STATE FARM MUT. AUTOMOBILE INS. v. Hoang

• Citation: 682 A.2d 202
• Decision Date: 05 September 1996
• Docket Number: No. 95-CV-39,95-CV-40.,95-CV-39
• Parties: STATE FARM MUTUAL AUTOMOBILE INSURANCE CO., Appellant/Cross-Appellee, v. Tuan X. HOANG, Appellee/Cross-Appellant.
• Court: Court of Appeals of Columbia District

682 A.2d 202

STATE FARM MUTUAL AUTOMOBILE INSURANCE CO., Appellant/Cross-Appellee, v. Tuan X. HOANG, Appellee/Cross-Appellant.

Nos. 95-CV-39, 95-CV-40.

District of Columbia Court of Appeals.

Argued June 26, 1996.

Decided September 5, 1996.

Kathleen A. Carey, with whom Harold E. Jordan was on the brief, for appellant/cross-appellee.

Scott M. Strickler for appellee/cross-appellant.

Before FARRELL and KING, Associate Judges, and PRYOR, Senior Judge.

FARRELL, Associate Judge:

These consolidated appeals present the primary issue of whether the trial judge correctly reserved to himself the threshold issue of whether plaintiff Hoang met the "medically demonstrable ... impairment" requirements of the No-Fault statute, D.C.Code § 35-2105(b)(1) (1993), thus enabling Hoang to maintain this civil action despite having received PIP (personal injury protection) benefits under the statute. Relying on language in our decisions and his (correct) understanding that § 35-2105(b) was intended as a screening device "to filter out undeserving cases," the trial judge ruled that satisfaction of § 35-2105(b)'s standards presents a threshold issue of law and fact for the judge to decide, not the jury. Defendant State Farm Insurance Co. (State Farm) argues that this misapprehends our decisions and, if accepted, would place this jurisdiction at odds with the great preponderance of case authority interpreting similar provisions of state no-fault statutes. We agree with State Farm and hold that the proper analysis of proof under § 35-2105(b) follows the traditional summary judgment and directed verdict standards. We further hold that the seriousness of Hoang's injuries under § 35-2105(b) presented issues of material fact on which reasonable minds could disagree, thus requiring denial of State Farm's motion for a directed verdict. We reject Hoang's argument on cross-appeal that the trial judge erroneously removed the issue of punitive damages from the jury.

I.

This case arose from an automobile accident between Hoang and an uninsured motorist. State Farm, Hoang's insurer, paid him substantial PIP benefits for the injuries suffered in the accident, but after an examination by a physician of its naming, it terminated those benefits and also declined to pay him uninsured motorist benefits. Hoang then filed this civil action against State Farm for breach of contract, seeking punitive damages as well. At the end of Hoang's case, which was tried to a jury, the judge struck the claim for punitive damages. On the basis of Hoang's evidence concerning the nature and extent of his injuries, the judge denied State Farm's motion for a directed verdict, which asserted that the standards of § 35-2105(b)(1) had not been met. In doing so the judge tentatively stated his view that this issue was a preliminary one for the court to resolve. After State Farm's physician testified about Hoang's injuries (State Farm did not contest the fault of the uninsured motorist or causation), State Farm renewed its motion for a directed verdict but argued, in the alternative, that whether or not Hoang's injuries met § 35-2105(b)'s threshold should be left to the jury on disputed facts. The judge ruled otherwise, concluding that the issue was one solely for court resolution as a means "to filter out undeserving cases." He concluded that Hoang had presented sufficient evidence of a medically demonstrable impairment under § 35-2105(b)(1) to permit him to maintain the action for breach of contract against State Farm. The judge acknowledged at one point that this left for jury consideration little more than the issue of compensatory damages:

Once the determination was made that the provisions of § 2105 have been met and I conclude that the plaintiffs can bring the action, I don't know that there's much left for you to argue.... The jury can consider anew what they make of ... the personal injuries, whether they did or did not occur, and to what severity, to what extent, to what the value is.

The jury returned a verdict for Hoang of $30,000. State Farm's motion for judgment NOV or for a new trial, again arguing that compliance with § 35-2105(b) was a jury issue on disputed evidence, was denied.

II.

D.C.Code § 35-2105(b) provides:

A victim who elects to receive personal injury protection benefits may maintain a civil action based on liability of another person only if:

(1) The injury directly results a in substantial permanent scarring or disfigurement, b substantial and medically demonstrable permanent impairment which has significantly affected the ability of the victim to perform his or her professional activities or usual and customary daily activities, or c a medically demonstrable impairment that prevents the victim from performing all or substantially all of the material acts and duties that constitute his or her usual and customary daily activities for more than 180 continuous days; or

(2) The medical and rehabilitation expenses of a victim or work loss of a victim exceeds the amount of personal injury protection benefits available.

