This story is reprinted with permission from the Insurance Coverage Law Center, the industry’s only comprehensive digital resource designed for insurance coverage law professionals. Visit the website to subscribe.
The Supreme Court of Delaware has affirmed a trial court’s decision denying personal injury protection (“PIP”) benefits to a bicyclist injured in a collision with a car where the bicyclist received PIP benefits from the driver’s insurer and the PIP benefits available under the bicyclist’s insurance policy did not exceed the PIP benefits he had received.
After James L. Martin was injured in a collision with a car while riding his bicycle, he received $15,000 in PIP benefits from the driver’s insurance policy.
Contending that his losses from the accident, including medical and surgical expenses and lost income, exceeded $15,000, Mr. Martin sought PIP benefits under his policy with National General Assurance Company, which had a $15,000 limit.
National General denied his claim.
At an arbitration before an arbitration panel, the arbitrator found that Mr. Martin could not recover PIP benefits under the National General policy because the policy precluded stacking of PIP policies. The arbitrator entered a decision in favor of National General.
Mr. Martin sued National General, and the insurer moved to dismiss.
The trial court granted its motion, and the dispute reached the Supreme Court of Delaware.
There, Mr. Martin argued that, under the doctrine of contra proferentem, the National General policy allowed the recovery of PIP benefits from the driver’s insurance policy as well as from the National General policies.
The Delaware Supreme Court’s Decision
The court affirmed.
In its decision, the court explained that the doctrine of contra proferentem required ambiguous language in an insurance policy to be construed against the insurance company. The court added that the National General policy excluded PIP coverage for injuries sustained by the named insured or any family member while a pedestrian injured by an accident with any motor vehicle other than the covered auto with respect to which the insurance required by the Delaware Motorist Protection Act was in effect.
The court then ruled that the doctrine of contra preferentem was not applicable in this case because the “plain language” of the National General policy precluded Mr. Martin from recovering the $15,000 PIP policy limit under both the driver’s insurance policy and his own National General policy.
The case is Martin v. National General Assurance Co., No. 401 (Del. June 5, 2019).
Steven A. Meyerowitz, a Harvard Law School graduate, is the founder and president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. Meyerowitz is the director of the Insurance Coverage Law Center and editor-in-chief of journals on insurance law, banking law, bankruptcy law, energy law, government contracting law, and privacy and cybersecurity law, among other subjects. He can be contacted at firstname.lastname@example.org.