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SUZANNE BILLMAN v. PENNSYLVANIA ASSIGNED CLAIMS PLAN AND TRAVELERS INSURANCE COMPANY (01/21/86)

filed: January 21, 1986.

SUZANNE BILLMAN, A MINOR, BY HELEN E. BILLMAN, HER GUARDIAN, APPELLANT,
v.
PENNSYLVANIA ASSIGNED CLAIMS PLAN AND THE TRAVELERS INSURANCE COMPANY



Appeal from the Judgment entered March 11, 1985 in the Court of Common Pleas of Northampton County, Civil Division, at No. 1982-C-6266.

COUNSEL

William P. Coffin, Easton, for appellant (at 657) and appellee (at 745).

Jeffrey P. Hoyle, Lansdale, for appellants (at 745) and appellees (at 657).

Spaeth, President Judge, and Hoffman and Hester, JJ. Spaeth, President Judge, joined in this opinion before the expiration of his term on the court.

Author: Hoffman

[ 349 Pa. Super. Page 450]

These are cross-appeals from the judgment entered in favor of appellant, Suzanne Billman, pursuant to the lower court's order granting her motion for summary judgment in the amount of $6,955.15. Appellant contends that the lower court correctly granted her motion for summary judgment, but erred in refusing to award her (1) interest on the $6,955.15, (2) interest on the sum of $15,000 previously paid to her in partial settlement of her no-fault claims, and (3) attorney's fees. Cross-appellants, the Pennsylvania Assigned Claims Plan and The Travelers Insurance Co. (The Travelers), disagree, contending that the lower court erred in granting appellant's motion. We vacate the lower court's judgment, reverse its order, and remand for further proceedings.

On August 4, 1981, appellant, a minor, was injured in an automobile accident while a passenger in her brother's uninsured motor vehicle. Through her guardian, appellant applied to the Pennsylvania Assigned Claims Plan seeking uninsured motorist benefits and basic loss benefits under the No-fault Motor Vehicle Insurance Act (No-fault Act).*fn1 Her claim was assigned to The Travelers. Appellant then brought suit against cross-appellants for failure to pay her claims. The Travelers subsequently paid appellant $15,000

[ 349 Pa. Super. Page 451]

    in uninsured motorist benefits as partial settlement of her claims.*fn2 However, the Travelers refused to pay the $6,955.15 in medical expenses claimed by appellant as basic loss because those expenses had already been paid by her mother's Blue Cross/Blue Shield coverage. On November 8, 1984, cross-appellants filed a motion for summary judgment alleging that they were not liable to pay basic loss benefits when the medical bills constituting that basic loss had already been paid by Blue Cross/Blue Shield. On January 2, 1985, appellant filed a cross-motion for summary judgment, contending that she should be awarded basic loss benefits in the amount of $6,955.15 and interest thereon, interest on the uninsured motorist benefits previously paid, and attorney's fees. The lower court entered an order granting appellant's motion on February 12, 1985, but denying her requests for interest and attorney's fees. These cross-appeals followed.

The first issue that we must address is whether the lower court erred in finding that appellant was entitled to receive basic loss benefits although her medical expenses had already been reimbursed by Blue Cross/Blue Shield. This issue turns upon the construction of 40 P.S. 1009.108(a)(3) of the No-fault Act, which provides:

[I]f an individual receives basic loss benefits through the assigned claims plan for any reason other than because of the financial inability of an obligor to fulfill its obligation, all benefits or advantages that such individual receives or is entitled to receive as a result of such injury, other than life insurance benefits or benefits by way of succession at death or in discharge of familial obligations of support, shall be subtracted from loss in calculating net loss.

[ 349 Pa. Super. Page 452]

(Emphasis added). Basic loss benefits are paid on the net loss sustained by a victim. Id. ยง 1009.103. Cross-appellants contend that the Blue Cross/Blue Shield payments made for appellant's medical bills constitute benefits that should be subtracted from appellant's total loss in order to determine the basic loss benefits that she is entitled to receive. Because appellant has only claimed loss for her medical expenses, and Blue Cross/Blue Shield has paid all of those expenses, cross-appellants contend that no basic loss benefits are due. Appellant, however, argues that because the payments were made pursuant to her mother's Blue Cross/Blue Shield ...


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