Pappas v. Prudential Property & Casualty Insurance

588 A.2d 22, 403 Pa. Super. 45, 1991 Pa. Super. LEXIS 448
Superior Court of Pennsylvania·Decided February 25, 1991·No. No. 02052 Philadelphia 1990·Published

Opinion

MONTEMURO, Judge:

Appellant, Prudential Property and Casualty Insurance Company (“Prudential”), appeals from a grant of summary judgment in favor of the insured, appellee Chester Pappas, in this action to recover work loss benefits under the Pennsylvania No-Fault Motor Vehicle Insurance Act.1 The [47] issue on appeal concerns the proper method of calculating work loss benefits pursuant to § 206 of the No-Fault Act in cases where the no-fault insurer is entitled to a deduction for income tax savings realized by the insured through the receipt of nontaxable benefits.

The underlying facts in this case are undisputed. On January 18, 1982, Chester Pappas was seriously injured while operating a motor vehicle during the course of his employment. The Injuries left Pappas permanently disabled and unable to return to his job. Since the date of his accident, Pappas has been receiving worker’s compensation benefits; he has also received Social Security Disability benefits. Through his counsel, on September 8, 1982, Pap-pas notified Prudential, his no-fault insurer, that he had sustained work loss and benefits were therefore owing under the No-Fault Act. Pappas thereafter supplied Prudential with information necessary to process his claim for work loss benefits. Although in January, 1988, Prudential made partial payments to Pappas amounting to $1675.26, Prudential thereafter refused to honor any further requests for payments made on behalf of Pappas. Pappas brought this action for no-fault work loss benefits from Prudential to recover the balance of his lost wages not covered by the worker’s compensation and social security benefits. Pappas also included claims for interest on the overdue benefits at a rate of 18% per annum, as allowed under 40 P.S. § 1009.-106(a)(2), and reasonable attorney’s fees pursuant to 40 P.S. § 1009.107.

In cases where the insured is unable to return to work due to injuries from the accident, the No-Fault Act requires no-fault insurers to pay the insured work loss benefits, defined as “loss of gross income of a victim,” subject to a statutory maximum of $15,000. 40 P.S. §§ 1009.103, 1009.-202(b). In computing the amount of an insured’s net loss, the insurer is entitled to subtract from the insured’s work loss any benefits received from other sources to compensate for the injury. 40 P.S. § 1009.206(a). The insurer is also entitled to deduct from the no-fault wage loss benefits any [48] income tax savings which the insured realizes through receipt of nontaxable loss-of-income benefits. 40 P.S. § 1009.206. The parties here disagree as to how the tax deduction should be computed.

The relevant provisions of the No-Fault Act state:

§ 1009.206. Net Loss
(a) General. — Except as provided in section 108(a)(3) of this act, all benefits or advantages (less reasonably incurred collection costs) that an individual receives or is entitled to receive from social security (except those benefits provided under Title XIX of the Social Security Act and except those medicare benefits to which a person’s entitlement depends upon use of his so-called ‘life-time reserve’ of benefit days) workmen’s compensation, any State-required temporary, nonoccupational disability insurance, and all other benefits (except the proceeds of life insurance) received by or available to an individual because of the injury from any government, unless the law authorizing or providing for such benefits or advantages makes them excess or secondary to the benefits in accordance with this act, shall be subtracted from loss in calculating net loss.
(b) Tax deduction. — If a benefit or advantage received to compensate for loss of income because of injury, whether from no-fault benefits or from any source of benefits or advantages subtracted under subsection (a) of this section, is not taxable income, the income tax saving that is attributable to such loss of income because of injury is subtracted in calculating net loss for work loss. Subtraction may not exceed twenty per cent (20%) of the loss of income and shall be in such lesser amount as the insurer reasonably determines is appropriate based on a lower value of the income tax advantage.

40 P.S. § 1009.206.

Relying on Motley v. State Farm Mutual Insurance Co., 502 Pa. 335, 466 A.2d 609 (1983), the trial court held that the income tax deduction must be based solely on the work loss benefits payable by Prudential under the no-fault poli[49] cy. We disagree. A careful reading of Motley shows that the Motley court did not address the issue before this Court. In a footnote, the Court simply noted that “[ujnder Section 206(b) of the No-Fault Act, the wage loss payment to the insured shall be adjusted so as to take into consideration the tax advantages which accrue to the claimant.” 502 Pa. at 340 n. 7, 466 A.2d at 611 n. 7. Motley provides no further guidance as to how the tax advantage is to be calculated.

The statute is clear on its face. Under § 206(a), the amount of worker’s compensation benefits and social security benefits which Pappas receives are to be subtracted from his gross work loss in figuring his net work loss. Additionally, under § 206(b), Prudential is entitled to a deduction for Pappas’ income tax savings resulting from the receipt of any loss-of-income benefits which are nontaxable under the federal and state tax codes. If Pappas had not been injured, he would have had to pay income tax on the income he received from his employer. Because some of the wage loss compensation benefits which he is receiving are not taxable under the taxation statutes, Prudential need not compensate Pappas for income tax which he would have had to pay had he been working. “The purpose of § 206(b) is to prevent a no-fault claimant from receiving a windfall by virtue of income tax savings.” Brown v. City of Pittsburgh, 126 Pitt.Legal J. 312, 317 (1978).

As we read the statute, the amount of the tax savings deduction depends on those loss-of-income benefits, including, inter alia, the work loss benefits paid by the no-fault insurer, worker’s compensation benefits, and social security benefits, that constitute nontaxable income under the tax laws. We disagree with Pappas’ position that the deduction must be based only on the work loss benefits payable by Prudential under the no-fault policy.

The Pennsylvania Code, 31 Pa.Code §§ 66.54, 66.55, provides guidance as to the proper method of calculating the net work loss which Prudential is required to pay. Sections 106(a)(1) and (2) of the No-Fault Act require that the no-[50] fault benefits be paid monthly as loss accrues; the no-fault insurer must pay interest at a rate of 18% per annum on those benefits which are not paid within 30 days of submission of proof of the loss. 40 P.S. § 1009.106. Accordingly, we will compute the amount of benefits owing to Pappas on a monthly basis.

Pappas’ net loss, that is, the work loss payable by Prudential, is computed by subtracting the value of Pappas’ worker’s compensation, social security disability benefits and income tax savings from his total lost income. See 31 Pa.Code §§ 66.54(b)(2)(ii), (iii).

I. TOTAL LOST INCOME

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Pappas v. Prudential Property & Casualty Insurance, 588 A.2d 22, 403 Pa. Super. 45, 1991 Pa. Super. LEXIS 448 (Pa. Ct. App. 1991).

588 A.2d 22 (Pappas v. Prudential Property & Casualty Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Motley v. State Farm Mutual Automobile Insurance
466 A.2d 609 (Supreme Court of Pennsylvania, 1983)