J-A27029-15

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

ALISHA L. FORD, IN THE SUPERIOR COURT OF

PENNSYLVANIA

Appellant

v.

AMERICAN STATES INSURANCE

COMPANY,

Appellee No. 1800 WDA 2014

Appeal from the Order Entered October 17, 2014

In the Court of Common Pleas of Westmoreland County

Civil Division at No(s): 3733 OF 2013

BEFORE: BOWES, OLSON & STABILE, JJ.

MEMORANDUM BY OLSON, J.: FILED DECEMBER 30, 2015

Appellant, Alisha L. Ford, appeals from the order entered on October 

17, 2014. The subject order granted the motion for summary judgment that 

was filed by Appellee, American States Insurance Company (hereinafter 

“ASIC”), and denied Appellant’s cross-motion for summary judgment. We 

affirm.

The trial court ably summarized the underlying facts and procedural 

posture of this case. As the trial court explained:

The instant case arose from a motor vehicle accident that 

occurred on March 19, 2013[,] between [Appellant] and 

another vehicle driven by Carl Showalter. [Appellant], who 

was operating the insured vehicle, attempted to turn left 

with the right of way, when Mr. Showalter drove his vehicle 

through a solid red light and collided with [Appellant’s] 

vehicle. As a result of the collision, [Appellant] suffered 

numerous injuries, including a fracture to her left ankle and 

a mild traumatic brain injury.
J-A27029-15

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After the accident, [Appellant] gave notice to [ASIC] that 

she was pursuing an underinsured motorist [(hereinafter 

“UIM”)] claim under [an automobile insurance policy with 

ASIC (hereinafter “the Policy”). Appellant’s mother, Audrey 

Ford, purchased the Policy that insured the vehicle; 

Appellant was a listed driver on the Policy and was a 

permissive user of the vehicle at the time of the accident]. . 

. . 

[O]n May 23, 2013, Mr. Showalter’s insurance carrier 

tendered and paid to [Appellant] his liability policy limit[] of 

$25,000.00. On that same date, [ASIC] forwarded to 

[Appellant] the UIM rejection form[] contained in the Policy, 

wherein[, ASIC contended, Appellant’s mother had] rejected 

[] UIM coverage [].

[The] UIM rejection form [at issue in this case] reads as 

follows:

Rejection of Underinsured Motorists Protection

By signing this waiver I am rejecting underinsured 

motorists coverage under this policy, for myself and all 

relatives residing in my household. Underinsured 

motorists coverage protects me and relatives living in 

my household for losses and damages suffered if injury 

is caused by the negligence of a driver who does not 

have enough insurance to pay for all losses and 

damages. I knowingly and voluntarily reject this 

coverage.

[Stipulations of Fact between Appellant and ASIC, 8/19/14, 

at “Exhibit 2”]. Below this paragraph is a signature line for 

the Policy’s first named insured, which was signed and 

dated by [Appellant’s] mother, Audrey Ford, on August 10, 

2011.

Subchapter C of [Pennsylvania’s Motor Vehicle Financial 

Responsibility Law (“MVFRL”)], 75 Pa.C.S.A. § 1731, 

governs the availability and rejection of UIM coverage. 

Section 1731(c) . . . sets forth the following form to be used 

when an insured is rejecting such coverage:
J-A27029-15

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REJECTION OF UNDERINSURED MOTORIST 

PROTECTION

By signing this waiver I am rejecting underinsured 

motorist coverage under this policy, for myself and all 

relatives residing in my household. Underinsured 

coverage protects me and relatives living in my 

household for losses and damages suffered if injury is 

caused by the negligence of a driver who does not have 

enough insurance to pay for all losses and damages. I 

knowingly and voluntarily reject this coverage.

_______________________________

 Signature of First Named Insured

_______________________________

Date

75 Pa.C.S.A. § 1731(c). . . .

Section 1731(c.1) then provides[]:

Insurers shall print the rejection forms required by 

subsections (b)[fn.1] and (c) on separate sheets in 

prominent type and location. The forms must be signed 

by the first named insured and dated to be valid. The 

signatures on the forms may be witnessed by an 

insurance agent or broker. Any rejection form that does 

not specifically comply with this section is void.

