.

Candace N. Edgar

Portrait of Candace N. Edgar

Candace is a member of the Professional Liability Department with over 15 years of litigation experience devoted almost exclusively to insurance defense litigation, representing both insurers and insureds in state, federal and appellate courts in Pennsylvania. Candace has successfully defended a myriad of cases, including insurance coverage, bad faith, first-and third-party auto, transportation, premises liability, employment, construction, medical malpractice and subrogation cases. She is experienced in all facets of a case from pre-suit investigation through verdict and appeal. She has presented at several insurance conferences and seminars, as well as provided training to claims professionals on best claims handling practices.

Candace graduated from Penn State University Dickinson School of Law in 2008 where she was recognized for her accomplishments in oral and written advocacy, including receipt of the ALI-ABA Scholastic and Leadership Award, The George F. Douglas, Jr. Memorial Award and the CALI Award for Excellence in Advocacy to name a few. Prior to law school, she graduated cum laude from Millersville University where she studied Broadcast Journalism and Political Affairs.
 

    • Penn State Dickinson Law (J.D., 2008)
    • Millersville University of Pennsylvania (B.S., cum laude, 2004)
    • Pennsylvania, 2008
    • U.S. District Court Eastern District of Pennsylvania
    • U.S. District Court Middle District of Pennsylvania
    • U.S. Court of Appeals 3rd Circuit
    • Dauphin County Bar Association
    • Pennsylvania Association of Mutual Insurance Companies
    • Pennsylvania Bar Association
    • Pennsylvania Defense Institute
    • Life Care Plans: Cutting Them Down To Size, 2023 PAMIC Claims Summit, Gettysburg, PA, April 19, 2023
    • Retail & Hospitality Webinar, The Harmonie Group, February 23, 2021 
    • Successfully defended insurers in cases involving coverage disputes and claims of insurance bad faith, including a successful appeal to the Pennsylvania Superior Court reversing and vacating a sizeable award for attorney fees against the insurer.
    • Successfully handled through resolution claims made against auto insurers for uninsured and underinsured motorist benefits and first party benefits.
    • Successfully defended commercial motor vehicle carriers in wrongful death and catastrophic bodily injury cases.
    • Successfully obtained multiple defense verdicts in favor of commercial property owners, including a national retailer and amusement park.
    • Dauphin County Pro Bono Program
    • Love the Hill - Wildheart Ministries, Harrisburg, Pennsylvania

Results

Thought Leadership

Legal Updates for Insurance Services

Third Circuit Upholds Household Vehicle Exclusion for Uninsured Dirt Bike, Overturning District Court Ruling

September 9, 2024

The Gallagher decision initially led to widespread uncertainty and confusion. However, Pennsylvania Courts have since given its holding substantial clarity and limitation, as this recent precedential decision from the Third Circuit demonstrates.  Fifteen-year-old Levi Werley was seriously injured while riding an uninsured dirt bike on private property in Kempton, Pennsylvania. The tortfeasor, who was also 15 years old, struck the dirt bike while driving a Jeep CJ-7. The Jeep was insured under a policy providing $100,000 in bodily injury coverage, which was paid, in full.  Levi then sought payment of UIM benefits under the two Mid-Century policies in the Werley household. The one policy belonged to Levi’s parents and insured four vehicles, providing $250,000/$500,000 in UIM benefits. The second policy belonged to Levi’s father and sister and insured one vehicle, similarly providing $250,000/$500,000 in UIM benefits. Stacking had been waived under both policies. However, pursuant to Donovan v. State Farm Mut. Auto. Ins. Co., 526 A.3d 1145, 1157 (Pa. 2021), the stacking waiver executed for the multiple-vehicle policy was invalid as to inter-policy stacking or stacking amongst separate policies. As stated, the dirt bike Levi was riding at the time of the accident was completely uninsured, so it had no coverage of any kind, including UIM benefits.  Although both household policies contained household vehicle exclusions, their language materially differed. Specifically, the household vehicle exclusion of the single-vehicle policy applied only to an accident involving a “car.” Because Mid-Century determined that the dirt bike did not meet the definition of a “car” under the policy, it paid Levi the $250,000 UIM limit. In contrast, the household vehicle exclusion under the multiple-vehicle policy applied to any accident involving a “vehicle,” which included a dirt bike. Accordingly, Mid-Century denied coverage based upon the household vehicle exclusion and subsequently filed an action for declaratory judgment in the Eastern District Court of Pennsylvania.  In a 55-page opinion, the District Court decided in favor of Levi and invalidated Mid-Century’s household vehicle exclusion under the multiple-vehicle policy, concluding that it acted as an impermissible de facto waiver of stacking in violation of 75 Pa. C.S.A. § 1738 and Gallagher v. GEICO Indemnification Co., 201 A.3d 131 (Pa. 2019). Central to the District Court’s decision was Mid-Century’s payment of UIM benefits under the single-vehicle, household policy because such payment meant that Levi was no longer seeking UIM benefits in the first instance. Instead, Levi had recovered UIM benefits he was now seeking to stack upon, differentiating this case from the Supreme Court’s recent holding in Erie Ins. Exch. v. Mione, 289 A.3d 524 (Pa. 2023), where the host vehicle had no UIM coverage and both the household polices excluded UIM coverage under their household vehicle exclusion.  On appeal, a unanimous panel of the Third Circuit issued a precedential decision vacating the District Court’s order, holding that the household vehicle exclusion was valid under these facts, pursuant to recent Pennsylvania Supreme Court precedent. See Mione, supra; Rush v. Erie Ins. Exch., 308 A.3d 780 (Pa. 2024). The Third Circuit rejected the District Court’s holding that the uninsured status of the dirt bike was irrelevant, finding that the Werleys’ failure to insure the dirt bike meant that they had no reasonable expectation of coverage, thus, “application of the household vehicle exclusion here deprived the Werleys of nothing for which they had bargained.” According to the Third Circuit, a household vehicle exclusion is invalid only if: (1) a policy insures the vehicle involved in the accident, (2) that policy provides UIM coverage on that vehicle, and (3) the household vehicle exclusion of a second policy sought to stack on top of the first policy would exclude UIM coverage for that vehicle. Because no policy insured the dirt bike, the Third Circuit concluded that the household vehicle exclusion of the multiple-vehicle policy was applied validly.  This case and other recent decisions are evidence that the household vehicle exclusion remains a valid and enforceable exclusion for Pennsylvania insurers with its application prohibited in only very limited circumstances.     Legal Update for Insurance Services - September 9, 2024, has been prepared for our readers by Marshall Dennehey. It is solely intended to provide information on recent legal developments and is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We welcome the opportunity to provide such legal assistance as you require on this and other subjects. If you receive the alerts in error, please send a note to tamontemuro@mdwcg.com. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2024 Marshall Dennehey. All Rights Reserved.

