Leader National Insurance v. Penson

336 S.E.2d 595, 176 Ga. App. 478, 1985 Ga. App. LEXIS 2349
Court of Appeals of Georgia·Decided October 18, 1985·No. 70423·Published

Opinion

Beasley, Judge.

This case is another of the many stemming from Jones v. State Farm &c. Ins. Co., 156 Ga. App. 230 (274 SE2d 623) (1980) and Flewellen v. Atlanta Cas. Co., 250 Ga. 709 (300 SE2d 673) (1983), involving liability of an insurance company for optional personal injury protection (PIP) coverage under OCGA § 33-34-5 (former Code Ann. § 56-3404b) as it existed prior to November 1, 1982.

On April 2, 1976, Willie Penson completed an application for automobile insurance with Leader. His wife Margie was not a co-applicant or a named co-insured on the application. The insurance company issued the policy which included coverage for Mr. Penson from April 2, 1976, until April 2,1977, and which purported to provide PIP or “no-fault” coverage in the minimum required amount of $5,000.

On March 12, 1977, Willie Penson, while a pedestrian, was killed in a motor vehicle accident. At the time of the death, Mrs. Penson did not have another automobile insurance policy nor, she claims, had ever read her husband’s policy with Leader. She made no claim to the insurance company and initiated no communication with it in 1977. Apparently in 1983, Mrs. Penson saw a newspaper advertisement about possible recovery for certain individuals for PIP benefits due to the changes wrought by Jones and Flewellen; she then sought legal counsel.

On December 14, 1983, Penson’s counsel wrote the insurer: “At this time, our client does hereby demand payment for all unpaid Personal Injury Protection benefits up to $50,000.00 in accord with O.C.G.A. §§ 33-34-4 and 33-34-5 (Michie, 1982). Our client hereby tenders to Leader National Insurance Company all premiums due for $50,000.00 PIP coverage under the above-referenced policy from the effective date of that insurance contract through and including March 12, 1977, the date of the collision. Please provide us with the amount due for such benefits and we will immediately remit said sum to you. Please accept this as our client’s unconditional tender of such [479] sum. . . .

“Demand is hereby made for prompt payment of all sums due to our client under the authority of O.C.G.A. §§ 33-34-4 (b) and 33-34-5.”

On December 22, the attorney sent a follow-up letter with a copy of the December 14 demand. By letter of January 3, 1984, the insurance company’s claims manager notified Penson’s counsel: “please be advised that due to the age of this loss, we do not have any records in this office. Therefore, I have requested this file from our Home Office. Until I receive the file, I am not in a position to accept or reject your demand at this time.” Penson’s lawyer wrote again on February 7, asking whether the needed information had been received and whether the company would require additional proof of economic losses.

On February 29, Penson filed suit in her own name against the insurance company alleging that as a result of the fatal collision and pursuant to the terms of the subject insurance policy, she was entitled to receive in monthly installments up to $50,000 as survivor’s benefits under OCGA §§ 33-34-4 and 33-34-5 and that as of February 25,1984, $45,539.60 in survivor’s benefits had accrued. The complaint further alleged that the insurer had without good faith failed and refused to pay any portion of the accrued survivor’s benefits. Penson sought $45,539.60 actual damages, statutory penalties not to exceed twenty-five percent of the amount of insurance benefits due under OCGA § 33-34-6, punitive damages, and costs of litigation including reasonable attorney fees.

Penson filed a motion for partial summary judgment and then an amended motion for partial summary judgment on the grounds that there were no genuine issues of material fact as to 1) her standing to pursue the claim in her own name, 2) the amount of optional PIP benefits available to her under the policy, 3) the defectiveness of the insurance application, 4) her right to activiate $50,000 PIP coverage, 5) her tender of the premium due for $50,000 PIP and 6) her submission of reasonable proof of her claim for survivor’s benefits. The insurance company filed its motion for summary judgment.

Following a hearing, consideration of the record, briefs and arguments of counsel, the trial court entered an order denying the insurer’s motion for summary judgment and granting Penson’s amended motion for partial summary judgment after finding that Penson had standing to pursue the matter in her own name, that the insurance application did not fully or substantially comply with OCGA § 33-34-5 (b), that the policy provided for $50,000 PIP coverage from April 2, 1976 through and including March 12, 1977, that as the surviving spouse Penson had effectively activated the $50,000 PIP coverage provided under the policy by tendering the premium due [480] and submitting reasonable proof of her claim for survivor’s benefits under OCGA § 33-34-5 (a) (2), and that her claim for survivor’s benefits was not barred by OCGA § 9-3-24.

The insurance company appeals both the grant of Penson’s motion and the denial of its motion. It contends that 1) appellee Penson is contractually barred from pursuing her claim because of a failure to comply with a condition in the insurance policy requiring notice to the insurance company as soon as practicable after an accident; 2) that the application for insurance signed by appellee’s husband was in substantial compliance with OCGA § 33-34-5 (b); 3) that appellee’s claim is barred by the applicable statute of limitations; 4) that the tender of payment for additional optional PIP coverage was a condition precedent to recovery by appellee; and 5) that the appellee had no standing to bring the present suit.

1. We first address appellee’s standing to bring the lawsuit.

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Leader National Insurance v. Penson, 336 S.E.2d 595, 176 Ga. App. 478, 1985 Ga. App. LEXIS 2349 (Ga. Ct. App. 1985).

336 S.E.2d 595 (Leader National Insurance v. Penson) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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