Brown v. Travelers Insurance

BROSKY, Judge,

dissenting.

This case is before us on appeal from judgment entered in favor of the defendant, Travelers Insurance Company. The sole issue for our determination is whether appellant, the owner/operator of an uninsured motor vehicle, allegedly innocent of causing an accident, is entitled to receive uninsured motorist benefits from the insurance company designated by the Pennsylvania Assigned Claims Plan1 to process appellant’s claim. Although I agree to a large extent with the majority Opinion, I believe dicta in Supreme Court cases should lead us to reach a different result.

In Tubner v. State Farm Mutual Auto Ins. Co., 496 Pa. 215, 436 A.2d 621 (1981), our Supreme Court decided the issue of “whether a company designated to provide insurance coverage pursuant to the assigned claims plan of the No-Fault Act is required to pay not only ‘basic loss benefits,’ but also uninsured motorist benefits.” In that case, a passenger in an uninsured automobile was killed in an accident, and the administratrix of his estate brought an action against the appellant insurance company to recover uninsured motorist benefits. Appellant had been designated as the participating insurer under the assigned claims provisions of the No-Fault Act, and had paid basic loss benefits. The company refused, however, to pay uninsured motorist benefits. The Supreme Court ruled that the ad-ministratrix was entitled to the benefits.

The court found that section 108(b)2 of the Act required assigned insurers to compensate motor vehicle accident victims who were not otherwise covered by insurance, just *546as if a policy of basic loss insurance had been issued. The court stated: “Because assigned insurers are obligated precisely as if they had issued basic loss insurance policies, and because every policy of basic loss insurance issued in Pennsylvania must include uninsured motorist coverage, the right to uninsured motorist benefits under the assigned claims plan follows a fortiori from a straightforward reading of the statute and the regulation lawfully promulgated thereunder.” 496 Pa. at 219, 436 A.2d at 623 (emphasis in original). The court reasoned that adopting a contrary view would have the effect of affording recovery of general damages to all motor vehicle victims injured by uninsured motorists except those covered by the assigned claims plan, with harsh results. The court added that because a claimant under the assigned claims plan is covered as if he had obtained a policy of basic loss insurance, his right to uninsured motorist benefits cannot be distinguished from that of holders of valid insurance policies.

In Modesta v. SEPTA, 503 Pa. 437, 469 A.2d 1019 (1983), a bus passenger, injured when the bus in which she was *547riding was struck from behind by an uninsured motorist, sought uninsured motorist benefits from the transportation authority. The Supreme Court held on appeal that the transportation authority, as a self-insurer, was required to provide uninsured motorist coverage. The court stated:

[UJntil today there were two groups of individuals who received no uninsured motorist protection: uninsured motorists who caused accidents and uninsured occupants of self-insured vehicles. It is reasonable to deny uninsured motorist coverage to the first group, since they have not only chosen not to comply with the mandatory insurance law, but have also caused the accidents which resulted in their injuries; however, it makes no sense in terms of any policy of deterrence, retribution or liberal construction of a remedial statute, to deny uninsured motorist coverage to uninsured individuals who have not caused the accidents which resulted in their injuries, simply because they were occupants of self-insured vehicles. 503 Pa. at 443, 469 A.2d at 1022-23 (footnotes omitted; emphasis added).

The court went on to hold that the uninsured occupant of the self-insured vehicle was entitled to uninsured motorist coverage. Although the quoted language does not constitute the holding of Modesta, it seems to indicate the Supreme Court’s feeling that only uninsured motorists who are actually responsible for accidents are to be denied uninsured motorist coverage.

Accepting the result that an innocent but uninsured owner/ operator may recover uninsured motorist benefits, there are two ways to proceed. We might find that a party claiming uninsured motorist benefits should be entitled to receive such benefits from the assigned claims carrier, who could later recover the amounts paid if the claimant was found to have caused the accident. This approach would be supported by a broad interpretation of Section (d) of the Uninsured Motorist Act. That section provides: “In the event of payment to any person under the coverage required by this section, the insurer making such payment *548shall, to the extent thereof, be entitled to the proceeds of any settlement or judgment resulting from the exercise of any rights of recovery of such person against any person or organization legally responsible for the bodily injury for which such payment is made____” (Emphasis added.)

