Home » LAW » BARRON CHIROPRACTIC & REHABILITATION, P.C. vs. NORFOLK & DEDHAM GROUP (You have the right not to accept settlement with an insurance company and continue your lawsuit against them so they can cover your attorney fees and other costs if you win)

BARRON CHIROPRACTIC & REHABILITATION, P.C. vs. NORFOLK & DEDHAM GROUP (You have the right not to accept settlement with an insurance company and continue your lawsuit against them so they can cover your attorney fees and other costs if you win)

SUMMARY: If an insurer has not paid your benefits within 30 days of when those benefits became due and payable, then you can sue them for breach of contract. If an insurer offers you to settle before trial and you accept, you cannot continue suing them and they don’t have to pay your lawyer.

This case simply says that you have the right NOT to accept the settlement and to go trial and if you win, the insurance company will have to pay your attorneys fees plus your interest and other costs.

 

 

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SJC-11561
BARRON CHIROPRACTIC & REHABILITATION, P.C. vs. NORFOLK &
DEDHAM GROUP.
Norfolk. May 5, 2014. – October 15, 2014.
Present: Ireland, C.J., Spina, Cordy, Botsford, Gants, Duffly,
& Lenk, JJ.1
Insurance, Motor vehicle personal injury protection benefits,
Unfair act or practice. Contract, Insurance. Practice,
Civil, Summary judgment, Attorney’s fees. Consumer
Protection Act, Insurance.
Civil action commenced in the Dedham Division of the
District Court Department on November 25, 2009.
The case was heard by James J. McGovern, J., on a motion
for summary judgment.
The Supreme Judicial Court granted an application for
direct appellate review.
Francis A. Gaimari (Robert N. Fireman & Stephen B. Byers
with him) for the plaintiff.
Joseph R. Ciollo (Michael L. Snyder with him) for the
defendant.
E. Michael Sloman, for Automobile Insurers Bureau, amicus
curiae, submitted a brief.
1 Chief Justice Ireland participated in the deliberation on
this case prior to his retirement.
2
Christopher M. Moutain, for American Insurance Association
& others, amici curiae, submitted a brief.
LENK, J. The personal injury protection (PIP) provision of
the automobile insurance statute permits an unpaid party to
bring an action for breach of contract against an automobile
insurer if the latter has not paid PIP benefits for more than
thirty days after those benefits became due and payable. G. L.
c. 90, § 34M, fourth par. If the unpaid party receives a
judgment for any amount due and payable by the insurer, it also
may recover its costs and reasonable attorney’s fees. The
primary question before us is whether an unpaid party who has
brought suit and thereafter refused the insurer’s tender of
amounts due and payable, made prior to the entry of judgment,
may proceed with the suit and, if successful, obtain a judgment
for those amounts as well as its costs and attorney’s fees. We
conclude that it may proceed with the action under G. L. c. 90,
§ 34M.
1. Background. The plaintiff, Barron Chiropractic &
Rehabilitation, P.C. (Barron), provided chiropractic services to
Nicole Jean-Pierre following her automobile accident on
August 20, 2008. Jean-Pierre was injured while driving a
vehicle insured by the defendant Norfolk & Dedham Group
(Norfolk) pursuant to G. L. c. 90, § 34A, which requires
3
compulsory motor vehicle liability insurance, including PIP
benefits.2 See G. L. c. 90, §§ 34A, 34M.
Norfolk received notice of the accident on August 22, 2008,
and, on October 10, 2008, received Jean-Pierre’s application for
PIP benefits.3 Shortly thereafter, pursuant to its contractual
right under the terms of Jean-Pierre’s insurance policy, as well
as language in the PIP provision, Norfolk requested that Jean-
Pierre undergo an independent medical examination (IME)4 by Kevin
Morgan, a licensed chiropractor of its selection. On
October 27, 2008, Morgan submitted his IME report to Norfolk.
