J-A16007-23

2023 PA Super 253

NATIONWIDE PROPERTY AND 

CASUALTY INSURANCE COMPANY

v.

ELVIA CASTANEDA AND CHRISTINA 

TAPIA CASTANEDA 

Appellants

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 IN THE SUPERIOR COURT OF

 PENNSYLVANIA

 No. 1030 MDA 2022

Appeal from the Order Entered July 14, 2022

In the Court of Common Pleas of Dauphin County 

Civil Division at No(s): 2019-CV-04983-CV

BEFORE: PANELLA, P.J., BENDER, P.J.E., and McCAFFERY, J.

OPINION BY PANELLA, P.J.: FILED: DECEMBER 5, 2023

Christina Tapia Castaneda1 was driving her mother’s car, with her 

mother’s permission but without a valid driver’s license, when she was rear 

ended by another car. Christina suffered severe injuries in the accident. 

Because Christina’s mother had an insurance policy (“the Policy”) covering the 

vehicle, Christina submitted a claim for first party medical expense benefits to 

the insurer, Nationwide Property and Casualty Insurance Company. 

Nationwide denied the claim. It maintained it had no duty to cover Christina’s 

medical expenses under the unlicensed driver exclusion contained in the 

____________________________________________

1 While the appellant’s first name is spelled as both Christina and Cristina in 

various filings, we will follow the spelling of the name used in the caption. 
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Policy. Nationwide eventually sought a declaration and judgment on the 

pleadings from the Court of Common Pleas of Dauphin County that it was not 

obligated to pay first party medical benefits to Christina under this exclusion.

The trial court agreed with Nationwide that Nationwide did not have an 

obligation to pay the benefits to Christina under the unlicensed driver 

exclusion in the Policy and issued a judgment on the pleadings in favor of 

Nationwide. Christina argues on appeal that the court erred by finding the 

unlicensed driver exclusion relieved Nationwide of its obligation to pay for her 

medical expenses sustained in the accident. According to Christina, the 

unlicensed driver exclusion is not valid under the Motor Vehicle Financial 

Responsibility Law (“MVFRL”), 75 Pa. C.S.A. §§ 1701-1799.7, when that 

exclusion is applied in the context of statutorily-mandated first party medical 

expense benefits. We agree the exclusion is not valid in such a context, and 

we therefore also agree that the trial court erred by entering judgment on the 

pleadings in favor of Nationwide. We reverse, and remand for proceedings 

consistent with this opinion.

This Court’s review of an order granting a motion for judgment on the 

pleadings is plenary, and we apply the same standard as the trial court. See 

Southwestern Energy Production Co. v. Forest Resources, LLC, 83 A.3d 

177, 185 (Pa. Super. 2013). When considering a motion for judgment on the 

pleadings, a trial court must look only to the pleadings and relevant 

documents and must accept as true all well pleaded statements of fact, 
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admissions, and any documents to the pleadings presented by the party 

against whom the motion is filed. See id. We will affirm the trial court’s order 

granting a motion for judgment on the pleadings only when the “moving 

party’s right to succeed is certain and the case is so free from doubt that [a]

trial would clearly be a fruitless exercise.” Id. (citation omitted). 

Applying that standard here, we look first to the pleadings and note that 

the “parties agree to the following facts as set forth in the pleadings[.]” Trial 

Court Opinion, 7/14/2022, at 2. On January 15, 2019, Christina was driving a 

2002 Toyota Sienna owned by her mother. Christina was driving the Sienna 

with her mother’s permission, and her mother was a passenger in the car. The 

Sienna was rear ended by another vehicle, and Christina suffered serious 

injuries as a result of the accident.

The Sienna was covered by the Policy, which Christina’s mother had

purchased from Nationwide and Nationwide had issued to Christina’s mother 

as the policyholder. At the time of the accident, Christina was not licensed to 

operate a motor vehicle by the Commonwealth of Pennsylvania and “she was 

not the named insured on any policy providing first party benefits coverage; 

nor was she an insured on any policy other than the Policy providing first party 

benefits coverage.” Id. Christina also did not regularly reside with her mother.

Christina submitted a claim for first party medical expense benefits 

under the Policy, which covers first party medical expense benefits up to 

$10,000 for a person driving with the permission of a policyholder. Nationwide 
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denied the claim. The denial was based solely on the Policy’s Exclusion 14 

(“unlicensed driver exclusion”), which states in relevant part:

Coverage exclusions:

We will not pay First Party Benefits in certain circumstances, as 

follows:

...