The parties agree that only § 35-2105(b)(1) is at issue in this case, and then only the sub-provisions we have lettered "b" and "c." State Farm first challenges the trial judge's determination that this threshold issue is for the court alone to decide. Hoang defends that ruling by arguing that compliance with the statutory threshold amounts to an issue of subject matter jurisdiction, which the court decides upon its own independent review of the evidence. See, e.g., Matthews v. Automated Business Sys. & Servs., Inc., 558 A.2d 1175, 1179 (D.C.1989).

Hoang points first of all to the language of the statute, which conditions the right to "maintain a civil action" upon satisfaction of one of the tests of (b)(1) or (2). But the quoted language will not carry the weight Hoang gives it. A threshold jury determination that none of the tests has been met, no less than a court determination, would bar the plaintiff from maintaining suit against (in the typical case) another driver for negligence. The statute of limitations, D.C.Code §§ 12-301 and -302 (1995), operates similarly as a condition on "the right to maintain an action," yet that issue is submitted to the jury on disputed issues of fact. See, e.g., Burns v. Bell, 409 A.2d 614 (D.C.1979). Nor has Hoang cited anything in the legislative history of the No-Fault statute suggesting the D.C. Council considered the issue one of "subject matter jurisdiction" and meant to withhold factual disputes regarding satisfaction of § 35-2105(b) from the jury. That history, as our own examination confirms, sheds no light on the issue one way or the other.

Hoang instead relies upon language from two of this court's decisions which at first look appears to support his contention. In Smith v. Washington Metro. Area Transit Auth., 631 A.2d 387 (D.C.1993), the court, in referring to the No-Fault Act's restrictions on suit for personal injuries, stated: "It is a threshold question of law for the court to decide whether appellant has met the strict statutory requirements as set forth in the No-Fault Act sufficient to overcome the Act's restrictions against tort actions for non-economic losses." Id. at 391. For this point we cited Monroe v. Foreman, 540 A.2d 736, 742 (D.C.1988). All Monroe said on the subject, however, was that "the No-Fault Act permits a person who is eligible for PIP benefits to recover noneconomic losses in a tort action only when certain statutory thresholds have been met." Id. (emphasis added). We said nothing there about who decides whether they have been met. Nevertheless, the sentence from Smith appeared once again in Musa v. Continental Ins. Co., 644 A.2d 999 (D.C.1994). There, as in Smith, we affirmed the trial court's grant of summary judgment to the defendant on the ground that the plaintiff had not overcome the barrier posed by § 35-2105(b). After holding "as a matter of law" that he had not done so, we addressed "Musa's invitation to treat the statutory thresholds set out in section 35-2105(b)(1) as issues of fact requiring jury resolution." Id. at 1003. We rejected the invitation, citing as dispositive the sentence from Smith. Id.

The cited language in the two cases would seem to support Hoang's argument decisively, were it not for the context in which we used it each time. Both decisions, as mentioned, concerned appeals from the grant of summary judgment to defendants on the ground that the plaintiff had not satisfied the threshold requirements of § 35-2105(b). Strictly speaking, language in either opinion suggesting that if a plaintiff surmounts summary judgment, the threshold issue remains one for court determination, would therefore have been dictum. But we do not think the court intended to decide the issue in either case. In Smith the trial judge had rejected the plaintiff's claim that fulfillment of § 35-2105(b) "was a question for the jury to determine," not because this could never be a jury issue, but because the plaintiff had not met the standards for opposing summary judgment. 631 A.2d at 389-90. We began by reviewing those standards, including the rule that:

Once movant has made the requisite showing in support of its motion for summary judgment, the non-moving party, in order to make the evidentiary showing that will permit her to advance to trial, must show that she has a plausible ground to maintain the particular cause of action; i.e., she must produce enough evidence to make out a prima facie case in support of her claim.

Id. at 390. We held, in accordance with the trial judge's ruling, that the weakness of the plaintiff's "evidentiary showing ... entitled WMATA to summary judgment as a matter of law." Id. at 391. With respect to her claim, for example, that her injuries kept her from performing "all or substantially all" of her duties for 180 continuous days, we relied on the decision of the New York Court of Appeals in Licari v. Elliott, 57 N.Y.2d...