[75 Pa.C.S.A. § 1731(c.1)].

[fn.1] [75 Pa.C.S.A. § 1731(b) concerns uninsured 

motorist coverage]. 

Trial Court Opinion, 10/17/14, at 1-3.

On June 3, 2013, Appellant forwarded a letter to ASIC, wherein she 

again demanded UIM coverage. Within the letter, Appellant declared: 

The rejection form provided in this matter is not in strict 

compliance with the language required by Pennsylvania 

statute. I would refer you specifically to the second 
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sentence of the rejection form, which reads: “Underinsured 

Motorists Coverage protects me and relatives living in my 

household for losses and damages suffered if injury is 

caused by the negligence of a driver who does not have 

enough insurance to pay for all losses and damages.” . . . 

The addition of the word “Motorists” deviates from the 

statutorily mandated language, as the statute refers only to 

“Underinsured coverage,” rather than to “Underinsured 

Motorists Coverage.”

Appellant’s Letter to ASIC, dated 6/3/13, at 2-3 (emphasis in original).

On July 1, 2013, ASIC sent Appellant a letter, declaring that it was 

“uphold[ing] [its] denial of coverage based on Mrs. Ford’s rejection of [UIM] 

. . . benefits.” ASIC Letter to Appellant, 7/1/13, at 2. Appellant then filed a 

complaint for declaratory judgment, wherein Appellant claimed that the UIM 

rejection form that was signed by Appellant’s mother was void, as it did not 

“specifically comply” with 75 Pa.C.S.A. § 1731(c). Appellant’s Complaint, 

7/17/13, at ¶ 19. 

On August 19, 2014, ASIC filed a motion for summary judgment and, 

on August 20, 2014, Appellant filed a cross-motion for summary judgment. 

Within ASIC’s motion, ASIC claimed that it was entitled to summary 

judgment because Appellant’s mother expressly rejected UIM coverage and: 

[the ASIC] rejection form contains the exact language as 

the statutory form except for the addition of the letter ‘s’ to 

the word ‘Motorist’ in the heading. This is inconsequential 

surplusage and/or an immaterial variance which should not 

result in an insured’s getting a windfall of UIM coverage 

when the insured neither intended to have nor paid for such 

coverage.

ASIC’s Motion for Summary Judgment, 8/19/14, at 3. 
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Conversely, Appellant claimed that she was entitled to summary 

judgment because the UIM rejection form did not “specifically comply” with 

the language of 75 Pa.C.S.A. § 1731(c) and, thus, the form was void. 

Appellant’s Motion for Summary Judgment, 8/20/14, at 1-2. 

Attached to both summary judgment motions were stipulations of fact, 

wherein the parties agreed:

. . .

6. At all times material hereto, [Appellant] was an insured 

under her mother’s Policy because [Appellant] was a 

resident of her mother’s household.

7. On July 1, 2013, [ASIC] denied that there was [UIM] 

coverage under the Policy for [Appellant] as to the subject 

accident. This rejection was based on the “Underinsured 

Motorists Coverage Selection/Rejection” which was signed 

by Audrey Ford on August 10, 2011. . . .

. . .

9. 75 [Pa.C.S.A.] § 1731(c) and (c.1) of the MVFRL govern 

the rejection of UIM coverage. . . . 

10. There are two differences between the statutory 

language of 75 [Pa.C.S.A.] § 1731(c) and the language of 

the [ASIC] form. These two differences are: 1) the [ASIC] 

form refers to “Motorists” in the heading, while the 

statutory form refers to “Motorist”; and 2) the [ASIC] form 

adds the word “motorists” in the second sentence to read 

“Underinsured motorists coverage,” while the statutory form 

reads “Underinsured coverage.”

11. Premiums were not paid by [Appellant] or her mother 

for [UIM] coverage.

Stipulations of Fact between Appellant and ASIC, 8/19/14, at 2-3.
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By order entered October 17, 2014, the trial court granted ASIC’s 

motion for summary judgment, denied Appellant’s cross-motion for 

summary judgment, and dismissed Appellant’s complaint. Appellant filed a 

timely notice of appeal and now raises the following claim to this Court:1

Whether the [trial] court erred or abused its discretion when 

holding that [ASIC’s] [UIM] rejection form “specifically 

complies” with Section 1731 of the [MVFRL] despite 

[ASIC’s] rejection form incorporating additional language 

that deviates from the mandated rejection form contained in 

Section 1731?

