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In order to keep you abreast of the recent developments in the law, we are reporting the substance of several current decisions of major import in the jurisdictions of Maryland, the District of Columbia, and Virginia
This material is being provided for your general information only, and is not a substitute for obtaining legal advice. The information provided is not given as legal advice nor in the course of an attorney-client relationship. You should always consult an attorney for advice about the specific circumstances of your case.
Recent Developments in the Law
Jeffrey R. Schmieler, Esquire
Saunders & Schmieler, P.C.
8737 Colesville Road
Suite L-200
Silver Spring, Maryland 20910
(301) 588-7717
www.sslawfirm.com
© Saunders & Schmieler, P.C. 2002
PIP and Tort Claims in the District of Columbia
The District of Columbia’s no-fault automobile insurance
compensates automobile accident victims for their losses without
regard to tort liability. Under the traditional liability
insurance system, automobile accident victims first must establish
fault and degree of injury before compensation can be
awarded. In contrast, the 'no-fault solution'
provides that accident victims receive compensation from their
insurance companies for out-of-pocket losses, regardless of
fault. However, along with the certainty of no-fault benefits comes the
requirement that the victim surrender any claim based on the fault
of another that may have arisen from the accident, unless certain
exceptions are met.
The D.C. Code § 31-2405(b) states that “a victim who
elects to receive personal injury protection benefits may maintain
a civil action based on liability of another person only if:
(1) The injury directly results in substantial permanent
scarring or disfigurement, substantial and medically demonstrable
permanent impairment which has significantly affected the ability
of the victim to perform his or her professional activities or
usual and customary daily activities, or a medically demonstrable
impairment that prevents the victim from performing all or
substantially all of the material acts and duties that constitute
his or her usual and customary daily activities for more than 180
continuous days; or
(2) The medical and rehabilitation expenses of a victim or
work loss of a victim exceeds the amount of personal injury
protection benefits available.”
§ 31-2405(c) states that “nothing in section (b) of this
section shall prevent the survivors of a victim whose death arises
out of the maintenance or use of a motor vehicle from maintaining a
civil action based on the liability of another person for the loss
and noneconomic loss resulting from the victim's death
regardless of whether the victim had previous to his or her death
elected to receive personal injury protection benefits.”
Musa v. Continental Insurance Company, 644 A.2d 999 (D.C.
1994), interpreted and applied the language within this
statute. The Musa Court noted that there are certain
exceptions that allow the most seriously injured accident victims
to bring tort actions even after having received PIP
benefits. In Musa, the Plaintiff relied upon one
of these exceptions, as set forth in the previous no-fault statute,
section 35-2105(b)(1), which required a showing that the injury has
resulted in a "substantial and medically demonstrable
permanent impairment which has significantly affected the
ability of the victim to perform his or her professional activities
or usual and customary daily activities" Id. (emphasis
added).
The Musa Court held that the facts established that the
Plaintiff’s injuries did not "significantly affect"
his activities. See Id. The Court based
its decision primarily on the fact that the Plaintiff remained
enrolled as a full-time student at UDC in the semesters immediately
following the accident, during which he earned between eighteen and
twenty credit hours per semester. Thus, since the accident did not
interfere with his studies, the Court found that there was no
factual showing upon which to conclude that his usual and customary
daily activities were disrupted as a result of the
injuries.
Moreover, the Plaintiff was also able to continue working at his
part-time job as a security guard until more than five months after
the accident. The Musa Court found that these
two factors substantially outweigh the allegation that after the
accident he was unable to return to work at his second part-time
job with the cleaning service. The Court found that it
appeared from the record that despite the accident the Plaintiff
was able to resume the activities that had previously occupied most
of his waking hours: going to school and working as a security
guard. Id.
In Smith v. Washington Metropolitan Area Transit
Authority, 631 A.2d 387, 390 (D.C.1993), the District of
Columbia Court of Appeals similarly concluded that the
Plaintiff’s evidentiary showing was insufficient to maintain
a cause of action under the statutory provisions of the No-Fault
Act and WMATA was entitled to summary judgment as a matter of
law. In order to try to meet the substantial
permanent impairment exception of the No-Fault Act's
restrictions against tort actions for noneconomic losses, the
Plaintiff was examined by a doctor almost five years after the
accident. Though the report described the
Plaintiff’s condition as of that date as
"permanent" on the ground that "she will continue to
have [back] problems from time to time," the described
injuries were minor and relieved by aspirin. See
Id.
Thus, in order to defeat the motion, the Plaintiff had to meet her
burden of demonstrating that she met the substantial permanent
impairment exception to the statute's restrictions against tort
actions solely on her answers to interrogatories. In
the answers the Court found that the Plaintiff continued to work
full time as a legal secretary where she was "required to
perform computer work, filing, and ... administrative duties that
require [her] to move around the office a lot" for which she
has been paid between $24,500 to $28,090 per year which belied her
claim of substantial permanent injuries.
In addition, the Smith Court found that the
Plaintiff’s answers to interrogatories were insufficient to
show that her injuries from the accident prohibited her from
performingall or substantially all of her duties for
180 continuous days. The Smith Court considered that
"substantially all" means what it says, i.e., to
"a great extent." Id. In her
answers, the Plaintiff stated that she curtailed her normal
activities, stayed at home in bed a lot, and was able to work only
part-time. Without sworn medical affidavits as to the extent of her
impairment for 180 continuous days, however, the Court found these
merely conclusory answers were inadequate to meet the requisite
"substantially all" exception to the No-Fault
statute. Therefore, the Smith Court found that the
Plaintiff had not provided, through her answers to interrogatories,
sufficient evidence to demonstrate that her cause of action
remained viable under the exceptions to the No-Fault Act's
restrictions against tort actions for noneconomic
losses. The Court found that she failed to make a prima
facie showing that she suffered substantial permanent impairment or
was virtually incapacitated for 180 continuous days after the
accident.
As was seen in Musa and Smith, this D.C. statute has
the potential to eliminate one of the major problems in a no-fault
insurance jurisdiction – double recovery – which arises
in jurisdictions with no-fault insurance that allow
motorists to recover in tort as well as receive no-fault benefits.
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