Opinion ID: 1684265
Heading Depth: 1
Heading Rank: 2

Heading: Did the Med Pay Provision Cover Chiropractic Services?

Text: As noted, the trial court found the med pay provision to be clear and unambiguous. State Farm is correct that where unambiguous, an insurance contract is not construed in favor of the insured, but rather is construed as written. Ford v. Lamar Life Ins. Co., 513 So.2d 880, 886 (Miss. 1987); State Farm v. Scitzs, 394 So.2d 1371 (Miss. 1981); Insurance Co. of North American v. Deposit Guaranty National Bank, 258 So.2d 798 (Miss. 1972); Key Life Ins. Co. of South Carolina v. Tharp, 253 Miss. 774, 179 So.2d 555 (1965). Since under its policy State Farm agreed to cover medical expenses, and there is really no dispute that Mrs. Gregg's treatment generated an expense, the present problem concerns whether that expense is within the construction of the term medical. State Farm argues that the plain meaning of medical excludes chiropractors. There is, of course, support for the proposition that medical pertains to or relates to physicians or the science or practice or study of medicine. See Lowman v. Kuecker, 246 Iowa 1227, 71 N.W.2d 586 (1955); Mashak v. Poelker, 356 S.W.2d 713, 720 (Mo. Ct. App. 1962). There are opinions to the contrary, however, although admittedly many courts reaching the opposite result did so interpreting broad legislative enactments. See Williams v. Capital Life & Health Ins. Co., 209 S.C. 512, 41 S.E.2d 208 (1947) (naturopathy and other healing arts have been so far recognized by the legislature that any one engaged in the practice stands for all purposes in the position of a physician in the orthodox fields of medicine, at least within specialty); Miller v. Johnson, 496 Pa. 290, 436 A.2d 1187 (1981) (chiropractic services included within medical services where legislative act reflected intent to include not only direct but also supplemental support services.); Green v. Rawlings, 290 Mich. 397, 287 N.W. 557 (1939) (chiropractor engages in practice of medicine for workmen's compensation statute allowing for remuneration for services); Shober v. Industrial Commission, 92 Utah 399, 68 P.2d 756 (1937) (practice of chiropractic is the practice of medicine and expenses should have been allowed in workmen's compensation case); Arizona Public Service Co. v. Industrial Commission, 27 Ariz. App. 369, 555 P.2d 126 (1976) (since a chiropractor may testify as medical expert, then we cannot perceive rational basis for not considering a chiropractor as rendering medical services within meaning of workmen's compensation law). One court's interpretation of the legal consequences attaching to use of the term medical should not restrict us, however, since in construing this term as written we are also concerned with giving to it a meaning reasonable to the average person who purchased this particular policy. The Oxford English Dictionary (4th ed. 1978) defines the word medical, used as an adjective, thusly: Pertaining or related to the healing art or its professors. Also, in a narrower sense, pertaining or related to `medicine' as distinguished from surgery, obstetrics, etc. Black's Law Dictionary (5th ed. 1979) defines medical as: Pertaining, relating, or belonging to the study and practice of medicine, or the science and art of the investigation, prevention, cure, and alleviation of disease. Even State Farm agrees that chiropractors, while they do not practice medicine, consider all health care (and, therefore, treatment of disease) to center around the correct alignment of the spine. The definition of the practice of chiropractic found in Miss. Code Ann. § 73-6-1 (Supp. 1987) states: The practice of chiropractic involves the analysis of any interference with normal nerve transmission and expression, and the procedure preparatory to and complementary to the correction thereof, by an adjustment of the articulations of the vertebral column and its immediate articulations for the restoration and maintenance of health without the use of drugs or surgery. Thus, by definition, the practice of chiropractic is the practice of healing without drugs or surgery by adjustment of the articulations of the vertebral column. While we have not expressly dealt with this issue, in Mississippi Farm Bureau Mutual Insurance Co. v. Garrett, 487 So.2d 1320 (Miss. 1986), we addressed a similar issue. In Garrett we held that a chiropractor was not barred from rendering an expert opinion within his area of expertise simply because the chiropractor was not a physician. We did not, contrary to Mrs. Gregg's argument, hold in Garrett that chiropractors practice medicine in a limited sense. We have held to the contrary on several occasions, and we decline to follow the Arizona Court of Appeals' lead in Arizona Public Service Co. v. Industrial Commission, supra . Garrett simply held that chiropractors could give expert opinions the same as would qualified witnesses in any other recognized discipline. What is important to our discussion, however, is the recognition in Garrett that though a chiropractor does not practice medicine, he provides health care which, in some sense, overlaps the care that could be provided by a physician. This distinction provides the answer to our present dispute. Appellant State Farm goes to great lengths to assure us that chiropractors do not practice medicine and indeed have a totally different concept for curing illness. This may be true, but the medical payment provision of Mrs. Gregg's policy does not sufficiently distinguish between care involving the practice of medicine and care involving services of a chiropractor. Included within the definitions of medical mentioned above would seem to be the practice of medicine and other healing disciplines dealing with the investigation, prevention, cure and alleviation of disease. While a chiropractor does not and indeed cannot practice medicine, and, therefore, may not provide medical care in the narrowest sense, a chiropractor in the broadest sense does provide what generally can be considered medical care by attempting to cure or prevent disease through proper alignment of the spine. The point may be made differently. A paramedic is not licensed to practice medicine. Paramedic services are not specifically enumerated as covered expenses in Mrs. Gregg's policy. Few could argue, however, that the healing services rendered by a paramedic at the scene of an accident are not in some broad sense medical services. In addition, ascribing a narrow meaning to the word medical just does not agree with the language of this provision. The provision covers medical expenses for accidental bodily injury. The second sentence in the provision states: The expenses are for necessary medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, and funeral services, eyeglasses, hearing aids, and prosthetic devises. Thus, by its own terms, as used in the first sentence of the provision, medical includes services or health care in addition to services provided by a physician or at a physician's direction. Since State Farm uses the phrase medical expenses to cover expenses related to services from health care providers other than just physicians, a more expansive definition of medical should apply, as well, and we hold that under this med pay insurance policy provision, medical includes healing arts in addition to the practice of medicine. Had State Farm wanted to confine its coverage to only those services rendered by a physician or at a physician's direction, it could have stated exactly that in its policy. The use of the term in the policy refutes this interpretation, however. To interpret this provision as State Farm would suggest would create an ambiguity, since it would necessitate interpreting medical to mean something in one sentence, but something else in the very next sentence. Were we to read into the policy this ambiguity, we would not then hesitate to construe the ambiguous term against State Farm. Under either interpretation, our decision would be the same. We hold that under the med pay provision in Mrs. Gregg's policy, State Farm must pay for reasonably necessary expenses for chiropractic care rendered to alleviate the effects of accidental bodily injury. The trial court's award of summary judgment in favor of Mrs. Gregg for $780 is affirmed. AFFIRMED. ROY NOBLE LEE, C.J., HAWKINS, P.J., and PRATHER, ROBERTSON, SULLIVAN, ANDERSON, GRIFFIN and ZUCCARO, JJ., concur.