Appellant’s Brief at 4 (subheadings omitted and some internal capitalization 

omitted).

We reviewed the briefs of the parties, the relevant law, the certified 

record, and the well-written and thorough opinion from the able trial court 

judge, the Honorable David A. Regoli. We conclude that the claim raised in 

Appellant’s brief fails and that Judge Regoli’s opinion, filed on October 17, 

2014, meticulously and accurately explains why Appellant’s claim fails. 

Therefore, we adopt the trial court’s opinion as our own. In any future 

filings with this or any other court addressing this ruling, the filing party 

shall attach a copy of the trial court’s opinion.

____________________________________________

1 The trial court ordered Appellant to file and serve a concise statement of 

errors complained of on appeal, pursuant to Pennsylvania Rule of Appellate 

Procedure 1925(b). Appellant complied with the trial court’s order and, 

within her Rule 1925(b) statement, Appellant listed the claim she currently 

raises in her brief.
J-A27029-15

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Order affirmed.

Judgment Entered.

Joseph D. Seletyn, Esq.

Prothonotary

Date: 12/30/2015
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i · illM coverage affords b~nefits ~he~ anothe/~~;;;. is. at ~a~~~ fo~ ~j~ but. lac~ strllici~nt. . . . 

insurance to coverall losses caused by the.accident. See 75 Pa.C.$,A,.§ 17Jl(c). •.-· .. . ·. , . ; ·; .. · 

. · 2 . It is stipulated that the Plaindffwa·s an iriimred under the Policy, which··was in her mother's name .. 

However, for the sake of this Opinion, the Policy wiU be referred to as the Plaintiff's policy. 

• '. • • .' : • • "•• I • • ,· • •; • • • • ;, • ·: •• ~ ··~ • \ ~ • • ' • • 

· The instant case arose from a motor vehicle accident-that occurred on March 'i9,-20.l3 

between· the Plaintiff, · Alisha L ·Ford;· 'and' another vehicle driven by·:· Carl Showalter,': .The 

\ . . . 

I. Factual Background 

for Summary Judgment. 

denies the Plaintiff's Motion .for. Summary Judgment and, further, grants the Defendant's Motion .. 

"specifically comply" with the Pennsylvania Motor Financial Responsibility Law ("MYFRL"); 

75 Pa.C.S.A. § 1731. The Court does not agree, and for the reasons set forth below, hereby . 

an. underinsured co~erage ;ej~ction form ("UIM rej~on. f~nn")1 c~ntafued .in th.e Plaintiff's . 

. autoinsurance policy with the DefendantIthefPolicy") .. 

2 The. Plaintiff seeks summaryjudgment · 

in her favor' on the. basis that the Defendant's Ulfyi rejection form ·is void fot. failure to. . . . . 

This matter is before the Court on cross-motions for summary judgment filed by both the 

. : . . . : . . . . . . .... ' . . . . . .'· .. _;;.. ·:·. .. . . 

· · Plaintiff and: Defendant.. Atissue in,--~·ch party's. niotiori. for s-~-jildgment is the validity .. of 

. . . . ·. . . . . . .· . . . .. 

OPINION AND ORDER OF COURT 

Defendant. 

AMERICAN STATES INSl.JRANCE 

COMPANY> 

Plaintiff; 

No. 3733 of2013 

) 

) 

) 

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) 

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) 

) 

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). 

) 

) 

ALISHA L. FORD, 

IN THE COURT OF COMMON PLEAS OF WESTMORELAND COUNTY, 

COMMONWEALTH OF PENNSYLVANIA 

CIVILDMSION 

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REJECTION OF UNDERINSURED MOTORIST PROTECTION 

By signing this waiver I am rejecting underinsured motorist coverage under this· 

policy, for myself and ·all relatives residing in my household. Underinsured · · . , 

coverage protects me and relatives .living in my household for losses and damages · 

suffered ifinjury is caused-bythe negligence of a driver who does not have · 

when an insured is rejecting such coverage: 

See-Exhibit "2" to the Stipulations· ofFact. Below. this paragraph is a signature .line forthe 

. Policy's first namedinsured, which wassigned anddated by the.Pl~ntiff's mother, Audrey Ford, 

I · ' on August 10, 201 L' · 

Subchapter C of the MVFRL, 75 Pa C.S.A. § r'731, governs the availability and rejection 

of UIM 'coverage .. Section 1731 (c) of that Subchapter sets forth the following form to be used . 

