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Gebretsadike v. Travelers Home and Marine Insurance Co.

United States District Court, District of Columbia

September 22, 2016



          CHRISTOPHER R. COOPER United States District Judge.

         Pro 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.

         I. Background

         On New 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.

         A few 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.

         Travelers 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.

         Gebretsadike 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.[1] 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 lawsuit. Compl.

         During 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 offers. Id.

         II. Standard of Review

         Summary 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.

         In 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).

         III. Analysis

         A. District of Columbia Consumer Protection Procedures Act Claim

         This 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., ...

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