Ruggles Ex Rel. Estate of Mayer v. Grow

FABE, Justice,

with whom BRYNER, Justice, joins, concurring in part and dissenting in part.

Although I agree that the superior court properly construed our remand in Grow v. Ruggles, I disagree with the majority’s conclusion that the superior court appropriately deducted the amount of Allstate’s medical payments from the judgment that its insured, Carolyn Ruggles, obtained against Monte Grow. Ruggles’s obligation to reim*514burse Allstate for medical expenses involves a contractual dispute separate from her underlying tort case. Yet the superior court reduced Ruggles’s judgment without first reviewing and interpreting her insurance contract. I believe that the case should be remanded to the superior court to resolve the contractual dispute between Ruggles and Allstate.

Ruggles argues that the question whether she must reimburse Allstate for its payment of her medical expenses “is properly between Allstate and Ruggles, and should not have been before the trial court in this matter on remand.” She seeks to resolve this issue according to the terms of her contract with Allstate.

The superior court assumed, and the majority appears to agree, that “principles of subrogation” automatically resolve any dispute between Allstate and Ruggles in Allstate’s favor. In the court’s view, this conclusion obviates the need for consideration of Ruggles’s claims against Allstate’s right to reimbursement. But in Maynard v. State Farm Mutual Automobile Insurance Co.,1 we determined that whether an insurer is entitled to seek reimbursement from an injured party when it insures both the injured party and the tortfeasor depends on the contract between the insurer and the injured party.2 Maynard presented the following-question: “May an insurance company seek reimbursement for medical expenses paid to its insured under his policy when it also insures the tortfeasor and the insured brings an action against the tortfeasor seeking damages for the same medical expenses?”3 We answered the question in the affirmative.4 Our conclusion that the insurance company was entitled to seek reimbursement from the insured party, however, was based on a close analysis of the contract between the parties, not on general principles of subrogation.5 The contract between Maynard and his insurer conclusively barred double recovery and provided that the insurer would “not pay any expenses for which the claimant ha[d] already been compensated.”6

In this case, by contrast, the superior court reduced Ruggles’s judgment against Grow without reference to the contract between Ruggles and Allstate. Indeed, although Ruggles points to a portion of the contract requiring disagreements to be resolved through arbitration, and Grow refers to the affidavit of an Allstate employee stating that Ruggles’s policy includes a subrogation clause, the entire contract does not even appear in the record. It is therefore impossible to evaluate either Ruggles’s contractual claims against Allstate or Groves allegations regarding the contract’s subrogation clause. I agree with the court that both Brinkerhoff v. Swearingen Aviation Corp.,7 and Rice v. Denley8 stand for the proposition that a subrogated insurer controls its claim and may direct its insured not to pursue it.9 But there is no way to be certain that Allstate is in fact a subrogated insurer without analyzing the contractual language. And if we cannot determine that Allstate is the subro-gee, then it follows that we cannot determine whether Allstate controlled the claim.

Whether Allstate is entitled to reimbursement of the medical expenses portion of the judgment against Grow is best resolved in the context of Allstate’s contractual dispute with Ruggles. In my view, the case should *515therefore be remanded to give the trial court an opportunity to resolve the contractual dispute separately. Ruggles would then be afforded the same opportunity as the insured party in Maynard. I therefore respectfully dissent.

. 902 P.2d 1328 (Alaska 1995).

. See id. at 1331-32.

. Id. at 1329.

. See id. at 1334. Ruggles contends that Maynard stands for the proposition that an insurer may not subrogate against its own insured. We did not so hold; rather, we explained that "[t]he cases giving rise to the rule prohibiting subrogation against one’s own insured all involve situations in which the insurer paid out on a loss to its insured and then sought to hold a second coinsured party under the same insurance contract liable for the loss.” Id. at 1332. The case at hand, like Maynard, does not involve coin-sured parties.

. See id. at 1331-34.

. Id. at 1332.

. 663 P.2d 937 (Alaska 1983).

. 944 P.2d 497 (Alaska 1997).

. See Rice, 944 P.2d at 500; Brinkerhoff, 663 P.2d at 942.