HomeMy WebLinkAbout2005-5626 CivilDUANE M. DONISON, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION --LAW
HCR MANOR CARE,
Defendant : NO. 05-5626 CIVIL TERM
IN RE: DEFENDANT'S MOTION FOR SUMMARY JUDGMENT
BEFORE OLER and EBERT, JJ.
ORDER and OPINION OF COURT
Oler, J., November 6, 2008
In this civil case, an insured has sued a nursing home for allegedly advising
him incorrectly that his insurance would not cover his spouse's expenses at the
facility, leading to a certain financial loss on his part.' Plaintiff's claims sound in
negligence2 and "detrimental reliance .,3
For disposition at this time is a motion for summary judgment filed by
Defendant, contending that Plaintiff's claims are time-barred .4 The matter was
argued on October 22, 2008.
For the reasons stated in this opinion, Defendant's motion for summary
judgment will be granted.
STATEMENT OF FACTS
Plaintiff commenced the present action by a praecipe for writ of summons
on October 31, 2005.5 Plaintiff's amended complaint alleges that he disposed of
about $30,000.00 in assets to qualify for Medicaid coverage for care of his spouse
at Defendant's facility. It alleges further that Plaintiff did so because Defendant
erroneously advised him that certain insurance which Plaintiff had through a
' Plaintiff's Amended Complaint, paras. 14, 16-17, 23-24, filed October 16, 2006.
2 Plaintiff's Amended Complaint, Claim One, filed October 16, 2006.
' Plaintiff's Amended Complaint, Claim Two, filed October 16, 2006.
4 Motion for Summary Judgment of Defendant HCR Manor Care, filed August 11, 2008.
' Plaintiff's Praecipe for Writ of Summons, filed October 31, 2005.
company called Tricare would not cover her expenses .6 Defendant disposed of the
assets, according to the complaint, on or about March 13, 2001.7 He testified at a
deposition that he had used the proceeds to buy an automobile,$ an asset which
apparently did not adversely affect Medicaid eligibility.
In his deposition, Plaintiff conceded that at a meeting on July 17, 2001, a
discussion had occurred with his caseworker from the Cumberland County
Assistance Office, Lynne Gordon, "about the coordination of benefits and that we
should never have gone through the down spend process."9 More specifically, he
stated in the deposition that he realized around July 17, 2001, that Manor Care had
proceeded incorrectly and that his disposition of assets had been unnecessary:
Q And you realized by July 17 of 2001, that it was unnecessary
for you to have spent those assets, the $29,900 and some dollars, because
Manor Care should have been billing TRICARE, correct?
A Something like that, yes.'o
According to an April 30, 2003, letter that he wrote to several governmental
officials, he was told at a hearing on August 20, 2001, by a welfare hearing officer
of the Commonwealth that he "had grounds for a lawsuit against the nursing
home. "11
A letter dated October 27, 2003, from Defendant to the Office of the
Pennsylvania Attorney General seemed to indicate its ultimate concurrence with
Plaintiff's position that Tricare did provide coverage for his spouse during the
6 Plaintiff's Amended Complaint, paras. 1-24, filed October 16, 2006.
Plaintiff's Amended Complaint, para. 19, filed October 16, 2006.
s N.T. 63-64, Deposition of Plaintiff, March 6, 2008 (attached to Defendant's Motion for
Summary Judgment as Ex Q.
9 N.T. 67, Deposition of Plaintiff, March 6, 2008 (attached to Defendant's Motion for Summary
Judgment as Ex. Q.
'o N.T. 94, Deposition of Plaintiff, March 6, 2008 (attached to Defendant's Motion for Summary
Judgment as Ex. Q.
" Deposition of Plaintiff, March 6, 2008 (letter attached to Defendant's Motion for Summary
Judgment as Ex. A).
2
period in question, according to Plaintiff. 12 A letter to the Office of the Attorney
General from Tricare dated December 16, 2003, also confirmed its coverage of
Plaintiff s spouse, according to Plaintiff s deposition testimony. 13
As previously noted, the present litigation was commenced by Plaintiff on
October 31, 2005.
