On May 17, 2019, Dennis Malcolm Patterson was struck while crossing the street by an automobile driven by Abhay Kumar Singh. Singh ran a stop sign and hit Patterson.
Patterson sued Singh and sought uninsured/underinsured motorist (UM/UIM) coverage from his own insurer, United Services Automobile Association (USAA).
On February 17, 2021, Patterson hired an attorney and forwarded the police report to a USAA adjuster on March 5, 2021. 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; Patterson appealed.
The Court's Ruling
On appeal, the Georgia Court of Appeals found Patterson's delay unreasonable as a matter of law and affirmed the trial court's order. The USAA 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.
The trial court also determined that Patterson's ignorance of the fact that a pedestrian can benefit from his own UIM coverage is not an excuse that creates a jury issue.
A notice provision expressly made a condition precedent that 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 the insured did not read or otherwise make himself aware of the policy provisions, the Georgia 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 Georgia 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 Georgia Court of Appeals concluded that Patterson's delay was unreasonable as a matter of law, and the trial court properly dismissed his claim.
Conclusion
Since the law in most states requires 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, it is not an excuse for failing to comply with conditions precedent. Therefore, a 21-month delay in giving notice defeats coverage and is unreasonable as a matter of law.
Opinions expressed in Expert Commentary articles are those of the author and are not necessarily held by the author's employer or IRMI. Expert Commentary articles and other IRMI Online content do not purport to provide legal, accounting, or other professional advice or opinion. If such advice is needed, consult with your attorney, accountant, or other qualified adviser.
On May 17, 2019, Dennis Malcolm Patterson was struck while crossing the street by an automobile driven by Abhay Kumar Singh. Singh ran a stop sign and hit Patterson.
Patterson sued Singh and sought uninsured/underinsured motorist (UM/UIM) coverage from his own insurer, United Services Automobile Association (USAA).
On February 17, 2021, Patterson hired an attorney and forwarded the police report to a USAA adjuster on March 5, 2021. 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; Patterson appealed.
The Court's Ruling
On appeal, the Georgia Court of Appeals found Patterson's delay unreasonable as a matter of law and affirmed the trial court's order. The USAA 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.
The trial court also determined that Patterson's ignorance of the fact that a pedestrian can benefit from his own UIM coverage is not an excuse that creates a jury issue.
A notice provision expressly made a condition precedent that 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 the insured did not read or otherwise make himself aware of the policy provisions, the Georgia 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 Georgia 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 Georgia Court of Appeals concluded that Patterson's delay was unreasonable as a matter of law, and the trial court properly dismissed his claim.
Conclusion
Since the law in most states requires 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, it is not an excuse for failing to comply with conditions precedent. Therefore, a 21-month delay in giving notice defeats coverage and is unreasonable as a matter of law.
© 2025 Barry Zalma, Esq., CFE
Opinions expressed in Expert Commentary articles are those of the author and are not necessarily held by the author's employer or IRMI. Expert Commentary articles and other IRMI Online content do not purport to provide legal, accounting, or other professional advice or opinion. If such advice is needed, consult with your attorney, accountant, or other qualified adviser.