Adams v. State Farm Mutual Automobile Insurance Co.

JOHNSON, Presiding Judge,

dissenting.

I agree with the trial court that State Farm was entitled to set off its $100,000 UM coverage by the full $25,000 paid from the tortfea-sor’s liability policy. I, therefore, respectfully dissent from the majority’s position. Adams’ election to voluntarily divert part of the $25,000 liability payment to satisfy his hospital bill did not reduce the available liability coverage below $25,000 or increase his UM coverage.

Here, contrary to Adams’ assertions, the legislative intent of the UM statute is not to make insureds whole, but “to place insureds in the same position they would be in relation to coverage if the tortfeasors causing the injuries had obtained at least the minimum prescribed liability insurance.”1 The legislative intent of the General Assembly is not served by reducing the amount of “available coverage” by the amount of a hospital bill or lien. If the payment of hospital bills or liens constituted a payment of “other claims or otherwise” such that it reduced limits of available coverage, UM coverage would automatically be increased in every instance where an injured insured receives treatment at a hospital and the hospital receives payment for such treatment under the liability policy. In this case, Adams received $25,000 from the tortfeasor’s insurance carrier and chose to use $9,217.66 to pay off his hospital bill. I find no error in the trial court’s grant of summary judgment to State Farm.

Adams’ argument that Thurman v. State Farm &c. Ins. Co.2 requires a different result is not persuasive. Thurman addressed a situation involving federal claims on an injured party’s settlement, where reimbursement of the federal claims was mandatory regardless of whether or not the injured party had been fully compensated.3 The applicable federal statute, 5 USCS § 8132, specifically provides *255for mandatory adjustment after recovery from a third party:

If an injury or death for which compensation is payable under this subchapter [5 USCS § 8101 et seq.] is caused under circumstances creating a legal liability in a person other than the United States to pay damages, and a beneficiary entitled to compensation from the United States for that injury or death receives money or other property in satisfaction of that liability as the result of suit or settlement by him or in his behalf, the beneficiary, after deducting therefrom the costs of suit and a reasonable attorney’s fee, shall refund to the United States the amount of compensation paid by the United States and credit any surplus on future payments of compensation payable to him for the same injury. No court, insurer, attorney, or other person shall pay or distribute to the beneficiary or his designee the proceeds of such suit or settlement without first satisfying or assuring satisfaction of the interest of the United States.4

The Supreme Court of Georgia noted that the federal policies directly contradicted Georgia law on the issue, and to mitigate the financial harm inflicted by the federal policies, the Thurman Court held that the amount reimbursed to the federal benefits providers constituted a reduction in liability coverage.5 The Supreme Court of Georgia, however, carefully limited Thurman to apply only when a federal employee is required by federal law to reimburse benefit providers, resulting in the federal employee not receiving full compensation.6

Similarly, Toomer v. Allstate Ins. Co.7 addressed a situation involving the repayment of a federal Medicare lien, where Medicare paid for the collision-related medical payments. In that case, we again noted that federal law specifically required the injured party to repay the provider of benefits without regard to whether the injured party had been fully compensated: “[N]o court, insurer, attorney, or other person shall pay or distribute to the beneficiary of Medicare payments the proceeds of any suit or settlement without first satisfying or assuring satisfaction of the interest of the United States.”8 As in Thurman, Georgia’s public policy of complete com*256pensation could only be furthered by holding that “available coverages” under the UM statute are reduced by reimbursements to federal benefits providers.

Decided April 14, 2009 Reconsideration denied June 9, 2009 Chambers, Aholt & Rickard, Clyde E. Rickard III, for appellant. Carlock, Copeland & Stair, William M. Cheves, Jr., Harper, Waldon & Craig, Kimberly A. McNamara, Russell D. Waldon, Jane N. Wilkes, Ryan A. Johnson, Rodney S. Shockley, for appellee. Robertson, Bodoh & Nasrallah, Mathew G. Nasrallah, Jonah A. Flynn, amici curiae.

Here, unlike in Thurman or Toomer, neither federal nor state law required payment to the benefits provider. Although the Georgia hospital lien statute provides that a lien arises upon a cause of action, it does not employ the mandatory payment language contained in the federal laws applicable in Thurman and Toomer,9 Thus, Nationwide, with Adams’ consent, voluntarily paid a claimant whose repayment was not mandatory. Thurman and Toomer do not control this case.

I am authorized to state that Presiding Judge Blackburn and Presiding Judge Smith join in this dissent.

(Punctuation and footnote omitted.) Crafter v. State Farm Ins. Co., 251 Ga. App. 642, 644 (554 SE2d 571) (2001); see also Young v. Maryland Cas. Co., 228 Ga. App. 388, 390 (1) (491 SE2d 839) (1997).

278 Ga. 162 (598 SE2d 448) (2004).

The purpose of the federal policies’ provision of reimbursement upon the insured’s receipt of insurance proceeds is to minimize the cost of the federal programs to the federal government, not to ensure that the insured has been fully compensated. Thurman, supra at 164.

(Emphasis supplied.)

Id. at 164-165.

Id.

292 Ga. App. 60 (663 SE2d 763) (2008).

(Punctuation and footnote omitted.) Id. at 63.

OCGA § 44-14-470; compare 5 USCS § 8132.