Salvado v. Prudential Property & Casualty Insurance

PRICE, Judge,

concurring and dissenting:

I agree with the majority’s conclusion that the claims of those appellants not laboring under a legal disability were barred by the lapse of more than two years from the last payment of benefits and that a claimant’s minority is to be treated as a “legal disability” within the purview of section 106(c)(5). I disagree, however, that the duration of a claimant’s legal disability is to be excluded from the calculation of time in which an action for further benefits must be commenced. Therefore, I respectfully dissent.

The time limitations imposed upon actions to recover basic loss benefits under the No-fault Act are set forth in section *310106(c).1 An action to recover benefits for losses arising otherwise than from death must be brought within two years from the date of actual or constructive knowledge of a motor vehicle-related loss, or four years after the accident, whichever is earlier.2 If no-fault benefits have in fact been paid, there obtains an additional two year statutory period from the date of the last payment during which the same, or another, claimant may commence an action for further benefits.3

However, section 106(c)(5) creates an exception to these time limitations.4 That section expressly provides that the duration of a claimant’s legal disability is not included as part of the time limited for beginning an action for no-fault benefits.

In reaching its decision that Lucretia Monteiro’s action for further benefits was not time-barred, the majority held that the disability exception contained in section 106(c)(5) applies equally to all of the limitation provisions contained in section 106(c)(1).5 They reasoned that since the language of section 106(c)(5) unambiguously provides that the time fixed for “commencement of [an] action”6 is tolled during periods of disability, even actions to recover additional benefits are within its intended scope. According to the majority, any other result would be tantamount to disregarding the clear meaning of section 106(c)(5) under the pretext of pursuing its spirit.

I disagree that section 106(c)(5) is so plainly expressive of an intent to encompass every action for benefits that nothing is left for interpretation. Indeed, if anything is free from doubt, it is that this section’s indeterminate reference *311to the complex limitation provisions of the Act creates genuine uncertainty whether it has equal application to them all. In my view, to allow Lucretia Monteiro’s claim because of her minority7 does violence to both the general purposes underlying the No-fault Act and those purposes identified specifically with its statutes of limitation.

The No-fault Act is animated by one general purpose and intent: “[T]o establish at reasonable cost to the purchaser of insurance, a statewide system of prompt and adequate basic loss benefits for motor vehicle accident victims and the survivors of deceased victims.”8 The limitation periods in section 106(c)(1) are designed to protect the same important public policy considerations expressed in other statutes of repose.9 Of course, their particular complication rests upon the fact that, in contrast to the customary practice of paying tort claims in lump sum settlements or judgments, the thrust of the No-fault Act is to provide life-long medical expense benefits to those needing continuing treatment.10 The provision under which the period of limitation runs from the date of receipt of the last payment of benefits insures full compensation for a claimant’s loss even where the extent of that loss may not be wholly apparent until a *312significant period of time has elapsed.11 In addition, it “encourages exclusively out-of-court handling of claims by making it unnecessary for the claimant to consider bringing an action to protect his rights so long as benefits are being paid.”12

In view of these objectives, no purpose is served by allowing a minor claimant who has both elected to pursue her right to no-fault benefits and been paid for economic loss to bring suit for additional benefits after expiration of the two year limitation period. This is not the case of a minor claimant who has failed to sue for original protection more than four years after the accident or two years from the date of actual or constructive knowledge of a motor vehicle-related loss. Nor is it a situation where the interests of individual justice outweigh the public’s interest in repose, as where a plaintiff has been prevented from asserting his right to no-fault benefits because the existence of his injury was not known and could not be reasonably ascertained. The instant action was instituted more than two years after Lucretia Monteiro last received basic reparation benefits for her claimed loss. In this circumstance, a minor plaintiff is plainly in less need of protection from delay in the commencement of an action than if there had been no prior timely claim for benefits, and any bar to the running of the already generous time limits established by the Act only rewards the negligence of a minor who has slept on his rights.

Application of section 106(c)(5) to actions to recover further benefits also inflicts obvious and unnecessary harm on insurers. While ordinarily an adult claimant could not recover any portion of his loss incurred more than two years before the date on which his action was commenced, a minor plaintiff would be allowed to recover benefits for any portion of his claimed loss. “[T]he difficulty of determining the *313merits of long-delayed claims” in this situation, as well as “the attendant opportunities for fraud,” are inconsistent with the policy underlying the Act’s limitation periods.13 In addition, “the resulting impact on insurance ... rating processes”14 by insurers’ doubts about successfully defending claims of this type defeats the Act’s clearly defined goal of providing economic protection to all accident victims at reasonable cost.15

The cost of insurance will also be adversely affected by the impracticability of closing thousands of files through out-of-court settlements. As previously mentioned, the two year limitation period was intended, inter alia, to encourage the settlement of claims by eliminating the necessity for a claimant to bring an action as long as benefits are being paid by his insurer.16 The willingness of both parties to bargain flows, in theory, from the mutuality of advantage to each with his own reasons for wanting to avoid trial. In its immediate effect, however, tolling the limitation period during periods of disability robs the insurer of his incentive to pay a disputed loss since the claimant would no longer be compelled to bring suit within two years.

For all of the foregoing reasons, I would affirm the decision of the trial court that this minor’s action to recover further benefits is not subject to section 106(c)(5). Moreover, I would hold that the operative effect of invoking the No-fault Act and receiving a payment of benefits is to waive any specific personal disability that would ordinarily arrest the running of the statute of limitations in an original action. The literal import of section 106(c)(5) is clear: a person under legal disability should be given an opportunity to assert his claim in the same manner as other persons sui juris. It is not, however, intended to furnish a dilatory *314plaintiff with the advantage of establishing his claim at the expense of the Act’s legislative purposes.

. 40 P.S. § 1009.106(c) (Supp.1980-81).

. Id. § 1009.106(c)(1).

. Id.

. 40 P.S. § 1009.106(c)(5) (Supp.1980-81).

. See notes 2 & 3 and accompanying text supra.

. 40 P.S. § 1009.106(c)(5) (Supp.1980-81).

. “Minority” refers exclusively to that class of claimants who, at the time the right to bring an action first accrues, have not attained majority. It should not be confused with considerations of apparent hardship, as where a victim has been prevented from asserting a claim which could have not been reasonably discovered at an earlier date. See Rigotti v. J. C. Penney Cas. Ins. Co., 13 D & C 3d 472 (1980). The limitations provisions of the No-fault Act should not serve to preclude such a claim, nor should this result be different if a minor were involved.

. 40 P.S. § 1009.102(b) (Supp. 1980-81).

. Statutes of limitation are designed to suppress stale or fraudulent claims which may be difficult to defend by virtue of the passage of time. See Ins. Co. of North America v. Carnahan, 446 Pa. 48, 284 A.2d 728 (1971); Ulakovic v. Metropolitan Life Ins. Co., 339 Pa. 571, 16 A.2d 41 (1940).

. In accordance with the Act, loss accrues as expense is incurred, and not when injury is sustained. 40 P.S. § 1009.106(a)(1).

. See Uniform Motor Vehicle Accident Reparations Act § 28, Comment.

. R. Keeton & J. O’Connell, Basic Protection for the Traffic Victim 435 (1965).

. Id.

. Id.

. See 40 P.S. § 1009.102(b) (Supp.1980-81); id. § 1009.504(b).

. See note 12 and accompanying text supra.