Mass. high court sides with driver in case against auto insurer

Massachusetts’ highest court has handed down a ruling that may be applicable in many car accident cases. The Supreme Judicial Court held last week that a car accident victim may be entitled to medical expense benefits from her car insurance provider even if her medical expenses were already being covered by a health insurance policy.

The case at issue has been making its rounds in the court system since 2008. The case was originally filed after a Worchester woman was seriously injured in a car accident and sought $25,000 in MedPay benefits from her Liberty Mutual insurance policy to help cover her medical expenses.

The woman’s injuries resulted in more than $100,000 worth of medical expenses, all of which were covered by the woman’s separate health insurance policy. For that reason, Liberty Mutual denied the woman’s claim for MedPay benefits, saying that the benefits would only duplicate what she was already receiving.

The case went back and forth between the state Superior Court in Worcester and state Supreme Judicial Court for years, and the Supreme Judicial Court’s most recently ruling has been its second. The Supreme Judicial Court held that the woman was entitled to the MedPay benefits.

The Court reasoned that Liberty Mutual’s main argument runs contrary to its own policies, which do not explicitly prevent drivers from receiving MedPay benefits in cases where their health insurance policies cover their medical expenses resulting from a car accident.

The case is now remanded back to the Superior Court in Worcester, which is expected to hear the case within the next month or so with the Supreme Judicial Court’s in mind.

Although this decision applies narrowly to the case at hand, it could affect similar cases involving insurance policies that have not explicitly banned MedPay-type benefits when the driver’s health insurance policy already covers the medical expenses relating to an accident.

Source: Boston Business Journal, “Supreme Judicial Court rules against Liberty Mutual in car crash case,” Matthew L. Brown, Aug. 9, 2013