Ignorance of UM Coverage for Pedestrian Hit by Car is Inexcusable
Post 5107
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Dennis Malcolm Patterson was struck by an automobile while crossing the street, he sued the driver who hit him and sought uninsured/underinsured motorist coverage from his own insurer, United Services Automobile Association (“USAA”). USAA filed a motion to dismiss, arguing that Patterson failed to comply with the policy provision requiring prompt notification. Following a hearing, the trial court granted the motion and Patterson appealed.
In Patterson v. United Services Automobile Association, No. A25A0259, Court of Appeals of Georgia, Fifth Division (June 20, 2025) the trial court’s judgment was affirmed.
Key Points:
Trial Court’s Decision:
It treated the court’s order as a denial of summary judgment
Incident Details:
Patterson was injured on May 17, 2019, when a car driven by Abhay Kumar Singh ran a stop sign and hit him. Patterson hired an attorney on February 17, 2021, and forwarded the police report to a USAA adjuster on March 5, 2021 .
USAA’s Denial:
USAA denied coverage, arguing that Patterson failed to comply with the policy’s provisions requiring prompt notice .
Policy Provisions:
The policy required insureds to notify the insurer promptly of how, when, and where an accident or loss happened. Patterson’s 21-month delay in notifying USAA was deemed a failure to provide prompt notice .
Court’s Conclusion:
The Court of Appeals found Patterson’s delay unreasonable as a matter of law and affirmed the trial court’s order .
DISCUSSION
The trial court found that the policy provision requiring insureds to notify the insurer “promptly of how, when, and where an accident or loss happened” was a condition precedent to coverage. Patterson’s 21-month delay in notifying USAA meant that he failed “as a matter of law” to provide prompt notice.
The trial court also determined that Patterson’s ignorance of the fact that a pedestrian can benefit from his own uninsured motorist coverage is not an excuse that creates a jury issue.
A notice provision expressly made a condition precedent to coverage is valid and must be complied with. Where an insured has not demonstrated justification for failure to give notice according to the terms of the policy, then the insurer is not obligated to provide either a defense or coverage.
An insured may be able to present justification for delay in giving notice, and whether that justification was sufficient is generally a fact-based inquiry for a jury.
Georgia law is replete with cases finding that an insured’s reasons for delay are unreasonable as a matter of law. Patterson’s appeal falls into this category. Its courts have held that mere ignorance of coverage, without other justification for delay, presents no jury question.
If an insured does not read or otherwise make himself aware of the policy provisions, the Court of Appeals concluded that any ambiguity in the unread policy cannot have been a reason for his delay in providing prompt notification. It is well settled that the general rule is that an insured has an obligation to read and examine his insurance policy to determine the nature of the coverage therein.
The Court of Appeals explained that there was no evidence – indeed, not even an assertion – that Patterson’s ignorance of the terms of the insurance policy was due to any fraud or overreaching on the part of the insurer or its agents. The law requires more than just ignorance, or even misplaced confidence, to avoid the terms of a valid contract.
The Court of Appeals concluded that Patterson’s delay unreasonable as a matter of law. The trial court’s order properly dismissed his claim.
ZALMA OPINION
Since law in most states required insurance companies to write their insurance policies in “easy to read language” there is no way to claim the policy was difficult or impossible to read. States like Georgia require an insured to read the policy and find that if the insured is ignorant of the conditions of the policy is not an excuse for failing to comply with conditions precedent. A 21 month delay in giving notice defeats coverage and is unreasonable as a matter of law.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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The Largest Residential Burglary of All Time
Post 5407
Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma
See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
After ...
Chutzpah is not Enough
Post 5397
Posted on July 20, 2026 by Barry Zalma
See the video and at https://lnkd.in/gNUs2XzT and at https://lnkd.in/g2MawyzX
Magistrate Issues a Search Warrant if there is a Fair Probability that Contraband or Evidence of a Crime will be Found in a Particular Place.
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As part of the investigation, the FBI obtained an August 19, 2022 warrant to search Driscoll’s Sterling Pharmacy Yahoo email account for emails from January 1, 2018 through December 31, 2020. Driscoll moved to suppress the resulting evidence, arguing that the warrant lacked probable cause, was overbroad, and rested on material misstatements and omissions.
LAW:
The ...
Fraud Shouldn’t Pay
Post 5396
See the video and at https://rumble.com/v7ctgmq-the-great-jewel-theft.html at https://youtu.be/aRbQ2sJfGwA
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ¬¬¬Perpetrators than any Other Crime.
The Insured purchased, for the first time in his life, a policy of Personal Articles Floater Insurance (PAF) scheduling $125,000 worth of ladies jewelry. He advised the insurer that the jewelry was always kept in a class E safe at his residence. He also told the insurer that he was employed full time as the owner of a gasoline service station and that he had never been canceled or suffered a previous loss.
One month after the policy was ...
Day Care Owner Loses Subsidies Because She Criticized State
Post 5421
Posted on August 11, 2026 by Barry Zalma
First Amendment Right Will be Allowed to Go to Trial
In Betsey J. Grant v. Maine State Department Of Heath And Human Services, No. 1:25-cv-00490-JAW, United States District Court, D. Maine (August 6, 2026), Betsey J. Grant, a licensed childcare provider and operator of Tiny Tikes Daycare in Trenton, Maine, sued Maine DHHS and several employees after she publicly criticized DHHS before Maine’s Government Oversight Committee and alleged that officials retaliated against her.
She claimed DHHS imposed and extended a conditional license, published stigmatizing information, interfered with subsidies and program funding, removed her from a food program, rescinded an expansion grant, and used biased or falsified evidence in licensing proceedings. Following the March 10, 2023, GOC testimony, Ms. Grant alleges that foster children's subsidies (approximately $30,000) were withheld; she was removed from the ...
Rescission for Material Misrepresentation
Post 5418
Posted on August 5, 2026 by Barry Zalma
An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.
In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units. After an underlying personal injury action was filed, Union Mutual determined that the property actually contained three apartment units and rescinded the policies on the ground that the defendants had made a material misrepresentation in the applications.
LAW:
A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true ...
Rescission for Material Misrepresentation
Post 5418
Posted on August 5, 2026 by Barry Zalma
An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.
In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units.
LAW:
A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true facts been disclosed. To establish materiality as a matter of law, the insurer must submit documentation of its underwriting practices, such as manuals, guidelines, bulletins, or rules addressing similar risks.
DISCUSSION/ANALYSIS:
As a result, the...
