Employers Health Ins. v. General Cas. Co. of Wisconsin
| Citation | 154 Wis.2d 696,454 N.W.2d 10 |
| Parties | EMPLOYERS HEALTH INSURANCE, Plaintiff-Appellant, v. GENERAL CASUALTY COMPANY OF WISCONSIN, Defendant-Respondent, d William J. Klein, Defendant. 89-1021. |
| Decision Date | 07 February 1990 |
| Court | Wisconsin Court of Appeals |
Schellinger & Doyle, S.C. by Linda Vogt Meagher and Daniel J. O'Brien, on the briefs, Brookfield, for plaintiff-appellant.
Schulz, Schapekahm & Eiche, S.C. by Stuart B. Eiche and Penelope D. Hillemann, on the briefs, Milwaukee, for defendant-respondent.
Before MOSER, P.J., and SULLIVAN and FINE, JJ.
Employers Health Insurance (Employers) brought this subrogation action to recover medical expenses from General Casualty Company of Wisconsin (General Casualty). Both parties moved for summary judgment. The trial court granted General Casualty's motion for summary judgment, from which Employers now appeals.
On October 23, 1985, Hugh F. Oldenburg, Jr. (Oldenburg), was injured in an automobile accident involving an uninsured motorist, William J. Klein. Employers had issued a policy of health insurance to Oldenburg, and General Casualty was Oldenburg's automobile liability carrier. As a result of the accident, Oldenburg received bodily injuries requiring him to incur medical expenses in the amount of $54,853.23. Employers paid Oldenburg's medical expenses At the time of the accident, Employers provided health insurance coverage to Oldenburg under a group policy. Oldenburg was also covered under two policies for automobile liability insurance issued by General Casualty. One policy was issued to Hugh F. Oldenburg, and the other policy was issued to Fred Oldenburg, Jr. (a/k/a Hugh F. Oldenburg, Jr.). The two policies were exactly the same and they provided uninsured motorist coverage to Oldenburg.
pursuant to its health insurance coverage. Under its insurance contract, Employers was subrogated to all claims of Oldenburg. General Casualty paid Oldenburg's claim under its uninsured motorist coverage provisions of its policy. An annuity was purchased for Oldenburg providing him with $2,700 per month for life. This settlement, however, did not specify a particular sum as payment for medical expenses.
On February 22, 1988, Employers filed this action against General Casualty seeking a declaratory judgment. On September 23, 1988, General Casualty brought a summary judgment motion requesting that the trial court dismiss Employers' complaint on the grounds that it failed to state a claim upon which relief could be granted. Specifically, General Casualty alleged that one indemnity insurer did not have subrogation rights against another indemnity insurer. Employers filed a cross-motion for summary judgment on March 10, 1989.
A hearing on the summary judgment motions was held on March 20, 1989. The trial court held that under the terms of the insurance policies, Employers did not have a superior contractual right against General Casualty and, therefore, Employers was not entitled to subrogation. On April 13, 1989, the trial court issued an order granting General Casualty's motion for summary judgment. Employers filed this appeal on May 31, 1989. The sole issue on this appeal is whether the trial court erred in granting summary judgment to General Casualty and denying Employers recovery from General Casualty for the amount it paid to Oldenburg for his medical expenses.
Appellate courts are required to follow the same methodology as trial courts in reviewing motions for summary judgment. 1 Summary judgment must be entered if the pleadings, depositions, answers to interrogatories, admissions on file and affidavits, if any, show there are no material issues of fact and that the moving party is entitled to judgment as a matter of law. 2 We will review the trial court's grant of summary judgment to General Casualty by applying the standards set forth in sec. 802.08(2), Stats., in the same manner as the trial court.
General Casualty's policies provide, inter alia, the following:
PART C--UNINSURED MOTORISTS COVERAGE
We will pay damages which a covered person is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of bodily injury sustained by a covered person and caused by an accident. The owner's or operator's liability for these damages must arise out of the ownership, maintenance or use of the uninsured motor vehicle.
....
If there is other applicable similar insurance we will pay only our share. Our share is the proportion that our limit of liability bears to the total of all applicable limits. However, any insurance we provide with respect to a vehicle you do not own shall be excess over any other collectible insurance.
The Employers' policy provides, inter alia, the following:
EXCESS COVERAGE
....
No benefits will be payable under this Policy on account of any injury or Sickness caused by You, Your Dependent or any other party, for which there is any other insurance providing medical pay We will, nevertheless, process Your claim according to the provisions of the Policy and secure reimbursement from the medical payments or medical expense insurer.
[154 Wis.2d 701] coverage or medical expense coverage available to You or Your covered Dependent, regardless of whether such other coverage is described as being primary, excess or contingent.
You hereby assign to Us any right You have against such other insurer for reimbursement of medical expenses We have paid on Your behalf.
....
RECOVERY RIGHTS
If, after payments have been made under the Policy, You or Your covered Dependent has a right to recover damages from a responsible third party, We shall be subrogated to Your rights to recover. You or Your covered Dependent shall do whatever is necessary to enable Us to exercise Our Right and shall do nothing after loss to prejudice it. If We are precluded from exercising Our Right of Subrogation, We may exercise Our Right of Reimbursement.
If benefits are paid under the Policy and You or Your covered Dependent recovers from a responsible third party by settlement, judgment or otherwise, We have a right to recover from You or Your covered Dependent an amount equal to the amount We paid.
General Casualty's automobile liability policies contained the statutorily mandated uninsured motorist coverage as required in sec. 632.32(4), Stats. Section 632.32(4)(a) provides the following:
(4) Required Uninsured Motorist and Medical Payments Coverages. Every policy of insurance subject to this section that insures with respect to any motor vehicle registered or principally garaged in this state against loss resulting from liability imposed by law for bodily injury or death suffered by any person arising out of the ownership, maintenance or use of a motor vehicle shall contain therein or supplemental thereto provisions approved by the...
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