Thurman v. State Farm Mut. Auto. Ins. Co.
| Decision Date | 07 June 2004 |
| Docket Number | No. S03G1102.,S03G1102. |
| Parties | THURMAN et al. v. STATE FARM MUTUAL AUTOMOBILE INSURANCE CO. et al. |
| Court | Georgia Supreme Court |
OPINION TEXT STARTS HERE
Jerry B. Hatcher, Alpharetta, for appellants.
Sharon W. Ware & Associates, Ambadas B. Joshi, McLain & Merritt, P.C., William S. Sutton, Atlanta, for appellee.
Gail Thurman, a postal carrier for the United States Postal Service, was injured on the job when her postal truck was struck by a vehicle driven by appellee Mamie Brown. After filing suit against Brown for more than Brown's insurance policy limits of $100,000, Thurman and her husband settled with Brown for $95,554.19, Brown's policy limits reduced by the amount paid to the U.S.P.S. for damage to the postal truck ($4,445.81). Because Thurman had received payments for lost wages and medical expenses from her employer's workers' compensation carrier pursuant to the Federal Employees Compensation Act, 5 U.S.C.A. § 8101 et seq., and from her employer's group medical insurance carrier pursuant to the Federal Employees Health Benefits Act, 5 U.S.C.A. § 8901 et seq., those two carriers claimed subrogation rights from the proceeds of the settlement with Brown. Since "no court ... [or] ... attorney shall pay or distribute to the beneficiary the proceeds of such suit or settlement without first satisfying or assuring the satisfaction of the interest of the United States" (5 U.S.C.A. § 8132), Brown's liability insurance carrier issued three checks: one to the Thurmans, one to Thurman and the workers' compensation carrier as co-payees, and one to Thurman and the group medical insurance carrier as co-payees. As a result, the workers' compensation carrier and the medical insurance carrier received $34,666.32 from Brown's insurer and the Thurmans received $60,887.87. The Thurmans then turned to their uninsured motorist (UM) carrier, appellee State Farm Mutual Automobile Insurance Company, contending tortfeasor Brown was underinsured since their $75,000 UM State Farm coverage exceeded the net proceeds ($60,887.87) they had received from Brown's liability carrier. The trial court granted summary judgment to State Farm, and the Court of Appeals affirmed. Thurman v. State Farm Mut. Auto. Ins. Co., 260 Ga.App. 338, 579 S.E.2d 746 (2003). We granted the Thurmans's petition for a writ of certiorari, asking the parties to address whether "funds from an insurance policy that are used to cover the subrogation claims of the federal government, as claimant's employer, [are] counted in the calculation of `available coverages' for purposes of the Georgia Uninsured Motorists Statute, OCGA § 33-7-11 et seq.?"
Uninsured motorist coverage can be triggered by the involvement in the incident of an underinsured motor vehicle. OCGA § 33-7-11(b)(1)(D)(ii) defines an uninsured motor vehicle as one where the tortfeasor has liability insurance but the "available coverages" are "less than the limits of the uninsured motorist coverage provided under the insured's insurance policy...." The statute goes on to define "available coverages" as "the limits of coverage [of the tortfeasor's liability insurance] less any amounts by which the maximum amounts payable under such limits of coverage have, by reason of payment of other claims or otherwise, been reduced below the limits of coverage." Id. (Emphasis supplied.) The issue for determination is whether the subrogation payments made by the tortfeasor's liability insurer pursuant to 5 USCA § 8132 to the workers' compensation carrier and pursuant to the contractual provision of the group medical insurance carrier which provided benefits to the injured federal employee constituted "payment of other claims or otherwise," thereby reducing the amount of available coverage under tortfeasor Brown's insurance policy to less than the amount of UM coverage the Thurmans had with State Farm.
In its opinion, the Court of Appeals construed "other claims" to be claims by persons suffering injury in the same collision, other than the person seeking to recover UM benefits. The appellate court determined the two subrogation payments did not constitute "payments of other claims" because the subrogation payees were not "other" claimants since they stood in Thurman's shoes with respect to the liability insurance proceeds. 260 Ga.App. at 339-340, 579 S.E.2d 746. Having resolved the meaning of "other claims," the Court of Appeals did not discuss the "or otherwise" segment of the definition of "available coverages."
