Oregon Case Law Update: PIP Benefits Do Not Include Medical-Related Transportation Costs

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Oregon Case Law Update: PIP Benefits Do Not Include Medical-Related Transportation Costs

From the desk of Josh Hayward: Oregon PIP claimants routinely seek reimbursement for expenses they believe are related to medical care, including transportation to doctor’s offices and pharmacies.  Oregon’s PIP benefits statute requires reimbursement for, among other things, “expenses of medical…services.” In this case, the Oregon Supreme Court decided whether transportation costs were included as expenses of medical services.  Read on to see what they determined.

Claims Pointer: In this case arising out of a car accident, the Oregon Supreme Court held that expenses for ordinary transportation to receive medical treatment or to obtain medication are not compensable PIP benefits under Oregon’s PIP benefits statute.  The case provides clarity on what has long been an unclear aspect of PIP benefits in Oregon and will have an impact on many PIP claims in the state.

Dowell v. Oregon Mutual Auto Ins. Co., 361 Or 62 (February 16, 2017)

In 2008, Stephanie Dowell (“Dowell”) was injured in a car accident.  Among other expenses, Dowell incurred $430.67 in transportation costs to attend medical appointments and to obtain medication.  She then applied for Personal Injury Protection (“PIP”) benefits under her own insurance policy with Oregon Mutual Auto Insurance Company (“Oregon Mutual”).  Oregon Mutual paid for Dowell’s medical care, but it declined to pay for her transportation expenses to obtain her medical care.

Dowell filed suit for breach of contract, alleging that her claim for medical expenses under ORS 742.524(1)(a) (Oregon’s PIP benefits statute) included her transportation costs and that Oregon Mutual had breached its contract by failing to reimburse her for those expenses.  Oregon Mutual responded by filing a motion for summary judgment, arguing that ORS 742.524(1)(a) did not require it to pay for transportation costs.  The trial court...

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