State Farm Mutual Automobile Insurance v. Davis

80 A.3d 628, 2013 WL 5878439, 2013 Del. LEXIS 556
CourtSupreme Court of Delaware
DecidedNovember 1, 2013
DocketNo. 10, 2013
StatusPublished
Cited by22 cases

This text of 80 A.3d 628 (State Farm Mutual Automobile Insurance v. Davis) is published on Counsel Stack Legal Research, covering Supreme Court of Delaware primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Farm Mutual Automobile Insurance v. Davis, 80 A.3d 628, 2013 WL 5878439, 2013 Del. LEXIS 556 (Del. 2013).

Opinion

RIDGELY, Justice:

This interlocutory appeal involves whether Delaware’s personal injury pro[630]*630tection (PIP) statute1 requires insurers to reserve PIP benefits for lost wages when requested. The plaintiff suffered severe injuries as a passenger in a car accident. While he was in a coma, his mother signed for him an assignment of insurance benefits in favor of the hospital. Plaintiff has not challenged the validity of this assignment. The hospital’s claim was promptly paid by the insurance company. When the plaintiff later requested the insurers to reserve his PIP benefits for his past and future lost wages, he was informed that the benefits had been exhausted by the payment to the healthcare provider.

On cross-motions for summary judgment, the Superior Court held sua sponte that the unchallenged assignment to the healthcare provider was invalid. The court also held that the policy underlying the PIP statute requires insurers to reserve PIP benefits for lost wages upon request. But the issue of the validity of the assignment of plaintiffs benefits was not briefed or argued below. Plaintiffs counsel conceded to the trial court, “[w]e haven’t contested the validity of the assignment” which he described as “an assignment of medical expenses, not an assignment of lost wages.”2 The Superior Court erred as a matter of law in deciding this uncontested issue. Because the assignment on behalf of the plaintiff resulted in the exhaustion of his PIP benefits before the plaintiff requested the reservation of PIP benefits for his lost wages, the legal issue of whether the insurer was required to reserve PIP benefits for lost wages is moot. Accordingly, we REVERSE the judgment of the Superior Court.

Facts and Procedural History

This matter arises from a single-vehicle accident in 2009. Melvin Davis was the passenger in a car being driven by James Sheppard who lost control of the vehicle. Davis was seriously injured and spent six weeks in Christiana Hospital. The owner of the car was Donna Wilson. Wilson had an insurance policy on the car with State Farm Mutual Automobile Insurance Company (“State Farm”), which provided $15,000 in PIP benefits. Following the accident, and while Davis was in a coma, his mother executed a revocable assignment of insurance benefits in favor of Christiana Care, which authorized the health care facility to seek payment directly from State Farm. The assignment provided:

I assign and request payment of benefits to Christiana Care Health Services and to physicians providing hospital-based services ... for which I am entitled under the terms of any and all policies under which I have coverage. This assignment applies to all services related to my current [hospital] admission or, for outpatient services, until revoked.3

The cost of the medical treatment Davis received in the hospital exceeded $185,000. Davis currently suffers from neurological problems as a result of the injuries sustained in the accident.

On December 29, 2009, after issuing a reservation of rights letter to Davis, State Farm notified Davis that liability coverage was denied, but it agreed to pay PIP benefits. On January 5, 2010, a paralegal for Davis’ counsel called State Farm to check on the status of Davis’ insurance coverage. State Farm told the paralegal that the insurance coverage had been denied in all respects. But on January 6th, State Farm [631]*631paid the PIP policy-maximum amount, $15,000, to Christiana Care and the Delaware Neurological Group. On that same day, Davis’ counsel wrote to State Farm requesting a PIP application. On January 8th, State Farm mailed Davis’ counsel a letter stating that his PIP benefits had been exhausted through the payments to his health care providers. State Farm did not receive Davis’ January 6th letter requesting a PIP application until January 11th. On February 1st, Davis’ counsel called State Farm and asked it to reserve Davis’ PIP benefits for his lost earnings. Counsel was informed that pursuant to State Farm’s first-in, first-out policy, the PIP benefits had been fully exhausted.4 On February 5th, State Farm received a facsimile again requesting a PIP application and reservation of lost earnings benefits. This request was denied by State Farm.

In September 2010, Davis filed a complaint asserting four claims against State Farm seeking lost earnings, general damages for emotional distress, punitive damages, and attorneys’ fees.5 In May 2011, Davis filed an amended complaint, pleading the case as a class action and seeking a declaratory judgment on State Farm’s obligation under 21 Del. C. § 2118 to reserve lost earnings benefits. Davis also alleged claims of breach of contract, bad faith, and violations of 21 Del. C. § 2118B, which addresses penalty interest on claims that go unpaid for more than 30 days. Pursuant to a stipulation and order entered by the Superior Court, the parties filed cross-motions for summary judgment on these issues.

In September 2012, the Superior Court granted Davis’ motion for partial summary judgment and State Farm’s motion for summary judgment on Davis’ negligent infliction of emotional distress claim. The trial court found sua sponte that the assignment of benefits given by Davis’ mother was invalid and that State Farm improperly paid the $15,000 in PIP benefits to Christiana Care and the Delaware Neurological Group. Even though the validity of the assignment was not challenged and the limit of the PIP benefit was exhausted by the payment to the medical providers, the trial court stated:

There are now $15,000 in PIP benefits available for Davis and his health care providers. The question now is whether State Farm is obligated [under § 2118] to reserve Davis’s PIP benefits for his lost earnings at the expense of his health care providers and in a manner that will cause State Farm some additional administrative expense.6

The trial court ultimately held “that the legislature would want the PIP statute to be applied in such a manner that allows the injured person to reserve his or her PIP benefits that have otherwise not been properly paid for his or her lost earnings. This is certainly to Davis’s benefit.”7 This interlocutory appeal followed.

[632]*632 Discussion

This Court reviews a Superior Court’s grant of summary judgment de novo.8 This review extends to both “the facts and the law in order to determine whether or not the undisputed facts entitled the movant to judgment as a matter of law.”9 We “must view the evidence, and all reasonable inferences taken therefrom, in the light most favorable to the non-moving party and determine whether an issue of material fact exists such that summary judgment was improper.”10 When interpreting a statute, Delaware courts must “ascertain and give effect to the intent of the legislature.” 11

21 Del. C. § 2118 requires the minimum insurance coverage for motor vehicles registered in Delaware.12 State Farm urges this Court to overturn the trial court’s interpretation of 21 Del. C. § 2118 and hold that the statute does not require an insurer to reserve PIP benefits for lost wages.

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Bluebook (online)
80 A.3d 628, 2013 WL 5878439, 2013 Del. LEXIS 556, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-mutual-automobile-insurance-v-davis-del-2013.