Firm Highlights

Thought Leadership

Commonwealth Court Reaffirms the Constitutionality of Act 111's IRE Provisions

In this case, the claimant sustained a work injury of January 6, 1994, which was acknowledged by Notice of Compensation Payable (NCP). After the claimant’s receipt of 104 weeks of temporary total disability benefits, the employer filed a Request for an Impairment Rating Examination (IRE). The IRE was performed in May 2023 and the IRE physician found that the claimant had a 5% whole person impairment, under the AMA Guides. The employer filed a Petition based on the IRE results, and the Petition was granted by the WCJ. During litigation, the claimant argued that the IRE provisions of Act 111 (Section 306(a.3) of the Act) were not applicable to her injury, since it predated June 24, 1996, the date Act 57 went into effect, and that the IRE provisions were unconstitutional. The Workers’ Compensation Judge (WCJ)) granted the Petition and the Board affirmed. On appeal to the Commonwealth Court, the claimant argued that Act 111 violated the nondelegation doctrine and that its retroactive application to the claimant’s injury was unconstitutional. The court rejected the arguments on the basis that they had already found the same arguments without merit in multiple, prior cases. The court also addressed an argument made by the claimant that Act 111 was procedurally defective under the Pennsylvania Constitution because it was only considered on two days in each House after having undergone amendments and reassignments. The court noted that the Pennsylvania Constitution requires every bill to be considered on three different days in each House. The claimant maintained that, according to the legislative history, the bill did not receive three separate days of consideration from each House when it was assigned a new bill number. The court pointed out, however, that the bill number, H.B. 1840 remained constant and was considered on three occasions by the House. Further, the court concluded that minor amendments to the bill were germane to its original subject, which was to modify the Act’s IRE process, in accordance with Protz II.

Thought Leadership

Florida Supreme Court Rules Florida Statute §627.70152 Does not Apply Retroactively

