Dowell v. Oregon Mutual Insurance
268 Or. App. 672
Or. Ct. App.2015Background
- Plaintiff (insured) was injured in a 2008 motor vehicle accident and sought Personal Injury Protection (PIP) benefits under an Oregon-mandated auto policy issued by Oregon Mutual.
- Defendant insurer paid medical PIP benefits but refused to reimburse $430.67 plaintiff spent on transportation to medical appointments and to obtain medication.
- Plaintiff sued for breach of contract, arguing ORS 742.524(1)(a)'s phrase "expenses of medical ... services" includes transportation costs related to obtaining medical care.
- Defendant moved for summary judgment, arguing PIP covers payments for medical services provided by licensed health-care "providers," and does not include transportation or self-transport costs.
- The trial court granted summary judgment for defendant; the insured appealed. The appellate issue is statutory interpretation of ORS 742.524(1)(a).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether "expenses of medical ... services" in ORS 742.524(1)(a) includes transportation costs to obtain care/medication | The phrase should be broadly construed to cover expenses related to medical services, including travel to appointments and to get medication | The phrase refers to expenses for services provided by licensed medical providers; transportation (by third-party drivers or self) is not a covered "service" by a provider | Court held the statutory phrase does not include transportation costs; summary judgment for defendant affirmed |
Key Cases Cited
- State v. Thompson, 328 Or. 248 (review of statutory interpretation)
- PGE v. Bureau of Labor & Industries, 317 Or. 606 (text is best evidence of legislative intent)
- State v. Gaines, 346 Or. 160 (use text, context, and legislative history to discern intent)
- Elk Creek Mgmt. Co. v. Gilbert, 353 Or. 565 (examine statutory terms in context)
- Force v. Dept. of Rev., 350 Or. 179 (consider other parts of the statute as context)
- To v. State Farm Mut. Ins., 319 Or. 93 (statutory interpretation controls over policy language)
- Perez v. State Farm Mut. Ins. Co., 289 Or. 295 (purpose of PIP scheme is prompt reimbursement regardless of fault)