. ' 

By signing this. waived am rejecting underinsured motorists coverage under this 

policy, ·for myself and all relatives . residing -in my household. Underinsured <, 

motorists coverage protects me and relatives living in my household for losses 

and· damages suffered if injury is caused by the negligence of a driver who does 

not have enough insurance to ·pay for all lossesand damages. t knowinglyand 

voluntarily reject-this coverage. 

that same date, the Defendant forwarded to the Plaintiff the UIM rejection forms contained in the . 

Policy, wherein it rejected the DIM coverage sought by the Plaintiff . 

. The Defendant's UIM rejection form re_ads as follows: 

Rejection ofUnderinsured Motorists Protection 

to her left ankle and a mild traumatic brain injury. 

After the accident, the Plaintiff gave notice to the Defendant that she was pursuing an 

underinsured motorist claim under the Policy. Subsequently! on May.23, 2013, fyfr .. Showalter's 

insurance-carrier tendered and paid to the Plaintiff his liability policy limits of szs.coo.co. On 

Plaintiff who was operating the insured vehicle, attempted to turn left with the right of way, 

when Mr; Showalter dr~ve his vehicle through a solid red light and collided with the Plaintiff's 

vehicle. AB a result of the collision, the Plaintiff suffered numerous injuries, including a fracture 

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173l(b). 

Subsection (b) explains the optional uninsured motorist ("UM") coverage. 75Pa.CS.A. § 

· The MVFRL does not define the phrase "specifically comply," nor have many courts 

.. attempted to 90 so. What's more, the courts have not been uniform in determining whether . 

additional language in a UIM rejection form specifically complies with Section 1731( c.1). 

II. Analysis 

. . 

· "motorists" in its tJIM rejection form "specifically complies" with Section 1731.(c). 

The question before the Court, therefore, is whether t~e Defendant's addition of'the term_ 

ambiguity into the form, nor does it change the party's understanding of the intended coverage -. 

. . . 

- under Section 173 l(c.1) op the following two grounds: ·(l) the addition of the letter.vs" to the 

term "Motorist't.in the rejection form's title; and (2) the inclusion of the word "motorists" _in th.e 

form 's second sentence. The Defendant, however, argues that despite the additions, its rejection 

form still contains the exact language as set forth in Section 1731 (c) and thus isvalid, The 

. = Defendant further reasons that the addition.of the word "motorists" does not introduce any 

Instantly, it is the Plaintiff'sposition that the Defendant's UIM rejection form isvoid . 

Id. at§ 173l(c.1). 

75 Pa.C.S.A. § 173l(c) (West 2014). Section 1731(c.1) then provides that: 

· Insurers shall print the rejection forms required by subsections (b)3 and (c) on 

separate sheets in prominent type and location. The forms must be signed by the . 

first named insured and dated to be valid.The signatures on the forms may be 

witnessed by an insurance agent or broker. Any rejection form that does not. 

specifically comply with 'this section is void. 

Date 

........................... , , 

·Signature of First Named Insured 

. ., . 

enough insurance to pay for all losses and damages. I knowingly and voluntarily 

reject this coverage. 

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effect of an omitted (or, presumably, additional) word is a factor to be considered when 

determining whether a rejection form "specifically complies" with Section 1731 ( c). 

Vaxmonsky, 916 A.2d at 1109. The Superior Court's analysis in this regard suggests that the 

form," wherein it reasoned that said omission "imposed ambiguity where none existed." 

examined "what effect, if any, the omission of 'all' has on the validity of the signed rejection 

In reaching its conclusion, the Vaxmonsky Court conducted more than just a perfunctory. 

comparison of the language used in Section 1731(c) with the UIM rejection form. Rather, it 

the word "all" from the phrase "all losses and damages" as provided for in Section 1731 ( c), 

that a UIM rejection form did not specifically comply with Section 173 l(c) due to its removal of 

916 A.2d 1106 (Pa Super. 2006); Jones, supra. In Vaxmonsky, the Superior Court concluded 

that the UIM rejection forms at issue were null and void. See Am. Int'l Ins. Co. v. Vaxmonsky, . . 

