Hilma Gisela Mejia v. State Farm Mutual Automobile Insurance Company

2025 Ark. App. 254
Court of Appeals of Arkansas·Decided April 23, 2025·Published

Opinion

Cite as 2025 Ark. App. 254 ARKANSAS COURT OF APPEALS DIVISION II

No. CV-24-58

HILMA GISELA MEJIA Opinion Delivered April 23, 2025

APPELLANT

APPEAL FROM THE BENTON

COUNTY CIRCUIT COURT

V. [NO. 04CV-23-2241]

STATE FARM MUTUAL AUTOMOBILE HONORABLE XOLLIE DUNCAN, INSURANCE COMPANY JUDGE APPELLEE

AFFIRMED

CINDY GRACE THYER, Judge

Hilma Gisela Mejia appeals a Benton County Circuit Court order granting summary judgment in favor of State Farm Mutual Automobile Insurance Company. On appeal, Mejia claims (1) that there are genuine issues of material of fact left to be decided, thereby precluding summary judgment and (2) that the circuit court erred as a matter of law in concluding that a claim is “paid” when a check is mailed by the insurance company and not when the check is received by the insured. We affirm.

The facts in this case are fairly simple. On December 18, 2022, Mejia’s son, MC, was injured in an automobile accident. At the time of the accident, MC was a passenger in a

vehicle driven by MC11 and owned by MC1’s parents. MC1’s vehicle, which was insured by State Farm, included a provision providing $5,000 in no-fault medical coverage.

In January 2023, State Farm paid a portion of MC’s medical bills under its no-fault provision when it issued a $2,129 check to Mercy Hospital Northwest Arkansas. On July 19, 2023, Mejia submitted a demand to State Farm for reimbursement of MC’s remaining healthcare charges. Her demand letter included copies of MC’s medical records and $6,067.39 in related medical bills.

On August 23, 2023, Mejia filed suit against State Farm, 2 claiming that payment had not been received within thirty days of her demand as required by statute 3 and seeking not only recovery of medical benefits but also attorney’s fees, pre- and postjudgment interest, and a 12 percent statutory penalty.4

1 The relationship between MC and MC1, if any, is unknown.

2 Arkansas Code Annotated section 23-89-208(e) (Repl. 2014) provides that “[i]n the event the insurer fails to pay the benefits when due, the person entitled to the benefits may bring an action in contract to recover them.”

3 Arkansas Code Annotated section 23-89-208(b) states that benefits are overdue if not “paid” within thirty (30) days after the insurer receives “reasonable proof of the amount of all benefits accruing during that period.”

4 Arkansas Code Annotated section 23-89-208(f) provides that “[i]n the event the insurer is required by the action to pay the overdue benefits, the insurer shall, in addition to the benefits received, be required to pay the reasonable attorney's fees incurred by the other party, plus twelve percent (12%) penalty, plus interest thereon from the date these sums became overdue.”

State Farm answered the complaint denying that it had breached its statutory duty and claiming that it had issued a timely payment within thirty days of receiving Mejia’s demand for medical-payment coverage. It also filed a motion for summary judgment arguing the same.

In support of its motion, State Farm attached an affidavit by the claims specialist handling the Mejia claim for medical benefits, Nydia Collins.5 Ms. Collins declared that, on August 16, 2023, State Farm had issued—and mailed—a $2,872 check to Mejia, as parent and natural guardian of MC, a minor. This check represented the balance of medical-payment benefits available after payment of the Mercy Hospital Northwest Arkansas claims in January 2023. She stated that, after this last payment to Mejia, the $5,000 medical-payment coverage limits were exhausted.

State Farm claimed that it satisfied its duty to Mejia when it issued and mailed the claims check within the thirty-day statutory time frame. State Farm’s position was based on both statutory interpretation and legislative and judicial guidance from other states. In support of its argument, State Farm further noted that insurance regulations speak in terms of the mailing or delivery of claim checks. It also argued that adoption of the mailbox rule in these situations would produce uniform, predictable results. To hold otherwise would be to punish insurers for the actions of parties outside their control.

5 State Farm also attached Mejia’s July 19 demand letter and a copy of Insurance Department Regulation 43.

Mejia responded that summary judgment was inappropriate because there were genuine issues of material fact left to be decided and because State Farm incorrectly interpreted the payment statute. As for the alleged factual dispute, Mejia challenged State Farm’s claim that it had timely mailed the payment, which was not received until August 25, 2023. Mejia contended that the claim file indicated that, on August 16, State Farm conducted “medical bill research”; sent the file for review; and processed her claim. She then highlighted the fact that on August 21—three days after the deadline—State Farm sent correspondence to her counsel and suggested that the check was actually mailed on that date.6 In making this argument, she asked the circuit court to take judicial notice that four business days is a typical amount of time for mail to be delivered from Atlanta, where the check was apparently mailed. Moreover, she asserted that, in the summary-judgment context, the circuit court could not make credibility determinations regarding the discrepancies between Ms. Collins’s “self-serving” affidavit and State Farm’s claim file.

As for State Farm’s statutory-construction argument, Mejia asserted that it was the legislature’s intent to encourage the prompt payment of no-fault insurance claims and that allowing the insurer to write a check but not actually deliver it within the statutory thirty-day

6 She did not include the correspondence nor did she provide an affidavit from her counsel regarding its content. The claim file showed that correspondence was emailed to the Swindle Law Firm on August 21, 2023, and noted “CONTACT CHANGE OF CLAIM HANDLER.” Mejia’s counsel did attach an affidavit to her response to the summary- judgment motion declaring that payment was received on August 25, 2023. She also attached the envelope in which payment was sent. The envelope in which the claims check was mailed was not postmarked and listed a return address in Atlanta, Georgia.

deadline would be contrary to that legislative intent. She argued that if the legislature had intended the statutory payment obligation to be satisfied by mailing, it could have explicitly said so; it did not. She further claimed that the word “paid” necessarily contemplates a delivery of payment and that a different interpretation would lead to absurd results. Moreover, she asserted that the mailbox rule championed by State Farm applies only to the acceptance of a contract, not the performance of it.

As for State Farm’s reliance on the insurance regulations’ concept of payment, she argued that those regulations were related to unfair claims practices, and her claim was one for breach of contract. As for its reliance on other jurisdictions, she argued that the cases were distinguishable. For example, she noted that the Louisiana cases involved bad-faith claims, not breach-of-contract claims. She also noted that Arkansas’s statute, unlike those of the other jurisdictions, had been written in the past tense— “paid”—and thus was focused on the completion of the process, not the initiation of the process.

Mejia then filed a countermotion for summary judgment, claiming that the check was not mailed until August 21 and thus was late even when mailed.7 State Farm filed a combined response to Mejia’s motion for summary judgment and reply to her response to its original motion. In it, State Farm attached a copy of the check issued on August 16 and copies of the correspondence informing counsel of a reassignment

7 In support of her motion, she attached the July 19 email submitting her claim to State Farm and the September 11 payment log noting that the $5,000 limits of the policy had been applied with a payment date of August 16, 2023.

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