If you are injured in an auto accident, you naturally assume that your insurance policy will help cover your damages. As with any contract, you need to carefully review and understand the terms of your policy. You may need to comply with a number of conditions before the insurer is legally obligated to provide you with coverage. Your failure to comply can–and will–be strictly held against you by the courts.
Geico General Insurance Company v. Breffle
A recent decision from the Georgia Court of Appeals, Geico General Insurance Company v. Breffle, provides a cautionary example. This case involves an insured driver (the plaintiff) who was injured in an April 2016 auto accident with another vehicle. The plaintiff sought medical treatment for his injuries a few days after the accident. In December 2016, about eight months after the accident, the plaintiff underwent a surgical procedure as part of his treatment. Later, in March 2017, the plaintiff’s doctors advised him that he would need a second surgery.
The other driver was insured for $250,000. The plaintiff said that once he was told he would need the second surgery, he realized that the total value of his accident-related injuries might exceed this limit. The plaintiff therefore notified his own insurance company, GEICO, about the accident in July 2017, as a pretext for seeking underinsured motorist benefits.
GEICO balked at providing coverage, noting that the plaintiff waited nearly 13 months to notify it of the accident. GEICO pointed to the language of the plaintiff’s auto insurance policy, which stated, “As soon as possible after an accident notice must be given to us or our authorized agent stating” the basic facts related to said accident. From GEICO’s perspective, 13 months was not “[a]s soon as possible,” and therefore it did not have to provide any coverage.
Although a trial court found this was an issue for trial, the Court of Appeals said GEICO was entitled to outright summary judgment. The appeals court said the language of the insurance policy was clear and “unambiguous.” Although the phrase “as soon as possible” gives an insured person “some leeway in providing notice” to GEICO, it does not excuse a “lengthy, unjustifiable delay.” And a 13-month delay was certainly “unreasonable.”
As described above, the plaintiff sought medical treatment almost immediately after the accident. He then underwent one surgery and prepared for a second surgery before thinking to even contact GEICO. The Court of Appeals did not credit the plaintiff’s explanation for this, i.e., that he only realized 13 months later that his total damages would exceed the other driver’s policy limits, thereby triggering the need to file a claim with his own insurer. There was simply no excuse, the court said, for not informing GEICO any sooner.