Court cases interpreting and applying Section 1731 ( c). In both cases, the Superior Court held 

In support of her Motion for Summary Judgment, the Plaintiff cites several Superior 

indicates that additional clarifying language vitiates an otherwise valid UIM rejection form"). 

. . 

Jones and holding that the UIM rejection form nevertheless complied with Section 1731 because 

it still used the exact language required by Section 1731 ( c) where Section 173 I ( c. l) "nowhere 

Heister, 2005 WL 2314372 (M.D.Pa. 2005) (examining the same additional language at issue in 

comply with the statute and is consequently void") with Unitrin Auto & Home Ins. Co. v. 

components, of the UIM rejection form required by 75 Pa.C.S.A. § 1731 fail to specifically 

"additions to the prescribed language, and deviation from the proximal relationship of the 

Compare Jones v. Unitrin Auto & Home Ins. Co., 40 A3d 125 (Pa. Super. 2012) (holding that 

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5 

Judge Cheryl Lynn Allen filed a Dissenting Opinion, in which she found that the rejection form 

specifically complied with the requirements of Section l n 1 ( c) as it was printed separately from the UM rejection. 

form, was signed and dated by the Appellant as the first named insured, and contained a verbatim recitation of 

Section 173l(c)'s language. Id.e: 131. · 

4 

In. order to be 'valid, UM 'or ·ullvf · rejection forms ·must comply with the 

requirements of section 1731(c.1") as follows: the UIM rejection· must appear on a . 

sheet separate from the UM· rejection; the first named insured must 'sign. the 

rejection; and the rejection must be dated. Instantly, the UIM form was separate 

from the UM form and Winslow-Quattlebaum, the first named insured; signed 

and dated the form. There is, therefore, no basis on which to declare such waiver 

void as it complies with all the requirements-of section 173 l(c.1 ). 

concluded that: 

related to rejection of UIM coverage," it did not "specifically comply" with Section .1731 ( c) as 

required by Section· 173 l(cJ). Id. at 129"'.130.· The Court then held that "additionsto the 

prescribed language, and deviation from the proximal relationship of the components, of the. 

DIM rejection form ] •.. J failto specifically comply.with the statute.and is consequently void." 

Id. at 1_31 (emphasis added). 

In addition to both Vaxmonsky and Jones, the Court finds guidance in the Supreme 

Court's decision in Winslow~Quattlehaum v. Maryla11d I11s. Group, 752 A2d ~78- (Pa. 2000) -, 

In Winslow-Quattlebaum, the Court deemed it acceptable for an insurer to place both the UIM 

rejection formand the. UIM stacking rejection fo~ on the same page -. °The Winsl~w.Couii . 

required language of Section 173 l(c) and the required signature and date Jines following said 

language. Id. at 129: The Court reasoned that because the UIM rejection form was not "directly 

Court examined the additional sentence in terms of its "proximal relationship" between the 

underinsured motorist coverage." Jones, 40 A.3d at 128. In reaching its holding, the Jones 

"By rejecting this coverage, I am also signing the waiver on P. 13 rejecting stacked limits of 

concluded that a UIM rejection form was invalid due to its inclusion of the following sentence: 

The Plaintiff also relies on Jones; supra; wherein a majority of the Superior Court4 

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. . 

· s · . . The Court finds this case especially persuasive given the relative lack of Pennsylvania authority on 

the speci fie is sue presented in this case. 

. In Jones, the Superior Court examined a UIM rejection form that included an 

additional sentence, which referredto an entirely different statutory provision [ ... ] 

The Jones court found that Ute UIM rejection form did not specifically comply. 

with § 1731 because the additional text did not pertain to the rejection of UIM 

coverage, and appeared between the text and signature line prescribed in § 

1731 ( c), Subject matter and placement of the additional language were essential 

in the Jones court's analysis ] ... ] 

· Jones, finding that Jones did not command a different result: 

TheRobinso1t Court then compared its decision with the Superior Court's decision in, 

. . 

