According to the Opinion, the Plaintiff was shopping at a Wal-Mart in Mansfield, Tioga County, Pennsylvania when a robber demanded cash from a customer service employee. The Plaintiff and several others chased the robber out into the parking lot and towards the robber’s car, which the robber had left running.
While these individuals scuffled with the robber, the Plaintiff entered the passenger side of the vehicle and attempted to remove the keys from the ignition. The robber put the vehicle in drive, stepped on the gas, and the Plaintiff was injured by the vehicle as a result.
As the robber had no car insurance, the Plaintiff pursued an uninsured motorist claim against GEICO.
Under the GEICO uninsured motorist provisions of the policy, it was provided that the Plaintiff must prove that she was “legally entitled to recover” from the operator of an uninsured motor vehicle in order to recover UM benefits.
The Plaintiff filed a Complaint against GEICO alleging breach of contract and bad faith. Under the breach of contract claim, the Plaintiff sought a declaratory judgment requiring GEICO to cover her for uninsured motorist coverage. The Plaintiff filed a bad faith count seeking damages, arguing that GEICO’s handling of her claim amounted to bad faith under 42 Pa. C.S.A. §8371.
A main issue before the court was whether the assumption of risk doctrine operated as a total bar to the Plaintiff’s recovery such that she was not "legally entitled to recover" against the uninsured operator of the vehicle that injured her.
Judge Matthew W. Brann M.D. Pa. |
In this regard, Judge Brann stated that, “to grant summary judgment on assumption of the risk as a matter of law, the court must – conclusively and beyond question – find that the Plaintiff was subjectively aware of a specific risk, voluntarily accepted it and acted in spite of that risk, and suffered harm contemplated by that specific risk.” Id. citing with “See, e.g.” signal, Zeidman v. Fisher, 980 A.2d 637, 641, Pa. Super. 2009).
Here, the court denied GEICO’s motion and granted the
Plaintiff’s motion on the assumption of risk issue. In this regard, Judge Brann found that there
were no facts that demonstrated that the Plaintiff was aware of the particular
danger from which she was ultimately injured.
More specifically, there were no facts to establish that the
Plaintiff was specifically aware of the risks that the robber would run her
over with his vehicle or otherwise cause her to fall down and strike her head
on the pavement.
The Court noted that awareness of a general risk of harm does not amount to an awareness of a specific risk as required by the assumption of risk doctrine.
The court also held that, under the assumption of risk doctrine, a court should look at what a Plaintiff actually knew, appreciated, and assumed in terms of the risks, rather than what a Plaintiff should have known under the circumstances. Here, the court found that there were no facts to demonstrate that the Plaintiff was subjectively aware of the danger that would eventually befall her.
The Court noted that awareness of a general risk of harm does not amount to an awareness of a specific risk as required by the assumption of risk doctrine.
The court also held that, under the assumption of risk doctrine, a court should look at what a Plaintiff actually knew, appreciated, and assumed in terms of the risks, rather than what a Plaintiff should have known under the circumstances. Here, the court found that there were no facts to demonstrate that the Plaintiff was subjectively aware of the danger that would eventually befall her.
Judge Brann also found that there were no circumstances
where the risk of harm was so obvious with this case in that the Plaintiff
implied relieved the robber from exercising due care for the Plaintiff’s
safety.
Accordingly, based upon the above factors, the court concluded that the assumption of risk doctrine did not serve to bar the Plaintiff’s claims.
Accordingly, based upon the above factors, the court concluded that the assumption of risk doctrine did not serve to bar the Plaintiff’s claims.
The court also added that, to the extent that GEICO
questions the reasonableness of the Plaintiff’s actions at trial, that is an
inquiry that should be resolved through comparative negligence principles and
not assumption of the risk principles.
The court noted that whether the Plaintiff acted reasonably under the
circumstances remains an issue for the jury to decide.
The Court found that the fact that GEICO ultimately erroneously relied upon that doctrine in this case, did not advance the Plaintiff’s bad faith claim because the presence or absence of bad faith does not turn on the legal correctness of the basis for a carrier’s denial of an insured’s claim.
The court additionally noted that, even if it was assumed that GEICO lacked a reasonable basis to rely upon the assumption of risk doctrine as an affirmative defense, the Plaintiff still failed to present clear and convincing evidence that GEICO knew or recklessly disregarded that lack of a reasonable basis as required by bad faith liability.
Judge Brann reiterated that, under the bad faith statute, the Plaintiff’s burden of proof is “substantial: ‘Bad faith must be proven by clear and convincing evidence and not merely insinuated. This heightened standard requires evidence so clear, direct, weighty, and convincing as to enable a clear conviction, without hesitation, about whether or not the Defendants acted in bad faith.’” [citations omitted].
The court additionally found that the Plaintiff could not show that GEICO unreasonably delayed in the handling of her claim as the parties communicated with each other over several months in an effort to resolve the case. Judge Brann also noted that, by the time the Plaintiff filed her Complaint, she had still not produced certain documentation, including the police report, requested by the carrier. As such, the court found that any delay incurred in GEICO’s resolution of Plaintiff’s claims cannot be construed as unreasonable.
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