BOTSFORD, J.
This is the second time this court has considered the present case. Again, the issue presented is whether a claimant may seek medical expense benefits under the "medical payments" coverage (MedPay) offered in a standard Massachusetts automobile insurance policy (auto policy) where those expenses
1. Background. We briefly summarize the facts that are pertinent to this appeal, as alleged in the complaint and contained in extrinsic documents introduced by the parties before the motion judge.
Golchin sustained significant personal injuries, resulting in medical expenses in excess of $100,000, when she was involved in a motor vehicle accident as an occupant of her husband's car. The car was insured under an auto policy issued by Liberty Mutual that included optional MedPay benefits of up to $25,000. At the time of the accident, Golchin also was insured under a health insurance policy issued by Blue Cross Blue Shield of Massachusetts (Blue Cross).
As a result of the accident, Liberty Mutual paid $8,000 in personal injury protection (PIP) benefits to Golchin. Blue Cross paid Golchin's additional medical expenses, the charges for which came to $100,893, and later asserted a lien in the civil action filed by Golchin against the alleged tortfeasor. The lien was in the amount of $32,033.03 — the sum Blue Cross actually
On September 30, 2008, Golchin commenced the present action against Liberty Mutual on behalf of herself and a putative class of similarly situated individuals, alleging that the company's failure to disburse MedPay benefits to her constituted a breach of contract, a breach of the implied covenant of good faith and fair dealing, and a violation of G. L. c. 93A, § 2. In Golchin I, 460 Mass. at 236-237, on further appellate review, we concluded that Golchin's complaint was sufficient to raise a right to relief, that Liberty Mutual had not demonstrated as a matter of law that Golchin may not receive MedPay benefits when she already had received medical expense benefits under her health insurance policy, and that it was error for a Superior Court judge to have allowed Liberty Mutual's motion to dismiss Golchin's complaint. On remand, Liberty Mutual filed its answer and a motion for judgment on the pleadings. A different Superior Court judge (motion judge) allowed the defendant's motion, agreeing with Liberty Mutual that as a matter of law, Golchin never "incurred" any expenses for medical services within the meaning of the auto policy's MedPay provisions because 211 Code Mass. Regs. § 52.12(8) (2008) prohibits medical services providers from billing patients for the charges of services covered by insurance, except for deductibles, copayments, or coinsurance.
2. Review of Liberty Mutual's motion. The motion at issue before us was filed as a motion for judgment on the pleadings pursuant to Mass. R. Civ. P. 12 (c), 365 Mass. 754 (1974), and
In the circumstances, where the parties and the motion judge have relied on these extrinsic materials, where neither party appears to claim any factual disagreement with them or prejudice from their being considered, and where it also appears that there are no material facts in dispute in any event, we review the motion as one for summary judgment. See Mass. R. Civ. P. 56 (c). Cf. Cousineau v. Laramee, 388 Mass. 859, 860 n.2 (1983), and cases cited (where plaintiffs have not challenged trial judge's implicit conversion of motion filed pursuant to Mass. R. Civ. P. 12 [b] [6], 365 Mass. 754 [1974], to motion for summary judgment and where no prejudice to plaintiffs' rights to present extraneous matters, court "review[s] the judge's dismissal of this action as though he had granted a motion for summary judgment" and "[s]uch motion is properly granted when `there are no genuine issues as to any material fact and ... the [moving party] is entitled to judgment as a matter of law'").
3. Discussion. Interpretation of an insurance policy is a question of law to be determined by the court. Massachusetts Bay Transp. Auth. v. Allianz Ins. Co., 413 Mass. 473, 476 (1992), citing Nelson v. Cambridge Mut. Fire Ins. Co., 30 Mass.App.Ct. 671, 673 (1991). "We interpret the words of the standard policy in light of their plain meaning,... giving full effect to the document as a whole[,] ... consider[ing] `what an
The standard policy contains two forms of coverage implicated by Golchin's claim: compulsory PIP benefits of up to $8,000,
Part 6 of the auto policy describes the MedPay coverage. It provides, in relevant part:
The terms "incur" and "expenses" are not defined in the auto policy. However, the plain meaning of the word "incur" is "[to] sustain," and the word "expense" is defined as "[a]n expenditure of money" or "a cost." American Heritage Dictionary of the English Language 625, 889 (4th ed. 2000). The auto policy thus requires only that there be expenses for medical services sustained as a result of bodily injuries suffered in an accident by the owner of the insured vehicle or an occupant of that vehicle; it does not say who must actually pay these expenses in order to trigger the MedPay coverage under Part 6.
