Case Name: Mark ZUBRIS, Appellant, v. PENNSYLVANIA ASSIGNED CLAIMS PLAN
Court: Superior Court of Pennsylvania
Jurisdiction: Pennsylvania
Decision Date: 1983-10-07
Citations: 321 Pa. Super. 83
Docket Number: No. 639
Parties: Mark ZUBRIS, Appellant, v. PENNSYLVANIA ASSIGNED CLAIMS PLAN.
Judges: Before HESTER, WICKERSHAM and POPOVICH, JJ.
Reporter: Pennsylvania Superior Court Reports
Volume: 321
Pages: 83–101

Head Matter:
467 A.2d 1139
Mark ZUBRIS, Appellant, v. PENNSYLVANIA ASSIGNED CLAIMS PLAN.
Superior Court of Pennsylvania.
Argued Oct. 26, 1982.
Filed Oct. 7, 1983.
Reargument Denied Dec. 16, 1983.
Petition for Allowance of Appeal Denied May 24, 1984.
Stephen P. Ellwood, Pottsville, for appellant.
David B. Glancey, Philadelphia, for appellee.
Before HESTER, WICKERSHAM and POPOVICH, JJ.

Opinion:
HESTER, Judge:
This is an appeal from an Order dated March 3, 1981, dismissing a complaint in assumpsit for no-fault benefits provided under the provisions of the Pennsylvania No-Fault Motor Vehicle Insurance Act (hereinafter the "No-Fault Act") and the Pennsylvania Assigned Claims Plan. Act of July 19, 1974, P.L. 489, No. 176, 40 P.S. § 1009.101 et seq. Appellee's request for a summary judgment was granted on the grounds that the complaint was filed beyond the two-year statute of limitations provided in the No-Fault Act.
Appellant, Mark Zubris, was injured on January 13, 1976, while a passenger in an automobile operated by Michael Wallace. Mr. Wallace's vehicle was struck by another vehicle operated by Edward Stoudt. Two weeks following the accident, appellant retained counsel for the purpose of recovering compensation for his injuries.
Appellant and his attorney were advised by Mr. Wallace that his motor vehicle was covered by insurance purchased by his father from The Pflueger Agency in Schuylkill Haven, Pennsylvania. It was not until March, 1978 that appellant learned that Wallace's insurance policy covered collision only; it did not cover the liability or basic loss benefits required under the No-Fault Act.
A notice of loss was filed with appellee, the Pennsylvania Assigned Claims Plan, on August 7, 1978. This notice of loss was followed by a notice of claim filed with appellee on August 18, 1978. When the claim was rejected, appellant filed an assumpsit complaint against appellee on September 26, 1978. Appellee responded with an answer and new matter containing an allegation that the complaint was untimely filed under the No-Fault Act.
Section 1009.106(c)(1) of the No-Fault Act sets forth the applicable limitations period for instituting this type of action:
"If no-fault benefits have not been paid for loss arising otherwise than from death, an action therefor may be commenced not later than two years after the victim suffers the loss and either knows, or in the exercise of reasonable diligence should have known that the loss was caused by the accident, or not later than four years after the accident, whichever is earlier. If no-fault benefits have been paid for loss arising otherwise than from death, an action for further benefits, other than the survivor's benefits, by either the same or another claimant; may be commenced not later than two years after the last payment of benefits. 40 P.S. § 1009.106(c)(1).
The limitations period, at the earliest, starts to run on the date the claimant suffers a "loss". Section 1009.103 defines loss as an "accrued economic detriment resulting from injury arising out of the maintenance or use of a motor vehicle consisting of, and limited to, allowable expense, work loss, replacement services loss, and survivor's loss." Appellant avers that the "loss" was not sustained until March, 1978, when he learned that The Pfueger Agency did not provide the mandatory no-fault coverage for Mr. Wallace. Conversely, appellee maintains that loss was sustained on January 13, 1976, the date of the accident.
The primary issue presented here is whether the "loss" occurred on the accident date (January 13, 1976), on the date of actual knowledge of no no-fault coverage for Mr. Wallace (March, 1978), or some other date falling between those advanced by the parties. This issue can be resolved only after a refinement of the definition of "loss" and a determination of when "loss" occurred here.