The report stated that, while treatments up to the date of the
2 Personal injury protection (PIP) benefits consist of “all
reasonable expenses incurred within two years from the date of
[the] accident for necessary medical, surgical, x-ray, and
dental services,” and, for employed persons, “any amounts
actually lost by reason of inability to work and earn wages or
salary or their equivalent.” G. L. c. 90, § 34A.
3 General Laws c. 90, § 34M, third par., states that a
“[c]laim for benefits due under the provisions of personal
injury protection or from the insurer assigned shall be
presented to the company providing such benefits as soon as
practicable after the accident occurs from which such claim
arises, and in every case, within at least two years from the
date of the accident, and shall include a written description of
the nature and extent of injuries sustained, treatment received
and contemplated and such other information as may assist in
determining the amount due and payable.”
4 The PIP provision provides that the “insured person shall
submit to physical examinations by physicians selected by the
insurer as often as may be reasonably required and shall do all
things necessary to enable the insurer to obtain medical reports
and other needed information to assist in determining the
amounts due.” G. L. c. 90, § 34M, third par.
4
IME had been appropriate, Jean-Pierre had reached “maximum
therapeutic benefit.” Based on this report, Norfolk concluded
that treatments Barron provided Jean-Pierre after the date of
the IME were unreasonable and unnecessary. A few days
thereafter, Norfolk provided Jean-Pierre’s counsel with a copy
of the report.
Approximately nine months later, on July 27, 2009, Norfolk
received a response to Morgan’s IME report from Scott Hayden, a
licensed chiropractor and a Barron employee. Hayden disagreed
with Morgan’s conclusion that Jean-Pierre had reached a medical
end result at the time of the IME, stating instead that proper
rehabilitation had required nine treatment visits after that
date. On August 17, 2009, Morgan sent Norfolk an addendum to
his initial IME report, indicating that Hayden’s rebuttal had
not altered his assessment of Jean-Pierre’s care, and stating
further that subsequent care offered by Barron, while “within
acceptable care guidelines” and “reasonable and necessary,”
appeared aimed largely at preexisting conditions.
As an additional component of its investigation of Jean-
Pierre’s claim, Norfolk sent Barron’s billing statements to BME
Gateway (BME), an independent third party, for financial
analysis. BME uses a computer database to determine whether a
medical provider has sought fees that are usual, customary, and
reasonable within a particular geographic region.
5
Barron submitted a bill to Norfolk seeking $3,940 in
payment for its treatment of Jean-Pierre. Upon review, Norfolk
concluded that it was not liable for the entirety of this
requested amount. Based on BME’s assessment, Norfolk deducted
$64.05 from Barron’s bill, allowing only $3,875.95 on that
ground. In reliance on Morgan’s IME report, Norfolk also
limited its payment to service provided prior to the date of the
IME, declining to pay a further $1,480 in charges for treatment
occurring after October 27, 2008. In total, Norfolk determined
that it was liable for only $2,395.95 of Barron’s submitted
fees, resulting in a disputed amount of $1,544.05.
On November 25, 2009, more than one year after Jean-Pierre
had submitted her application for PIP benefits, Barron filed a
complaint in the District Court.5 Barron sought payment of
$1,544.05, plus interest, attorney’s fees, and costs pursuant to
G. L. c. 90, § 34M; multiple damages and attorney’s fees
pursuant to G. L. c. 93A, § 11, for alleged unfair or deceptive
practices regarding Jean-Pierre’s insurance claim; and multiple
damages and attorney’s fees pursuant to G. L. c. 93A, §§ 9 and
5 We have construed the term “unpaid party” in G. L. c. 90,
§ 34M, to include, as here, “an unpaid medical provider who
treats an insured.” Boehm v. Premier Ins. Co., 446 Mass. 689,
691 (2006). The medical provider may thus “step into the shoes
of the insured and bring an action in contract to recover PIP
benefits.” Id.
6
11, for violations of G. L. c. 176D, § 3 (9), which prohibits
insurers from engaging in unfair settlement practices.
