M. F. A. Insurance Co. v. Hollingshad Ex Rel. Hollingshad

1971 OK 33, 483 P.2d 330
CourtSupreme Court of Oklahoma
DecidedMarch 23, 1971
Docket42412
StatusPublished
Cited by3 cases

This text of 1971 OK 33 (M. F. A. Insurance Co. v. Hollingshad Ex Rel. Hollingshad) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
M. F. A. Insurance Co. v. Hollingshad Ex Rel. Hollingshad, 1971 OK 33, 483 P.2d 330 (Okla. 1971).

Opinions

LAVENDER, Justice:

This appeal concerns a provision in a policy of automobile liability insurance which purports to limit the liability of the insurer to pay medical expenses of an injured passenger where that person has been paid an amount under the bodily injury liability provisions of the policy in'excess of the total amount which could have been claimed under the medical payment provisions of the policy.

Hollingshad, the plaintiff in the trial court and a minor, was injured while riding as a passenger in the insured automobile. Another of the passengers was killed and a third man was also injured. Under the bodily injury liability provisions of the insured’s policy, the maximum coverage was $5,000.00 per each person injured up to a maximum of $10,000.00 for each accident. A settlement was made with all of the parties involved by which the $10,000.-00 maximum was divided as follows: $5,-000.00 to the survivors of the fatally in-' jured person; $2,500.00 to the other passenger and $2,500.00 to Hollingshad. Because of the fact that Hollingshad was a minor, his settlement was approved by the trial court. Prior to the settlement the question of whether the insurer might be liable under a medical payment provision in the policy, up to the maximum of $500.-00 provided such coverage, was discussed by the attorney for Hollingshad and for the insurer. It was then stipulated that the insurer might be joined as a party to the Hollingshad personal injury action for the purpose of submitting to the trial court the question concerning possible liability under the medical payments coverage. The medical payments coverage is referred to in the policy as “Coverage C”; the bodily injury liability provision as “Coverage A." The parties shall be hereafter referred to by name or by their respective trial court designations.

It was more or less agreed — at least it does not seem to be disputed in the briefs of the respective parties — that Hollingshad had $1,869.95 in medical expenses. Only $55.00 of these medical expenses was paid by the insurer under its Coverage C. The question was whether the remaining $445.-00 (of the $500.00 maximum provided under Coverage C) should be paid to Hol-lingshad.

As it is important to our conclusion in this case that we state, as clearly as we can, the precise question which was submitted to the trial court, we will now refer to the respective pleadings of the parties. The plaintiff’s amendment to his petition merely alleged that the insurer was, by the terms of its policy, “legally obligated” to pay the remaining ($445.00) coverage under Coverage C to plaintiff. The defendant insurer’s answer alleges:

“That an agreement has been entered into to settle plaintiff’s claim against Ralph Dearinger, named insured of this defendant, for the sum of $2500.00. That said agreement is greater than the [332]*332medical coverages of said contract and therefore becomes a part thereof * * ⅜

The policy provision, on the basis of which the insurer contends it was entitled to credit for its payment of the $2,500.00 settlement with the plaintiff toward any claim against it under its “Coverage C,” is as follows:

“The amount of any payment under this Coverage C to or on behalf of any person shall be applied toward the settlement of any claim or the satisfaction of any judgment for damages entered against any insured because of bodily injury to such person arising out of any accident to which bodily injury liability (Coverage A) applies.”

In Great Northern Life Ins. Co. v. Cole (1952), 207 Okl. 171, 248 P.2d 608 we stated:

“The rule is settled that an insurance policy must be construed to give effect to all of its provisions, where possible, and that its terms and provisions are to be accepted in their usual and ordinary sense, and that exceptions which are inserted by the insurer to exempt it from liability are to be construed, in case of doubt, strictly against the insurer. See Great American Insurance Company v. O. K. Packing Company, 202 Okl. 231, 211 P.2d 1014; and Combined Mutual Casualty Company v. Metheny, 203 Okl. 522, 223 P.2d 533.”

In Community National Life Insurance Co. v. Graham (1966), Okl., 418 P.2d 670, we said:

“The law favors awarding to purchasers of life insurance the benefits and protection which they have paid for, when such benefits can be justified on sound legal considerations.”

We know of no reason why such rule should not also apply to automobile liability insurance policies and the benefits and protection purchased by the insured whether such protection be of himself, under the bodily injury liability section of the policy, or the protection be for the passengers in his car, under the medical payments provision.

We notice that the insurer specifically charged a premium for the medical payments coverage.

With the above rules in mind, we have studied the policy from its four corners and have concluded that the provision limiting the company’s liability for medical expenses was meant to have one purpose and one purpose only, that being to prevent an injured party from recovering such expenses twice from the same insurer. It was clearly meant to take care of the situation where, for example, a passenger is injured in an accident involving the insured vehicle and is furnished medical attention, or incurs medical services on the strength of the insurer’s obligation to pay up to $500.00 of such expense and then the insurer does, in fact pay such expense and the case is thereafter settled or a judgment is rendered in which the same medical expenses are attempted to be collected. In the latter event, the above quoted provision of the policy would permit the insurer to deduct such paid medical expenses. This was not the case here.

As we have seen, the insurer took the position in the trial court that it was entitled to credit, as it were, for any payment made by it to the injured party pursuant to its liability coverage (Coverage A). In other words, that such payments under Coverage A did not have to include specifically $500.00 worth of medical expenses. The record is silent with regard to whether in fact the plaintiff, injured passenger, actually included his medical expenses ($1,869.95) in the compromise settlement of $2,500.00. We are told the $2,-500.00 represented the balance of coverage left available for the satisfaction of any judgment plaintiff might obtain against the named insured. The inference is made— rather strongly — that this is the reason plaintiff settled with the insured for the [333]*333reduced figure of $2,500.00 rather than going ahead to trial on plaintiff’s original petition wherein he detailed personal injuries and prayed for damages in excess of $50,000.00 plus several thousand dollars for medical expense.

A considerable number of jurisdictions have held that, absent such a policy provision as hereinabove quoted, an injured party may be entitled to recover for his medical expenses both under the medical payments provision of the policy as well as under the bodily injury liability portion. Other jurisdictions, however, have held that even absent such a provision double recovery will not be allowed, at least from the same insurer, because it was not within the contemplation of the parties. See, for example, Tort v. Register, N.Car., 1962, 125 S.E.2d 754.

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M. F. A. Insurance Co. v. Hollingshad Ex Rel. Hollingshad
1971 OK 33 (Supreme Court of Oklahoma, 1971)

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Bluebook (online)
1971 OK 33, 483 P.2d 330, Counsel Stack Legal Research, https://law.counselstack.com/opinion/m-f-a-insurance-co-v-hollingshad-ex-rel-hollingshad-okla-1971.