Dowell v. Oregon Mutual Ins. Co.

Summarized by:

  • Court: Oregon Supreme Court
  • Area(s) of Law: Insurance Law
  • Date Filed: 02-17-2017
  • Case #: S063079
  • Judge(s)/Court Below: Nakamoto, J. for the Court; En Banc.

Under ORS 742.524(1)(a) the phrase “expenses of medical services” includes (1) the cost of professional services provided by licensed or certified healthcare providers and (2) medications and medical supplies and equipment that have prescribed for the injured motorist that they treat.

The issue in this case was whether the personal injury protection (PIP) medical benefit in ORS 742.524(1)(a) includes the insured plaintiff’s transportation costs to receive medical care. Under ORS 742.524(1)(a) the phrase “expenses of medical services” includes (1) the cost of professional services provided by licensed or certified healthcare providers and (2) medications and medical supplies and equipment that have prescribed for the injured motorist that they treat. The phrase “expenses of medical services” requires an insurer to pay for healthcare bills and items that a physician or other healthcare provider prescribes for treatment, such as medications, medical supplies, and equipment. PIP benefits for the “expenses of medical services” do not include an insured’s transportation costs for traveling to receive medical care. Therefore, the decision of the Court of Appeals and the judgment of the circuit court were affirmed.

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