Alessandro v. State Farm Mutual Automobile Insurance

393 A.2d 973, 259 Pa. Super. 571, 1978 Pa. Super. LEXIS 3944
CourtSuperior Court of Pennsylvania
DecidedNovember 1, 1978
Docket111, 122, 123, 124 and 125
StatusPublished
Cited by13 cases

This text of 393 A.2d 973 (Alessandro v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alessandro v. State Farm Mutual Automobile Insurance, 393 A.2d 973, 259 Pa. Super. 571, 1978 Pa. Super. LEXIS 3944 (Pa. Ct. App. 1978).

Opinion

Opinion of the Court

CERCONE, Judge:

Plaintiff brought this class action on behalf of all persons insured with the defendant insurance company whose uninsured motorist coverage payments had been reduced by set-offs equal to amounts paid by the company under medical payments coverage. The class excepted those whose claims were barred by the statute of limitations.

A clause customarily included in the insurance policies issued by defendant allows payments under uninsured motorist coverage to be reduced by payments under medical coverage. Plaintiff contends that this clause is void as it is repugnant to the Act of August 14, 1963, P.L. 908, Sec. 1, as amended December 19, 1968, P.L. 1254, No. 397, Sec. 1, effective January 1, 1969, 40 P.S. 2000. Section (a) of the Act reads as follows.

“No motor vehicle liability policy of insurance insuring against loss resulting from liability imposed by law for bodily injury or death suffered by any person arising out of the ownership, maintenance or use of a motor vehicle shall be delivered or issued for delivery in this State with *575 respect to any motor vehicle registered or principally garaged in this State, unless coverage is provided therein or supplemental thereto in limits for bodily injury or death as are fixed from time to time by the General Assembly in section 1421 of article XIV of “The Vehicle Code, act of April 29, 1959 (P.L. 58). (75 P.S. Sec. 1421) under provisions approved by the Insurance Commissioner, for the protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of uninsured motor vehicles because of bodily injury, sickness or disease, including death resulting therefrom.”

Plaintiff had uninsured motorist coverage in the amount of $10,000, the minimum required under the former Vehicle Code, 75 P.S. 1421 (1971), and medical payments coverage of $2,000. His individual claim was based on injuries his ten-year-old son received when he was struck by an uninsured motorist while riding a mini-bike. Plaintiff incurred medical bills in the amount of $2,321.75 as a result of the accident. He received an arbitration award of $5,000.00 under his uninsured motorist coverage. Neither party took an appeal from the arbitration proceedings.

Defendant offered him a check for $5,000.00 in return for a release of all his other claims arising from the same accident. Plaintiff believed that the release might bar his claim for reimbursement under the medical payment provision of his policy. He believed himself entitled to $5,000.00 plus reimbursement of medical bills to the extent of his medical payments coverage. Accordingly, he declined to accept the check or sign the release, but instead brought an action in assumpsit for the total amount he believed defendant owed him.

Defendant’s first response to the assumpsit complaint was to file preliminary objections to the case proceeding as a class action. The objections were overruled; the lower court held that there was a common question of law which predominated over any individual questions.

Defendant’s Answer and New Matter informed the court that plaintiff had accepted the $5,000.00 check and stated *576 that defendant had no reason to invoke the setoff clause against plaintiff since an independent basis for denying payment existed. Plaintiff admitted that he had accepted the check on advice of counsel.

The court next had occasion to consider the propriety of the class action when State Farm filed objections to plaintiff’s interrogatories. The interrogatories sought the names and coverage amounts of the other persons fitting within plaintiff’s definition of the class. The court below sustained the objections and withdrew class action status, apparently interpreting State Farm’s plea, that there was an alternative basis for nonpayment, as a waiver of the setoff clause. The court stated that the only issue remaining was whether the events giving rise to plaintiff’s claim came within the terms of the medical payments coverage. (State Farm interprets certain policy language as precluding payment because of the lack of insurance on the mini-bike the boy was riding.)

Upon plaintiff’s petition, the order was vacated and the class action was reinstated. The court stated:

“The acceptance and cashing of the post-complaint— $5,000.00 check by the individual class representative does not make the claims of the other members of the class which plaintiff purports to represent moot, and, consequently, it is our considered judgment that, in the circumstances of this case where many members of the class would be prejudiced by the bar of the statute of limitations if this class action was bumped to the status of an ordinary suit in assumpsit, this case should continue as a class action.” 1

*577 State Farm then filed a motion for partial decertification of the class. The court below, on September 19, 1975, issued an order limiting class membership to those policyholders who had received arbitration awards of $10,000 or more. The court’s reasoning was as follows.

“It is our holding that where the UMC coverage is sufficient to pay in full the tort damages suffered by the policy holder at the hands of an uninsured motorist, then there is nothing illegal or improper in a medical payments provision of the insurance policy which provides that the medical bills shall not be reimbursed to the policy holder if they have been paid or are payable under the UMC provisions of the policy. .
“The result of our holding is that the only members of the class in the instant law suit are those policy holders who have received an arbitration award under the policy in the amount of $10,000.00 or more. It is only those policy holders who may possibly have had denied to them the payment of their medical payments coverage on top of the $10,000.00 of tort damages payable because of the UMC insurance.”

Although the redefinition of the class excluded plaintiff, the court made an exception for him, stating:

“[W]e reject the argument of the defendant that the case should be terminated because the plaintiff himself is not a member of the class as we have defined it above. We are satisfied that as a matter of common sense and fairness a plaintiff who undertakes the institution of a suit as a class action under allegations which appear on their face to make him a member of a potential class that is not frivolous, successfully institutes a class action on behalf of all those persons who ultimately turn out to have been members of the class in fact. That is to say, a subsequent determination that the named plaintiff does not qualify for class membership will not be permitted to amount to a defect that would cause the litigation to abort.” [Emphasis supplied.]

sylvania in any way material to the instant litigation. Compare Pa.R.C.P., Rule 2230 (1975).

*578 Discovery subsequently revealed that nine members remained in the class other than plaintiff.

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Cite This Page — Counsel Stack

Bluebook (online)
393 A.2d 973, 259 Pa. Super. 571, 1978 Pa. Super. LEXIS 3944, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alessandro-v-state-farm-mutual-automobile-insurance-pasuperct-1978.