· MVFRL. Cf; Vaxmonsky, 916 A.2~ at 1109[.Y1 Robinson, 520 Fed.Appx. at 88~- The Court. 

continued: "the addition of the word 'motorist' did not introduce ambiguity into the form, did not. 

change the meaning or scope of the coverage, and-indisputably-did not contravene any 

party's. understanding of the intended coverage/ Id. at 89, 

ambiguity into the rejection form, :~din fact made the phrase consistent with the restof the 

i 

and reasoned that, "the 'additional word' was one word-a word that didnot introduce 

. . . . 

1- 

' 

Section 1731. In doing so, the Court referenced the Superior Court's. decision in Vaxmonsky 

phrase read "underinsured motorist coverage," rather than "underinsnred coverage," The Court 

? . . . 

concluded 'that despite the additional word, the insurer' s UIM rejection form complied with 

insureradded the word "motorist" tothe second sentence of its UIM rejection form to make the. 

Furthermore, the Court finds persuasive the Third Circuit case of Robinson v. Travelers 

Indem. cc, 520 Fed.Appx. 85 (3d'Cir. 2013).5 In Roblnson; similar to the instant case, the 

Maryland Ins. Group, 723 A.2d 681 (Pa. Super. 1998)(rev'd). 

Winslow-Quattlebaum, 752 A.2d at 8~2. The Court thus reversed the Superior Court's .· 

holding that the insurer's UIM rejection form did not specifically comply with Section. 

1731 ( c, l) because it' did not stand alone on its own page. See Wlnslow~Q11attleha111n v. 

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6 While the Court notes that the Defendant used the plural version of"motorist" throughout the 

form, the Court does not feel that this alteration changes the instant analysis. 

the addition of the word "motorists" or that she otherwise misunderstood the meaning of the 

Lastly, there is no evidence that the first named insured, Audrey Ford, was confused by 

uniform throughout the paragraph. 

impose any ambiguity; rather, it could-be argued that its inclusion makes the waiver more 

[.;.]By signing this waiver I am rejecting underinsured motorist coverage ] ... ]") (emphasis 

added). As such, the addition of the word "motorists" to the fonn's secondsentence does.not 

See 75 Pa. CS.A. § 1731 (c) ('•REJECTION OF UNDERINSURED MOTORIST PROT~C'.TION 

and, in fact, makes the form consistent with the title and first sentence of Section 1731 (c) 's form .. 

Furthermore, the term "motorists" is directly related to the rejection ofUityl-~verage 

insured, directly below the rejection paragraph. See Winslow-Quattlebaum, .752 A.2d at 882. 

form, whichwas also properly signed and dated by the Plaintiff's mother, as the first named 

language. Indeed, all of Section 1731 ( c)'s required language is included in the IBM rejection 

required language of Section 1731 (c) and the required signature and date lines following the 

form itself. Accordingly, there is no deviation from the "proximal relationship" between the 

additional paragraph or sentence, nor does it change the format or the spacing of the rejection 

the addition of one word-"motorists"-in its second sentence. 6 It does not include an 

In the case at bar, the Defendant's UIM rejection form, akin to Robinson, only contains 

Id. (internal citations omitted). 

Neither concern is at issue in this case-the additional word "motorist" does not 

come between the language specified in § 1731 ( c) and the signature and date line. 

Moreover, the word "motorist" is directly related to the rejection ofUTh1 

coverage-indeed, the word "motorist" could be considered clarifying, as it 

makes the phrase consistent throughout the section. Thus, even under Jones, we 

believe that Robinson has no right to the VIM coverage that Tri-County 

knowingly and intentionally rejected. 

---------------------···------- 

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.... 

VIM rejection form as a result. Rather, the Policy language is clear and unambiguous and 

plainlydenotes that the Plaintiff is "rejecting underinsured motorists coverage." The Plaintiff: 

however) knowingly and.voluntarily rejected said coverage and, consequently, did not pay for 

the same. As such; she is now seeking to recover a benefit for which she never bargained or 

paid, The Court cannot permit such a recovery, as it finds that the Defendant ts UIM rejection 

form specifically complies with Section 1731 ( c) and is thus valid and enforceable, The Court, . 

therefore) enters the following Order: · 

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