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Superior Court of Pennsylvania Rules PTSD is Covered under Bodily Injury

Superior Court of Pennsylvania Rules PTSD is Covered under Bodily Injury

Superior Court of Pennsylvania Rules PTSD is Covered under “Bodily Injury” When Physical Injury Results in PTSD

On December 4, 2019, the Superior Court of Pennsylvania reversed the Court of Common Pleas of Wayne County’s grant of summary judgment in favor of Defendant Travelers Insurance Company (“Travelers”) involving the issue of whether a plaintiff was able to receive first party benefits for PTSD treatment, which accompanied physical injuries sustained in a motor vehicle collision.

The facts of the case are as follows: in September of 2014 Plaintiff Carol Evans (“Evans”) was operating her vehicle southbound in the left lane on the Pennsylvania Turnpike when Rodolfo Hudson (“Hudson”) attempted to move his tractor trailer into the left lane causing a violent collision. Evans v. Travelers Insurance Co., No. 2531 EDA 2018, 2019 WL 6519678, at *1 (Pa. Super. Ct. Dec. 4, 2019). As a result of the collision, she started to feel dizzy the week after the incident. Evans, No. 2531 EDA 2018, 2019 WL 6519678, at *1. Eventually, Evans experienced symptoms such as: “persistent headaches and neck pain, dizziness, balance issues, fogginess of her mental processes, extreme exhaustion, nightmares, flashbacks, and panic attacks.” Id. It was an undisputed fact that Evans was treated for various injuries including post-traumatic stress disorder (PTSD). Id.

Evans subsequently attempted to obtain first party benefits coverage from her insurer, Travelers, which defined “bodily injury” as “accidental bodily harm to a person and that person’s resulting illness, disease, or death.” Id. at *2.  After initially paying for treatment of Evans’s PTSD, Travelers denied coverage for future treatment for PTSD. Id. Travelers maintained the position that “PTSD does not constitute ‘bodily injury’ as defined by the endorsement.” Id. In support of its position, Travelers relied on Zerr v. Erie Ins. Exchange, 446 Pa. Super. 451, 667 A.2d 237 (1995), which established “emotional or mental injuries were not covered under that definition of bodily injury, unless they were caused by a physical injury.” Id. The trial court subsequently granted summary judgment in favor of Travelers finding that Evans “failed to produce evidence that her mental injuries resulted from her physical injuries, which is essential to the cause of action.” Id.

On appeal, Evans argued mental injuries, including her PTSD did, in fact, constitute “bodily injury” under her Travelers’ policy. Id. at 3. In reversing the trial court’s grant of summary judgment, the Superior Court of Pennsylvania stated:

While this Court is bound by precedent in Zerr which provides that physical manifestations of emotional distress cannot constitute “bodily harm”… Zerr is distinguishable as Zerr’s claim for coverage was based solely on emotional injury without any accompanying physical injury whereas it is undisputed that  Evans suffered both physical injuries and emotional distress (including PTSD) in her accident. Pursuant to Zerr, Evans is entitled to benefits under her policy if the physical harm she sustained in the accident resulted in an illness.

Id. at *5.

The Superior Court of Pennsylvania believed that Evans PTSD was a result of the collision and her physical injuries, which were still evident three years following the collision. Id.

The decision in Evans v. Travelers Insurance Company allows for one to recover for emotional distress, such as PTSD, when the physical injuries incurred resulted in the emotional distress. As seen in the opinion, the Court distinguished Zerr from Evans’ situation because the plaintiff in Zerr had only emotional injuries; while, Evans suffered both emotional and physical injuries.

Going forward, injuries will be heavily examined to determine whether the emotional injuries were a result of the physical injuries suffered.

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