Court Opinion

ID: 9785312
Source: CourtListenerOpinion
Date Created: 2023-08-30 21:15:17.091622+00
Date Added: 2024-06-11T07:36:15.584532
License: Public Domain

KID WELL, Justice Pro-Tem,
dissenting:
The significant arbitration issue raised by this case is whether an automobile insurance company can pay only a percentage of reasonable and necessary expenses where there is a pre-existing injury, when the arbitration clause provides for payment of “reasonable and necessary” medical expenses incurred for bodily injury caused by the accident.
An insurance company can limit their liability with express language in the policy. That is not the situation in this case and they should not prevail because of an arguable ambiguity. The overwhelming prevailing Idaho law gives the benefit of the doubt to the insured when a policy has unclear language.
Here, the insurance company should not be allowed to compel arbitration because the dispute over the percentage apportionment of medical expenses is not, as required by the policy, a question of “whether or not the medical expenses were reasonable and necessary.”