DISCUSSION
Statement of the Law
Summary judgment. Pennsylvania Rule of Civil Procedure 1035.2 provides
as follows:
After the relevant pleadings are closed, but within such
time as not to unreasonably delay trial, any party may move
for summary judgment in whole or in part as a matter of law
(1) whenever there is no genuine issue of any
material fact as to a necessary element of the cause of
action or defense which could be established by additional
discovery or expert report, or
(2) if, after the completion of discovery relevant to
the motion, including the production of expert reports, an
adverse party who will bear the burden of proof at trial has
failed to produce evidence of facts essential to the cause of
action or defense which in a jury trial would require the
issues to be submitted to a jury.
Statute of limitations burden of proof and discovery rule. "Where the
statute of limitations is at issue, the burden of proof falls on the plaintiff to
demonstrate that the cause of action is not barred by the passage of time and that
his or her failure to file the action in timely fashion is excusable." Jones v.
Harleysville Mutual Ins. Co., 2006 PA Super 100, ¶11, 900 A.2d 855, 858
(citation omitted). The "discovery rule," with respect to operation of statutes of
limitations, has been described as follows:
'Z See Defendant's Answer in Opposition to Motion for Summary Judgment Presented by HCR
Manorcare, Ex. B, filed October 15, 2008.
" N.T. 109-10, Deposition of Plaintiff, March 8, 2008 (attached to Defendant's Motion for
Summary Judgment as Ex. C); see Defendant's Answer in Opposition to Motion for Summary
Judgment Presented by HCR Manorcare, Ex. C, filed October 15, 2008.
3
The discovery rule is an exception to the requirement that a complaining
party must file suit within the statutory period. The discovery rule provides
that where the existence of the injury is not known to the complaining
party and such knowledge cannot reasonably be ascertained within the
prescribed statutory period, the limitations period does not begin to run
until the discovery of the injury is reasonably possible.... The statute
begins to run in such instances when the injured party possesses sufficient
critical facts to put him on notice that a wrong has been committed and
that he need investigate to determine whether he is entitled to
redress.... The party seeking to invoke the discovery rule bears the
burden of establishing the inability to know that he or she has been injured
by the act of another despite the exercise of reasonable diligence.
Baselice v. Franciscan Friars Assumption BTM Province, Inc., 2005 PA Super
246, ¶13, 879 A.2d 270, 276 (citations omitted).
With regard to the discovery rule, "the point at which the complaining party
should reasonably be aware that he has suffered an injury is generally an issue of
fact to be determined by the jury." E.J.M. v. Archdiocese of Philadelphia, 424 Pa.
Super. 449, 455, 622 A.2d 1388, 1391 (1993). However,
[w]here the facts are so clear that reasonable minds cannot differ ... the
commencement of the limitations period can be determined as a matter of
law.... Additionally, if a party has the means of discovery within his
power but neglects to use them, his claim will still be barred.
Baselice v. Franciscan Friars Assumption BTM Province, Inc., 2005 PA Super
246, ¶18, 879 A.2d 270, 277. In this context,
once the running of the statute of limitations is properly tolled, only where
the facts are so clear that reasonable minds cannot differ may the
commencement of the limitations period be determined as a matter of law.
Crouse v. Cyclops Industries, 560 Pa. 394, 404, 745 A.2d 606, 611 (2000)
(emphasis in original).
Negligence. As a general rule, the statute of limitations for negligence
actions is two years. Act of July 9, 1976, P.L. 586, §2, as amended, 42 Pa. C.S.
§5524(7) (2008 Supp.). The discovery rule normally applies to negligence actions.
See, e.g., Szpynda v. Pyles, 433 Pa. Super. 1, 639 A.2d 1181 (1994) (medical
malpractice).
