No Good Deed Goes Unpunished
Read the full article at https://lnkd.in/gRdjs-S6 and see the full video at https://lnkd.in/gTHtBnrJ and at https://lnkd.in/guV9yUzN and at
https://zalma.com/blog plus more than 4400 posts.
GEICO Advantage Insurance Company and GEICO Choice Insurance Company (collectively “GEICO”) appealed a decision of the Circuit Court of the City of Richmond granting summary judgment to Liosha Miles (“Miles”) on the issue of whether each of the two insurance policies at issue provided separate tranches of insurance for uninsured motorist (“UM”) coverage and underinsured motorist (“UIM”) coverage. GEICO contended that the statute and each of the applicable policies provide only a single tranche of coverage applicable to both UM and UIM claims.
In GEICO Advantage Insurance Company And GEICO Choice Insurance Company v. Liosha Miles, No. 220004, Supreme Court of Virginia (December 1, 2022) the Supreme Court interpreted the statute and the policies wording.
BACKGROUND
On April 18, 2019, Miles sustained extensive personal injuries in a single automobile accident caused by the negligence of two different drivers. One driver, Carlos Figuero, was insured under an automobile insurance policy issued by Integon General Insurance Company (“Integon”) with a liability limit of $25,000. The second driver (“Doe”) did not stop at the scene of the accident and was never identified, and thus, is considered an uninsured motorist pursuant to Code § 38.2-2206(B).
At the time of the accident, Miles was insured under two policies: she was the named insured under a GEICO Advantage policy covering her vehicle and also was a covered insured under her brother’s GEICO Choice policy by virtue of her being a “resident relative” of the named insured.
Each of the GEICO policies contained UM/UIM coverage with bodily injury limits of $50,000 per person and $100,000 per occurrence. GEICO concedes that Miles’ injuries from the accident resulted in damages that exceeded all available insurance coverage, “no matter how that is calculated.” On behalf of Figuero, Integon tendered its policy limit of $25,000.
The two GEICO policies paid, quickly, what they believed in good faith, was the limits of liability of the policies.
Claiming a $25,000 credit as a result of Integon’s tender, GEICO Advantage tendered $25,000 related to Miles’ claim against Figuero.
GEICO Advantage also tendered an additional $25,000 related to Miles’ claim against Doe, the unknown, and hence, uninsured motorist. Thus, GEICO Advantage tendered a total of $50,000 as a result of Miles’ UM/UIM claims.
As a result of these tenders, GEICO Advantage asserted that it had exhausted the limits of its policy’s UM/UIM coverage.
Separately, GEICO Choice tendered $50,000 to Miles related to her claim against Figuero. GEICO Choice made no tender related to Miles’ claim against Doe. As a result of its good faith tender of its limits, GEICO Choice asserted that it had exhausted the limits of its policy’s UM/UIM coverage.
Miles asserted that neither GEICO entity had exhausted its limits of UM/UIM coverage. Contending that each policy provided both a $50,000 limit for UM claims and another $50,000 limit for UIM claims entitling her to an additional $50,000.
Miles sued seeking a declaration that each policy contained separate $50,000 limits for UM and UIM coverage. GEICO countered asserting that each policy provided a single $50,000 limit for both UM and UIM claims. The circuit court granted Miles’ motion for summary judgment and denied GEICO’s cross-motion.
ANALYSIS
Addressing questions of statutory interpretation, the Supreme Court’s primary objective is to ascertain and give effect to legislative intent, as expressed by the language used in the statute.
Code § 38.2-2206(A)
The parties agree that the dispositive question in this appeal is whether Virginia law requires an insurance company to provide separate UM and UIM coverage in an automobile liability policy or if the UIM coverage is properly understood as a component part of the UM coverage.
Affording the words chosen by the General Assembly their plain and ordinary meanings the Supreme Court concluded that UIM coverage is a constituent part of UM coverage and does not represent a separate tranche of available coverage when UM coverage has been exhausted.
