Failure to Read Policy Fatal to Claim

Ignorance of UM Coverage for Pedestrian Hit by Car is Inexcusable

Jun 25, 2025

Key Points:

Trial Court’s Decision:

It treated the court’s order as a denial of summary judgment

Incident Details:

Patterson was injured on May 17, 2019, when a car driven by Abhay Kumar Singh ran a stop sign and hit him. Patterson hired an attorney on February 17, 2021, and forwarded the police report to a USAA adjuster on March 5, 2021 .

USAA’s Denial:

USAA denied coverage, arguing that Patterson failed to comply with the policy’s provisions requiring prompt notice .

Policy Provisions:

The 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 .

Court’s Conclusion:

The Court of Appeals found Patterson’s delay unreasonable as a matter of law and affirmed the trial court’s order .

DISCUSSION

The trial court found that the policy provision requiring insureds to notify the insurer “promptly of how, when, and where an accident or loss happened” was a condition precedent to coverage. Patterson’s 21-month delay in notifying USAA meant that he failed “as a matter of law” to provide prompt notice.

The trial court also determined that Patterson’s ignorance of the fact that a pedestrian can benefit from his own uninsured motorist coverage is not an excuse that creates a jury issue.

A notice provision expressly made a condition precedent to 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 an insured does not read or otherwise make himself aware of the policy provisions, the 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 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 Court of Appeals concluded that Patterson’s delay unreasonable as a matter of law. The trial court’s order properly dismissed his claim.

ZALMA OPINION

Since law in most states required 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 is not an excuse for failing to comply with conditions precedent. A 21 month delay in giving notice defeats coverage and is unreasonable as a matter of law.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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