Title: Allstate Ins. Co. v. Williams

State: pennsylvania

Issuer: Pennsylvania Supreme Court

Document:

347 Pa. Superior Ct. 468 (1985) 500 A.2d 1151 ALLSTATE INSURANCE COMPANY, Appellant, v. Pamela G. WILLIAMS, Cynthia Nairn and Mary Zotis on Behalf of Themselves and Other Members of a Class Similarly Situated, Appellees. Supreme Court of Pennsylvania. Argued March 26, 1985. Filed November 15, 1985. *469 John A. Crittenden, Pittsburgh, for appellant. Richard C. Schomaker, Pittsburgh, for appellees. Before MONTEMURO, ROBERTS and BLOOM, JJ.[*] PER CURIAM: The sole issue presented by this appeal is whether appellees, possessing valid automobile insurance policies issued pursuant to the Pennsylvania No-Fault Motor Vehicle Insurance Act ["No-fault Act"],[1] may recover, as accident related expenses, for services in the nature of physical therapy provided by doctors of chiropractic. On November 22, 1983, appellees filed a complaint in class action for declaratory judgment and equitable relief in the Court of Common Pleas of Allegheny County. By an order dated February 24, 1984, the court below sustained four of appellant's preliminary objections and directed appellees to file an amended complaint setting forth more specifically their claim with regard to physically therapeutic services. On March 23, 1984, appellees filed an amended class action complaint in assumpsit and for declaratory judgment. *470 At paragraph three of this complaint, appellees asserted the following: On April 13, 1984, appellant filed a preliminary objection in the nature of a demurrer to appellees' amended complaint. Following discovery, the taking of depositions, the filing of extensive briefs, a hearing, and the agreement of counsel to a limited stipulation, the court below dismissed appellant's preliminary objection on June 12, 1984. Thereafter, in response to a motion by appellant, the court below amended its June 12, 1984 order to include a paragraph certifying its interlocutory ruling for immediate appeal and staying any further proceedings below pending appeal. On September 26, 1984, this court granted appellant's petition for permission to appeal an interlocutory order. Initially, we note that, in attempting to ascertain and implement the pertinent legislative intent behind the No-Fault Act in close cases, courts must err, if at all, in favor of extending coverage to insureds. See Steppling v. Pennsylvania *471 Manufacturers' Association Insurance Company, 328 Pa.Super. 419, 477 A.2d 515 (1984); Bills v. Nationwide Mutual Insurance Company, 317 Pa.Super. 188, 463 A.2d 1148 (1983). Furthermore, one of the legislature's avowed purposes in enacting the No-fault Act was to establish "a Statewide system of prompt and adequate basic loss benefits for motor vehicle accident victims . . .". 40 P.S. § 1009.102(b). "Loss", for the purpose of calculating an insured's recovery pursuant to the No-fault Act, was defined as "accrued economic detriment resulting from injury arising out of the maintenance or use of a motor vehicle consisting of, and limited to, allowable expense, work loss, replacement services loss, and survivor's loss." 40 P.S. § 1009.103 (emphasis supplied). Section 103 defined "allowable expense" in pertinent part as: In addition, by way of further definitional clarity, section 103 defined "medical and vocational rehabilitation services" as: In Miller v. Johnson, 496 Pa. 290, 436 A.2d 1187 (1981), our supreme court observed: Id., 496 Pa. at 294-95, 436 A.2d at 1189 (emphasis supplied). Accepting that an insured may recover necessary chiropractic expenses as "allowable expenses" pursuant to the No-fault Act, the issue before us becomes whether doctors of chiropractic may indeed provide services in the nature of physical therapy, recoverable as chiropractic expenses. *473 As set forth in the Chiropractic Registration Act [Chiropractic Act][2] at section 602(b), "chiropractic" is described as: (emphasis supplied). In dismissing appellant's preliminary objection and therefore finding that chiropractors may perform physical therapy, the court below relied upon this rather broad definition of "chiropractic", encompassing "the furnishing of necessary patient care for the restoration and maintenance of health . . .". Both appellant and amicus curiae, the Pennsylvania Physical Therapy Association, in their briefs to this court, direct our attention to Commonwealth, Department of State v. Schatzberg, 29 Pa.Commw. 