Robinson v. Aetna Life Insurance Company, 5737.

• Citation: 288 A.2d 236
• Decision Date: 06 March 1972
• Docket Number: No. 5737.,5737.
• Parties: W. Junius ROBINSON, Appellant, v. AETNA LIFE INSURANCE COMPANY, Appellee.
• Court: Court of Appeals of Columbia District

288 A.2d 236

W. Junius ROBINSON, Appellant, v. AETNA LIFE INSURANCE COMPANY, Appellee.

No. 5737.

District of Columbia Court of Appeals.

Argued September 15, 1971.

Decided March 6, 1972.

Jay L. Westbrook, Washington, D. C., for appellant. Michael Nussbaum, Washington, D. C., also entered an appearance for appellant.

James P. Schaller, Washington, D. C., for appellee.

Before KELLY, FICKLING and GALLAGHER, Associate Judges.

GALLAGHER, Associate Judge:

This is an appeal from the trial court's judgment denying appellant, plaintiff below, recovery of expenses incurred in transporting his injured wife from Athens, Greece to New York City. Appellant based his claim upon an insurance contract with appellee, Aetna Insurance Company (Aetna), which provided under certain conditions for payment of the cost of "professional ambulance service."

Appellant's wife fell and sustained a fracture of the femur bone while she and her husband were passengers on a cruise en route from the island of Crete to the island of Rhodes. She was taken to a hospital in Rhodes where she stayed for two days while X-rays were taken and a heavy body cast was applied. A few days later, she was transported by plane to Athens, Greece. After arriving there, Mrs. Robinson was examined by a doctor in the admitting section of a hospital but due to overcrowded conditions in the hospital appellant obtained a hotel room where he and his wife spent the night. Having decided to return immediately to the United States, he acquired tickets the next morning to New York on a regularly scheduled flight of Sabena Belgian World Airlines.

The following day Sabena provided an ambulance to pick her up at the hotel and transport her to the airport. She was taken aboard the plane by stretcher and was then placed on a different, specially-designed stretcher formed by folding down three seats and fitting the stretcher onto those seats. The plane then proceeded on the journey to New York, stopping only in Vienna and Brussels.

The cost for the three seats and services provided for Mrs. Robinson was $850.00, and her bill contained no itemization of the cost of the various services she received. The coach fare for appellant aboard the same flight was $283.00, virtually one-third of the cost of Mrs. Robinson's ticket. She received no substantial medical treatment from any hospital in Europe, except for the body cast.

Upon arrival in New York, appellant and Mrs. Robinson spent the night in a hotel, and the next day Mrs. Robinson was transported by land ambulance to the George Washington University Hospital in the District of Columbia. The cost of the ambulance from New York to Washington was $235.00, and Aetna paid without delay the percentage called for by the policy of this ambulance cost.

Appellant filed a claim with appellee for the $850.00 plane fare from Athens to New York, but appellee refused payment stating that this expense was not covered by the appellant's policy. In relevant part the policy provided:

ALLOWABLE EXPENSES

* * * * * *

Professional ambulance service to the first hospital where treated, from that hospital to another in the area if necessary treatment is not available at the first hospital, and from the hospital to the home if required by the patient's condition.¹ (Emphasis supplied.)

After a trial without jury, the trial court found that the language "professional ambulance service" was not ambiguous and had a popular sense. It further found that although a common carrier might under certain circumstances fall within the policy's coverage, under the facts of this case, Sabena had not supplied "professional ambulance service" to appellant. Finally, the trial court held that the transportation from Athens to New York did not constitute "professional ambulance service to the first hospital where treated, from that hospital to another in the area if necessary treatment is not available at the first hospital. . . ." (Emphasis supplied.)

Appellant argues that nonpayment by Aetna is not justified by the requirement that the transportation be to another hospital "in the area" of the first hospital. In support of this contention he relies upon the payment by...