Folks v. State Farm Mutual Insurance

299 F. App'x 748
CourtCourt of Appeals for the Tenth Circuit
DecidedOctober 20, 2008
Docket05-1356
StatusUnpublished
Cited by6 cases

This text of 299 F. App'x 748 (Folks v. State Farm Mutual Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Folks v. State Farm Mutual Insurance, 299 F. App'x 748 (10th Cir. 2008).

Opinion

ORDER

TERRENCE L. O’BRIEN, Circuit Judge.

This matter is before the Court on the petition for rehearing en banc and alternative petition for panel rehearing filed by State Farm Mutual Automobile Insurance Company (State Farm) on October 29, 2007.

The published opinion in State Farm, Mutual Automobile Insurance Co. v. Boellstorff 540 F.3d 1223 (10th Cir.2008), resolves the issue raised by State Farm in the present petition. In light of Boellstorff, we conclude the present petition contains nothing that would change the disposition of this appeal.

We will, however, grant State Farm’s alternative petition for panel rehearing in part. The Order and Judgment issued on October 29, 2007, is withdrawn and the attached Order and Judgment which specifically references Boellstorff, is substituted therefore. Apart from the changes reflected in the substituted Order and Judgment, State Farm’s alternative petition for panel rehearing is denied. The substituted Order and Judgment has been circulated to the Court in light of the still pending request for rehearing en banc. An order will issue on that portion of State Farm’s petition following the en banc court’s review.

ORDER AND JUDGMENT **

Roberta Folks and Kim Nguyen appeal from the district court’s grant of summary judgment to State Farm Mutual Automobile Insurance Company. Exercising jurisdiction pursuant to 28 U.S.C. § 1291, we reverse as to Folks and affirm as to Nguyen.

I. Background

A. The No-Fault Act

In 1973, the Colorado legislature enacted the Colorado Auto Accident Reparations Act (“CAARA” or “No-Fault Act”) which governed the sale of automobile insurance in the state. 1 See Colo.Rev.Stat. *750 §§ 10-4-701 through 726. The purpose of the No-Fault Act was to avoid inadequate compensation to victims of automobile accidents. Brennan v. Farmers Alliance Mut. Ins. Co., 961 P.2d 550, 553 (Colo.App.1998). Under CAARA, automobile insurance policies had to include a basic level of personal injury protection (PIP). 2 This basic level included: (a) $25,000 per individual, $50,000 per accident for legal liability coverage and $15,000 for property damage, exclusive of interest and costs; (b) $50,000 for medical services per person for any one accident regardless of fault if performed within five years of the accident; (c) $50,000 for rehabilitative services per person for any one accident regardless of fault if performed within ten years of the accident; (d) reimbursement for up to $400 of gross income per week plus expenses up to $25 a day for fifty-two weeks; and (e) $1,000 in death benefits. See Colo.Rev. Stat. § 10-4-706(l)(a)-(e). These basic levels applied to “1) the named insured, 2) resident relatives of the named insured, 3) passengers occupying the insured’s vehicle ■with the consent of the insured, and 4) pedestrians who are injured by the covered vehicle.” Brennan, 961 P.2d at 553; see also Colo.Rev.Stat. § 10-4-707(1). In connection with the basic level of coverages, CAARA allowed an insurer to offer managed care options through health maintenance organizations (HMO) or preferred provider organizations (PPO). See Colo.Rev.Stat. § 10-4-706(2) (2001).

From 1992 through its repeal in 2002, § 706(3) 3 of CAARA allowed an insurer to offer an “alternative to the minimum coverages” known as a “reduced” PIP policy. 4 See Colo.Rev.Stat. § 10-4-706(3) (1992 through 2002). The reduced coverages included: (I) up to $25,000 per person for any one accident for identified types of medical procedures, if performed within five years of the accident; (II) no compensation for rehabilitation; and (III) $5,000 of death benefits. See Colo.Rev.Stat. § 10 — 4—706(3)(b)(I)—(III) (2001). In order to qualify for the reduced coverages, the combined annual gross income of the person applying and their spouse could not exceed 185% of the federal poverty level for a family of four, adjusted upward for family size. See Colo.Rev.Stat. § 10-4-706(3)(c)(I). The reduced policy was limited to “the named insured, resident spouse, and resident child.” See Colo.Rev.Stat. § 10-4-706(3)(f)(I) (2001).

Enacted and repealed at the same time as the reduced PIP coverages, CAARA also contained a provision which required insurance companies to provide written explanations of available § 706 coverage options to their insureds:

An insurer issuing policies providing coverages as set forth in this section shall provide written explanations of all available coverages prior to issuing any policy to an insured. After a named insured selects a policy with desired personal injury protection coverage, an insurer shall not be under any further obligation to notify such policyholder in any renewal or replacement policy of the availability of a reduced personal injury *751 protection policy or of any alternative personal injury protection coverage.

Colo.Rev.Stat. § 10-4-706(4)(a) (2001).

Apart from the basic PIP coverages, CAARA also required insurance companies to offer their insureds optional enhanced PIP benefits in exchange for higher premiums. Section 10-4-710(2)(a) provided:

Every insurer shall offer the following enhanced benefits for inclusion in a complying policy, in addition to the basic coverages described in section 10-4-706, at the option of the named insured:
(I) Compensation of all expenses of the type described in section 10-4-706(l)(b) [medical expenses] without dollar or time limitation; or
(II) Compensation of all expenses of the type described in section 10-4-706(l)(b) [medical expenses] without dollar or time limitations and payments of benefits equivalent to eighty-five percent of loss of gross income per week from work the injured person would have performed had such injured person not been injured during the period commencing on the day after the date of the accident without dollar or time limitations.

Colo.Rev.Stat. § 10-4-710(2)(a) (2003). 5 Though not specified in § 10-4-710 or elsewhere in CAARA, Brennan held these enhanced PIP coverages applied to the same category of people outlined in § 10-4-707(1), including pedestrians. Brennan, 961 P.2d at 553.

B. Case Facts

1. Roberta Folks

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Cite This Page — Counsel Stack

Bluebook (online)
299 F. App'x 748, Counsel Stack Legal Research, https://law.counselstack.com/opinion/folks-v-state-farm-mutual-insurance-ca10-2008.