The MedPay provisions of the auto policy considered as a whole as well as in comparison to the other provisions of the
What is not present here is an exclusion from or limitation on MedPay coverage for medical expenses that are also covered under a separate health insurance policy. We interpret the absence of such a provision to mean, by implication, that the policy does not bar MedPay benefits in such a situation. See Allstate Ins. Co. v. Bearce, 412 Mass. 442, 447 (1992).
Part 2 of the auto policy, describing PIP benefits, is also instructive. It expressly limits PIP coverage based on the availability
In this case, the record indicates that the personal injuries Golchin sustained in her automobile accident resulted in medical expenses of $32,033.03. Such expenses were clearly "incurred" within the plain language of the auto policy — first, by Blue Cross, and later by Golchin when the lien placed by Blue Cross on her tort recovery pursuant to G. L. c. 111, § 70A,
Notwithstanding the plain language of the auto policy, Liberty Mutual argues that various statutes and regulations preclude payment of MedPay benefits in the circumstances of this case. Its principal contention is the one it advanced successfully before the motion judge, namely, that MedPay benefits are not
Liberty Mutual's interpretation flies in the face of the auto policy's language and grossly inflates the import of 211 Code Mass. Regs. § 52.12(8). A regulation that restricts patient billing by health care providers for services covered by patients' health insurance contracts has no bearing on the availability of MedPay under the auto policy, a completely separate type of insurance contract. As discussed, expenses related to medical services provided are still "incurred" within the meaning of the auto policy's MedPay provisions, regardless of whether the expenses are paid by a health insurer or the claimant; 211 Code Mass. Regs. § 52.12(8) is irrelevant. Moreover, the auto policy nowhere states that its MedPay coverage is limited to deductibles, copayments, or coinsurance, as Liberty Mutual contends; it simply covers "reasonable expenses for necessary medical... services." See Metropolitan Prop. & Cas. Ins. Co. v. Blue Cross & Blue Shield of Mass., Inc., 451 Mass. 389, 393 n.6 (2008), citing Creswell v. Medical W. Community Health Plan, Inc., 419 Mass. 327, 331 (1995) ("There appears to be no legislative history supporting ... th[e] position[]" that "MedPay is intended to cover expenses not otherwise covered under a health insurance plan or PIP, such as copayments, out-of-network care, and out-of-formulary prescription medications"). Liberty
Remarkably, Liberty Mutual also argues that Bulletin 2008-12 (bulletin), in which the commissioner addresses the coordination of benefits among PIP, health insurance, and MedPay, makes the unavailability of health insurance benefits a prerequisite to the availability of MedPay benefits. Liberty Mutual advanced the same argument before this court in Golchin I. Now, as then, "Liberty Mutual drastically overstates the support offered to its position by the bulletin." Golchin I, 460 Mass. at 230. We see no reason to depart from our conclusion there that the bulletin simply "does not advise insurers regarding proper procedures where a claimant receives complete recovery from his or her health insurer and nevertheless seeks MedPay benefits for the same expenses" and that, therefore, the bulletin cannot require dismissal of Golchin's complaint.
Finally, Liberty Mutual argues that recovery of MedPay in this case would result in benefits that are impermissibly duplicative of payments made under a policy of health insurance, in violation of common-law principles governing indemnity insurance. Although in Golchin's case no double recovery will result because of her payment in full satisfaction of Blue Cross's lien, we acknowledge it is possible that operation of the plain language of the auto policy, as we have construed it, could result in MedPay benefits duplicating payments made by a health insurer. We therefore address the argument briefly.
This court has "recognize[d] the indemnity character of medical and hospital expense benefits," Frost v. Porter Leasing Corp., 386 Mass. 425, 430 (1982), and that common-law indemnity
That being said, Liberty Mutual's concern about duplicative payments may be warranted. Indeed, we have observed that "it seems quite probable that MedPay was originally intended to cover medical expenses in the event of an accident for people who did not have health insurance — a benefit that may be approaching irrelevance in light of the recently enacted `universal' health care mandate," although we have found no legislative purpose underlying MedPay benefits to support this proposition. Metropolitan Prop. & Cas. Ins. Co. v. Blue Cross & Blue Shield of Mass., Inc., 451 Mass. at 393 n.6, citing G. L. c. 111M, § 2, inserted by St. 2006, c. 58, § 12. Liberty Mutual, however, is
4. Conclusion. The judgment of the Superior Court is reversed, and the case is remanded to that court for further proceedings consistent with this opinion.
So ordered.