Facts
- Sandra Malu was insured under a private passenger automobile insurance policy issued by Security National Insurance Company. Sandra Malu v. Security Nationa…
- On or about March 17, 2001, Malu was involved in a motor vehicle accident.
- As a result of the accident, Malu sustained personal injuries that required medical treatment.
- Malu submitted a claim for Personal Injury Protection (PIP) medical benefits under Security National’s policy. Her claim number was 01801968.
- In order to receive medical treatment related to the accident, Malu used her private passenger automobile to travel to and from her medical providers and incurred transportation-related expenses.
- Security National reimbursed Malu for her automobile transportation expenses at a fixed mileage rate of 34.5 cents per mile.
- Malu did not dispute that automobile transportation expenses were payable under the PIP statute or that Security National paid transportation benefits at a mileage-based rate.
- Malu did dispute the reasonableness of the rate itself, alleging that Security National’s mileage reimbursement rate of 34.5 cents per mile was unreasonably low.
- Malu alleged that she was uncertain whether Security National’s reimbursement rate complied with the PIP statute, particularly in light of:
- Existing Florida case law from the Fifth District Court of Appeal recognizing reimbursement of reasonable travel costs under PIP; and
- Information published by the United States Department of Transportation, which reflected a higher mileage rate based on the cost of operating a vehicle.
- As part of her requested relief, Malu sought a declaratory ruling from the trial court to determine whether Security National’s mileage reimbursement rate was reasonable under Florida’s PIP statute.
Issue
Whether transportation expenses incurred in connection with obtaining reasonably medically necessary treatment are compensable benefits under Florida’s Personal Injury Protection statute.
Procedural History
- Malu brought a two count complaint against Security National Insurance Company in Broward County Circuit Court alleging that Security National violated Florida’s PIP statute by failing to reasonably reimburse medical transportation expenses.
- The trial court dismissed the complaint with prejudice, concluding that the mileage reimbursement rate paid by the insurer was reasonable as a matter of law.
- Malu appealed to the Fourth District Court of Appeal, which affirmed the dismissal on alternative grounds, holding that medical transportation expenses were not compensable under the PIP statute.
- The Fourth District certified conflict with the Fifth District Court of Appeal’s decision in Hunter v. Allstate Insurance Co., which had held that transportation expenses were compensable under PIP.
- The Florida Supreme Court accepted jurisdiction to resolve the inter-district conflict regarding whether transportation expenses are payable PIP benefits.
Purpose and Liberal Construction of the PIP Statute
The Court emphasized that the purpose of Florida’s No-Fault Law is to ensure prompt payment of medical expenses and access to care for persons injured in automobile accidents. Consistent with that purpose, the statute must be liberally construed in favor of coverage rather than narrowly interpreted to limit benefits Sandra Malu v. Security Nationa….
Transportation as a Reasonable Medical Expense
The Court reasoned that transportation expenses are incidental to obtaining medical treatment and therefore fall within the statute’s requirement that insurers pay for “reasonable expenses” related to medically necessary services. Without transportation, an injured person may be unable to access medical care at all.
Ambulance Reference Is Not Exclusive
The insurers argued that because the statute specifically references ambulance services, other forms of transportation were excluded. The Court rejected this argument, holding that the inclusion of ambulance services does not operate to exclude other reasonable transportation expenses incurred to obtain medical care
Holding
The Florida Supreme Court held that transportation expenses incurred in connection with medical treatment that is reasonably medically necessary are reimbursable under Florida’s PIP statute. The Court quashed the Fourth District’s decision in Malu and approved the Fifth District’s reasoning in Hunter.
Court’s Reasoning
- Purpose and Liberal Construction of the PIP Statute
The Court emphasized that the purpose of Florida’s No-Fault Law is to ensure prompt payment of medical expenses and access to care for persons injured in automobile accidents. Consistent with that purpose, the statute must be liberally construed in favor of coverage rather than narrowly interpreted to limit benefits
- Transportation as a Reasonable Medical Expense
The Court reasoned that transportation expenses are incidental to obtaining medical treatment and therefore fall within the statute’s requirement that insurers pay for “reasonable expenses” related to medically necessary services. Without transportation, an injured person may be unable to access medical care at all. - Ambulance Reference Is Not Exclusive
The insurers argued that because the statute specifically references ambulance services, other forms of transportation were excluded. The Court rejected this argument, holding that the inclusion of ambulance services does not operate to exclude other reasonable transportation expenses incurred to obtain medical care
Conclusion
The Florida Supreme Court held that transportation expenses incurred to obtain reasonably medically necessary treatment are compensable benefits under Florida’s PIP statute.
Disclaimer: This summary is provided for educational and informational purposes only and does not constitute legal advice.
