On March 13, 2017, Aman K. Sharma, Esquire, of K/M’s Wilmington office, obtained summary judgment in favor of an automobile insurance carrier for personal injury protection (“PIP”) benefits in which the Plaintiff’s last demand before trial was the policy limit—$300,000. The Plaintiff alleged bodily injuries and lost wages as the result of an alleged hit-and-run accident.
In the aftermath of the alleged accident, Plaintiff was asked to attend two (2) Independent Medical Examinations (“IMEs”). Plaintiff failed to appear for either without cause. Mr. Sharma argued, in his Motion for Summary Judgment on behalf the carrier, that Plaintiff’s refusal to appear for the IMEs constituted a material breach of the insurance agreement between Plaintiff and the insurance carrier and that Delaware courts have held that before an insurer is required to make payments on a claim, the insured must comply with all statutory obligations as well as contractual conditions set forth in the policy. In addition, Plaintiff’s failure to appear for properly-noticed IMEs substantially prejudiced the carrier by denying it the opportunity to evaluate Plaintiff’s health at a time close enough to the accident to permit a comprehensive determination of his alleged injuries.
In granting the Motion for Summary Judgment in favor of the carrier, Superior Court Judge Ferris W. Wharton held that Plaintiff’s appearance for IMEs was, in fact, a condition precedent in the policy. Consequently, the carrier was not obligated to provide Plaintiff with PIP benefits.
For further information about the law and facts of this case, please contact Aman K. Sharma, Esq. at 302 352 3124 or firstname.lastname@example.org.