Detrimental reliance. "Detrimental reliance is another name for promissory
estoppel.... Under this theory, a promise which the promisor should reasonably
11
expect to induce action or forbearance on the part of the promisee and which does
induce such action or forbearance is binding if injustice can be avoided only by
enforcing the promise." Matarazzo v. Millers Mutual Group, Inc., 927 A.2d 689,
692 (Pa. Commw. 2007) (citations omitted). "The doctrine of promissory estoppel
sounds in contract law and, like other contract actions, is subject to the four-year
statute of limitations set forth at 42 Pa.C.S. § 5525." Id.
As with negligence actions, the discovery rule has been applied to
promissory estoppel actions. See Crouse v. Cyclops Industries, 560 Pa. 394, 745
A.2d 606 (2000).
Application to Facts
According to Plaintiff, acting in reliance on a negligent misrepresentation
of Defendant he disposed of certain property unnecessarily on March 13, 2001,
and suffered some economic loss as a result. Although he conceded in his
deposition that he was aware as early as July 17, 2001, that it had been
"unnecessary for [him] to have spent those assets ... because Manor Care should
have been billing TRICARE," it is his position that the statutes of limitations did
not begin to run on his negligence and promissory estoppel claims until Tricare's
letter of December 16, 2003, "conclusively" showed that Defendant had made a
mistake. 14
However, it appears clear to the court from Plaintiff's own testimony that
he had been on notice by July 17, 2001, that his disposition of assets had been
unnecessary and that any advice or action on the part of Defendant to the contrary
had been erroneous. By August 20, 2001, he had been expressly advised by a state
hearing officer that he had a cause of action against Defendant. Under these
circumstances, and given (a) the burden of proof upon Plaintiff with respect to
statutes of limitations in general and the discovery rule in particular, (b) the
necessity under the summary judgment rule for Plaintiff to produce evidence in
14 Plaintiff's Memorandum of Law in Opposition to Motion for Summary Disposition, at 6,
submitted October 15, 2008.
E
accordance with this burden, and (c) the principle that the discovery rule will not
delay the operation of a statute of limitations beyond the point that an injured party
possesses sufficient critical facts to put him or her on notice that a wrong has been
committed and that he or she needs to investigate to determine whether he or she
is entitled to redress, the court is constrained to conclude that Plaintiffs action
herein, filed on October 31, 2005, more than four years after the aforesaid events
in 2001, is time-barred as a matter of law.
For the foregoing reasons, the following order will be entered:
ORDER OF COURT
AND NOW, this 6th day of November, 2008, upon consideration of
Defendant's motion for summary judgment, and for the reasons stated in the
accompanying opinion, the motion is granted and Plaintiff s amended complaint is
dismissed.
Richard R. Gan, Esq.
64 South Pitt Street
Carlisle, PA 17013
Attorney for Plaintiff
B. Craig Black, Esq.
Patricia Haas Corll, Esq.
1017 Mumma Road
Suite 100
Wormleysburg, PA 17043
Attorneys for Defendant
0
BY THE COURT,
s/ J. Wesley Oler, Jr.
J. Wesley Oler, Jr., J.
DUANE M. DONISON, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION --LAW
HCR MANOR CARE,
Defendant : NO. 05-5626 CIVIL TERM
IN RE: DEFENDANT'S MOTION FOR SUMMARY JUDGMENT
BEFORE OLER and EBERT, JJ.
ORDER OF COURT
AND
NOW,
this
6th day of November,
2008, upon consideration
of
Defendant's
motion
for
summary judgment, and
for the reasons stated in
the
accompanying opinion, the motion is granted and Plaintiff's amended complaint is
dismissed.
BY THE COURT,
J. Wesley Oler, Jr., J.
Richard R. Gan, Esq.
64 South Pitt Street
Carlisle, PA 17013
Attorney for Plaintiff
B. Craig Black, Esq.
Patricia Haas Corll, Esq.
1017 Mumma Road
Suite 100
Wormleysburg, PA 17043
Attorneys for Defendant