Personal Injury Protection Benefits

Drivers in Weatherford, Mineral Wells, Aledo, Azle, Springtown, Decatur, Peaster, Millsap, Brock, Hudson Oaks, Poolville, Newark, Willow Park, and other parts of Texas are all offered Personal Injury Protection (PIP) benefits coverage when they buy coverage for their automobile. It is the law.
It is the law that the coverage be offered. However, it can be rejected. To reject it, the rejection must be clearly made and in writing. This law is found in the Texas Insurance Code, Section 1952.152(b).
Here is a 1978 case by the Texas Supreme Court dealing with the rejection. The style of the case is, Unigard Security Insurance Company v. Charles Schaefer et al. Here is some background.
Schaefer and others sued to recover under the PIP endorsement of an auto policy issued by Unigard. The case was tried on stipulated facts. The trial court ruled for Unigard. The first appeals court reversed the trial court and then this Supreme Court upheld the first appeals court decision. All the people sueing for benefits in this case were killed or seriously injured in an accident where a David Wyloge was the driver of the car in which everyone was riding.
Prior to the accident, Abraham Wyloge obtained liability insurance coverage from Unigard. The policy included an Endorsement 243, which was PIP, mandated by the Legislature in the then existing Insurance statutes. That statute is the predecessor of the current 1952.151 thru 1952.161.
Under that law the only exclusion of benefits provided in the statute was injury caused to oneself intentionally or while in the commission of a felony or attempting to elude arrest. Mr. Wyloge did not reject the PIP coverage. On the contrary the policy was written with coverage included in Endorsement 243, and Unigard collected a premium for it.
On a subsequent date, Mr. Wyloge signed a Form 119. “Exclusion of Named Driver” endorsement. It excludes claims arising from any accidents occurring while any automobile is operated by David Wyloge. Unigard asserted that the exclusion in Endorsement 119 was tantamount to a partial rejection, while David was driving, of the PIP coverage. This is the reason Unigard denied the claim.
In this case, there was much arguement over the difference between an endorsement and an exclusion and the effect of signing the Form 119 exclusion and the Endorsement 243.
In making it’s decision the court stated as follows:
“This holding is consistent with that part of (old statute) which sets forth the only exclusion of benefits authorized by the statute. They are: when the insured causes injury to himself intentionally or is injured while in the commission of a felony or attempting to elude arrest. Any attempt to add another exclusion applicable when the automobile is being operated by an unauthorized driver would be repugnant to the statute. When specific exclusions or exceptions to a statute are stated by the Legislature, the intent is usually clear that no others shall apply. When the Legislature specifies a particular extent of insurance coverage, any attempt to void or narrow such coverage is improper and ineffective.”
“Even if Endorsement 119 were not inapplicable because of the terms of (old statute) and Endorsement 243, we do not agree with Unigard that 119 was sufficient as a partial rejection of the statutory (PIP). As heretofore indicated, there is not a word in that endorsement which mentions (PIP, the old statute) or Endorsement 243. A matter of public policy involving more than the present litigants is here involved. The Legislature has declared it to be the public policy of this State that ‘no automobile liability insurance policy … shall be delivered or issued for delivery … unless personal injury protection coverage is provided therein or supplemental thereto.’ Among the purposes are to provide injured occupants of the insured automobile with up to $2,500 per person for hospital and doctor bills arising from accidents ‘without regard to fault or nonfault of the named insured or recipient …'”
This is an old case upholding the current law stating that rejection of PIP benefits must be clear and in writing. There are a lot of cases dealing with PIP benefits and whenever someone finds themselves in a position where those benefits are being denied, they should seek the advice of an experienced Insurance Law Attorney.