In refining the definition of "loss", a review of recent decisions on limitations of actions under the No-Fault Act is in order. In Donnelly v. DeBourke, 280 Pa.Super. 486, 421 A.2d 826 (1980), the plaintiff was injured while riding as a passenger in a vehicle struck from behind. A complaint in trespass for damages in excess of the threshold amounts was not filed against the negligent motorist until two years and nine months had passed from the accident date. The defendant's preliminary objection on grounds that the statute of limitations was not complied with was sustained and the action dismissed. In affirming, this Court rejected the plaintiff's argument that the limitations period cannot begin to run before the threshold requirements are met. The Donnelly court held, in accordance with its view of tradition, that the limitations period begins to run on the date the injuries were sustained even though the nature and extent of the injuries are not yet certain. The Donnelly court especially noted that the threshold limits do not preclude the filing of a tort cause of action; they merely limit the amount of recovery. Its concern for an unwieldly court calendar may have led the Donnelly court to its holding.
The Donnelly decision did not remain precedential for long. This same court in Bond v. Gallen, 292 Pa.Super. 207, 437 A.2d 7 (1981), under identical facts, overruled the Donnelly decision. In Bond, supra, the court viewed the No-Fault Act as a mechanism eliminating a cause of action and not merely limiting the amount of damages. In accordance with this premise, the Bond court held that the limitations period does not begin to run, and the cause of action does not accrue, until the claimant knows or should have known that one of the § 1009.301(a) thresholds had been reached. The Bond court recognized the discovery dangers of the threshold being reached only after many years; nevertheless, its fears were allayed when it also recognized the four-year statute of repose built into § 1009.106(c). No action may be filed beyond four years of the accident date irrespective of the threshold remaining unsatisfied.
In further interpretation of "loss", Myers v. U.S.A.A. Casualty Ins. Co., 298 Pa.Super. 366, 444 A.2d 1217 (1982), held that the date of accident does not necessarily begin the running of the statute of limitations under the No-Fault Act; rather, the limitations period begins to run when the cause of action accrues. Two of the three plaintiffs in Myers, supra, were passengers in a motor vehicle operated by the third plaintiff, Lynn Wagner Myers. Miss Myers' vehicle collided with another vehicle resulting in serious physical injury to the three plaintiffs. The defendant was the insurer of the vehicle operated by Miss Myers. When the defendant insurer refused to honor a claim for medical bills, lost wages, impairment of earning capacity and loss of ability to work, the plaintiffs filed a complaint in assumpsit and trespass against the defendant. The lower court agreed with the defendant insurer's preliminary objections and ordered the complaint dismissed with prejudice for failure to file within the statutory period of limitations.
In holding that the accident date there did not begin the running of the two-year statute of limitations, the Myers court reasoned that the creation of a four-year statute of repose unequivocally suggests that the two-year limitations period could begin its run somewhere between the accident date and the ultimate four-year limitation from the accident date. Under the particular facts presented in Myers, supra, the cause of action arose from the alleged breach of the defendant's contractual obligation to pay no-fault benefits; therefore, "loss" was construed to occur at the time of breach of contract. The underlying tort cause of action was immaterial.
We recognize that, unlike the instant matter, Bond, supra, and Myers, supra, involve complaints filed against parties other than an insurance carrier assigned the claim under the assigned claims plan; nevertheless, such a factual distinction is not determinative. Both decisions refused to consider the day of the accident for the purpose of commencing the limitations period; instead, they looked solely to the date when the cause of action accrued against the respective defendants.
Prior to discussing when "loss" occurred, we must note the special statute of limitations set forth in § 1009.-106(c)(4). Section 1009.106(c)(4) provides:
Except as 'paragraph (1), (2), or (3) prescribes a longer period, an action by a claimant on an assigned claim which has been timely presented in accordance with the provisions of section 108(c) of this act may not be commenced more than sixty days after the claimant receives written notice of rejection of the claim by the restoration obligor to which it was assigned.
Section 1009.106(c)(4) incorporates, by reference, the following language set forth in § 1009.108(c)(1):
(c) Time for presenting claims under assigned claims plan.—
(1) Except as provided in paragraph (2) of this subsection, an individual authorized to obtain basic loss benefits through the assigned claims plan shall notify the assigned claims bureau of his claim within the time that would have been allowed pursuant to section 106(c) of the act for commencing an action for basic loss benefits against any obligor, other than an assigned claims bureau, in any case in which identifiable no-fault insurance coverage was in effect and applicable to the claim.
We are mindful that appellant commenced the lower court action within sixty days following appellee's notice of rejection of benefits. As alluded to above, appellant filed his assumpsit complaint within sixty days of the filing of both his notice of loss and notice of claim with appellee. Consequently, that action was necessarily commenced within sixty days of notice of rejection of his claim. As the following discussion will indicate however, appellant failed to notify appellee within two years of date of loss, the limitations period set forth in § 1009.108(c)(1) and § 1009.106(c)(1).
