Tuesday, March 2, 2021

Plaintiff's Securing of Retroactive Full Tort Coverage After an Accident Allowed To Stand

In the case of Maola v. Monsour, No. 10337 of 2019, C.A. (C.P. Lawr. Co. Dec. 16, 2020 Motto, P.J.), the court addressed various limited tort issues.

The first issue the court addressed was whether the Plaintiff was covered by the limited tort option.

According to the Opinion, the Plaintiff had full tort coverage under her initial automobile insurance policy. When the Plaintiff later changed insurance agents, the Plaintiff expressed that she wished to continue to have full tort coverage. However, the form signed by the Plaintiff included a limited tort election.

The Plaintiff did not discover this mistake until after the accident. She contacted her carrier to see what can be done to remedy that situation. The Plaintiff was advised by the carrier that she could obtain full retroactive coverage if she paid the back premiums and executed a full tort election form. The Plaintiff complied with these requirements and the carrier provided her with full tort coverage that was retroactive to the date prior to the subject accident.

In this matter, the defense asserted that the retroactive application of full tort coverage was not permissible after an accident had already occurred.

The Plaintiff responded by asserting that she had complied with the terms set by her own insurance carrier such that she should be entitled to full tort coverage.

The court acknowledged that Pennsylvania case law holds that a limited tort elector was generally prohibited from retroactively obtaining full tort coverage after an accident had occurred. 

However, in this matter, the Plaintiff’s carrier was not necessarily prohibited from providing the Plaintiff with retroactive full tort coverage. In this case, the Plaintiff offered evidence that she had explicitly requested her new insurance agent to provide her with full tort coverage and that the issuance of a limited tort policy was based upon a mistake. The court also emphasized that the record established that it was the Plaintiff’s intention to have full tort coverage and that she met her own insurance company’s requirements for that retroactive coverage.

As such, Judge Motto found that the Plaintiff had a reasonable expectation of full tort coverage at the time the accident occurred. Accordingly, the court ruled that the Plaintiff was a full tort Plaintiff relative to this matter. 

The court also noted that the Plaintiff had offered sufficient evidence to allow her claim of serious injury to proceed to a jury in any event. The Plaintiff allegedly experienced neck, chest, knee, shoulder, and ankle pain. She also underwent multiple types of diagnostic testing and therapy. The record further established that the Plaintiff had continuously reported her pain as being severe and she offered testimony as to how the pain affected her activities of daily living.

The court emphasized that the focus of the limited tort question was not on the injuries themselves but upon how the injuries affected the Plaintiff’s ability to perform her everyday activities.

Anyone wishing to review a copy of this decision may click this LINK.

Source: “Digest of Recent Opinions.” Pennsylvania Law Weekly (Feb. 2, 2021).

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