At some point prior to trial, Norfolk learned that Morgan’s
fee to appear as an expert witness was $500 per hour, with a
minimum of five hours to be billed.6 Although still maintaining
that it did not owe Barron any additional payments, Norfolk
determined that its anticipated litigation costs would exceed
the amount of the disputed medical fees by a substantial sum.
Accordingly, on September 28, 2010, six days prior to the second
scheduled trial date,7 Norfolk sent Barron a check for $1,544.05
with an attached check stub that stated “full and final
settlement for Nicole Jean Pierre.” Norfolk included a letter
stating that its payment was made pursuant to Fascione v. CNA
Ins. Cos., 435 Mass. 88 (2001) (Fascione); the letter requested
that Barron sign an acknowledgment of the receipt of final
payment and file a stipulation of dismissal in the District
Court as to its claims under the PIP provision. On October 12,
2010, Barron’s counsel returned the check to Norfolk’s counsel
with a letter stating, “Your client’s offer of settlement is
rejected.”
6 In its pretrial memorandum, dated May 11, 2010, Norfolk
indicated that Morgan was expected to testify as to the
substance of his independent medical examination and report.
7 The trial initially was scheduled for August 3, 2010, but
was rescheduled at the parties’ request for October 4, 2010.
7
Norfolk then filed a motion for summary judgment as to both
the G. L. c. 90, § 34M, and G. L. c. 93A claims, supported by an
affidavit from its claims supervisor, as well as by relevant
medical records and BME’s financial analysis. Barron filed an
opposition, but neither alleged that any issues of material fact
remained in dispute, nor included any counter affidavits or
other documents indicating any factual dispute. A District
Court judge granted Norfolk’s motion for summary judgment, and,
on Barron’s appeal, the Appellate Division of the District Court
affirmed the judgment. Barron filed a notice of appeal in the
Appeals Court, and we granted Norfolk’s subsequent application
for direct appellate review.
2. Discussion. Summary judgment is appropriate where
there are no genuine issues of material fact in dispute and the
moving party is entitled to judgment as a matter of law.
Community Nat’l Bank v. Dawes, 369 Mass. 550, 553 (1976). If
the moving party, in its pleadings and supporting documentation
pursuant to Mass. R. Civ. P. 56 (c), as amended, 436 Mass. 1404
(2002), asserts the absence of any triable issue, the nonmoving
party must respond and make specific allegations sufficient to
establish a genuine issue of material fact. Drakopoulos v. U.S.
Bank Nat’l Ass’n, 465 Mass. 775, 777-778 (2013). Pederson v.
Time, Inc., 404 Mass. 14, 16-17 (1989). Bare assertions made in
the nonmoving party’s opposition will not defeat a motion for
8
summary judgment. O’Rourke v. Hunter, 446 Mass. 814, 821
(2006). Mass. R. Civ. P. 56 (e), 365 Mass. 824 (1974) (“A party
may not rest upon the mere allegations or denials of his
pleading”). We review the disposition of a motion for summary
judgment de novo. Miller v. Cotter, 448 Mass. 671, 676 (2007).
Barron contends that summary judgment was inappropriate as
to its claim under § 34M. Because Barron declined Norfolk’s
late tender, made on the eve of trial, it remained an “unpaid
party” pursuant to § 34M, and was entitled to seek a judgment
for benefits due and payable. Relying on Fascione, supra,
Norfolk maintains that it was entitled to summary judgment once
it tendered a complete payment of benefits owed, notwithstanding
Barron’s rejection of that tender. Because we conclude, for the
reasons set forth below, that Barron was permitted to refuse
Norfolk’s tender and pursue its suit, the order granting
Norfolk’s motion for summary judgment on the G. L. c. 90, § 34M,
claim must be vacated and the case remanded for trial.
