Berry v. Dairyland County Mutual Insurance Co. of Texas

534 S.W.2d 428, 1976 Tex. App. LEXIS 2540
CourtCourt of Appeals of Texas
DecidedFebruary 27, 1976
Docket17695
StatusPublished
Cited by18 cases

This text of 534 S.W.2d 428 (Berry v. Dairyland County Mutual Insurance Co. of Texas) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Berry v. Dairyland County Mutual Insurance Co. of Texas, 534 S.W.2d 428, 1976 Tex. App. LEXIS 2540 (Tex. Ct. App. 1976).

Opinion

OPINION

BREWSTER, Justice.

The trial court sustained the defendant’s plea of privilege and the plaintiff has appealed.

The plaintiff, Marion Reese Berry, filed this suit against the defendant, Dairyland County Mutual Insurance Company of Texas, seeking to recover upon the “personal injury protection” coverage sold by defendant to plaintiff in connection with the automobile liability insurance policy that Berry had purchased from the defendant.

Plaintiff had purchased the liability policy from defendant on July 2, 1973. On August 27, 1973, Art. 5.06-3 of the Texas Insurance Code became effective and by its terms the defendant Company provided “Personal Injury Protection” to every automobile liability policyholder upon renewal of his policy unless the insured rejected such coverage in writing.

Before the loss involved here occurred the plaintiff’s policy was renewed and he did not reject such coverage in writing. In addition to that, the evidence shows that each month after August 27, 1973, plaintiff was charged for and he paid $5.00 extra to defendant as a premium for the “personal injury protection” coverage.

After the statute referred to became effective and even though plaintiff each month thereafter paid to defendant the premium for such insurance, no endorsement was ever issued to plaintiff by defendant to evidence the fact that he had this “personal injury protection” coverage.

The defendant does not question the fact that plaintiff had such insurance in force with defendant at the time of the loss.

The defendant also admits that no question is involved on this appeal as to whether the notices and proofs of loss provided for in the policy were given by plaintiff to defendant in the required time. Such questions are not involved on this appeal because defendant did not file a sworn denial as is required by Rule 93(m) in order to raise such questions.

The undisputed evidence at the venue hearing showed that the plaintiff, Berry, sustained an injury on April 25, 1974, while in the process of alighting from his insured automobile. Berry was the named insured in the liability policy issued to him by defendant and the car that he was alighting from when hurt is the same automobile that is described in the liability policy involved as being the insured’s “owned automobile.” On the occasion when injured, Berry had been driving his car and had stopped it and turned off the ignition key. He had phlebitis in his left leg and was favoring it as he twisted in order to get out of the car and as he did so his right knee caught and the cartilage snapped while he was engaged in the act of getting out of the car. In treating the injury his leg was operated on and he was hospitalized causing him to incur an expense of $1,322.45. The injury caused him to lose $1,000.00 in wages also.

The plaintiff sought to maintain venue in Tarrant County under Subd. 23 of Art. 1995, V.A.C.S. The trial court sustained defendant’s plea of privilege on the grounds that the plaintiff had failed to carry his burden of proving at the hearing that the plaintiff had a cause of action against the defendant.

*430 In this connection the defendant contends that plaintiff failed to prove that he had a cause of action against defendant, as he was required by Subd. 23, Art. 1995, V.A. C.S., to prove, in that he failed to prove that plaintiff sustained a loss insured against by reason of having sustained bodily injury caused by accident, “in a motor vehicle accident,” within the meaning of the policy sued on.

We reverse and render.

In plaintiff’s first point of error he contends that the trial court erred in holding that an injury sustained while alighting from a vehicle is not sustained in a motor vehicle accident. In his second and third points of error plaintiff contends that the trial court erred in sustaining defendant’s plea of privilege and in holding that plaintiff had not proved a cause of action.

We sustain those three points of error.

In defendant’s brief it says that the sole question to be determined on this appeal is whether an injury received while alighting from an automobile is a “bodily injury caused by accident, in a motor vehicle accident” within the meaning of the “personal injury protection coverage” afforded by defendant’s policy.

Article 5.06-3 of the Texas Insurance Code is the statute that relates to Personal Injury Protection Coverage that is involved here and it provides in part as follows:

“Personal Injury Protection Coverage (a) No automobile liability insurance policy . shall be delivered or issued for delivery in this state unless personal injury protection coverage is provided therein or supplemental thereto. The coverage provided in this article shall be applicable unless the insured named in the policy rejects the coverage in writing, and the coverage shall be provided in or supplemental to a renewal policy unless it is rejected in writing by the insured named in the policy, (b) ‘Personal injury protection’ consists of provisions of a motor vehicle liability policy which provide for payment to the named insured in the motor vehicle liability policy and members of the insured’s household, any authorized operator or passenger of the named insured’s motor vehicle including a guest occupant, up to an amount of $2,500 for each such person for payment of all reasonable expenses arising from the accident and incurred within three years from the date thereof for necessary medical, surgical, X-ray and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services, and in the case of an income producer, payment of benefits for loss of income as the result of the accident; . .” (Emphasis ours.)

It will be noted that this statute provides that the Personal Injury Protection will provide the coverage for the named insured, the members of his household, any authorized operator or passenger of the named insured’s car, and any guest occupant. The coverage will pay the reasonable medical expense, not exceeding $2,500, incurred by one of those persons in the treatment of injuries arising from the accident. It will also pay them for loss of income as a result of the accident Nowhere in the statute is it provided that the accident referred to must be a motor vehicle accident. It will also be noted that the statute provides for the same coverage to be afforded to each of the persons referred to above that the statute provides shall be covered by such insurance.

Defendant had a form 243 that it generally issued to insureds who purchased its “Personal Injury Protection Coverage.” The practice was to issue its form 243 as an endorsement to the liability insurance policies held by those insureds who on renewal desired the additional coverage. The evidence does not show whether or not this form had been approved by the Board of Insurance Commissioners.

As stated, the undisputed evidence in this case shows that although plaintiff did purchase such insurance, the defendant never did provide him with a form 243 as an endorsement to his policy.

*431

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Bluebook (online)
534 S.W.2d 428, 1976 Tex. App. LEXIS 2540, Counsel Stack Legal Research, https://law.counselstack.com/opinion/berry-v-dairyland-county-mutual-insurance-co-of-texas-texapp-1976.