 |
 |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|
|
|
|
Samsel v. Allstate Insurance Company12/12/2002
sured was negligent or the victim of negligence? And what of those who do pursue a tort remedy? Do they actually incur medical expenses at the time they receive treatment or only when and if they recover their medical expenses from a tortfeasor? If they actually incur expenses only upon recovery, can they ask their insurers to make payment before the tort action ends? If the tort action resolves through settlement, has the insured incurred medical expenses or not? Or has the insured incurred medical expenses only if the settlement agreement separately defines and requires payment of such expenses? These questions arise by virtue of the majority's interpretation, which unnecessarily contorts the language of the contract. And, in the end, reality tells us that even if Lisa successfully pursues a tort action, she will not have actually incurred the medical expenses for which she seeks payment. Allstate's contract of insurance still will not provide coverage, for Lisa still has actually incurred no medical expenses.
The majority finally addresses the issue raised by this action by asking whether the policy's reference to medical expenses actually incurred by an insured person means "actually incurred for treatment of an insured person or . . . expenses for which the insured person is directly and legally liable?" Supra 28. Only in the world of the legally arcane could one suggest that contract language referring to expenses incurred "by an insured person" really means expenses "incurred [by the provider] for the treatment of an insured person." Certainly no reasonable policy holder could interpret his or her insurance contract as meaning that coverage promised for expenses incurred by the insured includes expenses incurred by the insured's medical provider.
The majority's failure to limit its review to the interpretation of the insurance policy involved provokes the majority to ask one final question. After noting again that the insured was immunized from liability, the opinion asks, " ut . . . why should it make a difference who can be sued?" Supra 30. The simple and inescapable answer is that it makes a difference because the policy obligates Allstate to pay only those insureds who incurred liability. Lisa cannot be sued by the provider because she is immune from suit. The fact that Lisa can never be held liable for her medical expenses means that, under the terms of the policy, she never incurred those expenses. Because we are interpreting a contractual provision related to the legal liability of the insured, it matters who can be sued.
I return to my statement that this is a simple case. Lisa did not incur expenses for her treatment at UMC because she was not liable for those expenses. She received exactly those benefits promised under the contract of insurance when Allstate paid those portions of her expenses for which she was liable under section 20-1072. I would reverse the decision of the superior court and vacate the opinion of the Court of Appeals.
Ruth V. McGregor, Vice Chief Justice
Concurring:
Charles E. Jones, Chief Justice
Page 1 2 3 4 5 6 7 8 9 10 11 12 Arizona Personal Injury Attorneys
Personal Injury Lawyers
|
| |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|