Moritz v. Horace Mann Property & Casualty Insurance
Opinion of the Court
ORDER
Plaintiffs, Cynthia Moritz (“Moritz”), and her husband, George Moritz, have filed this action seeking to recover underinsured motorist (UIM) benefits from their insurer, Horace Mann Property & Casualty Insurance Company (“Horace Mann”), as a result of an automobile accident on August 26, 2010, in which Moritz was injured. The accident occurred when a vehicle operated by Cynthia Parlanti crossed into Moritz’s lane of travel an collided with her automobile. (Joint pre-trial order, filed as docket entry no. 39, at p. 2). The parties agree that Ms. Parlanti was solely responsible for the accident, and the only issue to be decided by the jury is the amount of damages recoverable by Moritz and her husband. (Id. at pp. 2-3).
In anticipation of the jury trial scheduled to commence on November 12, 2014, the parties filed motions in
Reference to Underinsured Motorist Coverage
In her pre-trial submissions, Moritz has indicated her intention to advise the jury that Horace Mann issued a policy to Moritz which affords UIM coverage, that Moritz collected the negligent motorist’s liability insurance policy limits, and that Moritz is seeking to recover damages pursuant to the above-quoted provisions of Moritz’s UIM coverage. Horace Mann posits that the jury should merely be informed that this case involves an automobile accident between Moritz and Cynthia Parlanti, that liability for the accident is not in dispute, that the parties contest the nature and extent of the injuries caused by the accident, and that the only issues to be decided by the jury are the damages recoverable by Moritz and her husband. (Docket entry no. 50, Exhibit B at p. 1). The gist of Horace Mann’s argument is that any reference to or explanation of UIM insurance is irrelevant and unduly prejudicial. (Id; Docket entry no. 43 atfll7-21).
Prior to 2005, jury trials were not conducted in claims for uninsured motorist (UM) or underinsured motorist (UIM) benefits since those disputes were subject to binding
Section III, p. 11 of Moritz’s insurance policy with Horace Mann provides for arbitration “in accordance with the provisions of the Pennsylvania Uniform Arbitration Act” if Moritz and Horace Mann cannot agree “as to the amount of damages” recoverable under the UIM coverage. (Docket entry no. 46, Exhibit A at p. 31). However, Horace Mann’s “Uninsured/Underinsured Motor Vehicle amendatoiy endorsement CC-N04PA1 (10/06)” accompanying Moritz’s policy expressly states that “[t]he Arbitration section has been deleted” from Moritz’s UIM coverage. (Id. at p. 17). As a consequence, Moritz’s UIM claim is not subject to arbitration, and pursuant to that amendatory endorsement, Moritz filed the instant civil action to collect UIM benefits.
Reference to insurance was a non-issue in UM/UIM proceedings when those disputes were subj ectto mandatory arbitration and decided by a panel of lawyers who were aware of the existence of UM/UIM coverage. See, e.g., Hartford Ins. Co. v. O’Mara, 907 A.2d 589, 591 (Pa. Super. 2006) (arbitration panel found that insured’s signature on coverage option forms did not constitute proper written request for reduction of UM/UIM coverage under 75 Pa.
The Civil Instructions Subcommittee of the Pennsylvania Supreme Court Committee for Proposed Standard Jury Instructions has not published any recommended instructions for UM/UIM jury trials after Koken, nor have the appellate courts had occasion to consider the propriety of specific instructions that have been fashioned and used by trial courts in such cases. See, e.g., Alabama Pattern Jury Instructions — Civil § 20.53 (3rd. ed. 2012); Connecticut Civil Jury Instruction § 3.7 — 14 (4th ed. 2008); Delaware Civil Pattern Jury Instruction § 17.4 (2000); Iowa Civil Jury Instruction No. 1440.1 (2012); Maryland Civil Pattern Jury Instruction 18:11 (4th ed.). Some states have adopted the approach
Following Stepanovich, the UIM insurer may be identified as the party defendant without violating the proscription in Pa.R.E. 411 against the introduction of liability or indemnity insurance for the purpose of proving that a person acted negligently or wrongfully. With regard to specific jury instructions, “atrial court has wide latitude in its choice of language when charging a jury,” and should “explain the principles of law which are fairly raised under the facts of a particular case so as to enable the jury to comprehend the questions it must decide.” Drew v. Work, 95 A.3d 324, 329 (Pa. Super. 2014) (quoting Lockhart v.
