410_C167


GEOGRAPHIC LIMITATION CLAUSE CHALLENGED


Automobile

Coverage Territory

Uninsured Motorist

 

In May 2001, Paula MacNealy was walking on a beach in Mexico when she was struck and injured by a dune buggy. MacNealy filed a claim for uninsured motorist coverage under her State Farm Mutual Automobile Insurance Company automobile insurance policy. State Farm denied coverage because the accident took place in Mexico. According to State Farm, under the terms of the policy, liability coverage applied to areas of Mexico, but uninsured motorist coverage was excluded.

MacNealy filed a complaint claiming she was entitled to uninsured motorist coverage. The trial court and the appellate court decided in favor of MacNealy, finding that the geographic limitation provision relied upon by State Farm was invalid and unenforceable. Because its decision conflicted with decisions of other courts, the court of appeals certified two issues for review by the Supreme Court of Ohio. The first issue was whether limiting the geographic scope of uninsured motorist coverage violated the statute that governed uninsured motorist coverage in Ohio. The second issue, which was dependent upon resolution of the first, was how to define the scope of the geographic limitation of the State Farm policy.

MacNealy argued that geographic limitations on uninsured motorist coverage are unenforceable because they keep insureds from obtaining coverage for causes of action recognized by Ohio law. The Supreme Court of Ohio disagreed. The court explained that the public policy of the state is to ensure that all motorists maintain some form of liability coverage on motor vehicles operated within Ohio. To construe the law to preclude insurers from imposing geographic limitations would require them to insure risks that were either unknown or so high as to make coverage impractical. Premiums would dramatically increase, and motorists who did not travel outside the country would end up subsidizing those who did. The court concluded that Ohio's uninsured motorist statute did not prohibit insurers from limiting uninsured motorist coverage to accidents occurring in the United States and Canada.

Next, the court evaluated the geographic scope of the coverage under the State Farm policy. As required by Ohio law, when MacNealy applied for her automobile insurance, State Farm offered her uninsured motorist coverage as well. As to coverage in Mexico, the relevant provision in the policy stated that "The liability, medical payments and physical damage coverages also apply in Mexico within 50 miles of the United States border. A physical damage coverage loss in Mexico is determined on the basis of cost at the nearest United States point." Uninsured motorist coverage was limited to the United States and Canada. Because the law did not require State Farm to offer uninsured motorist coverage that was equivalent in all ways to the liability coverage available under the policy, and because MacNealy accepted State Farm's offer of uninsured motorist coverage, the court held that MacNealy was not entitled to uninsured motorist coverage for the accident that occurred in Mexico.

The judgment of the court of appeals was reversed.

Fazio vs. Hamilton Mutual Insurance Company-No. 2004-1559-Supreme Court of Ohio-October 12, 2005-835 North Eastern Reporter 2d 20