Barron also contests the entry of summary judgment for
Norfolk as to the G. L. c. 93A claims. In its opposition to
Norfolk’s motion, however, Barron did not allege the existence
of any factual disputes and submitted no documentation that
might reveal such disputes. See Mass. R. Civ. P. 56 (e) (“[A]n
adverse party [to a motion for summary judgment] . . . must set
forth specific facts [in its affidavits and pleadings] showing
9
that there is a genuine issue for trial”). Accordingly, we
affirm the order granting Norfolk’s motion for summary judgment
on the G. L. c. 93A claims.
a. Claim under G. L. c. 90, § 34M. The PIP provision,
G. L. c. 90, § 34M, specifies that an “unpaid party,” that is, a
claimant whose PIP benefits remain unpaid for more than thirty
days after those benefits become “due and payable,” shall have
the right to bring an action in contract against an insurer to
recover those benefits, as well as attorney’s fees and costs
should the unpaid party prevail.8 Under common-law principles of
contract, which we have deemed applicable to “action[s] in
contract” under § 34M, see Boehm v. Premier Ins. Co., 446 Mass.
689, 691 (2006) (Boehm), a plaintiff may reject a defendant’s
disputed tender of payment, made after the date set for payment
has expired, and litigate its breach of contract claim to
8 Specifically, G. L. c. 90, § 34M, fourth par., states, in
relevant part:
“Personal injury protection benefits . . . shall be
due and payable as loss accrues, upon receipt of reasonable
proof of the fact and amount of expenses and loss
incurred . . . . In any case where benefits due and
payable remain unpaid for more than thirty days, any unpaid
party shall be deemed a party to a contract with the
insurer responsible for payment and shall therefore have a
right to commence an action in contract for payment of
amounts therein determined to be due in accordance with the
provisions of this chapter . . . . If the unpaid party
recovers a judgment for any amount due and payable by the
insurer, the court shall assess against the insurer in
addition thereto costs and reasonable attorney’s fees.”
10
completion. Here, Norfolk attempted to tender the disputed
$1,544.05 nearly one year after Barron had commenced its
contract action, and just six days prior to trial. We conclude
that Barron properly could reject this tender, forgo the
certainty it offered, and opt instead to pursue recovery not
only of the disputed unpaid PIP benefits, but also of the
attorney’s fees and costs provided by the PIP provision.
To construe this provision, we “look first to the text of
the statute.” Boehm, supra at 690. General Laws c. 90, § 34M,
fourth par., provides that suits brought to recover PIP benefits
shall sound in contract, noting that an unpaid claimant “shall
be deemed a party to a contract with the insurer” and may bring
an “action in contract” to obtain any benefits held to be due
and payable. Given these unambiguous statutory references to
actions in contract, we have held that a § 34M suit brought to
procure unpaid PIP benefits is governed generally by ordinary
contract principles.9 In Boehm, supra at 689, we considered
whether G. L. c. 90, § 34M, conferred the right to a jury trial.
In concluding that PIP claimants were so entitled, we emphasized
that an unpaid claimant “has a ‘right’ to seek recovery through
9 Barron contends also that it was entitled to reject
Norfolk’s efforts at late tender pursuant to the tender statute,
G. L. c. 232A, § 1. Since we conclude that common-law contract
principles govern here, we do not address this argument. See
Fascione v. CNA Ins. Cos., 435 Mass. 88, 90 n.1 (2001).
11
‘an action in contract,'” deeming this text “determinative of
the issue at bar.” Boehm, supra at 691, quoting G. L. c. 90,
§ 34M, fourth par. At common law, we noted, parties to contract
actions “enjoyed the right to a jury trial,” and “the
Legislature is presumed ‘to know the preexisting law and the
decisions of this court.'” Boehm, supra, quoting Selectmen of
Topsfield v. State Racing Comm’n, 324 Mass. 309, 313 (1949).
“Had the Legislature intended to treat contract
actions brought pursuant to § 34M, fourth par., differently
from the ordinary contract action, it could have said so
explicitly as it did in the very next paragraph, which
directs insurers to resolve disagreements concerning
subrogation through arbitration.”
Boehm, supra. “That § 34M does not explicitly refer to the
right to a jury trial,” we concluded, “is of no consequence.”