Having, then, defined "loss" as the time at which the cause of action accrues, we turn to a review of the particular facts to determine when "loss" occurred here. When the cause of action accrued is determined by the intensity of appellant's efforts in discovering the extent of insurance coverage on the Wallace motor vehicle.
An evidentiary hearing was conducted on February 4, 1981 on the limitation of actions issue. It was elicited that counsel was retained by appellant in January, 1976, approximately two weeks following the accident. Upon learning from Michael Wallace that The Pflueger Agency was his insurer, appellant spent the remainder of 1976, all of 1977, and the first two months of 1978 telephoning the Agency for the precise coverage provided. In March, 1978, appellant finally learned that only collision coverage, no coverage under the No-Fault Act, was provided for Michael Wallace. Thereafter, on August 7, 1978, appellant notified the appellee of his loss and requested a personal injury protection form. He filed a claim for benefits on August 18, 1978; appellee's denial of the claim compelled appellant to institute the lower court action in September, 1978, approximately two years and eight months following the accident date. The notice of loss was filed nearly two years and seven months following the accident.
We note that the vice president of The Pflueger Agency testified that appellee's work files did not reflect any communication from appellant concerning insurance coverage until March 13, 1980; therefore, the implication follows that no reasonable diligence was exercised in an attempt to determine date of "loss". We also note, however, the vice president's admission that a record is not kept of all phone calls. Furthermore, he admitted that it was not unusual for an employee to disclose to a telephone inquirer the insurance coverage of a particular insured without creating a record.
The granting of preliminary objections for the dismissal of a complaint will be sustained on appeal only where the pre-trial hearing results in a clear and unequivocal portrayal of facts justifying a denial of the claim. Allstate Ins. Co. v. Fioravanti, 451 Pa. 108, 299 A.2d 585 (1973); Legman v. Scranton School District, 432 Pa. 342, 247 A.2d 566 (1968). The facts extracted below unambiguously reflect appellant's failure to meet his burden of proof, a burden properly imposed upon him since he was denying that he knew or had reason to know that "loss" occurred prior to March, 1978. See O'Neill v. Metropolitan Life Ins. Co., 345 Pa. 232, 26 A.2d 898 (1942); Hillman Transp. Co. v. Home Ins. Co. of New York, 268 Pa. 547, 112 A. 108 (1920).
In light of the vice president's admissions, we conclude that appellant did make several phone calls from the accident date through March, 1978 in an attempt to discover the extent of Michael Wallace's coverage; however, these inquiries do not, without evidence to the contrary, amount to reasonable diligence. A twenty-six month period of nothing more than telephone calls is not a demonstration of intense effort. Investigation of insurance coverage by letter and personal visits to the insurer or by perusal of the actual policy would constitute "reasonable diligence". The record does not indicate whether appellant performed any of these.
The notice of loss was filed on August 7, 1978; consequently, the cause of action must have accrued, i.e., the "loss" occurred, no earlier than August 7, 1976. In light of the accident date of January 13, 1976, we must decide whether a seven-month period (January 13, 1976 through August 7, 1976) was enough time for appellant to actually know or be charged with the knowledge of knowing that "loss" occurred. Such a determination does not depend entirely upon appellant's actions. It similarly depends upon the representations of The Pflueger Agency when responding to appellant's request for information relating to precise insurance coverage and whether appellant reasonably relied upon such representations. It de pends also upon appellee's insurer's representations and whether appellant reasonably relied upon them as well. The record is devoid of such evidence; appellant offers no substantive justification for his rather meager efforts to discover the extent of insurance coverage. We find, therefore, that appellant could have discovered, through the exercise of reasonable diligence, the absence of no-fault insurance benefits before August 7, 1976; consequently, the filing of his notice of claim on August 7, 1978, was untimely.
Although it discussed the limitation of action issue, the lower court opined and appellee avers that any issues raised by appellant on appeal were waived due to his failure to file exceptions under Rule 1038 of the Pa.R.C.P. We disagree. Rule 1038 requires the filing of exceptions within 10 days after notice of the decision in a non jury trial. Rule 1038 does not extend the requirement for exceptions to orders dismissing a complaint following a pre-trial hearing on a motion for summary judgment.
Order affirmed.
WICKERSHAM and POPOVICH, JJ., filed concurring opinions.
. The instant matter does not fall within the parameters established by this Court's recent en banc decision in Warren v. Reliance Insurance Company, 318 Pa.Super. 1, 464 A.2d 487 (1983). Warren involved three separate cases and each plaintiff notified the Pennsylvania Assigned Claims Plan of its loss well within two years of the accident date. Therefore, the sixty-day limitations period in § 1009.-106(c)(4) was properly at issue.