Court Opinion

ID: 9514867
Source: CourtListenerOpinion
Date Created: 2023-08-06 22:52:14.255171+00
Date Added: 2024-06-11T09:06:21.941889
License: Public Domain

JOHNS, Circuit Judge,
(dissenting on Issue One).
[¶ 37.] After considering the authorities submitted by the parties, I would submit that Trouten’s fine of authority is more persuasive and that, under the language of the policy, Trouten is a third party beneficiary. First, the language of the “Legal Action Against Us” provision does not say that Trouten cannot bring a direct action for medical expenses. Rather, it clearly states that he can bring a direct action if the policy provisions are complied with. The only relevant policy provisions are those that place obligations on the insured *865which obligations the injured party would have to establish upon bringing the action.5
[¶ 38.] Second, the insuring agreement provision states that, the insurer “mil make the [medical expense] payments regardless of fault.” (emphasis added). It does not say that it is within the insurer’s unbridled discretion to make the payments. It does not follow, however, that the injured party is relieved from proving that he or she was actually hurt on the insured premises. The no fault clause simply provides that the injured person does not have to prove negligence upon the part of the insured in order to receive medical expense payments.
[¶ 39.] Third, I agree with the analysis that medical expense payment provisions in liability policies provide separate insurance coverage divisible from the remainder of the policy. As such, these provisions create a fund for payment of medical services for those injured persons who may not want to impose liability upon the insured for any amounts in excess of the medical expense limits.'
[¶ 40.] Fourth, the coverage is designed to benefit a clearly ascertainable group of persons. As sttch, they are not remote or incidental beneficiaries and, in many instances, they may well benefit as much or more than the insured. “Incidental is defined as: ‘[depending upon or appertaining to something else as primary; something necessary, appertaining to, or depending upon another which is termed the principal; something incidental to the main purpose.’ ” Robinson & Muenster As-socs. v. Dept. of Rev., 1999 SD 132, ¶ 31, 601 N.W.2d 610, 617 (Sabers, J., dissenting) (quoting Black’s Law Dictionary 762 (6th ed 1990)). Injured persons certainly are more than just incidental beneficiaries of the medical expense benefit coverage although they are incidental beneficiaries of the liability coverage.
[¶ 41.] Based upon the foregoing, I would hold that Trouten is a third party beneficiary under the terms of the medical benefit portion of the policy. As such, he is entitled to recover medical benefits up to the $5,000 maximum irrespective of whether he ever brings suit against the property owner and irrespective of whether he is successful in any such suit.
[¶ 42.] The insurance company has contractually bound itself to pay medical benefits to a person injured on the insured premises “regardless of fault.” Since Trouten was allegedly injured on the insured premises, he should be able to prosecute this action without having to sue and recover against the insured on a liability theory. I would affirm the trial court on this issue.
[¶ 43.] MILLER, Chief Justice, joins this dissent as to Issue One.

. This is not to imply that there may not be other matters which the injured party must establish. For example, under the policy, the injured person must submit to examinations by the insurer’s physicians.