Appeal from the United States District Court for the Western District of Pennsylvania (Erie).
Aldisert and Becker, Circuit Judges, and Pollak, District Judge.*fn*
This diversity case presents an issue of first impression and requires that we interpret an important statutory component of the Pennsylvania No-Fault Motor Vehicle Insurance Act, PA. STAT. ANN. tit. 40, §§ 1009.101-1009.701 (Purdon Supp. 1983). We must decide if a provision of the Act's Assigned Claims Plan, § 1009.108, permits an accident victim to recover under the statute for hospital and medical expenses which have previously been paid by a Blue Cross/Blue Shield insurance plan. We hold that such recovery is allowed.
Appellant Erin Killeen is the minor daughter of divorced parents. On December 3, 1980 she sustained serious injuries in an automobile accident while riding as a passenger in her mother's uninsured car. As a result, Erin incurred some $70,000 in hospital and medical expenses. Because she was the beneficiary under a Blue Cross/Blue Shield insurance policy, Erin was substantially reimbursed for these expenses. The Blue Cross/Blue Shield policy was paid for by her father in fulfillment of his support obligations under an Ohio divorce decree. The decree provided, inter alia, that he was "responsible for payment of all [of Erin's] necessary and reasonable medical, dental and hospital expenses. . . ." App. at 25a.
After the accident, Erin, through her mother, filed a complaint in Pennsylvania state court to recover the hospital and medical expenses, under the no-fault Act, for which Blue Cross/Blue Shield reimbursement had already been received. Travelers Insurance Co., the insurer assigned to Erin's claim under § 1009.108, claimed that payment by it would amount to a double recovery by Erin, and refused to reimburse her for these costs. Travelers removed the proceedings to federal district court pursuant to 28 U.S.C. § 1441(a), and there obtained a judgment in its favor. This appeal followed.
Before we address the substance of appellant's claims, we will discuss the relevant portions of the Pennsylvania No-Fault Motor Vehicle Insurance Act. We begin by noting that there is no legislative history to enlighten us as to the meaning of any of the Act's provisions. Therefore, to ascertain the intent of the Pennsylvania legislature we must rely on the language of the statute itself. See American Tobacco Co. v. Patterson, 456 U.S. 63, 71 L. Ed. 2d 748, 102 S. Ct. 1534 (1982). Furthermore, Pennsylvania courts instruct that if a court is to err in ascertaining the legislative intent behind the no-fault Act in close or doubtful cases, it should err in favor of extending coverage. See Crawford v. Allstate Ins. Co., 305 Pa. Super. 167, 171, 451 A.2d 474, 476 (1982).
The Act requires Pennsylvania motorists to purchase automobile insurance that provides coverage for property damage and personal injuries,*fn1 but, if a motorist is uninsured, the Act's Assigned Claims Plan allows for reimbursement of accident related personal injury expenses.*fn2 This protection for uninsured motorists is provided, on a rotating basis, by every insurance carrier authorized to sell no-fault automobile insurance in the state.*fn3
If an individual, injured in an automobile accident is covered by a no-fault automobile insurance policy and, in addition, by a general health and accident policy, he or she may be entitled to reimbursement under each such policy for hospital and medical expenses incurred as a result of a motor vehicle accident.*fn4 What amounts to a double recovery is allowed because the insured has paid two premiums and is entitled to the benefits purchased under each policy. Where, however, the injured individual is not covered by a privately purchased no-fault automobile insurance policy, but is covered only under a general health and accident policy, the reimbursements available through the Assigned Claims Plan will not, unless a statutory exemption applies, allow a double recovery for incurred hospital and medical expenses. As § 1009.108(a)(3) provides:
If an individual receives basic loss benefits through the assigned claims plan for any reason other than because of the financial inability of an obligor to fulfill its obligation, all benefits or advantages that such individual receives or is entitled to receive as a result of such injury, other than life insurance benefits or benefits by way of succession at death or in ...