports patients to and from doctors’ appointments. (ECF No. 45-2, Pl.’s Dep. 8:7-13.) On September 16, 2013, Plaintiff was assigned to an ambulance with Justin Jackson, her co-worker. (ECF No. 55-3 at 1 ¶ 2.) Plaintiff and Jackson transported a patient to the H. F. Mabry Cancer Center for treatment. (Id. at ¶ 4.) While Plaintiff was waiting for the patient to complete treatment, she witnessed an accident on Cook Road, which runs in front of the cancer center. (ECF No. 45-2, Pl.’s Dep. 15:12-22.) Plaintiff activated the ambulance’s lights and pulled onto the roadway behind the accident vehicles to barricade the accident scene from oncoming traffic. (Id. at 16:11-12, 17:11-15, 19:10-12, 48:18-24, 52:16.) Plaintiff left the ambulance’s lights on and engine running as she exited the vehicle to assess the accident scene. (Id. at 19:16-20:2.) After checking on the motorists, Plaintiff walked to the shoulder of the road, which was located across from the ambulance, in order to avoid traffic. (Id.) Plaintiff contacted 911 to request highway patrol. (Id. at 27:14, 23.) Plaintiff then headed towards the ambulance to radio her employer to report the accident. (Id. at 23: 8-10.) On her way to the ambulance, but while still on the shoulder of the road, she waved a few cars through so that she could cross safely. (Id.) During the process of returning to the ambulance, while still standing on the shoulder of the road, Plaintiff was struck by an underinsured vehicle operated by Mary Ann Walley. (Id. at 29:22-30:2, 30:23, 50:8, 54:5-6.) Plaintiff estimates that at the time she was struck by the vehicle, she was standing about eight feet away from the ambulance. (Id.) Plaintiff suffered injuries as a result of being struck by the vehicle.

         Defendant issued a policy of insurance to Plaintiff’s employer, St. Matthews Ambulance Service, providing Underinsured Motorist (“UIM”) coverage with limits of $100, 000.00 per accident. (ECF No. 45-3.) Defendant denied UIM coverage to Plaintiff asserting that she was not an “insured” under the language of the policy. Subsequently, Plaintiff filed this action in the Court of Common Pleas for Orangeburg County on August 25, 2014. (ECF No. 1-1.) On October 2, 2014, Defendant filed for removal to this court on the basis of diversity jurisdiction. On October 20, 2015, Plaintiff filed a motion for summary judgment. (ECF No. 45.) Subsequently, Defendant filed a response in opposition on November 6, 2015. (ECF No. 47.) Plaintiff filed a reply to Defendant’s response. (ECF No. 51.) Thereafter, Defendant filed a motion for summary judgment on December 3, 2015. (ECF No. 55.) Plaintiff filed a response in opposition. (ECF No. 56.) A hearing on the motions was held on April 12, 2016.


         A. Summary Judgment Generally

         Summary judgment should be granted “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). A fact is “material” if proof of its existence or non-existence would affect the disposition of the case under the applicable law. Anderson v. Liberty Lobby Inc., 477 U.S. 242, 248-49 (1986). A genuine question of material fact exists where, after reviewing the record as a whole, the court finds that a reasonable jury could return a verdict for the nonmoving party. Newport News Holdings Corp. v. Virtual City Vision, 650 F.3d 423, 434 (4th Cir. 2011).

         B. General Principles of South Carolina Insurance Law

         In an action based upon diversity of citizenship, the relevant state law controls. Erie R.R. Co. v. Tompkins, 304 U.S. 64, 78 (1938). Under South Carolina law, insurance policies are subject to the general rules of contract construction. B.L.G. Enters., Inc. v. First Fin. Ins. Co., 514 S.E.2d 327, 330 (S.C. 1999). “When a contract is unambiguous, clear, and explicit, it must be construed according to the terms the parties have used.” Id. The court must enforce, not write, contracts of insurance and must give policy language its plain, ordinary, and popular meaning. Id. “[I]n construing an insurance contract, all of its provisions should be considered, and one may not, by pointing out a single sentence or clause, create an ambiguity.” Yarborough v. Phoenix Mut. Life Ins. Co., 225 S.E.2d 344, 348 (S.C. 1976). “A contract is ambiguous when it is capable of more than one meaning when viewed objectively by a reasonably intelligent person who has examined the context of the entire integrated agreement and who is cognizant of the customs, practices, usages and terminology as generally understood in the particular trade or business.” Hawkins v. Greenwood Dev. Corp., 493 S.E.2d 875, 878 (S.C. Ct. App. 1997). “Where language used in an insurance contract is ambiguous, or where it is capable of two reasonable interpretations, that construction which is most favorable to the insured will be adopted.” Poston v. Nat’l Fid. Life Ins. Co., 399 S.E.2d 770, 772 (S.C. 1990).

         An insurer’s obligation under a policy of insurance is defined by the terms of the policy itself and cannot be enlarged by judicial construction. S.C. Ins. Co. v. White, 390 S.E.2d 471, 474 (S.C. Ct. App. 1990). A policy clause extending coverage must be liberally construed in favor of coverage, while insurance policy exclusions are construed most strongly against the insurance company, which also bears the burden of establishing the exclusion’s applicability. M & M Corp. v. Auto-Owners Ins. Co., 701 S.E.2d 33, 35 (S.C. 2010); Owners Ins. Co. v. Clayton, 614 S.E.2d 611, 614 (S.C. 2005). “However, if the intention of the parties is clear, courts have no authority to torture the meaning of policy language to extend coverage that was never intended by the parties.” S.C. Farm Bureau Mut. Ins. Co. v. Wilson, 544 S.E.2d 848, 850 (S.C. Ct. App. 2001).

         III. ANALYSIS

         The material facts of this case are undisputed. The parties agree that Plaintiff was on the shoulder of the road across from the ambulance and attempting to clear the roadway by directing a few cars through so that she could reenter the ambulance when she was struck by another vehicle. (See ECF Nos. 45-1 at 2; 55-1 at 2-3.) The parties agree that Defendant issued a UIM coverage policy to Plaintiff’s employer. Under the UIM coverage policy, an “insured” is defined as “anyone ‘occupying’ a covered ‘auto’ or a temporary substitute for a covered ‘auto’.” (ECF No. 45-3 at 3 ¶ B(2)(a).) Under the policy, “occupying” is defined as “in, upon, getting in, on, out or off.” (Id. at 5 ¶ F(2).)

         Here, the parties disagree as to the interpretation of the UIM coverage policy’s definition of “occupying.” Plaintiff asserts that she is entitled to summary judgment because, under the UIM coverage policy, Plaintiff was “occupying” the ambulance at the time of the accident. Alternatively, Plaintiff asserts that the definition of “occupying” is ambiguous such that it should be construed in favor of providing Plaintiff coverage under the UIM coverage policy. Finally, Plaintiff asserts that the UIM coverage policy’s definition of “insured” is void because it is contrary to South Carolina law, such that Plaintiff should be entitled to coverage because she was using the ambulance at the time of the accident. Defendant disagrees and asserts ...

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