Government Employees Ins. Co. v. Andujar
| Decision Date | 13 August 1991 |
| Docket Number | No. 89-1594-C.,89-1594-C. |
| Citation | 773 F. Supp. 282 |
| Court | U.S. District Court — District of Kansas |
| Parties | GOVERNMENT EMPLOYEES INSURANCE COMPANY, Plaintiff, v. Roman David ANDUJAR, individually, and as Administrator of the Estates of Nereida Andujar, deceased, and Yaritza Andujar, deceased, Stephen Freed, as Special Administrator of the Estates of Carmen Sara Alicea, deceased, and Brenda Omayra Alicea, deceased; Juan R. Alicea-Sanchez; Juan R. Alicea-Esteras, Jr.; United States Army; Allstate Insurance Company; and Dairyland Insurance Company, Defendants. |
David G. Seely, Fleeson, Gooing, Coulson & Kitch, Wichita, Kan., for Government Employees Ins. Co.
Anne B. Miller, Everett, Seaton, Miller & Bell, Manhattan, Kan., Rogers L. Brazier, Jr., Topeka, Kan., for Roman David Andujar.
Stephen Freed, pro se.
Stephen Freed, Meryl D. Wilson, Stites, Hill, Wilson, Knopp & Abbott, Manhattan, Kan., for Juan R. Alicea-Esteras, Jr.
Stephen K. Lester, U.S. Attorney's Office, Wichita, Kan., for U.S. Dept. of the Army.
D. Lee McMaster, Wichita, Kan., for All-state Ins. Co.
Bryce A. Abbott, Wallace, Saunders, Austin, Brown & Enochs, Wichita, Kan., for Dairyland Ins. Co.
This case arises out of an automobile accident caused by the negligence of Donald Good, an uninsured motorist. The accident resulted in the death of Good and all of the occupants of the car with which he collided. The other car, driven by Nereida Andujar, was covered by an automobile insurance policy issued by the Government Employees Insurance Co. (GEICO), which included uninsured motorist coverage. This action was filed by GEICO to determine its rights and obligations under the insurance contract.
As a result of injuries caused by the accident, the United States Army (United States), as authorized and required by law, furnished hospital, medical and surgical care and treatment to Nereida Andujar, Yaritza Andujar and Carmen Sara Alicea. The United States, under the Federal Medical Care Recovery Act, (FMCRA) 42 U.S.C. § 2651, et seq., claims that it is entitled to recover from GEICO the reasonable value of the care and treatment it furnished.
GEICO named Allstate Insurance Company (Allstate) as a defendant in its complaint as that company "may claim a right of subrogation for payments made to or on behalf of Carmen Sara Alicea and/or Brenda Omayra Alicea, pursuant to its policy of insurance."1 GEICO named Dairyland Insurance Company (Dairyland) as a defendant in its complaint as that company "may claim a right of subrogation for payments made to or on behalf of Carmen Sara Alicea and/or Brenda Omayra Alicea, pursuant to its policy of insurance."2
This case comes before the court upon the motions of defendants Roman David Andujar (husband of Nereida and father of Yaritza), Juan R. Alicea-Esteras, Jr., Juan R. Alicea-Sanchez, Carmen Sara Alicea, deceased, and Brenda Omayra Alicea, deceased, for summary judgment. Roman David Andujar has filed a memorandum in which the other defendants moving for summary judgment join. In these motions, the defendants argue that the United States is not entitled to any portion of the proceeds of the uninsured motorist insurance. The United States opposes the defendants' motion for summary judgment, contending that it is entitled under the FMCRA and the terms of the insurance agreement to the reasonable value of the medical services provided.
Summary judgment is appropriate when the movant can demonstrate that there is no genuine issue of material fact and is entitled to judgment as a matter of law. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986); Celotex Corp. v. Catrett, 477 U.S. 317, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). Fed.R.Civ.P. 56(c). As the issues presented by these motions are purely questions of law, summary judgment is appropriate.
The essential facts are uncontroverted; the United States's response adds additional facts to the defendants' statement of uncontroverted facts and controverts one statement of fact which is immaterial to the court's decision. A copy of the insurance policy issued by GEICO is included as an exhibit to the memoranda in support of the motions for summary judgment.
GEICO is a foreign insurance corporation duly qualified to do business in Kansas and having its principal place of business in Chevy Chase, Maryland. The United States of America administers the Civilian Health and Medical Program of the Uniform Services (CHAMPUS). 10 U.S.C. § 1072(4). Nereida Andujar, David Andujar, and their children were covered by CHAMPUS as a military family for a specified portion of health care obtained by them from civilian hospitals and doctors.
