Despina KAMPERIS, Individually and as parent and natural guardian to her minor children George, Basilios and Jordanus, and Dimitrios Kantyltzoglou, Administrator of the Estate of Christos Kamperis, Appellants, v. NATIONWIDE INSURANCE COMPANY, Appellee.
Supreme Court of Pennsylvania.
Argued Oct. 26, 1983. Decided Dec. 30, 1983.
469 A.2d 1382
Thomas H. Goldsmith, Patrick McConnell Shea, Philadelphia, for appellee.
Before ROBERTS, C.J., and NIX, LARSEN, FLAHERTY, MCDERMOTT, HUTCHINSON and ZAPPALA, JJ.
FLAHERTY, Justice.
We are called upon to address the timeliness оf an action to recover work loss benefits under the Pennsylvania No-fault Motor Vehicle Insurance Act, Act of July 19, 1974, P.L. 489, No. 176,
Appellants’ decedent, Christos Kаmperis, was killed in a motor vehicle accident on June 28, 1978, while he was a passenger in his employer‘s vehicle and within the scope of his employment as a painter-sandblaster. Appellants, dece
The applicable provision of the Act regarding the limitation of time for bringing a civil action to recover work loss benefits payable under the Act is § 106(c)(1), see Sachritz v. Pennsylvania National Mutual Casualty Insurance Co., 500 Pa. 167, 455 A.2d 101 (1982). That section provides in pertinent part as follows:
(c) Time limitations on actions to recover benefits.-
(1) If no-fault benefits have not been paid for loss arising otherwise than from death, an action therefor may be commenced not later than two years after the victim suffers the loss and either knows, or in the exercise of reasonable diligence should have known, that the loss was caused by the accident, or not later than four yeаrs after the accident, whichever is earlier.
Section 103 of the Act defines “loss” as “accrued economic detriment resulting from injury arising out of the maintenаnce or use of a motor vehicle consisting of, and limited to ... work loss ....”
Our inquiry does not end here, however, as, in furtherance of its broad remedial purposes, the Act clearly looks to a continuing series of losses with each failure of a victim to receive his or her normal financial remuneration for work the victim could have performed had the accident not rendered the victim unable to work. This is evident by review оf the provision of § 106(a)(1): “No-fault benefits
As there are not sufficient facts of record to enable us to determine when Mr. Kamperis would have received his next paycheck, or when Mr. Kamperis would have suffered total work loss equal to $15,000, the maximum amount recoverable under the statute, we are unable to conclude whether the instant action was timely. Therefore, the order of the Superior Court is reversed and the case is remanded to the trial court for further proceedings consistent with this opinion.
Reversed and remanded.
HUTCHINSON, J., files a concurring and dissenting opinion.
LARSEN, J., files a dissenting opinion.
Without abandoning my view that Heffner v. Allstate, 491 Pa. 447, 421 A.2d 629 (1980) is wrongly decided, I join Mr. Justice Flaherty‘s opinion in this case, which I read as limiting postmortem work loss actions to two years from the date each payment of lost wages would have been due, absent the loss, in an amount equal to the paychecks then due within that portion of the two year period remaining when the aсtion is filed, up to a $15,000.00 maximum, or whatever portion of that $15,000.00 amount the plaintiff would sustain within four years of the accident.
LARSEN, Justice, dissenting.
The question raised in this appeal is whether or not appellants’ action for work loss benefits was filed timely.
The appellants’ decedent was killed in an automobile accident on June 28, 1978. At the time of his death, the decedent was in the course of his employment, riding as a passenger in his employer‘s vehicle. On October 17, 1978, the employer‘s No-fault insurance carrier paid $5,000.00 in survivor‘s loss benefits. On February 6, 1980, $1,000.00 toward the funeral bill was also paid by the employer‘s carrier.1 Subsequently, the appellants presented a claim for work loss benefits to decedеnt‘s personal no-fault insurer, the appellee, Nationwide Insurance Company. Appellee denied the claim.2
On July 10, 1980, two years and two weeks after the accident and death of the decedent, suit was filed against appellee for recovery of the benefits which appellee refused to pay. The lower court found in favor of appellants and
On appeal, the Superior Court reversed, holding that appellants’ action was not brought within two years after the loss and, therefore, was barred. The Superior Court‘s opinion fixes the date of decedent‘s death as the date of loss. I agree with the majority that, for the purposes of the statute of limitations, the date of death is not the date of loss. I disagree, however, with the majority‘s construction of
The statute of limitations applicable to actions for the recovery of no-fault benefits is set forth in Section 106(c) of the No-fault Act.
