Opinion ID: 2411574
Heading Depth: 1
Heading Rank: 3

Heading: Limitations upon benefits and liability.

Text: BRB is [12] confined to economic loss consisting of medical expense, loss of work income, expense for assistance and, in the event of death, funeral expenses not exceeding $1,000 and certain other incidental losses to the survivors. [13] Except for the item of medical expense it is limited [14] to $200 per week and an over-all maximum of $10,000. [15] Losses of this category in excess of the injured party's BRB are recoverable from the tortfeasor free of any limitation imposed by the no-fault law. [16] Though KRS 304.39-060(2)(a) speaks in terms of abolishing tort liability, it is an abolition only in the most technical sense, because in practicality the injured party's right of recovery is enhanced by his entitlement to BRB without proof of fault. From his standpoint, it is only the necessity of proving fault that is abolished, and from the standpoint of the alleged tortfeasor, of course, whatever is abolished in the way of liability is all to the good. Therefore, KRS 304.39-060(2)(a) confers a positive benefit on both parties at no disadvantage at all to either of them. The rub comes with KRS 304.39-060(2)(b), the next subsection, which is aimed at eliminating the main brunt of small personal-injury claims but undoubtedly will in some instances abolish claims for pain and suffering that are not so small. KRS 304.39-060(2)(b) provides in substance that in any tort action against the owner, registrant, operator or occupant of an automobile for which the required liability and BRB coverage has been provided, or against a defendant who is responsible for the acts or omissions of such a party, the plaintiff may recover for pain, suffering, mental anguish and inconvenience because of bodily injury, sickness or disease . . only in the event he meets one or more of the following threshold conditions: (1) His reasonable medical expenses [17] exceed $1,000 (disregarding exclusions and deductions) or, if he was entitled to and received free medical or surgical treatment, the value of such treatment was at least $1,000; (2) The injury or disease includes one or more of the following: (a) Permanent disfigurement; (b) Fracture of a weight-bearing bone; (c) A compound, comminuted, displaced or compressed fracture; (d) Loss of a body member; (e) Permanent injury within reasonable medical probability; (f) Permanent loss of bodily function; or (3) The injury results in death. This limitation upon recovery for pain, suffering, mental anguish and inconvenience [18] does not apply if the plaintiff was not an owner, operator, maintainer or user of an automobile. Hence it does not apply to an injured pedestrian unless at the time of the accident he owns or maintains an automobile, or is an operator or user in the sense that upon occasion he drives, uses, or has driven or used an automobile on the roadways of this state. [19] In this special respect, one who uses an automobile (e. g., a passenger) is not a user unless he is a named insured in a policy with BRB coverage or is covered as a member of the named insured's household. [20] Nor does it apply if either the injured claimant or the person against whom his claim is asserted has rejected it. [21] KRS 304.39-060(2)(a) and (b) lack some degree of clarity, partially because, it is said, subsection (b) was lifted out of context from the Florida statute. [22] Apparently there has been some thought that KRS 304.39-060(2)(b) not only restricts recovery for pain, suffering, mental anguish and inconvenience but also limits it to those items of damage, thus eliminating, for example, the element of destruction or permanent impairment of earning capacity. But we see nothing to call for such a construction. Read carefully in this aspect, the statute says only that unless the threshold requirement is satisfied there can be no recovery of these particular, enumerated elements of damage. If the threshold is met, there is no limitation on the kind or amount of damages recoverable over and above the BRB paid or payable to the plaintiff. [23] Factual questions vital to a determination of whether and to what extent tort limitations apply in any given litigation must, of course, be raised by the pleadings, and presumably are subject to trial by jury. Which party must plead what, and bear the burden of proving it, is a mundane detail of importance, we suppose, only to judges and practitioners of the art of litigation, since it appears thus far to have escaped attention all around. In the absence of legislative amendment to supply the deficiency it will just have to be hammered out on a case-by-case basis.