U.S. COURT OF APPEALS FOR THE TENTH CIRCUIT
No. 17-1282. Allen v. United Services Automobile Ass'n. 10/29/2018. D.Colo. Judge Holmes. Automobile Insurance—One-Year Limit on Medical Expenses—Doctrine of Reasonable Expectations—MedPay Statute—Plain Text.
Allen was injured in an automobile accident. His automobile insurance policy included coverage for medical expenses arising from car accidents, but did not allow reimbursement for medical expenses that accrued a year or more after an accident. Allen sought reimbursement for medical expenses that accrued more than a year after his accident. His insurer, United Services Automobile Association (USAA), denied reimbursement. Allen filed a class-action lawsuit against USAA, and USAA moved for summary judgment. The district court granted the summary judgment motion and entered final judgment against Allen.
On appeal, Allen argued that the one-year limit on medical payments coverage is unenforceable because it violates Colorado's reasonable-expectation doctrine. He claimed that based on a USAA disclosure form, he could have reasonably expected that there would be no time limit attached to the medical payments coverage. The reasonable-expectation doctrine renders exclusionary language in an insurance policy unenforceable where an ordinary, objectively reasonable insured would be deceived into believing he or she has coverage, while the insurer maintains he or she does not. Here, the disclosure form was not deceptive and the policy clearly limited medical expenses to one year. The doctrine of reasonable expectations did not apply.
Allen also argued that the one-year limit on medical payments coverage is unenforceable because it is prohibited by Colorado's MedPay statute, which requires car insurance companies to offer at least $5,000 of coverage for medical expenses. Nothing in the plain text of the MedPay statute prohibits an insurance company from putting a time limit on medical payments. Thus, the one-year time limit in Allen's insurance policy is enforceable.
The judgment was affirmed.
No. 17-7051. United States v. DeLia. 10/29/2018. E.D.Okla. Judge Phillips. Statute of Limitations—Wartime Suspension of Limitations Act—Waiver.
DeLia, who was a licensed physician, operated a medical clinic in Oklahoma...