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Davis v. State Farm Insurance Companies, Del. Super., C.A. No. N14C-02-250, Butler, J. (February 2, 2015) (Mem. Op.)

Court Grants Insurance Company’s Motion for Summary Judgment after Plaintiff Fails to Submit Medical Expenses to the Carrier Within the Statute of Limitations

Anthony Davis (“Plaintiff”), received no fault insurance coverage from his insurer, GEICO, as a result of an automobile accident that occurred on August 11, 2011. On November 21, 2012, GEICO notified Plaintiff’s counsel that Plaintiff’s personal injury protection (“PIP”) benefits were exhausted. On November 4, 2013, almost a year after his benefits had expired, Plaintiff sought additional coverage from his mother’s policy through State Farm Insurance Company (“State Farm”). Plaintiff filed suit against State Farm to receive those benefits. In filing an Answer to Plaintiff’s Complaint, State Farm formally denied coverage to the Plaintiff, as Plaintiff failed to submit the medical expenses within two years of the date of the accident.

State Farm filed a Motion for Summary Judgment, arguing that Delaware’s PIP statute precluded Plaintiff’s recovery as a result of his failure to submit his medical expenses within the two-year limitation required by the statute. Plaintiff argued that his submission was timely, but if it was not, that State Farm had waived a statute of limitations defense in that it failed to raise the defense in writing within thirty days of Plaintiff submitting the expenses to State Farm. Plaintiff then filed a Cross Motion, arguing that State Farm failed to comply with the requirements of 21 Del. C. § 2118B(c), by not paying the claim or providing written explanation for the denial within thirty days of Plaintiff’s submission of the expenses.

The Court granted State Farm’s Motion, finding that Plaintiff claim was filed outside the two-year statute of limitations. As such he was not entitled to payment unless a grace period applied, which it did not. A grace period did not apply because Plaintiff was not able to show that it was impractical to submit expenses within the two-year window. The Court noted that Plaintiff was unable to make a showing of impracticality, noting that Plaintiff offered no explanation for why he waited almost a year after exhausting coverage with GEICO to submit expenses to State Farm.

In denying Plaintiff’s Motion for Summary Judgment, the Court found that State Farm had properly notified Plaintiff that the two years had passed in a letter dated December 4, 2013. State Farm also asserted the defense in the Answer to the Complaint. Even if State Farm never replied to the Plaintiff, the correct remedy to apply would be the rate of interest provided by 21 Del. C. § 2118B(c), to the amount of unpaid benefits due, not waiver of State Farm’s defense. Furthermore, Plaintiff did not detrimentally rely on any position taken by State Farm, and State Farm maintained a consistent position and defense throughout the dispute. Therefore, State Farm’s Motion for Summary Judgment was granted.

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