Boehm, supra at 691-692. The Legislature’s explicit
determination that an unpaid PIP claimant may file a contract
suit “carries with it the principle[s]” of the common law of
contracts. Id. at 692. See Commonwealth v. Burke, 392 Mass.
688, 690 (1984) (statute must be construed as consistent with
common law absent clear contrary legislative intent).
Principles of contract law are “dispositive” of the present
case, just as they were of the question addressed in Boehm. At
common law, tender of a sum owed under a contract is valid only
when made prior to the parties’ agreed-upon date for payment,
12
even if that tender is for the entire disputed sum.10 There can
“be no ‘tender’ in the legal meaning of the word if the offer
was made after the day fixed for payment had passed and the
contract to pay had been broken.” Levin v. Wall, 290 Mass. 423,
426 (1935). See City Bank v. Cutter, 3 Pick. 414, 418 (1826)
(“the plea of tender is bad, the tender not having been made
until the day after the debt became due against the
defendants”); 17B C.J.S. Contracts, Tender of Performance § 729
(2011) (“In order to be valid, a tender of payment on a contract
must be timely . . .”); M.G. Perlin & S.H. Blum, Procedural
Forms Annotated § 54:230, Tender (6th ed. 2009) (tender invalid
if made after payment date).
A party who receives an invalid late tender is not obliged
to accept it. See Levin v. Wall, supra at 427 (plaintiff
permitted to reject tender made on first day of trial for breach
of contract and pursue his claim to judgment); Davis v.
Harrington, 160 Mass. 278, 280 (1894) (plaintiff who accepted
complete tender after filing breach of contract suit “could have
preserved his right to interest by way of damages, and also to
10 Norfolk never conceded its liability for $1,544.05 of
Barron’s requested fees. Nevertheless, in light of the
litigation costs it might incur should the case proceed to
trial, Norfolk contends that it made a business decision to
tender this disputed amount. In conjunction with payments
already made, the tendered payment, if accepted, would have
compensated Barron for all of the PIP benefits it sought, not
including interest.
13
costs, by declining to accept the payment”); Loitherstein v.
International Business Machs. Corp., 11 Mass. App. Ct. 91, 92
(1980) (defendant’s late tender, which plaintiff rejected, did
not extinguish plaintiff’s claim for damages due to breach).
Where a defendant attempts to tender payment after it has
already breached the contract, “the rights of the parties
depend, not on a tender, but on the acceptance of a payment
which discharged the cause of action.” Davis v. Harrington,
supra at 280. Even if a plaintiff receives a tender of payment
in full for a disputed sum, as here, “an underlying debt may not
be discharged unless payment is accepted.” First Nat’l Bank v.
Commonwealth, 391 Mass. 321, 326 (1984). Late tender alone
therefore does not preclude a plaintiff from filing a claim for
breach or pursuing a then-pending suit.11
Here, Norfolk’s tender of $1,544.05 was made past the
deadline set forth in the PIP provision. General Laws c. 90,
11 To be sure, a plaintiff is also entitled to accept and
thereby validate an otherwise improper late tender. Such
acceptance removes the “foundation of [a potential contract]
suit” and necessitates the dismissal of a suit already
commenced. Davis v. Harrington, 160 Mass. 278, 280 (1894)
(plaintiff who accepted tender made after suit had commenced not
entitled to damages in form of interest and costs). See Hamlen
v. Rednalloh Co., 291 Mass. 119, 126-127 (1935) (plaintiff could
not recover costs after accepting late payment in full with
interest); Paul Revere Trust Co. v. Castle, 231 Mass. 129, 132
(1918) (“when the plaintiff accepted the principal in full
payment the right to recover the interest . . . was
extinguished”).
14
§ 34M, establishes the date of breach relevant to unpaid PIP
benefits, providing that, where “benefits due and payable remain
unpaid for more than thirty days, any unpaid party . . . shall
therefore have a right to commence an action in contract.”