14. There is no coverage from the use of any motor vehicle which 

any insured:

a) uses without a reasonable belief of being entitled to do so;

 b) has stolen; or

 c) knows to have been stolen.

An insured shall not be held to have a reasonable belief of 

being entitled to operate a motor vehicle if that person’s 

license has been suspended, revoked, or never issued.

 

 This exclusion does not apply to the use of your auto by:

a) you;

b) a relative; or

c) a business partner, employee, or agent of you or a 

relative.

Complaint, Exhibit A at F3-F4 (emphasis in original). 

“Relative” is defined by the Policy to be a “person who regularly resides 

in your household and who is related to you by blood, marriage or adoption.” 

Id. at D1 (emphasis in original). As Christina did not regularly reside with her 

mother, she was not a “relative” as defined by the policy. Accordingly, 
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Nationwide found the exclusion applied to Christina’s claim, and denied her 

coverage for first party medical expenses on that basis.

Christina requested that Nationwide reconsider the denial of her claim. 

Essentially, Christina argued that the unlicensed driver exclusion was invalid 

under the MVFRL as it was not one of the exclusions listed in Section 1718 of 

the MVFRL, which provides an enumerated list of persons who will be excluded 

from coverage of first party benefits:

(a) General Rule.--An insurer shall exclude from benefits any 

insured, or his personal representative, under a policy 

enumerated in section 1711 (relating to required benefits) or 1712 

(relating to availability of benefits), when the conduct of the 

insured contributed to the injury sustained by the insured in any 

of the following ways:

(1) While intentionally injuring himself or another or 

attempting to intentionally injure himself or another.

(2) While committing a felony.

(3) While seeking to elude lawful apprehension or arrest by 

a law enforcement official.

(b) Conversion of vehicle.—A person who knowingly converts 

a motor vehicle is ineligible to receive first party benefits from any 

source other than a policy of insurance under which he is an 

insured for any injury arising out of the maintenance or use of the 

converted vehicle.

(c) Named driver exclusion.—An insurer or the first named 

insured may exclude any person or his personal representative 

from benefits under a policy enumerated in section 1711 or 1712 

when any of the following apply:

(1) The person is excluded from coverage while operating a 

motor vehicle in accordance with the act of June 5, 1968 

(P.L.140, No. 78), relating to the writing, cancellation of or 

refusal to renew policies of automobile insurance.
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(2) The first named insured has requested that the person 

be excluded from coverage while operating a motor vehicle. 

This paragraph shall only apply if the excluded person is 

insured on another policy of motor vehicle liability 

insurance.

75 Pa.C.S.A. § 1718 (footnote omitted).

Nationwide filed a complaint requesting declaratory relief in the form of 

a judgment declaring that the unlicensed driver exclusion it relied upon to 

deny Christina first party benefits was valid and enforceable under the MVFRL.

It averred in its complaint that although Section 1718 sets out a list of 

exclusions for first party benefits’ coverage which does not include an 

unlicensed driver exclusion, this statutory list is not exhaustive and does not 

bar insurers from incorporating other valid exclusions to the recovery of first 

party benefits in their policies. Nationwide maintained that the unlicensed 

driver exclusion was valid, and it had properly denied benefits to Christina 

under this exclusion as she was undisputedly driving without a license at the 

time of the accident.

Christina filed an answer with new matter. She also filed a class-action 

counterclaim, requesting, individually and on behalf of a putative class, a 

judgment declaring that the unlicensed driver exclusion violated the MVFRL 

and public policy when applied to claims for first party medical expenses and 
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therefore, that any coverage denial for those expenses under the exclusion 

was improper.2

Nationwide filed a motion for judgment on the pleadings, averring that 

it was entitled to judgment as a matter of law. The trial court agreed with 

Nationwide, explaining:

[Christina argues that] exclusions must be explicitly 

included in the [limited set of circumstances prescribed by the 

legislature for exclusion of first party medical expense coverage 

in Section 1718] to be valid and because unlicensed drivers, 

otherwise insured under a policy, have not been statutorily 

excluded under the MVFRL, they cannot be excluded by an insurer. 

This Court disagrees.

Nationwide accurately points out that Section 1718 does not 

contain an exhaustive list of permitted first party benefit 

exclusions. Rather, it identifies a number of circumstances where 

an insurer shall exclude benefits, and a process by which an 

insurer or insured can limit specific individuals from receiving 

those benefits. Our Superior Court has explicitly recognized this 

proposition, stating “that the MVFRL does not contain an 

exhaustive list of permissible coverage exclusions.” Nationwide 

Mut. Ins. Co. v. Cummings, 652 A.2d 1338, 1342 (Pa. Super. 

