United States District Court, District of Columbia
CHRISTOPHER R. COOPER United States District Judge.
se plaintiff Awoke Gebretsadike sued his auto
insurer-Traveler Home and Marine Insurance Company
(“Travelers”)-for allegedly failing to honor the
terms of his automobile insurance policy after a hit-and-run
driver struck his car on New Year's Eve 2011. At the
motion-to-dismiss stage of the suit, the Court permitted two
of Gebretsadike's claims to proceed to discovery: first,
his contention that Travelers violated the District of
Columbia Consumer Protection Procedures Act
(“DCCPPA”) by not providing him with a full copy
of his insurance policy, and second, his claim that Travelers
breached the policy by not reimbursing him under its
personal-injury-protection or uninsured-motorist coverage
provisions. Gebretsadike v. Travelers Home & Marine
Ins. Co., 103 F.Supp.3d 78, 84-86 (D.D.C. 2015). With
discovery now complete, Travelers moves for summary judgment
on these remaining claims. For the reasons explained more
fully below, the Court will grant Travelers' motion on
the DCCPPA claim because the company has established that it
did in fact provide Plaintiff with a copy of the policy. It
will also grant Travelers' motion on Plaintiff's
allegation that he was entitled to personal injury protection
under the policy, as Gebretsadike failed to properly elect
that coverage within the required time period. Because
Gebretsadike further failed to cooperate in the claim
settlement process, the Court will likewise grant
Travelers' motion with respect to his uninsured-motorist
coverage, but with one caveat: Through the course of
litigation, Gebretsadike has established-and Travelers has
acknowledged-that he is entitled to $5, 421.50 in medical
expenses. The Court will therefore direct Travelers to
reimburse Gebretsadike for that amount.
Year's Eve of 2011, Mr. Gebretsadike was driving to a
restaurant in D.C. when another car crashed into him. Compl.
¶ 1-2. As a result of the accident, Gebretsadike briefly
lost consciousness and suffered injuries to his head and leg.
Id. The other driver fled the scene and Gebretsadike
reported what details he could remember to the police.
See Def.'s Mem. Supp. Mot. Summ. J.
(“MSJ”), Ex. 1. Gebretsadike had acquired
automobile insurance from an authorized Travelers agent six
months earlier. Def.'s MSJ, Ex. 2. Decl. of Dorothy
Kennard (“Kennard Decl.”) ¶ 4. The initial
policy was effective from June 15, 2011 through December 15,
2011, but it automatically renewed to cover an additional
term of December 15, 2011 to June 15, 2012. Id.
¶¶ 6-9. Under the terms of the policy, Gebretsadike
was potentially entitled to personal-injury-protection
(“PIP”) or uninsured-motorist coverage as a
result of his accident. See Kennard Decl., Ex. C.
The uninsured-motorist coverage provision required Travelers
to pay medical and property damages resulting from an
accident with an uninsured driver. Id. at 89. The
D.C.'s Compulsory No-Fault Motor Vehicle Insurance Act of
1982, D.C. Code § 31-2405, governed Travelers'
obligations to pay PIP benefits. Id. at 85.
days after the accident, Gebretsadike contacted Travelers to
report the incident and discuss these coverage options.
Kennard Decl. ¶¶ 11, 14. Travelers followed up by
sending him a letter explaining how he could invoke PIP
coverage and warning him that he must do so before March 2,
2012 or the option would expire. Kennard Decl., Ex F. The
letter further clarified that Gebretsadike could
either elect to use his PIP benefits, which had a
$50, 000 limit, or file a liability claim against the driver
who had hit him, but that he could not pursue both types of
claims except in certain, statutorily circumscribed
situations. Id. Gebretsadike then received a series
of forms- including a PIP election form and a medical
authorization form-to complete and return. Kennard Decl., Ex.
E at 125. He signed and returned all of the forms to
Travelers. Id. at 125-29. On the election form,
however, he indicated that he wanted to invoke his PIP
coverage as well as pursue a liability claim against the
unknown driver. Id. at 129.
promptly informed Gebretsadike that he could pursue only one
of these options, id. at 145, and reminded him that
his ability to elect PIP coverage would expire at the start
of March. Gebretsadike did not remit another PIP election
form, and on March 5, 2012, Travelers closed his PIP claim.
Id. at 174. While he was no longer eligible for PIP,
Travelers told Gebretsadike that he was still entitled to his
uninsured-motorist coverage because the police report
indicated that he was hit by an unknown driver. Def.'s
Statement of Material Facts ¶ 31; see also
Kennard Decl. ¶ 20; Kennard Decl., Ex. E at 165, 174.
During this exchange, Gebretsadike struggled to obtain
medical treatment for his injuries because he lacked health
insurance. Kennard Decl., Ex. E at 148. He requested help
from Travelers, which sent him a list of medical providers
but told him that they could not pre-authorize his
treatment-only settle his claims after reviewing the medical
bills he submitted. Id. at 145, 148. A long chain of
correspondence ensued, spanning almost three years, between
Gebretsadike and a series of Travelers claim representatives.