426, 371 A.2d 544 (1977). In Schatzberg, our commonwealth court upheld regulations forbidding licensed chiropractors from performing acupuncture. Interpreting section 602(b)'s definition of "chiropractic", the court found that acupuncture was a procedure beyond the professional bounds of those licensed in chiropractic. The court specifically noted, "Nothing in this record indicates that acupuncture is, or is intended as, a *474 treatment of misaligned or dislocated vertebrae or articulations." Id. at 431, 371 A.2d at 546-47. As alleged in appellees' amended complaint, the procedures at issue in the case sub judice, collectively labeled "physical therapy", were provided "in connection with [the] care of . . . spinal injur[ies]." We therefore find Schatzberg to be factually inapposite to this case. Nevertheless, appellant and amicus curiae rely on the following language in Schatzberg. Id. at 431-32, 371 A.2d at 547 (footnotes omitted). They contend that, since section 602(b)'s definition of "chiropractic" may not be read so expansively as to encompass practices uniquely within the professional sphere of physicians licensed to practice medicine and surgery, section 602(b)'s definition similarly should not be read to subsume the practice of licensees under the Physical Therapy Practice Act [Physical Therapy Act].[3] In responding to this argument, we find two considerations to be of particular significance. First, there are both qualitative and quantitative differences between the training and licensing requirements of physical therapists, chiropractors, and physicians. Clearly, the court's concern in Schatzberg was with protecting the public from those members of the chiropractic profession who offer and perform *475 general acupuncture for which they are unlicensed and which may only be offered or performed by physicians due to their more extensive training and testing. See also Commonwealth, Department of Transportation Hearing Board v. Pennsylvania Chiropractic Society, 22 Pa. Commw. 483, 349 A.2d 509 (1976). An attempt to extrapolate from this rationale a general prohibition against the performance of physically therapeutic techniques by licensed chiropractors is, in our view, tenuous. Second, a holding in favor of appellees herein does not mandate the subsumption of the practice of physical therapy into the practice of chiropractic in that chiropractic remains a limited science dealing with the treatment of misaligned or dislocated vertebrae or articulations and the related treatment of the nervous system. See Schatzberg, supra. The Physical Therapy Act defines "physical therapy" as: 63 P.S. § 1302.[4] The Act further provides, "Nothing in this act, however, shall prohibit any person trained and licensed or certified to practice or to act within the scope of his certification in this State under any other law, from engaging in the licensed or certified practice for which he is trained." Id. § 1304(a). We view this provision as anticipating that certain modalities of physical therapy are necessarily *476 employed in the proper performance of other health related practices, i.e., medicine and chiropractic. Section 1304(b.1) of the Physical Therapy Act states: (emphasis supplied). After quoting these provisions, appellant states, in its brief, "Clearly the Pennsylvania Legislature did not perceive a great deal of overlap between physical therapy and chiropractic; rather it viewed them as two separate disciplines." Appellant's brief at 32. Quite to the contrary however, we view the legislature's inclusion of the specific proviso in section 1304(b.1) as designed to relax any perceived restriction on physicians' and chiropractors' utilization of necessary physically therapeutic treatments. We find that a plain reading of the Chiropractic Act in conjunction with the Physical Therapy Act is conclusive as to the issue before us. In treating misaligned or dislocated vertebrae or articulations and related conditions of the nervous system, licensed chiropractors are clearly authorized to utilize, as necessary patient care, modalities of treatment properly defined as "physical therapy". Accordingly, we hold that the physical therapy provided to appellees in connection with their spinal injuries constitutes an allowable chiropractic expense recoverable pursuant to the No-fault Act. Order affirmed. [*] Judge Louis A. Bloom, Senior Judge, of the Court of Common Pleas, of Delaware County, Pennsylvania, is sitting by designation. [1] Act of July 19, 1974, P.L. 489, No. 176, arts. I-VII, §§ 101-701, 40 P.S. §§ 1009.101-701 (repealed). [2] Act of August 10, 1951, P.L. 1182, §§ 1 et seq., as amended, 63 P.S. §§ 601 et seq. [3] Act of October 10, 1975, P.L. 383, §§ 1 et seq., as amended, 63 P.S. §§ 1301 et seq. [4] As aforementioned, appellees admit in their amended complaint that the services provided by their chiropractors, for which recovery is sought, fall within this definition of "physical therapy".