Grand Prairie insurance lawyers will deal with auto policies from time to time and when doing so will also deal with the portion of the policy dealing with Personal Injury Protection (PIP). The Beaumont Court of Appeals issued an opinion in 2000, dealing with how PIP benefits are paid. The style of the case is, Texas Farmers Insurance Company v. Carabell Fruge. Here are some of the relevant information on the case.
This case raises questions related to PIP provided in an automobile liability insurance policy as required by Texas Insurance Code, Section 1952.151 through 1952.161. The underlying issue in this case is whether or not an insurance company breached its contract by placing the names of medical providers and Medicare as co-payees on checks paying PIP benefits to Carabell Fruge. The Court held that the company did breach its contract but that it was entitled to name Medicare as a co-payee to part of the PIP benefits.
Jackie Ryan had purchased an automobile liability insurance policy from Texas Farmers Insurance Company that provided her with $2,500 in PIP coverage. Fruge was a passenger in Ryan’s vehicle and was injured in a car wreck. After her injury, Fruge’s attorney filed on her behalf a PIP claim with Farmers supported by documents reflecting medical expenses of $3,490. Some of the supporting documents contained some reference to Medicare. At least one document was stamped “Benefits Assigned.” Farmers responded to Fruge’s claim by mailing her six checks totaling $2,500.30. Four of the checks, totaling $1,854.30, named medical providers, Medicare, or both as co-payees with Fruge. All six checks named the law firm representing Fruge as a co-payee. Fruge’s attorney returned all six checks with a letter advising Farmers that “some or all” of the medical bills related to the checks naming co-payees had been paid, complaining that it would take six months to get all of the necessary endorsements, and demanding payment naming Fruge as the sole payee.
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