(c) Time limitations on actions to recover benefits.-
(1) If no-fault benefits have not been paid for loss arising otherwise than from death, an action therefor may be commenced not later than two years after the victim suffers the loss and either knows, or in the exercise of reasonable diligence should have known, that the loss was caused by the accident, or not later than four years after the accident, whichever is earlier. If no-fault benefits have been paid for loss arising otherwise than from death, an action for further benefits, оther than survivor‘s benefits, by either the same or another claimant; may be commenced not later than two years after the last payment of benefits.
(2) If no-fault benefits have not been paid to the deceased victim or his survivor or survivors, an action for survivor‘s benefits may be commenced not later than one year after the deаth or four years after the accident from which death results, whichever is earlier. If survivor‘s benefits have been paid to any survivor, an action for further survivor‘s benefits by either the same or another
claimant may be commenced not later than two years after the last payment of benefits. If no-fault benefits have been paid for loss suffеred by a victim before his death resulting from the injury, an action for survivor‘s benefits may be commenced not later than one year after the death or six years after the last payment of benefits, whichever is earlier.
Act of July 19, 1974, P.L. 489, No. 176, Art. I, § 106,
This Court has construed the statutory provisions quoted above, as follows: “106(c)(2) covers no-fault benefits, including funeral expenses which, like wrongful death damages, are designed to compensate the insured‘s survivors for the loss they suffer by his death; 106(c)(1) covers other no-fault benefits [including work loss benefits], designed to compensate the insured himself.” Sachritz v. Pennsylvania National Mutual Casualty Insurance Company, 500 Pa. 167, 174, 455 A.2d 101, 105 (1982) (Larsen, J., dissenting.) “Work loss and other no-fault benefits belonging to the insured or a deceased insured‘s representative are subject to a two year statute.” Id., 500 Pa. at 177, 455 A.2d 101, 107. The instant action brought for the recovery of work loss benefits belonging to the decedent‘s representative is therefore governed by Section 106(c)(1) of the Act.
For an action to be timely, Section 106(c)(1) requires that it be initiated “not later than two years after the victim suffers the loss ...“.
Since its enactment, we have consistently interpreted the No-fault Act by applying the rule of liberal construction prescribed by the Statutory Construction Act.
“[T]he courts of this Commonwealth have routinely followed [the spirit of this statutory declaration] and found coverage for the insured in close or doubtful insurance cases. The tendency has been that if we should err in ascertaining the intent of the legislature ..., we should err in favor of coveragе for the insured.” Allstate v. Heffner, 491 Pa. 447, 421 A.2d 629 (1980).
The accident of June 28, 1978, which resulted in the immediate death of the appellants’ decedent, is not the date of loss within the contemplation of the statute of limitations, as urged by the appellee and as held by the Superior Court. Further, the date of loss is neither the date the decedent first failed to receive a paycheck as a result of the injuries he sustained in the accident, nor is it the date he “suffered the maximum amount recoverable under the Act for work loss, $15,000“, as the majority holds. Decedent‘s accidental death is the event which activated the appellee insurer‘s contractual duty to pay, to those entitled, the benefits it agreеd to pay. Correspondingly, this event activated the rights of the victim and his survivors to receive payment of the benefits provided for by the insurance contract. Part of those benefits which the appellant has a duty to pay and the appellant has a right to receive are wage loss benefits occasioned by the decedent‘s inability to engage in or continue to engage in gainful employment activities.
In passing the No-fault statute the General Assembly declared that its legislative policy aim was “to 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.”
The No-fault Act provides for the prompt and sure recovery of basic loss benefits instead of delayed and uncertain awards of the court. See: Singer v. Sheppard, 464 Pa. 387, 346 A.2d 897 (1975).
Because the No-fault Act assures a victim and a victim‘s survivors payment of all basic loss benefits, no loss is suffered, within the contexual sense of the act, at the time of the accident, at the amount of deаth, or when a paycheck is missed. It is when the insurance carrier breaches its contractual duty to pay the required benefits that loss is suffered. The failure to pay the benefits is the event which gives rise to a cause of action in assumpsit against the insured. It is inconsistent with concepts of fairness and with the remedial purposes of the No-fault Act to hold that a cause of action is barred by a statute of limitations which begins to run before the cause of action arises. See: Bond v. Gallen, 292 Pa.Super. 207, 437 A.2d 7 (1981).
In the present case, the decedent was killed in an automobile accident on June 28, 1978. At that time the decedent‘s right to work loss benefits was activated. No cause of action against the appellee insurer arose as a result of decedent‘s accident and death. Further, no cause of action arose when the decedent‘s next expected payday passed without a paycheck.5 The appellants’ requested that the appellee pay work loss benefits pursuant to the provisions of the no-fault insurance contract between appellee and decedent. When appellee declined to pay the benefits, which according to the record was on June 17, 1980, the appellants suffered a loss, a cause of action in assumpsit arose against the appellee, and the statute of limitations
Although I concur in reversing the order of the Superior Court, I dissent to the majority‘s construction of Section 106(c) of the No-fault Act.