Jarrell v. State Merit System of Personnel Admin. of Georgia

• Decision Date: 08 September 1992
• Docket Number: No. A92A0925,A92A0925
• Citation: 423 S.E.2d 1,205 Ga.App. 527
• Parties: , 79 Ed. Law Rep. 301 JARRELL v. STATE MERIT SYSTEM OF PERSONNEL ADMINISTRATION OF GEORGIA.
• Court: Georgia Court of Appeals

Page 1

423 S.E.2d 1

205 Ga.App. 527, 79 Ed. Law Rep. 301

JARRELL v. STATE MERIT SYSTEM OF PERSONNEL ADMINISTRATION OF GEORGIA.

No. A92A0925.

Court of Appeals of Georgia.

Sept. 8, 1992.

Reconsideration Denied Sept. 23, 1992.

Certiorari Denied Nov. 16, 1992.

Wilkes, Johnson & Smith, Kris Knox, Baxley, for appellant.

Michael J. Bowers, Atty. Gen., Wayne P. Yancey, Jeffrey L. Milsteen, Sr. Asst. Attys. Gen., Elaine S. Newell, Staff Atty., for appellee.

McMURRAY, Presiding Judge.

Plaintiff Darlene Jarrell, an Appling County teacher, is a member of the State Health Benefit Plan ("the Plan"), a self-insured plan of health care benefits operated for the benefit of certain governmental employees in the State of Georgia. The Plan is managed by defendant the State Merit System of Personnel Administration of the State of Georgia. Plaintiff's membership in the Plan included coverage for her stepdaughter, Stephanie Jarrell.

On June 10, 1989, Stephanie Jarrell, a minor, was injured in an automobile accident. She incurred medical and hospital expenses of $58,940.27. Personal injury protection benefits of $5,000 were paid for her medical bills and defendant has paid $15,341.52 of these medical expenses. Jerry Jarrell (Stephanie's father and plaintiff's husband), both individually and as guardian of Stephanie Jarrell's person and property, entered into a settlement agreement with third-party insurers in compromise of his and his daughter's claims arising from the motor vehicle collision.

Defendant has refused to make any further payment on Stephanie Jarrell's medical bills. This refusal is predicated on the funds paid under the settlement agreement and subrogation provisions of the Plan designed to prevent the Plan duplicating any medical expense benefits that are paid by a third party for the treatment of accidental injury.

Defendant admits that if Stephanie Jarrell had not received third-party benefits for her damages from the accident then it would have paid her remaining medical bills, subject to medical necessity, applicable deductibles and co-payment, and the Plan's usual-customary-reasonable test. It is stipulated that if defendant is liable for Stephanie Jarrell's remaining medical bills that the total amount defendant would owe to plaintiff is $37,328.25. Plaintiff contends that the subrogation provision of the Plan is inapplicable to the circumstances in this case and appeals the denial of her motion for summary judgment and the grant of summary judgment in favor of defendant. Held:

The total amount of third-party insurance available from the motor vehicle collision was $125,000. Another person injured in the collision was paid $9,750. Jerry Jarrell was paid $1,000 for the release of his claims arising from the collision. Pursuant to a separate release, the remaining $115,250 (which was reduced by attorney fees to $76,833.33) was paid to Jerry Jarrell, in his capacity as guardian of Stephanie Jarrell, in exchange for a release of claims for damages to her.

Stephanie Jarrell was a minor at the time of the motor vehicle collision which caused her injuries. Therefore, the right to recover damages for her medical expenses was vested exclusively in her parents. Rose v. Hamilton Med. Center, 184 Ga.App. 182, 183, 361 S.E.2d 1. Since Stephanie Jarrell, as a minor, had no right to recover for her medical expenses, no claims for medical expenses were compromised by the...