Sims v. Stewart
| Decision Date | 21 January 1998 |
| Citation | 973 S.W.2d 597 |
| Parties | William Kenneth SIMS and wife, Edna W. Sims, Plaintiffs-Appellees, v. Eddie STEWART, Jr., and Tennessee Farmers Mutual Insurance Company, Defendants-Appellants. |
| Court | Tennessee Court of Appeals |
Wesley A. Clayton and Robert B. Vandiver, Jr., Waldrop & Hall, P.A., Jackson, for Appellant, Tennessee Farmers Mutual Insurance Company.
T.J. Emison, Jr., Alamo, for Appellees.
This case involves a dispute concerning the amount due under an uninsured/underinsured motorist insurance policy. On September 27, 1993, William Kenneth Sims (hereinafter, "Sims"), while engaged in the scope of his employment as a Deputy Sheriff in Gibson County, was injured when he was struck by a motor vehicle driven by Defendant Eddie Stewart (hereinafter, "Stewart"). Sims suffered compound fractures of the left tibia and fibula as well as resulting complications to his preexisting diabetic condition.
Sims' complaint seeks $250,000 damages, and his wife, Edna W. Sims, seeks $50,000 damages for loss of consortium. Sims served Tennessee Farmers Mutual Insurance Company (hereinafter, "Tennessee Farmers"), his uninsured motorist carrier, with a copy of the complaint. Tennessee Farmers' answer avers policy limits of $100,000 per person and $300,000 per accident and pursuant to the policy provision seeks a credit or reduction for the amount of any workers' compensation benefits paid to Sims. Defendant Eddie Stewart filed an answer denying the material allegations of the complaint.
The case was tried on a written stipulation of facts which we quote:
The parties to this cause, by and through their counsel of record, hereby stipulate as follows:
1. All issues relating to Plaintiff Edna W. Sims' loss of consortium claim have been resolved. Edna W. Sims has settled her loss of consortium claim against Eddie Stewart, Jr. for $6,000.00, payable by his liability insurer. The Sims' UM coverage with TFMIC includes loss of consortium in the per person limits for William Kenneth Sims' bodily injury claim and Edna W. Sims can make no separate recovery for her loss of consortium from TFMIC's UM coverage. See Exhibit 1, page 28.
2. Defendant Eddie Stewart, Jr.'s auto liability coverage has limits of $25,000.00 per person, $50,000.00 per accident. A copy of the declaration sheet of his policy is attached as Exhibit 2.
3. William Kenneth Sims has settled his bodily injury claim against Eddie Stewart, Jr., for the $25,000.00 limits of his liability coverage.
4. William Kenneth Sims and Edna W. Sims had in full force and effect at the time of the accident, an automobile insurance policy with Tennesee Farmers Mutual Insurance Company which provided uninsured/underinsured motorist coverage in the amount of $100,000.00 per person. A certified copy of the Sims' policy is attached Exhibit 1.
5. The injuries sustained in the accident by William Kenneth Sims were incurred by accident and arose out of and in the course of his employment and were compensable under the Tennessee Workers' Compensation Act.
6. William Kenneth Sims' employer's workers' compensation insurer has paid temporary total disability, medical and permanent partial disability benefits totalling $61,862.57.
7. The workers' compensation carrier, cannot as a matter of law, reach any recovery made by William Kenneth Sims from his UM coverage.
8. The workers' compensation carrier has agreed to accept the $25,000.00 payable to William Kenneth Sims from Eddie Stewart, Jr.'s liability insurer, less a one-third attorney's fee, $8,333.00 to Jim Emison, in full satisfaction of its subrogation claim.
9. TFMIC's policy of insurance with the Sims contains a provision on page 29, Exhibit 1, reducing the amount of coverage under three circumstances. The policy language is quoted below:
"Damages payable under this coverage to or for a covered person shall be reduced by:
1. The amount paid under the liability and medical payments coverages of this policy or any other automobile insurance policy;
2. The amount paid or payable under any workers' compensation law, disability benefits law, or any similar law;
3. A payment made by or on behalf of the owner or operator of the uninsured motor vehicle, or by or on behalf of the person or entity who may be legally liable.
10. TFMIC has agreed to pay to William Kenneth Sims the limits of its UM coverage, $100,000.00, less the amount to which it is legally entitled to credit pursuant to its policy language and Tennessee law.
11. The only issue remaining in this case is whether TFMIC gets credit for the entire amount paid by workers' compensation, $61,862.57, and must pay William Kenneth Sims $38,137.43; or whether TFMIC gets credit for the $61,862.57 less the $25,000.00 recovered from Stewart, a net of $36,862.57, and must pay William Kenneth Sims $63,137.43.
This stipulation entered this 8th day of March, 1997."
The trial court concluded that Tennessee Farmers was entitled to a credit of $61,862.57 less $25,000 for a total credit of $36,862.57, and that Tennessee Farmers was obligated to pay Sims $63,137.43, which is the $100,000 coverage limit less the $36,862.57 credit. Tennessee Farmers timely filed a notice of appeal on May 12, 1997. Thereafter, Tennessee Farmers paid, and Sims accepted, the sum of $38,137.43 in partial satisfaction of the judgment. Tennessee Farmers arrived at that amount by deducting from the $100,000 policy coverage limits the $61,862.57 paid by the workers' compensation carrier, in order to obtain the full credit to which Tennessee Farmers contends that it is entitled.
The sole issue for review is whether Tennessee Farmers is entitled to a credit for the total sum paid to Sims as workers' compensation benefits. This issue is a question of law because the facts are not in dispute. Under such circumstances, the Court's scope of review is de novo upon the record with no presumption of correctness accompanying the trial court's conclusions of law. T.R.A.P 13(d); Union Carbide Corp. v. Huddleston, 854 S.W.2d 87, 91 (Tenn.1993).
Tennessee Farmers' Uninsured Motorist policy, which is at issue in this case, contains the following, relevant language:
Our limit of liability for this Uninsured Motorist Coverage shall be reduced by the sum of the limits payable under all liability and/or primary uninsured motorist insurance policies, bonds, and securities applicable to the bodily injury or death of the covered person.
Damages payable under this coverage to or for a covered person shall be reduced by:
1. the amount paid under the Liability and Medical Payments Coverages of this policy or any other automobile insurance policy;
2. the amount paid or payable under any workers' compensation law, disability benefits law or any similar law;
3. a payment made by or on behalf of the owner or operator of the uninsured motor vehicle, or by or on behalf of the person or entity who may be legally liable.
(emphasis added).
The first paragraph addresses coverage...
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