Dowell v. Oregon Mutual Ins. Co.

CourtOregon Supreme Court
DecidedFebruary 16, 2017
DocketS063079
StatusPublished

This text of Dowell v. Oregon Mutual Ins. Co. (Dowell v. Oregon Mutual Ins. Co.) is published on Counsel Stack Legal Research, covering Oregon Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dowell v. Oregon Mutual Ins. Co., (Or. 2017).

Opinion

62 February 16, 2017 No. 9

IN THE SUPREME COURT OF THE STATE OF OREGON

Stephanie M. DOWELL, individually and on behalf of others similarly situated, Petitioner on Review, v. OREGON MUTUAL INSURANCE COMPANY, an Oregon corporation, Respondent on Review. (CC 1205-06486; CA A153170; SC S063079)

En Banc On review from the Court of Appeals.* Argued and submitted March 8, 2016. Charles Robinowitz, Law Offices of Charles Robinowitz, Portland, argued the cause and filed the briefs for petitioner on review. Also on the briefs was Genavee Stokes-Avery. Thomas M. Christ, Cosgrave Vergeer Kester LLP, Portland, argued the cause and filed the briefs for respondent on review. Hadley Van Vactor, Portland, filed the brief for amicus curiae Oregon Trial Lawyers Association. NAKAMOTO, J. The decision of the Court of Appeals and the judgment of the circuit court are affirmed. Walters, J., dissented and filed an opinion, in which Baldwin, J., and Brewer, J., joined.

______________ * Appeal from Multnomah County Circuit Court, Henry C. Breithaupt, Judge pro tempore. 268 Or App 672, 343 P3d 283 (2015). Cite as 361 Or 62 (2017) 63

Case Summary: In 2008, plaintiff was injured in a motor vehicle accident. Among the costs she incurred as a result were $430.67 in transportation expenses accrued in the course of traveling to various medical appointments and picking up medications. Plaintiff applied for PIP medical benefits under her Oregon auto- mobile insurance policy, and defendant insurance company paid for the medi- cal care she had received from her healthcare providers. Defendant, however, declined to pay for the transportation costs associated with obtaining that care. Plaintiff subsequently filed an action against defendant, arguing that medical expenses under ORS 742.524(1)(a) included, as a statutory matter, transporta- tion costs and that as a result, defendant had breached its contract with her by failing to reimburse her for those expenses. On defendant’s motion for summary judgment, however, the trial court dismissed plaintiff’s action and the Court of Appeals went on to affirm that judgment in a written decision. In scrutinizing the statutory phrase “expenses of medical * * * services” as it was used in ORS 742.524(1), the Court of Appeals examined the text and context of the statute, opining that the phrase meant “something that is expended to secure a benefit relating to work that is performed by another, when that work involves the prac- tice of medicine[.]” After thus narrowing the meaning of that phrase, the Court of Appeals concluded that it could not be read to include transportation expenses related obtaining medical services. Held: The decision of the Court of Appeals and the judgment of the circuit court are affirmed. After examining the text, context, and legislative history of ORS 742.524(1) the Court concludes that the legislature intended the phrase “expenses of medical * * * services” to encompass costs that originate with, or arise by virtue of, the rendering of medical treatment or the work performed by a physician. Such costs would include the medications, medical supplies, and equipment prescribed by a physician for treatment of the injured person. The legislature did not intend, however, for ordinary transporta- tion expenses incurred in the course of obtaining medical treatment or medica- tions to qualify as a covered PIP benefit. The decision of the Court of Appeals and the judgment of the circuit court are affirmed. 64 Dowell v. Oregon Mutual Ins. Co.

NAKAMOTO, J. Auto insurers in Oregon must provide personal injury protection (PIP) benefits to their insureds for certain automotive injury-related expenses, regardless of who is at fault in an accident. ORS 742.520(1). The PIP medical bene- fits at issue in this case “consist of the following payments for the injury or death of each person” covered: “All reasonable and necessary expenses of medical, hospital, dental, surgi- cal, ambulance and prosthetic services incurred within one year after the date of the person’s injury, but not more than $15,000 in the aggregate for all such expenses of the person.” ORS 742.524(1)(a) (2007).1 On behalf of herself and others similarly situated, plaintiff contended in her action against defendant Oregon Mutual Insurance Company that insurers must pay transportation costs incurred to obtain medical care as part of PIP medical benefits. The trial court con- cluded that the PIP statutes, ORS 742.518 to 742.542, do not require insurers to pay for transportation costs and granted summary judgment for defendant. Plaintiff appealed, and the Court of Appeals affirmed. Dowell v. Oregon Mutual Ins. Co., 268 Or App 672, 343 P3d 283 (2015). The question on review is whether the PIP medical benefit in ORS 742.524(1)(a) includes the insured plaintiff’s transportation costs to receive medical care. We hold that PIP benefits for the “expenses of medical * * * services” do not include an insured’s transportation costs for traveling to receive medical care. Therefore, we affirm the decision of the Court of Appeals and the judgment of the trial court. I. BACKGROUND The relevant facts are not in dispute. Plaintiff had an Oregon auto insurance policy issued by defendant. In 2008, plaintiff was injured in a motor vehicle accident.

1 In 2009, the legislature amended ORS 742.524(1)(a), but those amend- ments apply only to policies issued or renewed after the January 1, 2010, effec- tive date. Or Laws 2009, ch 66, §§ 1, 3. The legislature again amended the stat- ute in 2015, but those amendments apply only to policies issued or renewed after the January 1, 2016, effective date. Or Laws 2015, ch 5, §§ 4, 7. Because this case involves a pre-2010 policy, those 2009 and 2015 amendments do not apply. For that reason, all the citations in this opinion are to the 2007 version of the relevant statutes, except where otherwise noted. Cite as 361 Or 62 (2017) 65

Among other expenses, plaintiff incurred $430.67 in trans- portation costs to attend medical appointments and to obtain medication. She then applied for PIP medical benefits under her insurance policy. Defendant paid for plaintiff’s medical care, but it declined to pay for her transportation expenses to obtain her medical care. Plaintiff then filed a complaint for breach of con- tract, both for herself and on behalf of others similarly situ- ated. She alleged that her claim for medical expenses under ORS 742.524(1)(a) included her transportation costs and that defendant had breached its contract by failing to reim- burse her for those expenses. Defendant responded by mov- ing for summary judgment, arguing that ORS 742.524(1)(a) did not require it to pay for transportation costs. After a hearing, the trial court granted defendant’s motion and entered a judgment in defendant’s favor.

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Dowell v. Oregon Mutual Ins. Co., Counsel Stack Legal Research, https://law.counselstack.com/opinion/dowell-v-oregon-mutual-ins-co-or-2017.