Langan v. Harleysville Insurance

POPOVICH, Judge,

dissenting:

I cannot join in the Majority’s determination that, under the applicable provision of the No-Fault Motor Vehicle Insurance Act repealed after the institution of the instant lawsuit, the law does not obligate the insurer to incur the cost of its insured’s purchase of a van and its subsequent conversion “necessary to secure medical and vocational rehabilitation services”. 40 Pa.S. § 1009.103 (repealed).

I find that the Majority gives too narrow a reading to § 1009.103 when it offers that the insured’s use of the van *379to “get to his recreational sources” discounts its being encompassed within the “medical and vocational rehabilitation services” approved under the No-Fault Act for the expenditure of monies by an insurer for its insured with regard to an almost paraplegic condition.

There is no dispute that the insured’s physician recounted how his patient’s “impairments are severe and prognostically ... not expected to remit.” This reduced the insured’s mobility function and necessitated the purchase of suitably equipped van “to enable him to get out of the home to get to his therapies____”

Under the No-Fault Act, as conceded by even the Majority, transportation aimed at rehabilitating a claimant, by means of medical and vocational services, is an approved expenditure called for under the law.

I fail to discern how the orthopedically-impaired claimant, whose condition is likely to degenerate to the point where a fusion of his knee is likely, falls outside the perimeters of the No-Fault Act because there is a possibility (which is unsubstantiated by the record) of his using the van for “recreational sources”.

Even if such were the case, I pose the following: Would not the ability to participate in some form, any form, of recreational activity be part and parcel of a complete rehabilitation program? I would think so. Further, to interact with others or merely experience the joy of accomplishing a task in a sports context, e.g., with one’s peers, cannot be minimized for it has its therapeutic benefits (psychologically) in aiding in the optimum progress and/or recovery of the injured party. Therefore, I find that the Majority has strayed afield in concluding that the insured failed to establish the non-existence of alternative, less-expensive means of traversing the streets and highways in his community to obtain the type of therapy necessary for his maximum, potential recovery. To so hold does a disservice to the insured and all of those similarly situated, at least as I read the statute in question.

*380Certainly, the insured’s need for the conventional forms of therapy and his accessibility to those avenues of treatment come within the perimeters of “medical and vocational rehabilitative services”. The Majority would deny the insured this admitted “coverage” because of the Majority’s speculation as to the use of the van for purposes other than those prescribed for the insured’s therapy. The record simply does not support such a syllogism.

On this same subject, I take issue with the Majority when it implies that it is the obligation of the insured to establish the non-existence of alternate sources of transportation and that the van would be used exclusively for his use.

My reading of the state and law on the subject discloses that imposition of no such obligation upon the insured. I find once the insured has established a “medically necessary” reason for the purchase and adaptation of a van for his rehabilitative needs, which I find he had done at bar, then the burden of proving otherwise would fall on the shoulders of the insurer. This did not occur here with regard to the insurer. Accordingly, giving it a liberal and common sense interpretation, I find that the statute would and does afford an insured the right to reimbursement for the purchase and adaptation of a van for his rehabilitative needs. See Zangrilli v. State Farm Mutual Automobile Insurance Co., 131 P.L.J. 468 (1983); see also Stewart v. Allstate Insurance Co., 103 N.J. 139, 510 A.2d 1131 (1986)1.

*381The possibility that the petitioner may make use of the van for purposes other than rehabilitation is pure speculation and has no place in a present review of the grant of the motion for summary judgment.

Being unpersuaded by the rationale of the Majority in reversing the actions of the court below, I would affirm the order of the court below.

. Would not the insured’s inability to operate the van on his own be even more of an indication of his need for vehicular assistance of the type at issue here. One who could motor on his/her own would appear to be a candidate for public transportation, as compared to the almost intractable insured here.

The insured has established his need for a specialized vehicle to aid him in his efforts to recover from an obviously crippling injury. His doctor concurred in the scope of the injury and a prognosis for restricted movement, in the future, for the insured. With a forecast of limited mobility, all means to aid the injured in the road to (partial/total) recovery has been insured against by his guardians. This writer would not withdraw this opportunity from the injured, and my reading of the law and cases on the matter are not to the contrary.