Though the Court of Appeals made a valiant and commendable effort to resolve this dispute, its resolution of this case is troubling in light of Georgia's public policy strongly supportive of the complete compensation rule: an insurer is prohibited from obtaining reimbursement for amounts paid under medical payments coverage unless and until the insured has been completely compensated for her loss. OCGA § 33-24-56.1(b); Davis v. Kaiser Foundation etc., 271 Ga. 508, 521 S.E.2d 815 (1999). See also Duncan v. Integon Gen. Ins. Corp., 267 Ga. 646, 482 S.E.2d 325 (1997). The complete compensation rule set forth in OCGA § 33-24-56.1(b) echoes the statutory limitation placed on the 1992 reinstatement of the subrogation lien in workers' compensation cases — the recovery of the employer or its insurer pursuant to that lien is conditioned upon the injured employee having been "fully and completely compensated ... for all economic and noneconomic losses incurred as a result of the injury." OCGA § 34-9-11.1(b). ...
To continue reading
Request your trial
-
Helfrich v. Blue Cross & Blue Shield Ass'n, 14–3179.
...the prevailing party in a suit between an insured and insurer). The state courts are divided. Compare Thurman v. State Farm Mut. Auto. Ins. Co., 278 Ga. 162, 598 S.E.2d 448, 451 (2004) (state law preempted), and Aybar v. N.J. Transit Bus Operations, Inc., 305 N.J.Super. 32, 701 A.2d 932, 93......
-
Nevils v. Grp. Health Plan, Inc.
...the insurance coverage and benefits. Other jurisdictions have followed the Buatte rationale. See, e.g., Thurman v. State Farm Mut. Auto. Ins. Co., 278 Ga. 162, 598 S.E.2d 448, 451 (2004); Aybar v. New Jersey Transit Bus Operations, Inc., 305 N.J.Super. 32, 701 A.2d 932, 937 (1997) N.J.App.D......
-
Calingo v. Meridian Res. Co.
...Pa. 1998) ("[C]laims under state subrogation statutes . . . present relatively easy cases for preemption."); Thurman v. State Farm Mut. Auto. Ins. Co., 598 S.E.2d 448 (Ga. 2004). In McVeigh, the Supreme Court observed two possible constructions concerning the application of Section 8902(m).......
-
Calingo v. Meridian Res. Co.
...Pa. 1998) ("[C]laims under state subrogation statutes . . . present relatively easy cases for preemption."); Thurman v. State Farm Mut. Auto. Ins. Co., 598 S.E.2d 448 (Ga. 2004). In McVeigh, the Supreme Court observed two possible constructions concerning the application of Section 8902(m).......
-
Insurance - Stephen M. Schatz, Stephen L. Cotter, and Bradley S. Wolff
...Nationwide and the insured settled for the liability policy limit of $25,000. Of that amount, $9,217.66 was paid to Grady Memorial 179. 278 Ga. 162, 598 S.E.2d 448 (2004). 180. See Cotter et al., supra note 1, at 148-50; Wolff et al., Insurance, Annual Survey of Georgia Law, 61 Mercer L. Re......
-
Insurance - Bradley S. Wolff, Stephen L. Cotter, and Stephen M. Schatz
...673 S.E.2d at 229-30. 20. Id. at 27, 673 S.E.2d at 230. 21. Id. at 28, 673 S.E.2d at 231. 22. Id. 23. Id. at 29, 673 S.E.2d at 231. 24. 278 Ga. 162, 598 S.E.2d 448 (2004). 25. Id. at 165, 598 S.E.2d at 451. 26. 292 Ga. App. 60, 663 S.E.2d 763 (2008). 27. Id. at 61, 663 S.E.2d at 764. 28. Id......
-
Insurance - Stephen L. Cotter, Stephen M. Schatz, and Bradley S. Wolff
...at 735. 84. O.C.G.A. § 9-11-60(g) (2006). 85. Mullinax, 303 Ga. App. at 77, 692 S.E.2d at 735-36. 86. Id. at 80, 692 S.E.2d at 737. 87. 278 Ga. 162, 598 S.E.2d 448 (2004). 88. See generally FRANK E. JENKINS III & WALLACE MILLER III, GEORGIA AUTOMOBILE INSURANCE LAW § 32:3 (2009-2010 ed.). 8......