Arguably, this section would give the insurance company the right to recover from the claimant any uninsured motorist benefits paid to the claimant if the claimant was responsible for causing the accident. Such an approach would be analogous to that followed by our court in Harleysville Mutual Insurance Co. v. Schuck, 302 Pa.Super. 534, 449 A.2d 45 (1982), in which a panel of our court approved the payment of No-Fault basic loss benefits to an owner/operator of an uninsured vehicle, and held that the insurance company was entitled to recover those benefits. In Schuck, our court noted that compensating an injured victim of a vehicular accident was one of the main purposes of the No-Fault Act, “[t]hus an injured victim, even if he or she is an uninsured owner, can receive ‘prompt and comprehensive professional treatment’ and thus be rehabilitated and returned as a productive member of society as quickly as possible.” 302 Pa.Super. at 538, 449 A.2d at 47.3

The other, and I believe better, approach would be to not require that uninsured motorist benefits be paid until such time as a determination has been made that the claimant was not at fault in causing the accident. The considerations of Schuck do not apply in the context of uninsured motorist benefits, since basic loss benefits have, in at least the vast majority of cases, already been paid, frequently directly to the provider of medical services or supplies, and since the uninsured motorist benefits will therefore in most cases be compensation for non-economic detriment, rather than being required for the claimant’s rehabilitation. Payment of uninsured motorist benefits can, without causing undue hard*549ship, await a determination of fault. Uninsured motorist benefits paid to a claimant would very likely be put to use by the claimant, and the insurance company would not be certain to obtain the money that it had paid out. The more sensible of the two approaches would therefore appear to be to require the insurance company to pay the uninsured motorist benefits only after a determination had been made that the claimant would not be required to return some or all of such payments to the insurance company.

I would find that the trial court erred in entering judgment in favor of appellee insurance company. Once it was determined that the claimant, the party entitled to basic loss benefits under the assigned claim provisions of No-Fault, was not at fault in causing the accident, the claimant would be entitled to receive uninsured motorist benefits from the obligor that had paid the basic loss benefits as if the claimant had been insured by a policy of basic loss insurance with uninsured motorist coverage. I would reverse the trial court and remand for further proceedings.

. Section 108 of the Pennsylvania No-fault Motor Vehicle Insurance Act, 40 P.S. § 1009.108.

. Section 108(b) provides:

(b) Assigned claims plan.—
(1) Obligors other than self insurers and governments providing basic loss insurance in this Commonwealth shall organize and maintain, subject to approval and regulation by the commissioner, *546as [sic] assigned claims bureau and an assigned claims plan and adopt rules for their operation and for assessment of costs on a fair and equitable basis consistent with this act. If such bureau and plan are not organized and maintained in a manner considered by the commissioner to be consistent with this act, he shall organize and maintain an assigned claims bureau and an assigned claims plan.
Each obligor insurer providing basic loss insurance in the Commonwealth shall participate in the assigned claims bureau and the assigned claims plan. Costs incurred shall be allocated fairly and equitably among the obligors.
(2) The assigned claims bureau shall promptly:
(A) assign each claim for no-fault benefits to an assignee who shall be a participating insurer; and
(B) notify the claimant of the identity and address of such assign-ee.
Claims shall be assigned so as to minimize inconvenience to claimants. The assignee thereafter has rights and obligations as if he had issued a policy of basic loss insurance complying with this act applicable to the injury or, in a case involving the financial inability of a restoration obligor to perform its obligations, as if the assignee had written the applicable basic restoration insurance, undertaken the self-insurance, or lawfully obligated itself to pay basic loss benefits.

. It should be noted that basic loss benefits may include compensation for work loss and replacement services loss as well as for medical expenses. It is not clear that the rationale of Schuck applies to such other basic loss benefits, nevertheless, the opinion did not differentiate among these types of basic loss benefits.