Virginia Farm Bureau Mut. Ins. Co. v. Hodges, 881145
| Decision Date | 10 November 1989 |
| Docket Number | No. 881145,881145 |
| Parties | VIRGINIA FARM BUREAU MUTUAL INSURANCE COMPANY v. Lisa Michelle HODGES. Record |
| Court | Virginia Supreme Court |
Michaux Raine, III (Raine & Perdue, Rocky Mount, on briefs), for appellant.
Eric H. Ferguson (Ralph B. Rhodes, Hutcherson & Rhodes, Rocky Mount, on brief), for appellee.
Present: CARRICO, C.J., and COMPTON, STEPHENSON, RUSSELL, THOMAS, * WHITING and LACY, JJ.
This case involves the interpretation of a medical payment provision contained in three automobile insurance policies. The provision in question limits the insurance company's liability to the payment of "all reasonable expenses incurred within one year from the date of accident for necessary medical ... services." We decide whether certain anticipated medical expenses were "incurred" within one year of the accident.
Lisa Michelle Hodges injured her right arm in an automobile accident on June 14, 1986. Virginia Farm Bureau Mutual Insurance Company (the insurance company) provided medical payment coverage to Hodges as an insured under two automobile liability policies, and as a claimant under a third automobile liability policy.
On March 3, 1987, Dr. Henry T. Brobst, a plastic and reconstructive surgeon, examined Hodges on referral from another physician who had treated Hodges for her injuries. Dr. Brobst was to determine whether he could improve the appearance of the scars on Hodges's right arm which resulted from the accident. During the examination, Hodges told Dr. Brobst that the insurance company informed her that it would not be liable for any of his surgical fees unless he completed the procedures within one year of her accident.
On March 16, 1987, Dr. Brobst wrote to Hodges's attorney advising him that surgery could improve the appearance of the scars on Hodges's right arm. However, he advised that because Hodges's arm had only recently healed, the surgery, which involved a number of separate procedures spaced approximately two months apart, could not be completed within one year from the date of the accident. He estimated his fee as $9,000 to $10,000, and that much, or slightly more, for hospital charges.
On June 11, 1987, Dr. Brobst again wrote Hodges's attorney Miss Lisa Michelle Hodges, who was initially examined by me in the office on March 16, has made a contractual agreement through her lawyer to me for surgery to be performed in the future to revise multiple scars involving the right forearm, elbow and wrist. This surgery, as yet, has not been done and will be scheduled in the future. The estimated cost of both surgery and hospital is ten thousand dollars ($10,000).
If any additional questions arise regarding this, please let this office know.
Doctor Brobst apparently erred in referring to the date as March 16. All other evidence in the case indicates that the only time he saw Hodges was on March 3, 1987.
On June 12, 1987, Hodges wrote and signed the following memorandum:
I hereby agree to pay Dr. Henry T. Brobst and the hospital where Dr. Henry T. Brobst performs the above surgery the sum of $10,000 to revise multiple scars on my right forearm, elbow, and wrist at such time as the above surgery is performed. Further, I agree and obligate myself for Dr. Henry T. Brobst to perform the above surgery at such time as Dr. Henry T. Brobst elects.
The record does not indicate what became of this memorandum after Hodges signed it. The original was filed as one of Hodges's exhibits but the appellate record fails to show who identified it as an exhibit or where it had been prior to its introduction in evidence.
On August 26, 1987, Hodges filed an action at law against the insurance company in which she "prays that the Motion for Judgment be granted against the defendant in the amount of the medical bills for the surgery [to be provided by Dr. Brobst] that has been contracted for...." In depositions taken by the insurance company on February 18, 1988, Hodges testified that she had not seen Dr. Brobst since his initial examination on March 3, 1987, and that he had not billed her for the recommended surgery. However, she described Dr. Brobst's two letters and her memorandum as the basis for her liability to him.
Dr. Brobst testified in another deposition taken by the insurance company that Hodges's condition required his treatment to be delayed until approximately 18 months after June 1987, when there would be "enough softening and resolution of tissue reaction" to permit the procedures. He also testified that he felt that his letter of June 11, 1987 bound him to perform the reconstructive surgery for $10,000; however, he did not think Hodges was obligated to him because he had no further contact with Hodges or her attorney after he sent the letter.
The final order was entered on August 10, 1988. 1 In the final order, the trial court construed the word "incurred," contained in the medical payment provisions of the policy, "to include the cost of treating future medical needs diagnosed within the specified time period, where the nature of the injury or...
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