Justices to decide if man should get denied medical benefits
Jessica M. Karmasek Mar. 30, 2011, 10:46am
CHARLESTON -- The West Virginia Supreme Court of Appeals has to decide whether a man should receive medical payment benefits previously denied by a circuit court.
On June 11, 2003, Michael W. Witt was operating a 1999 GMC Sierra truck owned by his employer, the South Charleston Sanitary Board, when he was rear-ended by a 1999 Chevy 1500 truck at the intersection of Kanawha Turnpike and Village Drive.
The accident left him seriously injured and with numerous medical bills.
Witt sued the driver of the other vehicle, Robert K. Sutton, State Farm Mutual Automobile Insurance Company and St. Paul Fire and Marine Insurance Company, the sanitary board's insurer.
He eventually settled his claims with St. Paul Fire and Marine Insurance, but maintained he was entitled to medical payment coverage under the State Farm policy, which covered his personal vehicle, for his medical bills.
State Farm said because the vehicle Witt was driving was owned by his employer, it was a "non-owned car" and therefore no medical payment coverage was available.
Witt's claims for medical payment benefits were brought before Kanawha Circuit Judge James Stucky, who granted State Farm's summary judgment.
Charleston lawyer Marvin Masters, who represented Witt at Wednesday's oral arguments, noted that medical payment benefits -- or medpay, as it was often referred to -- is marketed and sold as broad insurance coverage.
He argued that the policy exceptions in the medical payments and liability sections provide coverage while in an employer's vehicle.
"What the court did below is ignore the requirements of interpreting insurance policies where there's an exclusion," Masters told the justices.
"It's our position that he had coverage, they denied it and the circuit court was wrong."
Charleston lawyer Charles S. Piccirillo argued for State Farm on Wednesday.
Chief Justice Margaret Workman questioned Piccirillo on the policy. She, like Masters, found it to be "really confusing" with "very ambiguous" language.
Piccirillo argued because there is no liability coverage there isn't any medpay coverage. "It follows where liability coverage would apply," he explained.
Justice Robin Davis said she thought that medpay coverage followed the person.
Piccirillo said it does, mostly. It does not, however, follow a person through his or her employment, he said.
"This is just a reasonable scope of coverage," he told the Court.
To find in favor of Witt or that State Farm's policy is ambiguous, would mean making medpay coverage unaffordable to carry, he said.
"Right now, it is a reasonably affordable coverage that is not designed to be health insurance coverage," Piccirillo said.
"There's just no reason to go there," he said.