Tort Law

This page within Virginia Tort Case Law is a compilation of cases reported by the Virginia Supreme Court and summarized by Brien Roche dealing with the topic of Insurance Medical Payments and the related topic of vehicle accidents. For more information about insurance coverage see the page on Wikipedia.

Insurance Medical Payments-Cases

2013—Christy v. Mercury Casualty Company, 283 Va. 542, 722 S.E.2d 256.
Medical payments coverage was properly denied where benefits in whole or in part are payable under any workers’ compensation law.

2004 Jones v. State Farm Mut. Auto. Ins. Co., 268 Va. 396, 601 S.E.2d 645.
Trial court properly held the territorial limitations of auto insurance medical payment coverage for medical expenses is clear and unambiguous and reasonable and therefore, medical expenses incurred as a result of auto accident in St. Maarten is not covered.

2000 Pauley v. State Farm Mut. Auto. Ins. Co., 260 Va. 1, 530 S.E.2d 414.
Court reaffirmed holding in Cotchan v. State Farm Fire & Casualty Co., 250 Va. 232, 462 S.E.2d 78, stating exclusion in this insurance medical payments endorsement does not violate Va. Code § 38.2-2201. Therefore, stacking not allowed where coverage is sought under two different policies issued by same company.

1998 Scarbrow v. State Farm Mut. Auto. Ins. Co., 256 Va. 357, 504 S.E.2d 860.
Provision in auto policy excluding coverage for medical expenses that are payable under Worker’s Compensation Statute is valid and enforceable.

1998 State Farm Mut. Auto. Ins. Co. v. Bowers, 255 Va. 581, 500 S.E.2d 212.
Under insurance medical payments coverage of auto policy term “incurred” includes only those amounts that insured would be legally obligated to pay.

1995 Cotchan v. State Farm Fire & Cas. Co., 250 Va. 232, 462 S.E.2d 78.
Insurance medical payments coverage of auto policy excluded injury sustained by the insured or any relative while occupying any motor vehicle, owned by or available for regular use of insured or relative, which is not insured motor vehicle. In this instance, relative was occupying motorcycle which he owned and used on regular basis. Exclusion upheld.

1994 Allstate Ins. Co. v. Eaton, 248 Va. 426, 448 S.E.2d 652.
Insured submitted claim under medical payments coverage but refused to submit to independent medical exam. Insured relied upon defense that she intended to submit uninsured motorist claim and under that claim she was not required to submit to exam. This argument is without merit and insured must submit to exam. Her failure to submit constitutes breach of contract.

1994 Virginia Farm Bureau Mut. Ins. v. Frazier, 247 Va. 172, 440 S.E.2d 898.
Trial Court erred in permitting parents to recover under property damage provision of uninsured motorist coverage for medical expenses and loss of services as a result of injury to their minor child.

1994 Moore v. State Farm Mut. Auto. Ins. Co., 248 Va. 432, 448 S.E.2d 611.
Plaintiff injured at speedway when struck by automobile being driven in warm-up prior to race. Issue was whether coverage exists under his own automobile insurance policy for medical payments coverage. Coverage found to exist.

1991 Baker v. State Farm Mut. Auto. Ins., 242 Va. 74, 405 S.E.2d 124.
Unambiguous provision in auto policy excluded insurance medical payments coverage where those benefits are payable under workers’ compensation statute.

1989 Virginia Farm Bur. Mut. Ins. Co. v. Hodges, 238 Va. 692, 385 S.E.2d 612.
Med-pay coverage applied to expenses incurred within one year of accident, i.e., expenses paid for or legally obligated to pay for within one year. Expenses for future surgery not contracted for were not incurred within one year.

1989 State Farm Mut. Auto. Ins. v. Jones, 238 Va. 467, 383 S.E.2d 734.
Auto furnished to employee by employer for daily use was for “regular use.” Therefore excluded by employee’s auto policy definition of non-owned auto.

1988 State Farm Mut. v. Seay, 236 Va. 275, 373 S.E.2d 910.
Insured entitled to coverage for injuries while riding motorcycle in spite of policy language which purports to limit coverage for injuries sustained while occupying an auto.

1988 Virginia Farm Bur. v. Jerrell, 236 Va. 261, 373 S.E.2d 913.
Policy language which is inconsistent with language in statute for mandating coverage is stricken.

1988 Davis v. Preferred Risk Mut. Ins. Co., 236 Va. 158, 372 S.E.2d 150.
Insurance medical payments coverage existed where plaintiff struck by board which was placed under wheels of vehicle and when vehicle started, board was propelled into plaintiff.

1982 Lord v. State Farm Mut. Auto. Ins. Co., 224 Va. 283, 295 S.E.2d 796.
Substantial compliance with notice provisions in automobile liability policy is required as condition precedent to recovery of insurance medical payments; 173-day delay constituted breach of notice provision.

1981 Rogers v. Nationwide Mut. Ins. Co., 222 Va. 345, 281 S.E.2d 817.
Expenses for chiropractic services were held not included in insurance medical payments coverage of policy.

1966 Moorman v. Nationwide Mut. Ins. Co., 207 Va. 244, 148 S.E.2d 874.
Plaintiff injured while riding as passenger in insured’s auto; insurer settled liability claim with plaintiff. Liability and medical payment coverages listed separately, separate premium charged for each and no exemption or limitation stated as to medical payment coverage.