1994) (citing Marino v. General Acc. Ins. Co., 610 A.2d 477 

(Pa. Super. 1992)).

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2 Christina sought to represent a class of persons who: “(a) were not the 

named insured on a policy providing first party benefits coverage; (b) were 

not an insured under a policy providing first party benefits coverage; ( c) were 

occupants of a vehicle which was involved in a collision in which the individual 

sustained personal injury; (d) received treatment for injuries sustained in the 

motor vehicle accident; (e) submitted a claim for recovery of first party 

benefits to the defendant on the counterclaim, Nationwide; and (f) had their 

claim for recovery of first party benefits denied by reason of the unlicensed 

[driver] exclusion in the Nationwide Policy.” Answer to Complaint with New 

Matter and Class Action Counterclaim at 11. In addition, Cristina sought 

compensatory relief in the form of first-party benefits, interest, attorneys’ fees 

and treble damages. 
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Trial Court Opinion, 7/14/2022, at 6. The court then went on to state that it 

“agree[d] with Nationwide that Section 1718 does not preclude an insurer 

from excluding [first party] benefits for additional reasons,” such as for being 

an unlicensed driver. Id. at 8.

The trial court therefore found the unlicensed driver exclusion was valid 

under the MVFRL and also that it did not violate public policy and granted 

judgment in favor of Nationwide. The court also denied the motion for partial 

summary judgment Christina had filed and dismissed her counterclaim with 

prejudice. 

Christina filed a timely notice of appeal. On appeal, Christina does not 

dispute that the unlicensed driver exclusion, as written, applies to her claim. 

Rather, Christina continues to contend the exclusion itself is not valid under 

the MVFRL when an insurer uses that exclusion as a basis for denying first 

party medical expenses benefits, as Nationwide did here. We agree.

Christina’s claim that the unlicensed driver exclusion violates the MVFRL 

necessarily requires us to interpret the MVFRL and discern the intent of the 

legislature when enacting the MVFRL. See Johnson v. Phelan Hallinan and 

Schmieg, LLP, 235 A.3d 1092, 1097 (Pa. 2020). Importantly, when doing so, 

we must first look to the plain language used in the statute and look to the 

statute as a whole. See id. at 1097-1098. Specific to the MVFRL, we note that 

the underlying objective of the MVFRL is to provide broad coverage to assure 

the financial integrity of the insured, and therefore, the MVFRL is to be liberally 
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construed to “afford the greatest possible coverage to injured claimants.” 

Danko v. Erie Ins. Exchange, 630 A.2d 1219, 1222 (Pa. Super. 1993).

In making her claim that she is entitled to medical expense coverage 

here, Christina highlights the fact that the MVFRL specifically mandates that 

policyholders purchase, and insurers provide coverage for, first party medical 

expenses for injuries arising from the use of a motor vehicle. To that end, 

Section 1711 of the MVFRL, entitled “Required benefits,” provides:

(a) Medical benefit.--An insurer issuing or delivering liability 

insurance policies covering any motor vehicle of the type 

required to be registered under this title, except recreational 

vehicles not intended for highway use, motorcycles, motordriven cycles or motorized pedalcycles or like type vehicles, 

registered and operated in this Commonwealth, shall include 

coverage providing a medical benefit in the amount of $5,000.

(b) Minimum policy.--All insurers subject to this chapter shall 

make available for purchase a motor vehicle insurance policy 

which contains only the minimum requirements of financial 

responsibility and medical benefits as provided for in this 

chapter.

75 Pa.C.S.A. § 1711. See also id. at § 1713 (clarifying that first party benefits 

are recoverable for injuries “arising out of the maintenance or use of a motor 

vehicle”). 

As Christina points out, the General Assembly made clear from its 

language in Section 1711 that its intent was undoubtedly to require 

policyholders to purchase a minimum amount of medical expense coverage 

for injuries stemming from the use of motor vehicles, while at the same time 

requiring insurers to cover that amount should a first party claim for medical 
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expenses be submitted. And insurers must do so, Christina explains, without 

regard to fault. Such mandatory no-fault first party medical expense coverage, 

Christina continues, has historically been an inviolate part of Pennsylvania’s 

auto insurance coverage scheme:

Medical expense coverage is a no-fault coverage mandated 

by the MVFRL. The Legislature, in first mandating this coverage in 

1974 with the enactment of the Pennsylvania No-Fault Motor 

Vehicle Insurance Act, 40 P.S. 10009.101 et seq. (repealed) (“No 

Fault Act”), recognized the importance of the availability of prompt 

medical treatment to innocent motor vehicle accident victims 

without having to await a determination of fault in any tort action.