Moritz has confirmed in her pre-trial submissions that she does not seek to introduce evidence of Horace Mann’s UIM coverage limits or the amount of the tortfeasor’s liability insurance limits which she has already collected. Horace Mann contends that the jury should merely be advised “that this matter involves a motor vehicle accident involving 2 drivers, identifying the drivers, and also advising the jury that liability is not in dispute, but the extent of injuries being claimed by plaintiffs are in dispute and the only issue for the jury to decide is what injuries, if any, plaintiff, Cynthia Moritz, sustained as a result of the motor vehicle accident and what are the plaintiffs’ damages.” (Docket entry no. 50, Exhibit B at p. 1; docket entry no. 52 at p. 1). One common pleas court has furnished such an instruction in a UIM trial, and has simply informed the jury that “[a]ll that is necessary for you to know is that [plaintiff] has a claim for damages as a result of this accident” and that “[y]our duty will be to determine whether his claim is valid and, if so, how much in money damages he is entitled to receive.” Pelc v. Burkell, et al, 30 Crawford Co. L. J. 64, 71 (Crawford Co. 2013).
If the jury is not apprised of the reasons for Horace Mann being named as the only defendant in this case, some jurors may speculate as to why the admittedly negligent motorist, Cynthia Parlanti, is not named as a defendant or identified on the verdict slip. An insufficient explanation
Consequently, the jury in this case will be instructed that: (1) plaintiffs have brought this action against their own insurance company under coverage known as underinsured motorist coverage, which serves to provide compensation to a plaintiff for damages that would have been recoverable if the underinsured motorist had maintained an insurance policy which adequately covered the plaintiffs damages from an accident; (2) to recover against the defendant, the plaintiffs must prove that the other driver was negligent, that the negligence caused harm to the plaintiffs, and that the other driver did not have adequate liability insurance; (3) the defendant has stipulated that the plaintiffs’ insurance policy provides underinsured motorist coverage and that the policy was in effect at the time of the accident, such that the jurors need not concern themselves with the specifics of the policy; (4) the defendant has also agreed that the other driver was negligent and caused the accident, such that the jury need only determine whether the plaintiffs suffered harm as a result of the accident and, if so, what amount of money damages will fairly and adequately compensate the plaintiffs; (5) the fact that the plaintiffs
Members of the jury, this case arises from an automobile accident that occurred on August 26, 2010, at approximately 8:54 AM on Sturges Road in Blakely Borough. At that time, the plaintiff, Cynthia Moritz, was operating her automobile when another vehicle being driving by Cynthia Parlanti crossed into Cynthia Moritz’s lane of travel and collided with Cynthia Moritz’s vehicle. It is undisputed that the other driver, Cynthia Parlanti, was negligent and that her negligence was the sole cause of this automobile accident. Therefore, you need not concern yourself with the question of fault in causing the accident since the parties agree that the accident was caused by Cynthia Parlanti’s negligence.
You will note that the only parties in this case are the*84 plaintiffs, Cynthia Moritz and her husband, George Moritz, and the defendant, Horace Mann Property & Casualty Insurance Company. The plaintiffs have brought this action against their own insurance company, Horace Mann Property & Casualty Insurance Company, under coverage which is commonly referred to as underinsured motorist coverage. The purpose of such insurance coverage is to provide compensation to a plaintiff for damages that would have been recoverable if the underinsured motorist had maintained an insurance policy which adequately covered the plaintiffs damages from a motor vehicle accident.
To recover damages from the defendant, Horace Mann Property & Casualty Insurance Company, the plaintiff must show by a fair preponderance of the evidence that the other driver was negligent, that the other driver’s negligence caused injury to the plaintiffs, and that the other driver did not have adequate insurance to fairly and adequately compensate the plaintiffs for their damages caused by the accident. As I already mentioned, the plaintiffs and the defendant agree that the other driver, Cynthia Parlanti, was negligent and caused the accident, such that you need not consider or decide who was at fault in causing the accident. The parties have also stipulated that the plaintiffs’ insurance policy with the defendant provides underinsured motorist coverage, and that the insurance policy was in full force and effect at the time of the accident on August 26, 2010. Therefore, you need not concern yourself with the specifics of that policy. Your only task is to determine whether the plaintiff, Cynthia Moritz, suffered injuries as a result of the accident, and,*85 if so, what amount of money damages will fairly and adequately compensate the plaintiffs for their losses.
