Amica has inquired whether it has a good faith basis to deny coverage under the insured’s PIP coverage due to the insured’s failure to notify the personal injury protection insurer within 60 days of the accident of her election to receive personal injury protection benefits. For the reasons set forth, below it is our opinion that Amica has a good faith basis to deny coverage for the insured’s failure make an election with regard to PIP within 60 days of the loss. Should Amica disclaim coverage under its PIP policy, it is possible that the insured will argue that Amica waived its policy defense by providing payment to the insured in May of 2017. It is conceivable that should the claimant make such an allegation, that the Plaintiff could survive…show more content… Personal injury protection shall provide coverage for victims for injuries arising from accidents resulting from the operation or use of a motor vehicle by the insured or use of the insured motor vehicle within or outside the District. It shall provide benefits for medical and rehabilitation expenses, work loss, and funeral benefits as set forth in this section. Personal injury protection benefits are applicable only to a victim who is an insured or an occupant of the insured’s vehicle or of a vehicle which the insured is…show more content… D.C. Code Mun. Regs. tit. 26-A § 503.9.
Moreover, the regulations expressly state that “A victim sustaining injury in a motor vehicle accident which forms the basis of a claim against an insurer shall have the responsibility of informing the insurer of the accident according to the terms of the policy provided by the insurer.” D.C. Code Mun. Regs. tit. 26-A § 503.1. Indeed, “§§ 35-2105(a) and 35-2105(g) [of the D.C. Code] provide that if a covered person fails to file a PIP claim within 60 days of the accident, the person ordinarily is limited to pursuing a third-party liability action.” See Ward v. Nationwide Mut. Auto. Ins. Co., 328 Md. 240, 248 (1992).
The statutory framework created by the District of Columbia’s PIP provisions was designed with the ends of making PIP the coverage of last resort. Indeed, the District of Columbia has