See Kennard Decl., Ex. E.
went back and forth with Travelers on the uninsured motorist
coverage requirements and the documentation he needed to
provide to settle his claim. He dealt simultaneously with
another Travelers claim representative regarding the property
damage to his car. For a time, Gebretsadike stopped
communicating with Travelers agents, but he re-initiated
contact in the fall of 2013-after the police officially
closed its investigation of his accident-to enlist
Travelers' assistance in locating the hit-and-run driver.
Id. at 255, 259. When Gebretsadike also inquired
about his uninsured-motorist coverage, Travelers told him
that they would need a medical release authorization, a list
of his healthcare providers, and a wage verification form in
order to process his claim. Id. at 267-69. In
response, Gebretsadike submitted a letter from his former
employer claiming that Gebretsadike had been earning $789 a
week before the accident but had been unable to work since
then. Kennard Decl., Ex. G at 482. Gebretsadike expressed
discomfort though with providing the names of his doctors and
asked Travelers if he could submit the medical bills instead.
Kennard Decl., Ex. E at 272-73. Travelers agreed.
Id. at 273, 277. Yet Gebretsadike still wavered on
sending his medical expenses. Id. at 284-85.
Travelers stated that they could not proceed with his claim
adjustment without them, but offered him $500 in lieu of an
official settlement. Id. at 350-51. Around this
time, Gebretsadike also began to pursue legal remedies by
seeking the assistance of pro bono counsel, and he
requested that Travelers send him a complete copy of his
policy along with any other records they had on file
regarding his claims. Id. at 287. On March 18, 2014,
a dissatisfied Gebretsadike “respectfully request[ed]
[Travelers] not to send [him] any more email.”
Id. at 474. And on November 6, 2014, he filed this
the course of litigation, Travelers finally obtained medical
records totaling $5, 421.50 from Gebretsadike. Kennard Decl.
¶ 26. They also received an affidavit from
Gebretsadike's allegedly former employer, who stated that
he did not recall ever seeing or signing a letter on
Gebretsadike's behalf. Kennard Decl., Ex. G ¶ 5.
Despite this wrinkle, Travelers twice offered during
mediation to settle Mr. Gebretsadike's claim for $5,
421.50. Kennard Decl. ¶ 26. Gebretsadike rejected both
Standard of Review
judgment shall be granted “if the movant shows that
there is no genuine dispute as to any material fact and the
movant is entitled to judgment as a matter of law.”
Fed.R.Civ.P. 56(a). The movant bears the burden to
demonstrate an “absence of a genuine issue of material
fact” in dispute. Celotex Corp. v. Catrett,
477 U.S. 317, 323 (1986). For a factual dispute to be
material, it must “be capable of affecting the
substantive outcome of the litigation; to be genuine, [it]
must be supported by sufficient admissible evidence that a
reasonable trier-of-fact could find for the nonmoving
party.” Laningham v. U.S. Navy, 813 F.2d 1236,
1242-43 (D.C. Cir. 1987). In considering if there are genuine
factual disputes, the Court will consider “pleadings,
depositions, answers to interrogatories, admissions on file,
[and affidavits]” presented by both parties.
Celotex Corp., 477 U.S. at 323.
ruling on a motion for summary judgment, a court accepts as
true the nonmovant's evidence and draws all reasonable
inferences in favor of the nonmoving party. Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 255 (1986). But
“while the movant bears the initial responsibility of
identifying those portions of the record that demonstrate the
absence of a genuine issue of material fact, the burden
shifts to the non-movant to come forward with ‘specific
facts showing that there is a genuine issue for
trial.'” Klayman v. Judicial Watch,
Inc., 628 F.Supp.2d 112, 123-24 (D.D.C. 2009) (quoting
Matsushita Elec. Indus. Co. v. Zenith Radio Corp.,
475 U.S. 574, 587 (1986)). In doing so, the nonmovant may not
rely simply on allegations or conclusory statements.
Veitch v. England, 471 F.3d 124, 134 (D.C. Cir.
2006). Thus, “[i]f the evidence is merely colorable, or
is not sufficiently probative, summary judgment may be
granted.” Anderson, 477 U.S. at 249-50
(internal citations omitted). “[M]ere allegations or
denials in the adverse party's pleadings, ” for
example, “are insufficient to defeat an otherwise
proper motion for summary judgment.” Williams v.
Callaghan, 938 F.Supp. 46, 49 (D.D.C.1996).
District of Columbia Consumer Protection Procedures Act
Court previously noted that, under the DCCPPA, it is
“the insurer's duty to spell out in plainest
terms-terms understandable to the man in the street-any
exclusionary or delimiting policy provisions, ” and
that “this duty logically encompasses an obligation to
provide a policyholder with a complete copy of the
policy.” Gebretsadike, 103 F.Supp.3d at 84
(quoting Whiting v. AARP, 637 F.3d 355, 360 (D.C.
Cir. 2011)) (internal quotations omitted). Travelers has
since established-through a declaration and a copy of its
mailed policy-that it sent Gebretsadike a copy of his entire
policy within days of purchase. On June 15, 2011,
Gebretsadike provided an Ace Insurance Services agent a
signed copy of his application for Travelers' automobile
insurance. Def.'s MSJ, Ex. 3, Decl. of Emebet Bekele
¶ 6. Travelers, that same day, mailed a copy of the
purchased policy to the address Gebretsadike had provided on
his application. Kennard Decl. ¶ 7; see also
Kennard Decl., ...