Jones v. National Mutual Casualty Ins.

20 Pa. D. & C.3d 360, 1981 Pa. Dist. & Cnty. Dec. LEXIS 313
CourtPennsylvania Court of Common Pleas, Washington County
DecidedSeptember 10, 1981
Docketno. 265
StatusPublished

This text of 20 Pa. D. & C.3d 360 (Jones v. National Mutual Casualty Ins.) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Washington County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jones v. National Mutual Casualty Ins., 20 Pa. D. & C.3d 360, 1981 Pa. Dist. & Cnty. Dec. LEXIS 313 (Pa. Super. Ct. 1981).

Opinion

GLADDEN, J.,

FINDINGS OF FACT AND DISCUSSION

1. Plaintiff is June Ann Jones, currently of 2477 66th Avenue South, St. Petersburg, Florida, and formerly of 1228 Overlook Drive, Washington, Pa.

2. Defendant is Pennsylvania Mutual Casualty Insurance Company (hereinafter referred to as defendant insurance company), a Pennsylvania mutual stock insurance company licensed to do business in the Commonwealth of Pennsylvania, [361]*361with offices at 300 Penn Center Boulevard, Pittsburgh, Pa.

3. Plaintiff was an insured party under Policy No. 100308357, which was issued to her in compliance with the Pennsylvania No-fault Motor Vehicle Insurance Act of July 19, 1974, P.L. 439, 40 P.S. §1009.101 et seq. (hereinafter referred to as the Act) by defendant insurance company. Said policy was in effect on August 16, 1976.

4. On August 16, 1976, plaintiff was seriously injured in an automobile collision on Interstate 70 in the vicinity of the Murtland Avenue exit in Washington County, Pa.

5. As a result of this accident plaintiff instituted the instant civil action against defendant insurance company to recover work loss benefits under the act.

6. At no time after defendant insurance company’s receipt of plaintiff’s claim for work loss benefits or receipt of plaintiff’s physician’s medical report did defendant give plaintiff any instructions, impose upon plaintiff any requirements (e.g., that plaintiff be examined by defendant’s physician), or impress upon plaintiff the need to comply with any other internal procedures of the company that would aid defendant in processing plaintiff’s claim for work loss benefits.

7. To date defendant insurance company has not paid plaintiff any work loss benefits.

Plaintiff instituted this action against her insurance company by filing a petition to compel payment of benefits under the Pennsylvania No-fault Motor Vehicle Insurance Act. Plaintiff seeks to recover work loss benefits under section 205(c) of the act, 40 P.S. § 1009.205(c), which provides that, for a victim who has not worked for three years immediately preceding an accident in which injury occurred, “probable annual income” means the aver[362]*362age gross income of a production or non-supervisory worker in the private non-farm economy in the state in which the victim is domiciled at the time the accident occurs, absent a showing that it is or would be some other amount.

After a review of the facts and the applicable law, we find that plaintiff is entitled to receive the maximum amount of work loss benefits recoverable under the act.

From June 1, 1965, to June 30, 1970, plaintiff was employed full-time at Fairmont Supply Company, as a general purchasing clerk, at a salary of $355 per month. In June, 1970, she discontinued her employment at Fairmont to be married in July of 1970. On August 23,1971, plaintiff gave birth to a daughter.

Plaintiff was not employed from June 30,1970, to August 16, 1976, the date of the automobile collision which precipitated plaintiff’s claim for work loss benefits under the act. However, prior to the accident plaintiff had planned to seek part-time employment when her daughter would be attending kindergarten during the latter part of 1976 or in early 1977. Furthermore, plaintiff planned to seek full-time employment in August of 1977, when her daughter would be entering the first grade. The automobile collision of August 16 thwarted these plans. It should be noted that plaintiff is an attractive, well-groomed and pleasant young woman in her mid-thirties and, in our judgment, a good candidate for employment as an office clerk or similar type job.

As a result of the collision, plaintiff suffered serious injuries, including multiple facial lacerations, a fracture of the distal right radius, a subcapital fracture of the neck of the right femur, a chip fracture at the tip of the distal fibula, a fracture of the pelvis in the region of the left hip, and multiple [363]*363contusions and abrasions. Plaintiff underwent significant treatment for these injuries, including hip replacement surgery.

On the date of the collision there was in effect an insurance policy issued to plaintiff by defendant that complied with the requirements of the act. Plaintiff applied for benefits due her under that policy. Defendant compensated plaintiff for her medical expenses but refused to pay her work loss benefits. Defendant insurance company has attempted to justify its refusal to pay plaintiff on the basis of information found in plaintiff’s application for benefits. On that form and in response to defendant’s questions, “At the time of your accident were you employed?” and “Did you lose wages or salary as a result of your injury?” plaintiff wrote “No.” Consequently, it is defendant’s position that plaintiff is not entitled to work loss benefits. We disagree.

The Pennsylvania No-fault Act specifically provides for work loss benefits to be paid to victims who are not employed at the time of the accident and who have not been employed for the three years preceding the accident. Section 205(c) of the act, 40 Pa.C.S.A. § 1009.205(c), provides:

“Not employed. — The work loss of a victim who is not employed when the accident resulting in injury occurs shall be calculated by: (1) determining his probable weekly income by dividing his probable annualincome by fifty-two; and (2) multiplying that quantity by the number of work weeks, or fraction thereof, if any, the victim would reasonably have been expected to realize income during the accrual period.”
“Probable annual income” is defined by section 205(d) of the act, 40 P.S. § 1009.205(d), which provides in pertinent part:
[364]*364“Probable annual income” means, absent a showing that it is or would be some other amount, the following: . . . (C) the average annual gross income of a production or non-supervisory worker in the private nonfarm economy in the state in which the victim is domiciled for the year in which the accident resulting in injury occurs, for a victim who has not previously earned income from work.”

Because plaintiff had not been employed for the three years preceding the accident on August 16, 1977, plaintiff’s expected work-related income is to be calculated by reference to the “average annual gross income of a production or non-supervisory worker in the private nonfarm economy” in Pennsylvania. The Pennsylvania Insurance Commissioner reports and publishes the average annual gross income of such a worker in the Pennsylvania Bulletin. The Commissioner also reports the monthly maximum hmitations on work loss benefits as controlled by section 202(b) of the act, 40 P.S. § 1009.202(b)

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Bluebook (online)
20 Pa. D. & C.3d 360, 1981 Pa. Dist. & Cnty. Dec. LEXIS 313, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jones-v-national-mutual-casualty-ins-pactcomplwashin-1981.