After the expiration of that thirty-day period, Barron had yet
to receive $1,544.05 in medical fees which it maintains were
“due and payable.” Norfolk sent its check for that amount to
Barron on September 28, 2010, nearly two years after Jean-Pierre
first notified Norfolk of her claim for PIP benefits, and nearly
one year after Barron filed suit seeking payment of the disputed
balance. The “day fixed for payment had passed,” Levin v. Wall,
supra at 426, and, after that point, “a tender cannot be
effectual to bar the action for damages.” Suffolk Bank v.
Worcester Bank, 5 Pick. 106, 108 (1827) (where there had been no
tender at time contract suit commenced, “the tender afterwards
cannot avail in defence of the action”). Norfolk’s tender
therefore was improper under principles of common law, and
Barron was permitted to reject it and seek an award of the PIP
benefits it maintained were “due and payable,” as well as its
attorney’s fees, costs, and interest.
Norfolk maintains nonetheless that, under our decision in
Fascione, its tender of payment was sufficient to discharge all
of its obligations to Barron, and that the allowance of its
15
motion for summary judgment was proper.12 This argument
misapprehends the relevance of Fascione to the circumstances
here. In Fascione, supra at 89, an insurer inadvertently failed
to pay the full amount of a PIP claimant’s benefits, and
tendered the remaining payment after the claimant had filed suit
under G. L. c. 90, § 34M, to recover the amounts due. We held
that the claimant, who had accepted the insurer’s tender and was
fully compensated for her medical expenses, was not thereafter
permitted to seek costs, attorney’s fees, and interest under
§ 34M. Fascione, supra at 89-90, 92-94. A claimant may only
receive costs and attorney’s fees upon obtaining “a judgment for
any amount due and payable.” Id. at 92. The phrase “any amount
12 The parties’ disagreement as to the import of Fascione,
supra, reflects differences in decisions of the Appellate
Division of the District Court. Certain of those decisions have
interpreted Fascione to mean that an insurer’s tender of a full
PIP payment, made after a claimant filed suit but before
judgment has entered, will extinguish the G. L. c. 90, § 34M,
claim even where the claimant rejects such tender. See, e.g.,
Essex Chiropractic Office, LLC vs. Plymouth Rock Assur. Corp.,
Mass. Dist. Ct. App. Div., No. 08-ADMS-10032 (Dec. 17, 2008)
(“it would be an absurd result if a medical provider were able
to defeat the holding of Fascione merely by rejecting the tender
of full payment of a PIP claim”); Kratzer vs. Liberty Mut. Ins.
Co., Mass. Dist. Ct. App. Div., No. 9834 (May 28, 2003).
Other Appellate Division decisions, however, have concluded
that “[n]othing in Fascione dictates that a tender of the
balance due under the § 34M claim must necessarily stop that
part of the litigation in its tracks and require a judgment of
zero damages.” Metro West Med. Assocs., Inc. vs. Amica Mut.
Ins. Co., Mass. Dist. Ct. App. Div., No. 10-ADMS-10009 (June 29,
2010). See Olympic Physical Therapy vs. ELCO Admin. Servs.,
Mass. Dist. Ct. App. Div., 10-ADMS-10017 (Aug. 17, 2010).
16
due and payable,” we concluded, encompassed only PIP benefits
themselves, and did not include interest. Id. at 92-93.
Because the claimant had accepted the insurer’s full payment of
her PIP expenses, she could not recover a judgment for costs and
attorney’s fees. Id. at 94.
Fascione affords no basis upon which to conclude that a PIP
claimant, having filed an action in contract against an insurer
for its delayed payment of benefits, is obliged to accept late
tender and thus relinquish its suit. We held in that case that
G. L. c. 90, § 34M, provides no further remedy to a claimant who
has accepted an insurer’s late, but complete, tender of payment;
this in no way was intended to suggest that a claimant may not
reject such tender in an effort to obtain the attorney’s fees
and costs mandated by § 34M. Indeed, our analysis relied on the
claimant’s acceptance of the insurer’s reimbursement, which
removed any basis for a judgment in favor of the claimant by
compensating her for all “amount[s] due and payable.”
