Burgos v. Pilgrim Insurance

The plaintiffs have appealed the entry of summary judgment for the defendant-insurer on their breach of contract, G.L.c. 90, §34M, and G.L.c. 93A claims arising from the defendant’s refusal to pay Personal Injury Protection (“PIP”) benefits for their medical expenses. The dispositive issue is whether the plaintiffs’ delayed submissions of their PIP applications prejudiced the defendant-insurer’s investigation, thereby justifying the denial of their PIP claims.

The material facts are undisputed. On April 19,2006, defendant Pilgrim Insurance Company (“Pilgrim”) received two patently incomplete…