GEICO issued a policy of automobile insurance to Roman David Andujar which afforded liability, medical payments and uninsured motorist coverage.
On October 3, 1987, Nereida Andujar was driving a 1981 Toyota, insured by GEICO, west-bound on U.S. Highway 24 in Pottawatomie County, Kansas when it was struck by an east-bound motor vehicle driven by Donald Good. Yaritza Andujar, Carmen Sara Alicea and Brenda Omayra Alicea were passengers in the vehicle driven by Nereida Andujar at the time of the accident.
Nereida Andujar, Yaritza Andujar, Carmen Sara Alicea, Brenda Omayra Alicea and Donald Good died as a result of injuries suffered in the accident. Donald Good's negligence was the sole cause of the accident. Donald Good had no motor vehicle insurance in effect at the time of the accident.
As a result of the automobile accident, the United States Army, as authorized and required by law, furnished hospital, medical and surgical care and treatment to Nereida Andujar, Yaritza Andujar and Carmen Sara Alicea for their injuries caused by the negligence of Donald Good.
On behalf of Nereida Andujar and Yaritza Andujar, Roman David Andujar, as administrator of the estates of Nereida Andujar and Yaritza Andujar, and as sole heir of Nereida Andujar and Yaritza Andujar, has made claim against the proceeds of the GEICO uninsured motorist coverage in the amount of $50,000 and bodily injury liability coverage in the amount of $50,000. Stephen Freed, as special administrator of the estates of Carmen Sara Alicea and Brenda Omayra Alicea, Jaun R. Alicea-Sanchez, and Jaun R. Alicea-Esteras, Jr., also claims an interest in the proceeds.
On November 13, 1989, GEICO filed this lawsuit for a declaration of its rights and obligations as against the various claims of the defendants filed herein. The government claims an interest in the policy in the amount of $76,155.29 for the value of the care furnished to Nereida Andujar, Yaritza Andujar and Carmen Sara Alicea on account of the injuries they sustained as a result of the careless and negligent acts of Donald Good.
On May 23, 1990, the GEICO deposited with this court the sum of $100,000 as the proceeds of its bodily injury and uninsured motorist coverage afforded under the Andujar policy of insurance. Pursuant to the agreement of the parties and the order and judgment of this court, the obligations of plaintiff under its policy of insurance are satisfied and discharged.
Roman David Andujar, individually and for and on behalf of the heirs at law of Nereida Andujar and Yaritza Andujar, has filed a separate action in this court against Toyota Motor Distributors, Inc., and others, for the wrongful death of Nereida Andujar and Yaritza Andujar; and a survivorship action on behalf of Nereida Andujar.3
The aggregate of the claims of all the parties in the instant case exceed the maximum amount of GEICO's obligation under the policy — the $100,000 paid into the court.
The Andujars and the Aliceas have reached an agreement regarding the just and proper distribution of the proceeds of the GEICO policy: one-fifth ( 1/5 ) going to the heirs at law of the four (4) individuals for the wrongful death claims and another one-fifth ( 1/5 ) going to the heirs at law of Nereida Andujar for her survivorship claim. The United States acknowledges the existence of that agreement, but contends that its rights to the insurance proceeds are not affected by that agreement.
The parties agree that no decision from Tenth Circuit squarely addresses the issue presented by this case.
The parties seeking summary judgment contend that the United States is not entitled to any portion of the proceeds of Andujar's insurance policy. They contend that under FMCRA, the United States is only entitled to recover the reasonable value of medical expenses from the tortfeasor, Donald Good. Because GEICO is not the tortfeasor, the United States is not entitled to the proceeds of the uninsured motorist policy under the FMCRA. The parties seeking summary judgment argue that allowing the United States to recover medical expenses from Andujar's insurance policy is a windfall to the government which is neither supported by the legislative history nor the express language of the statute.4
The United States acknowledges that GEICO is not the "tortfeasor," but argues that it is nevertheless entitled to compensation for the reasonable value of medical services rendered. The United States cites several cases in which the court has allowed the government to access the uninsured motorist coverage proceeds, notwithstanding the fact that the government was not directly entitled to recover under the FMCRA. The United States contends that those courts have looked to the express terms of the insurance agreement and concluded that the government was either an "insured" under the insurance policy or was otherwise entitled to recover as a third party beneficiary.
The parties seeking summary judgment respond that the cases cited by the United States are inapposite as none of the insurance policies at issue in those cases contained the same limitations found in Andujar's policy with GEICO. They contend that under the express terms of the insurance...
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