The fact that the plaintiffs are suing the defendant, Horace Mann Property & Casualty Insurance Company, for underinsured motorist benefits suggests that the other driver, Cynthia Parlanti, had some insurance which was paid to the plaintiffs. If you award damages to the plaintiffs, they will not receive compensation twice for the same injuries or losses. Any award of damages in this case will be reduced by any amount that the plaintiffs have already received from the other driver or her insurance company. Thus, you should determine an amount of money damages that you believe will fairly and adequately compensate the plaintiffs for all the physical and financial injuries they have sustained as a result of the accident, without consideration of any amount that the plaintiffs may have received from another source, since any such amount will be deducted by me from the total sum that you may award in this case.
Evidence of Horace Mann’s Payment of First-Party Medical Expense Benefits
Moritz asserts that she suffered neck and shoulder injuries in the accident on August 26, 2010. Specifically, she maintains that she sustained a right rotator cuff tear requiring arthroscopic surgical repair, a comparable injury to her left shoulder which makes her a candidate for future shoulder surgery, and an aggravation of preexisting cervical degenerative disc disease. {See joint pretrial order, filed as docket entry no. 39, at pp. 6-8). Horace Mann has retained Dr. Peter Feinstein who conducted a physical examination of Moritz under Pa.R.C.P. 4010,
Moritz has filed a motion in limine “to introduce evidence that [Horace Mann] provided first party benefits coverage to Mrs. Moritz for the date of loss, including payment of $17,500.00 of her medical bills,” which payments were “for the treatment of injuries [Horace Mann] now claims are not causally related to the August 26, 2010, automobile accident.” (Docket entry no. 49 at ¶¶ 7, 11). Moritz submits that Horace Mann’s payment of those medical expenses “is relevant and goes to the credibility of [Horace Mann’s] argument” in this UIM case. (Id. at ¶ 15). Horace Mann counters in its own motion in limine that its payment of medical bills under its first party benefits coverage is inadmissible based upon the reasoning in Pantelis v. Erie Insurance Exchange, 890 A.2d 1063 (Pa. Super. 2006). (Docket entry no. 50 at ¶ 6).
In Pantelis, the plaintiff similarly argued that her insurer “should not have been allowed to dispute causation in the underinsured motorist proceeding after it paid first party benefits pursuant to its contract with [plaintiff].” Pantelis, 890 A.2d at 1065. On appeal, the Superior Court noted
Moritz attempts to distinguish Pantelis on the ground that it is not attempting to “preclude [Horace Mann] from refuting causation,” but instead “seeks to introduce evidence of such [medical expense] payments to refute the credibility of [Horace Mann’s] argument that the injuries for which it provided first party benefits are not causally connected to the automobile accident.” (Docket entry no. 47 atp. 5). Moritz’s argument in that regard is a conceptual distinction without a difference. “Evidence is relevant if it logically tends to establish a material fact in the case, tends to make a fact at issue more or less probable, or supports a reasonable inference or presumption regarding a material
Moreover, even if that evidence was arguably relevant, its probative value is outweighed by the danger of unfair prejudice since the admission of that evidence could sway the jury to render a verdict on an improper basis. See Lykes v. Yates, 77 A.3d 27, 33 (Pa. Super. 2013) (‘’’Unfair prejudice’ supporting exclusion of relevant evidence means a tendency to suggest decision on an improper basis or divert the jury’s attention away from its duty of weighing the evidence impartially.”), app. denied, 92 A.2d 812 (Pa. 2014). Admission of the fact that Horace Mann has paid $17,500.00 in medical expense benefits could be equally prejudicial to Horace Mann and Moritz. For example, the jurors could conceivably conclude that those medical expense payments, like the payment that Moritz has already received from Cynthia Parlanti’s liability insurer, should be deducted from its award of damages and thereby reduce its verdict sua sponte without prompting or suggestion by the court. For all these evidentiary reasons, Horace Mann’s payment of first party medical expense benefits of $17,500.00 is not admissible, and Horace Mann’s second motion in limine will be granted, whereas Moritz’s third motion in limine will be denied.
And now, this 10th day of November, 2014, upon consideration of defendant’s objections to plaintiffs’
1. Defendant’s objections to plaintiffs’ proposed voir dire questions are overruled, and the jury will be furnished with explanatory legal instructions in accordance with this order;
2. Plaintiffs’ motion in limine # 3 is denied and defendant’s motion in limine # 2 is granted; and
3. Plaintiffs are precluded from referencing or introducing any evidence that defendant paid first-party medical expense benefits of $17,500.00 to plaintiffs.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.