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DOROTHY E. BROWER v. NATIONWIDE MUTUAL INSURANCE COMPANY (03/13/87)

filed: March 13, 1987.

DOROTHY E. BROWER
v.
NATIONWIDE MUTUAL INSURANCE COMPANY, APPELLANT



Appeal from the Judgment entered August 23, 1985, Court of Common Pleas, Blair County, Civil Division at No. 1283 C.P. 1983.

COUNSEL

Karen E. Pfeffer, Altoona, for appellant.

Richard M. Serbin, Altoona, for appellee.

Cirillo, President Judge, and Cavanaugh, Wickersham,*fn* Rowley, Wieand, Olszewski, Del Sole, Popovich and Johnson, JJ. Del Sole, J., files a dissenting opinion.

Author: Johnson

[ 361 Pa. Super. Page 386]

This case presents the question of whether Section 203 of the Pennsylvania No-fault Motor Vehicle Insurance Act,

[ 361 Pa. Super. Page 387]

(No-fault Act), Act of July 19, 1974, P.L. 489, No. 176, § 203, 40 P.S. § 1009.203, repealed by the Act of February 12, 1984, P.L. 26, No. 11, § 8(a), effective October 1, 1984, affords any basis for requiring an insurer to pay collateral benefits in excess of the reasonable charges incurred for medical treatment by a motor vehicle accident victim. We think it does not. We reverse the order which granted summary judgment to the victim.

In March of 1983, Dorothy E. Brower (Brower) sustained serious injuries as a pedestrian when struck by a motor vehicle insured by Nationwide Mutual Insurance Company (Nationwide). Brower, who lived alone, did not own a motor vehicle. She did maintain coverage under a medical benefits group policy with Blue Cross/Blue Shield (BC/BS).

As a result of the injuries sustained, Brower received medical treatment and services at the Nason Hospital resulting in total billings of $31,148.35, after subtracting a minor sum for television services ($27) which was paid by Brower. Of this amount, BC/BS paid $9,000 directly to the hospital, following a reduction write-off of $17,106.35 based upon a reduced payment agreement between the hospital and BC/BS. A final payment by BC/BS in the sum of $300 was made to the hospital.

Brower made a demand upon Nationwide for payment to her in the sum of $26,106.35, representing the aggregate of the actual payment first made by BC/BS to the hospital ($9,000) and the write-off or allowance ($17,106.35). In response, Nationwide tendered its check to Brower for $9,000 pointing out that it was prepared to satisfy any final cash balance due the hospital after all BC/BS payments and allowances were completed. Nationwide refused to pay Brower for the amount of the write-off which BC/BS had allowed to the hospital pursuant to the agreement between BC/BS and the hospital.

This suit was instituted against Nationwide to recover the amount of the write-off. Following the close of pleadings, the trial court granted Brower's motion for summary judgment, holding ...


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