Moreover, to interpret Fascione as Norfolk suggests would
contravene the fee-shifting provision of G. L. c. 90, § 34M,
thereby enabling insurers to delay their payment of benefits
without consequence. The Legislature was “aware of the long
delays in getting financial aid to the injured person” when it
enacted the PIP provision. Pinnick v. Cleary, 360 Mass. 1, 20
(1971). Accordingly, the thirty-day payment period, in
17
conjunction with the provision for attorney’s fees and costs,
together protect “the right and need of all accident victims to
simple and speedy justice.” Id. at 21. Since a cause of action
lies against an insurer who fails to pay PIP benefits within the
statutory period, and since the insurer will be liable for
attorney’s fees and costs if a claimant obtains a judgment for
the unpaid amount, G. L. c. 90, § 34M, encourages the prompt
payment of benefits.13
But these incentives would diminish if an insurer could
disregard the thirty-day deadline yet nevertheless evade
liability for attorney’s fees and costs by tendering benefits at
will after a suit has commenced. Under Norfolk’s approach, the
timeframe for prompt payment established by the Legislature
would have little effect, since an insurer’s delay would
engender no more serious consequence than the payment of the
very benefits sought from it at the outset. See Insurance
Rating Bd. v. Commissioner of Ins., 356 Mass. 184, 189 (1969)
13 This, in turn, is intended to lessen the expense of
compulsory automobile insurance for all Massachusetts drivers,
by reducing the number of claims that insurers will choose to
litigate. See Fascione, supra at 94, citing Pinnick v. Cleary,
360 Mass. 1, 16-20 (1971) (“[T]he main objectives of the
automobile insurance law, of which § 34M is a critical part,
were to reduce the amount of motor vehicle tort litigation,
control the costs of automobile insurance, and ensure prompt
payment of claimants’ medical and out-of-pocket expenses”). See
also Dominguez v. Liberty Mut. Ins. Co., 429 Mass. 112, 115
(1999).
18
(“An intention to enact a barren and ineffective provision is
not lightly to be imputed to the Legislature”).
The provision for payment of attorney’s fees and costs
would be similarly toothless. When an insurer’s payment of PIP
benefits, as here, is made on the eve of trial, a claimant may
well have incurred substantial expenses. If, as Norfolk
suggests, a claimant were required to accept such late tender,
she would be bound to forgo the recovery of those expenses
whenever an insurer offered belated reimbursement of a disputed
sum. See Pine v. Rust, 404 Mass. 411, 416 (1989) (“If an offer
of the statutory minimum amount of damages were all that could
be expected by plaintiffs, there would be no need for provision
in the law for the award of attorney’s fees”). Moreover, a
contract suit under § 34M is only necessary, in the first
instance, if an insurer fails to reimburse a claimant by the
statutory deadline. Under Norfolk’s approach, far from reducing
the amount of litigation, § 34M would provide incentives for
insurers to delay payment until their insureds filed suit to
collect amounts owed; on a date of its choosing, an insurer then
unilaterally could terminate litigation prompted only by its own
delay. “[E]quity will not permit” such a result, which would
allow an insurer to “defeat a remedy which except for his
misconduct would not be available.” Lamb v. Rent Control Bd. of
19
Cambridge, 17 Mass. App. Ct. 1038, 1039 (1984), quoting Deitrick
v. Greaney, 309 U.S. 190, 196 (1940).
