Hoffman v. Travelers Indemnity Co. of America, 144 So. 3d 993

Ashley Hoffman was insured by Travelers and treated at BRMC after an auto accident.
BRMC discounted charges from $713.67 to $485.29 under its contract with AETNA, which Hoffman paid in full.
Travelers paid Hoffman $674.73, reflecting the full charges minus a geographic deduction; Hoffman sought the full non-discounted amount.
Hoffman filed a class action alleging Travelers failed to pay expenses incurred under the medical payments coverage.
The trial court denied Travelers’ summary judgment; the court of appeal denied relief; this court granted writs.
The issue is whether ‘incurred’ expenses under the policy means the full charged amount or the discounted contractually reduced amount.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Meaning of incurred in policy	Hoffman incurred the full charges even if discounted.	Incurred equals the discounted amount Hoffman actually owes.	Incurred means the discounted amount Hoffmann was legally obligated to pay ($485.29).

Thomas v. Universal Life Ins. Co., 201 So.2d 529 (La.App. 3rd Cir. 1967) (fundamental incurrence based on charges billed; liability matters)
Niles v. American Bankers Ins. Co., 229 So.2d 435 (La.App. 3rd Cir. 1969) (incurred expenses when charges were billed and liability exists)
Irby v. Gov't Employees Ins. Co., 175 So.2d 9 (La.App. 4th Cir. 1965) (incurred expenses require liability attachment)
Brackens v. Allstate Insurance Co., 339 So.2d 486 (La.App. 2nd Cir. 1976) (no incurred expense where there was no liability for payment)
Drearr v. Connecticut General Life Insurance Co., 339 So.2d 486 (La.App. 2nd Cir. 1976) (incurred defined by liability thrust upon insured)