***

The repeal of the No-Fault Act and its replacement with the 

MVFRL kept the system of mandatory no-fault medical benefits 

coverage intact. The MVFRL, enacted in 1984, and the Act 6 

Amendment to that statute in 1990, while reducing the amount of 

the medical benefit, retained the mandatory no-fault medical 

coverage benefit as a hallmark of Pennsylvania’s system of auto 

insurance. As currently constructed, [Section 1711 of the] MVFRL 

mandates the purchase and provision of first party medical 

benefits.

Appellant’s Brief at 10, 15.

By making medical expense coverage mandatory in the MVFRL, the 

General Assembly chose to treat medical expense coverage different from 

other first party benefit coverage. To be sure, there are no other first party 

benefits, other than medical expense coverage, listed as a required benefit in 

Section 1711. Instead, the following section of the MVFRL, Section 1712, 

entitled “Availability of benefits,” lists other first party benefits related to 

injury arising out of the use of a motor vehicle that an insurer does not have 
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to provide coverage for but instead, must make available for policyholders to 

purchase if they so choose. Those optional benefits include: income loss 

benefits, accidental death benefits and funeral benefits. See 75 Pa.C.S.A. §

1712. Unlike Section 1711, which requires an insurer to provide an identified 

minimum amount of medical expense benefits coverage in any motor vehicle 

liability policy it issues, Section 1712 only requires an insurer to provide the 

option to purchase the first party benefits listed in that section.

Of course, also central to this case is the fact that the MVFRL does 

identify certain claimants that cannot recover first party benefits.3 As noted 

above, Section 1718 provides enumerated grounds on which an insurer must 

exclude a claimant from recovering first party benefits. There is no dispute 

that being an unlicensed driver is not one of the permissible grounds included 

by the General Assembly in Section 1718 for denying first party benefits. The 

dispute, rather, is whether Section 1718 represents a finite set of permissible 

exclusions insurers may use to deny first party claims when the claim involves 

____________________________________________

3 Section 1714, entitled “Ineligible claimants,” is not at issue here but states:

An owner of a currently registered motor vehicle who does not 

have financial responsibility or an operator or occupant of a 

recreational vehicle not intended for highway use, motorcycle, 

motor-driven cycle, motorized pedalcycle or like type vehicle 

required to be registered under this title cannot recover first party 

benefits.

Id. at § 1714. Nationwide has never claimed Christina is an “ineligible 

claimant” under this section.
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mandatory medical expense benefits, as Christina contends, or whether, as 

Nationwide contends, Section 1718 does not represent an exhaustive list of 

exclusions insurers may invoke to deny a claim for mandatory medical 

expense benefits.

For her part, Christina argues that we cannot ignore the mandatory 

nature of medical expense coverage because doing so would necessarily 

ignore the legislature’s clear intent that insurers must provide a minimum 

amount of medical expense coverage for injuries sustained in a motor vehicle 

accident. She contends it is this mandatory nature of medical expense 

coverage that is the lens through which we must view the exclusions set forth 

in Section 1718. We agree. 

The MVFRL mandates that insurers provide first party medical expense 

coverage for injuries arising from the use of a motor vehicle, such as 

Christina’s. In Section 1718, the legislature set out a list of “limited 

circumstances where an insurer may exclude persons from the benefits of this 

mandatory no-fault medical expense coverage.” Appellant’s Brief at 10. Given 

the clear intent of the legislature’s mandate in the context of medical expense 

claims, we agree with Christina that the legislature intended that only the 

exclusions identified in the statute itself can be used as a means of denying 

the otherwise-mandated coverage for first party medical benefits. Indeed, if 

we were to permit insurers to add to the statutory list of selected exclusions 

and allow exclusion after exclusion to bar coverage for medical expenses, the 
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General Assembly’s mandate requiring insurers to pay first party medical 

expenses for injuries arising out of the use of motor vehicles could simply be 

diluted to the point where it loses all effect.

Nationwide counters that this conclusion is not supported by 

Pennsylvania law. It argues the trial court properly found that this Court has 

previously stated that the list of permissible coverage exclusions contained in 

the MVFRL is not an exhaustive one. Christina readily acknowledges this, but 

she emphasizes that such a recognition was in cases involving coverage other 

than the mandatory first party medical expense benefits at issue here. As 

such, Christina argues, these cases should not serve as pillars for affirming 

the validity of an insurer-written exclusion not included in Section 1718’s 

limited list of permissible exclusions but nonetheless invoked to deny 

mandatory medical expense coverage. Again, we agree.