The fact that the statute requires one endorsement for both UM and UIM incidents provides a sufficient basis to conclude that UIM coverage is a constituent part of the UM endorsement, and thus, is not a separate tranche of insurance. Any residual doubt is extinguished by the language regarding the limits of coverage available under the endorsement required by Code § 38.2-2206(A). The third sentence of the statute sets coverage limits for the endorsement required by the first sentence of the statute, providing that such “limits shall equal but not exceed the limits of the liability insurance provided by the policy, unless any one named insured rejects the additional uninsured motorist insurance coverage[.]” Code § 38.2-2206(A).
This language reflects a policy decision by the General Assembly to afford insured drivers some measure of protection against injuries caused by the acts of others, but to limit that protection to no more in insurance coverage than the insured driver has elected to provide for the benefit of others who may be injured by the acts of the uninsured or underinsured driver.
A cap on UM coverage with no corresponding cap on UIM coverage-would represent an anomaly bordering on an absurdity. Although the conclusion was compelled by the words of the statute, the Supreme Court noted that it also was consistent with its prior cases addressing the UM/UIM statute.
The circuit court’s interpretation of the statute not only fails to address the evil sought to be corrected by the legislature it leads to the very anomaly that the 1982 statutory amendment was designed to eliminate. Under the circuit court’s interpretation, Miles would be in a better position from an insurance coverage perspective because she was hit by one underinsured motorist and one uninsured motorist as opposed to two underinsured motorists.
Both the text of the Code § 38.2-2206(A) and prior cases interpreting the statute lead inexorably to the conclusion that UIM coverage is a constituent part of UM coverage. Concluding that the circuit court erred in granting Miles’ motion for summary judgment and denying GEICO’s cross-motion for summary judgment the Supreme Court reversed the judgment of the circuit court and final judgment was entered in favor of GEICO.
ZALMA OPINION
Uninsured and Underinsured Motorist insurance is designed to protect the insured from the danger of being injured by a person who cannot be held liable for the injury because of escaping the scene of the accident or having inadequate insurance to indemnify the injured. Unfortunately, insureds like Ms. Miles, buy only minimal insurance to protect themselves and more to protect others. GEICO, in good faith, paid everything they owed and Miles tried to double the coverage with an imaginative analysis of the UM/UIM coverages that simply failed to comport with the Virginia statute and the policy wording. The good claims handling, because of the severity of her injury, forced GEICO to defend to the state supreme court, it good deeds.
(c) 2022 Barry Zalma & ClaimSchool, Inc.
Subscribe and receive videos limited to subscribers of Excellence in Claims Handling at locals.com https://zalmaoninsurance.locals.com/subscribe.
Go to substack at substack.com/refer/barryzalma Consider subscribing to my publications at substack at substack.com/refer/barryzalma
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business.
He is available at http://www.zalma.com and [email protected] to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog; daily articles are published at Zalma on Insurance
By Barry Zalma
Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library
Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
Post 5119
Death by Drug Overdose is Excluded
See the full video at https://lnkd.in/geQtybUJ and at https://lnkd.in/g_WNfMCZ, and at https://zalma.com/blog plus more than 5100 posts.
Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.
KEY POINTS
1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...
GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement
See the full video at https://lnkd.in/gDpGzdR9 and at https://lnkd.in/gbDfikRG, and at https://zalma.com/blog plus more than 5100 posts.
Post 5119
Default of Settlement Agreement Reduced to Judgment
In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)
Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...
ZIFL – Volume 29, Issue 14
Post 5118
See the full video at https://lnkd.in/geddcnHj and at https://lnkd.in/g_rB9_th, and at https://zalma.com/blog plus more than 5100 posts.
You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
This issue contains the following articles about insurance fraud:
The Historical Basis of Punitive Damages
It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.
The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.
You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf
Insurer Refuses to Submit to No Fault Insurance Fraud
...
Rulings on Motions Reduced the Issues to be Presented at Trial
Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.
CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.
This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...