Maine Subscriber

A

The personal auto policy promises to pay the insured for “reasonable expenses incurred for necessary medical and funeral services because of 'bodily injury.'” Even if the insured suffered injury to her face when the glasses broke, it is hard to argue that fixing her glasses is a medical service needed to treat the injury to her face. The breakage of the glasses is property damage only.

The situation may have been different under the pre-simplified forms due to common practice more than policy language. The non-simplified family auto policy promised to pay “all reasonable expenses incurred within one year from the date of accident for necessary medical, surgical, x-ray and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services…to…the named insured…who sustains bodily injury.” Although this language was more descriptive than the current provision, the changes made were prompted more by the move to simplified language than an intent to change coverage. Under this pre-simplified language, glasses damaged in an auto accident were not considered “prosthetic devices,” (i.e., artificial devices used to replace a missing part of the body). However, the Mutual Insurance Rating Bureau, and the later Insurers Advisory Bureau, took the position that eyeglasses should be covered as “necessary medical” services when there was other covered bodily injury resulting from an accident. Obviously, an insurer can choose to cover such a loss as a good will gesture even under the current language, but a strict reading of the policy would not require it.

The insured may be able to turn to her homeowners policy. She would have coverage under the “vehicles” peril unless she is covered by an HO 00 01 policy. That policy precludes coverage if the damage was caused by a vehicle owned or operated by a resident of the residence premises. For a discussion of the broad scope of the “vehicles” peril, see Homeowners Perils.