In a decision that resolves years of appellate uncertainty and confirms that insurers and insureds alike can rely on the legal framework in place when a policy is issued, the Supreme Court of Florida last week found that Florida Statute §627.70152, which involves an insured’s requirement to provide an insurer with pre-suit notice before filing a suit, cannot be applied retroactively. In Universal Property & Casualty Insurance Company v. Hughes, the Court was presented with the issue of whether the statutory pre-suit notice requirement applied retroactively and whether it would apply to a breach of contract of an insurance policy that was issued before the statute went into effect. Before the Court was an appeal from a homeowner, Ms. Hughes, who sued her insurance carrier, Universal Property & Casualty Insurance Company (Universal) for breach of contract under an insurance policy that was in effect from April 24, 2019 through April 24, 2020. During the policy period, Ms. Hughes suffered a loss and, on May 29, 2019, made a claim for water damage. The carrier investigated the loss and issued payment; Ms. Hughes disputed the payment, finding the amount insufficient for repairs. On July 1, 2021, Florida Statute §627.70152 went into effect, which required insureds to provide notice of intent to initiate litigation against the carrier prior to filing a lawsuit; if an insured filed the lawsuit without complying with §627.70152, a court must dismiss the case without prejudice. On August 4, 2021, Ms. Hughes filed her lawsuit against Universal for breach of contract. Universal moved to dismiss based on her failure to comply with §627.70152. Ms. Hughes contended the notice requirement could not be applied retroactively. The trial court disagreed and dismissed the lawsuit without prejudice, and Ms. Hughes appealed. During the appeal, the Fourth District Court of Appeal, in Cole v. Universal Property & Casualty, 363 So. 3d 1089 (Fla. 4th DCA 2023), ruled that Florida Statute §627.70152 did apply retroactively to policies issued before the effective date of §627.70152. However, the Sixth District Court agreed with Ms. Hughes and overturned the trial court’s ruling, finding the statute could not retroactively apply to policies issued prior to the statute effective date. Thereafter, the other district courts weighed in, with the Third District Court agreeing with the Fourth District Court, and the First, Second and Fifth District Courts agreeing with the Sixth District Court. In resolving the conflict amongst the district courts, the Supreme Court advised “as a general rule, ‘the statute in effect at the time an insurance contract is executed governs substantive issues arising in connection with that contract.’ Hassen v. State Farm Mut. Auto. Ins. Co., 674 So. 2d 106, 108 (Fla. 1996). The Court applied the two-step test when deciding whether a statute has retroactive application: “First, the Court must ascertain whether the Legislature intended for the statute to apply retroactively. Second, if such an intent is clearly expressed, the Court must determine whether retroactive application would violate any constitutional principles.” Menendez v. Progressive Exp. Ins. Co., 35 So. 3d 873, 877 (Fla. 2010). In analyzing the Legislature’s intent, the Court must determine whether the Legislature has manifested a clear command for retroactivity in the statutory text.  In review of the statutory text, the Court found nothing in the language of the statute to indicate that the phrase “all suits” was serving another purpose of expanding its reach to suits based on policies that both predate and postdate the enactment of the statute. Buis v. Universal Prop. & Cas. Ins. Co., 394 So. 3d 738, 741 (Fla. 2d DCA 2024). Further, the Court noted the statute has an effective date, which has long been considered to be evidence against retroactive application of a statute. The Court concluded that, on its face, no provision of §627.70152 speaks to application of the statute to insurance policies issued before the statute’s effective date and therefore, the Legislature did not clearly command retroactivity of the statute to include insurance policies issued prior to the enactment of the statute. The Court briefly reviewed Universal’s argument that the presuit notice requirement was procedural, not substantive, and therefore should be applied retroactively; however, the Court agreed with the Sixth District Court’s finding that, in its entirety, §627.70152 transformed an insured’s ability to sue an insurance company under a property insurance policy and an insurer’s obligations to respond to and pay insurance claims, thus making the requirement a substantive change. The Court thereby upheld the decision of the Sixth District and disapproved the decision of the Fourth District in Cole.

Thought Leadership

WCJ Improperly Refused to Conduct C&R Hearing and Erroneously Required Settlement of All Pending Petitions

In this case, the claimant sustained injuries in the course and scope of her employment as a registered nurse. The employer acknowledged the injury by a Notice of Compensation Payable (NCP).  Subsequently, a Workers’ Compensation Judge (WCJ) expanded the description of injury. The employer then filed a Termination Petition, alleging the claimant was fully recovered from the injuries. Providers filed Utilization Review (UR) Petitions, challenging UR determinations finding their chiropractic treatment to be not reasonable and necessary. A settlement of the claim was eventually reached, and the employer filed a Petition to Seek Approval of a Compromise and Release (C&R) Agreement. The C&R outlined that the agreement fully resolved all future workers’ compensation claims except for the termination and UR Petitions. Briefs were filed and one day later, the WCJ issued an Interlocutory Order which stated if instructions were not followed regarding filing of a C&R, a settlement hearing date would not be given. The employer complied with the order, and filed the C&R. Subsequently, the WCJ notified the parties that the C&R must resolve all issues in the petitions, or would not be entertained. A settlement hearing was never held, and the WCJ then issued a decision, granting the Termination Petition and dismissing the UR Petitions. The WCJ also said that the Petition for Approval of a C&R was dismissed without prejudice, as the issues in the Termination and UR Petitions went to a decision. The claimant appealed to the Workers’ Compensation Appeal Board (Board). The Board granted the claimant’s appeal, finding that the WCJ violated the requirement of Section 449 that an expedited hearing be held when a Petition for Approval of a C&R is filed.  The Board further held that it was legally incorrect for the WCJ to insist that the C&R resolve all issues raised by the pending Petitions. The Board remanded the case to a new WCJ, and Employer appealed to the Commonwealth Court. The court affirmed the Board and held that the WCJ erred, as a matter of law, by refusing to hold an expedited hearing within 30 days, once the Petition for Approval of a C&R was filed.  The court noted that the language of Section 449(b) is mandatory, and a settlement hearing is not discretionary or dependent on a party’s separate request for a stay, or whether the record has been closed. The court further rejected Employer’s argument that the case should not be remanded to a new WCJ for a new decision on the termination and and UR Petitions, as the Board passed no judgment on whether the C&R Agreement resolved the termination and UR Petitions, and left it for the WCJ to decide in connection with the Petition for Approval of a C&R.