In West Virginia National Auto Insurance Co. v. Dobbins the Supreme Court of Appeals held that to deny a claim filed after a deadline in an insurance policy, an insurance company must show it was prejudiced by the late filing.
On February 15, 2019, Dobbins was struck by a vehicle that fled the scene. He “did not immediately report, or immediately seek medical treatment, for any physical injuries allegedly sustained as a result of the accident,” and did not notify the police until four days later, the same day he advised his insurance carrier. The insurance company denied the claim because the policy required that the insured notify the police within 24 hours.
Dobbins sued and the circuit court ruled in his favor, finding the accident was timely reported under applicable statutes and that even if the report was late, the insurer did not demonstrate that it was prejudiced. In West Va. Nat’l Auto Ins. Co. v. Dobbins, 249 W. Va. 681, 900 S.E.2d 730 (W. Va. Ct. App. 2023), the Intermediate Court of Appeals reversed the circuit court finding the judge “erred in tolling the twenty-four hour notice requirement set forth in West Virginia Code § 33-6-31(e)(1) and the WV National policy.” The appeals court also held that the circuit court erred in requiring the insurer to show prejudice from the late reporting of the claim.
In an opinion by Justice Charles Trump, the Supreme Court of Appeals reversed the appeals court and found that the unambiguous terms of the policy required the insurer to demonstrate prejudice from late claims because the policy “clearly and unambiguously provides that the failure to timely report the accident operates as a bar to coverage only if the failure to report is prejudicial to West Virginia National (italics added).” The circuit court therefore did not err in “requiring West Virginia National to prove that its investigative interests were prejudiced by petitioners’ failure to strictly adhere to the twenty-four-hour reporting requirement and in finding that West Virginia National failed to prove any such prejudice (italics added).”
This opinion is favorable to insureds who miss policy deadlines for filing claims because it places the burden on the insurance company to prove prejudice from the late filing.