In concluding Section 1718 does not create an exhaustive list of 

permissible first party benefit exclusions, the trial court first relied on several 

cases which upheld the validity of certain exclusions used to deny 

underinsured/uninsured motorists coverage, despite the fact that those 

exclusions were not specifically included in the MVFRL. Specifically, the cases 

cited by the trial court were Cummings, Marino, and St. Paul Mercury Ins.

Co. v. Corbett, 630 A.2d 28 (Pa. Super. 1993). 

These cases, however, are clearly distinguishable from the instant one. 

In the first place, these cases involve uninsured and underinsured benefits, 
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which are waivable by an insured. See 75 Pa.C.S.A. § 1731. These cases do 

not involve first party benefits, much less the non-waivable medical expense 

benefits insurers are mandated to cover by the MVFRL. See Burstein v. 

Prudential Property and Cas. Ins. Co. 809 A.2d 204, 209 (Pa. 2002) 

(discussing the MVRFL’s differing treatment of first party coverage from 

uninsured/underinsured coverage). These cases therefore also did not involve 

the list of exclusions to first party benefits set forth by Section 1718. 

The trial court then discussed cases that do involve first party benefit 

exclusions, and relying on these cases, it concluded that “Pennsylvania courts 

have routinely upheld a variety of first party benefit exclusions that are not 

specifically set out [in Section 1718].” Trial Court Opinion, 7/14/2022, at 7. 

However, none of the cases discussed by the trial court stand for the 

proposition that exclusions other than those listed in Section 1718 may 

properly be invoked to deny mandatory medical expense benefits. 

In fact, the first two cases cited by the trial court, Byoung Suk An v. 

Victoria Fire and Cas. Co., 113 A.3d 1283 (Pa. Super. 2015) and Brosovic 

v. Nationwide Mut. Ins., 841 A.2d 1071 (Pa. Super. 2004), do not discuss 

first party medical expense benefits at all. 

In Byoung, the appellant argued that a policy which only covered the 

named driver of the policy conflicted with the named driver exclusion provided 

for in Section 1718. This Court flatly rejected this argument, stating that “the 

‘named driver exclusion’ provision contemplated by section 1718(c) and 
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‘named driver only’ policies are entirely different creatures.” 113 A.3d at 1290. 

Brosovic, meanwhile, involved a claim for optional income-loss benefits and 

the issue in that case was whether a “use for hire” exclusion was unambiguous 

and applicable to the particular facts of that case. See Brosovic, 841 A.2d at 

1073-1074. The case did not mention Section 1718. 

The trial court also cited to a third first-party-benefit case, Huber v. 

Erie Ins. Exchange, 587 A.2d 333 (Pa. Super. 1991), which did involve a 

claim for first party medical benefits. There, a claimant was denied benefits 

based on an exclusion in the relevant policy barring benefits when a person 

sustained an injury loading or unloading a motor vehicle. In addressing the 

validity of the exclusion, this Court noted that the MVFRL requires that 

compensable injuries arise “out of the maintenance or use of a motor vehicle.” 

Id. at 334; see also 75 Pa. C.S.A. § 1711, § 1713. The Court found this was 

not true of the claim at hand as there was no causal connection between the 

motor vehicle and the injury.

In effect, then, Huber did not implicate the MVFRL’s mandate that 

insurers provide coverage for first party medical expense benefits, as they are 

only required to do so for injuries arising from the maintenance or use of a 

motor vehicle. Here, there is no dispute that Christina’s injuries arose from 

the use of a motor vehicle. There is also no dispute that she submitted a claim 

as an insured under the Policy for first party medical expense benefits, which, 

as emphasized above, are mandated to be covered under the MVFRL. 
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Given this mandatory system the legislature constructed for medical 

expense benefits, we agree that Christina was entitled to coverage for her 

medical expense claim unless one of the limited exclusions in Section 1718 

applied to her claim. Section 1718 does not include an unlicensed driver 

exclusion, and therefore it is not a valid exclusion upon which Nationwide can 

rely to refuse coverage for Christina’s medical expenses arising from the 

accident. 

We stress that our conclusion is confined to claims for first party medical 

expense benefits, the only benefits at issue in this case. 

Based on the above, we find the trial court erred by granting judgment 

on the pleadings in favor of Nationwide. We therefore reverse its order doing 

so, and remand for proceedings consistent with this memorandum. 

Order reversed. Matter remanded for proceedings consistent with this 

opinion. Jurisdiction relinquished. 

Judgment Entered.

Benjamin D. Kohler, Esq.

Prothonotary

Date: 12/5/2023