In sum, an insurer’s late tender of PIP benefits, made
after a claimant has filed suit and which the claimant declines
to accept, does not entitle an insurer to summary judgment. To
be sure, an insurer may opt to tender payment of outstanding PIP
benefits after the filing of a suit, and, if a claimant accepts
that tender, the action under G. L. c. 90, § 34M, will be
extinguished. See Fascione, supra at 91. But the mere tender
of such late payment will not, in itself, innoculate an insurer
against liability for attorney’s fees and costs if the claimant
opts to refuse tender and subsequently obtains a judgment for
PIP benefits. Here, because Barron rejected Norfolk’s tendered
check for $1,544.05, it remained an “unpaid party,” and
Norfolk’s motion for summary judgment on its G. L. c. 90, § 34M,
claim should have been denied.
b. Claims under G. L. c. 93A, §§ 9, 11. Barron contends
also that the judge erred in allowing Norfolk’s motion for
summary judgment on the G. L. c. 93A claims.14 To determine
whether a business practice is unfair under G. L. c. 93A, § 11,
14 In its complaint, Barron set forth two separate claims
for violations of G. L. c. 93A, one based on Norfolk’s asserted
failure to adhere to G. L. c. 90, § 34M, and one stemming from
Norfolk’s purported unfair claim settlement practices as defined
by G. L. c. 176D, § 3 (9) (b), (d), (e), (f), (g), and (n). As
did the Appellate Division, we assess both claims together.
20
we assess “(1) whether the practice . . . is within at least the
penumbra of some common-law, statutory, or other established
concept of unfairness; (2) whether it is immoral, unethical,
oppressive, or unscrupulous; [and] (3) whether it causes
substantial injury to consumers (or competitors or other
businessmen).” PMP Assocs., Inc. v. Globe Newspaper Co., 366
Mass. 593, 596 (1975).
In the circumstances of this case, there was no error in
allowing Norfolk’s motion for summary judgment on the G. L.
c. 93A claims. Norfolk’s motion stated that there were no
genuine issues of material fact as to the propriety of Norfolk’s
dealings under G. L. c. 93A, and indicated that Norfolk acted,
at all times, in accordance with appropriate business judgments.
In support of its motion, Norfolk included a detailed affidavit
by one of its senior claims supervisors outlining its conduct in
handling Jean-Pierre’s claim for PIP benefits. According to the
affidavit, Norfolk relied in good faith on the IME report in
deciding to limit payment to dates of medical service prior to
October 27, 2008, and relied similarly on BME’s fee analysis in
reducing Barron’s submitted bills by $64.05. See Duclersaint v.
Federal Nat’l Mtge. Ass’n, 427 Mass. 809, 814 (1998); Lumbermens
Mut. Cas. Co. v. Y.C.N. Transp. Co., 46 Mass. App. Ct. 209, 215
(1999).
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In its opposition to Norfolk’s motion for summary judgment,
Barron did not allege that material facts were in dispute,
stating only that “[n]othing in Norfolk’s submission
demonstrates that no genuine issue of fact remains on the G. L.
c. 93A claims. Thus, the plaintiff has no burden of rebuttal.”
Nor did the opposition include counter affidavits or any other
countervailing documentation that might have demonstrated the
existence of genuine issues of material fact. Although Barron
had alluded in its initial complaint to Norfolk’s purported bad
faith, a party opposing a motion for summary judgment may not
“simply rest on his pleadings.” Community Nat’l Bank v. Dawes,
369 Mass. 550, 554 (1976). See LaLonde v. Eissner, 405 Mass.
207, 209-210 (1989) (granting summary judgment for defendant
where plaintiffs did not dispute any relevant material fact).
Cf. Rule 9A(a)(2) of the Rules of the Superior Court (2014)
(“Affidavits and other documents setting forth or offering
evidence of facts on which the opposition is based shall be
served with the memorandum in opposition [to a motion for
summary judgment]”). Having failed to “set forth specific facts
showing that there is a genuine issue for trial,” Mass. R. Civ.
P. 56 (e), Barron was not entitled to trial on its G. L. c. 93A
claims.
3. Conclusion. The order allowing judgment for Norfolk on
count 1, the G. L. c. 90, § 34M, claim, is vacated and set
22
aside, and the matter is remanded to the District Court for
further proceedings on that claim. The entry of judgment for
Norfolk on counts two and three, the claims under G. L. c. 93A,
is affirmed.
So ordered.