Submitted On Briefs: October 21, 2015
Reissued: October 13, 2016
Laurence Willey, Jr., Esq., Willey Law Offices, Bangor, for
appellant Alberta Graf.
B. Main, Esq., Hoy & Main, P.A., Gray, for appellee State
Farm Mutual Automobile Insurance Company.
SAUFLEY, C.J., and ALEXANDER, MEAD, GORMAN, JABAR, and HJELM,
Alberta Graf was injured when the car she was driving was
struck from behind by an underinsured motorist. She claimed
uninsured/underinsured motorist (UM/UIM) coverage and medical
payments coverage under two separate State Farm Mutual
Automobile Insurance Company policies. Graf and State Farm
agreed to arbitrate the amount of damages caused by the
accident, but to leave to the court the dispute regarding the
extent of coverage, if any, available to Graf through the
identified policies. An arbitration panel determined that the
accident caused Graf $378, 000 in damages, $125, 000 of which
were identified as medical costs. The Superior Court
(Somerset County, Mullen, J.) determined that Graf
had coverage under only one of the State Farm policies;
deferred to the arbitration award as to her actual damages;
established the amount owed by State Farm; and reduced the
arbitration award accordingly upon entry of judgment. We
affirm the courts determination that only one of the policies
covered Graf, but we vacate the courts decision regarding the
amount due under that policy.
The parties do not dispute that on August 4, 2005, Alberta
Graf was operating her personal vehicle when it was struck
from behind by a vehicle operated by another motorist who was
fully responsible for causing the accident. At the time of
the accident, that motorist had liability motorist coverage
with Progressive Insurance Company in the amount of $50, 000.
Graf and her husband held two State Farm policies at the time
of the accident. The first (Policy 1) was in Grafs husbands
name; provided $1, 000, 000 of UM/UIM coverage; provided
$100, 000 of medical payments coverage; and did not cover
Grafs vehicle. The UM/UIM section contained a provision
entitled "When [UM/UIM Coverage] Does not Apply"
that stated: "There is no coverage ... for bodily injury
to an insured [sustained] while occupying a motor vehicle
owned by... you, your spouse or any relative if it is not
insured for this coverage under this policy." The
medical payments coverage under Policy 1 contained a similar
provision. The second policy (Policy 2) was in Grafs name;
provided $300, 000 of UM/UIM coverage; provided $100, 000 of
medical payments coverage for medical expenses incurred for
services furnished within three years of the accident; and
covered Grafs vehicle. It provided: "The uninsured motor
vehicle coverage shall be excess over and shall not pay again
any medical expenses paid under the medical payments
coverage." It also provided that medical payments
coverage would be denied "to the extent workers
compensation benefits are required to be payable."
In October 2009, Graf, with State Farms consent, settled her
claim against the other motorist for his policy limits of
$50, 000 through Progressive Insurance. In September 2011,
Graf filed a three-count complaint against State Farm in the
Superior Court (Somerset County) seeking coverage from State
Farm pursuant to both policies.
On August 20, 2013,  as the parties were preparing to go to
trial, Graf filed a motion for stay of proceedings due to an
arbitration clause in the policies, which the court
(Nivison, J.) granted. See generally
Uniform Arbitration Act, 14 M.R.S. ...