Allstate Insurance v. Druke

576 P.2d 503, 118 Ariz. 315, 1977 Ariz. App. LEXIS 841
Court of Appeals of Arizona·Decided September 1, 1977·No. No. 2 CA-CIV 2609·Published·Cited by 1 cases

Opinion

OPINION

HATHAWAY, Judge.

Petitioner, hereinafter referred to as Allstate, is the defendant in a pending superior court class action which, although alleging five counts, in essence attacks the validity of a provision in Allstate’s automobile insurance policy concerning medical payments coverage. Allstate now challenges the respondent court’s denial of its motion for summary judgment.

The Allstate liability insurance agreement provides in the General Conditions section at Paragraph 10:

“Subrogation
Upon payment under
(a) Section I [Liability Protection] or Section III [Loss to the Automobile Protection], Allstate shall be subrogated to the extent of such payment to all of the insured’s right of recovery therefor; and
(b) Part I of Section IV [Medical Payments insurance], each insured shall repay Allstate out of the proceeds, if any, recovered in exercise of his rights against any person liable to the insured because of the bodily injury for which such payment was made.
The insured shall do whatever is necessary to secure such rights and do nothing before or after loss to prejudice such rights.”

The record also reflects that- Allstate sends a form letter to its insured involved in an accident which contains the following:

“Did you incur medical expenses as a result of your recent accident?
If so, and you desire to present the claim under the Medical Payments coverage, the enclosed form should be completed by you and your doctor and returned to us with your itemized bills.
If the other party or his bodily injury liability insurance carrier makes a settlement with you, policy conditions applicable to the Medical Payments coverage require that you repay Allstate Insurance Company out of the proceeds of the settlement, to the extent of the payments made under the Medical Payments coverage.
In the event you do present a claim under Medical Payments coverage, we will notify the other party and his carrier of our interest and will request that Allstate’s name be included on any settlement draft or check.
Please indicate by checking the appropriate statement at the bottom of this letter, how you wish to handle your claim for medical expenses, and return the letter to us promptly.
******
_I do not desire to present a medical payments claim.
_I plan to submit a medical payments claim and understand that Allstate is to be repaid the amount of such claim out of the proceeds of any bodily injury liability settlement.
Signed_
Date_’ ’

[317] The basis of the plaintiffs’ claim was that under Arizona law Allstate had no right of subrogation to recovery by its insured against a tortfeasor who was or might be liable for tort damages arising from the automobile accident which caused Allstate to pay medical expenses and that Allstate had no right to obtain or require from its insured an assignment of all or any part of the insured’s cause of action against such tortfeasor. The complaint alleged that Allstate was contractually obligated to pay to or on behalf of its insured all medical expenses, up to policy limits, and had no legal rights to condition such payment upon assignment of or subrogation to the recovery by those insured of damages from any tortfeasor who was or might have been legally liable for payment of such damages. It further alleged that Allstate had systematically denied its obligation to pay such medical expenses in the absence of an agreement by its insured to assign a portion of their recovery or to acknowledge a right to subrogation and that the plaintiffs either had been refused payment of medical expense benefits because of this failure or refusal to acknowledge the right of subrogation or to execute an assignment, or had reimbursed Allstate out of the proceeds of recovery from a tortfeasor for medical expenses paid by Allstate under the medical payments coverage.

The basis for the respondent court’s denial of Allstate’s motion for summary judgment were the cases of Harleysville Mutual Insurance Company v. Lea, 2 Ariz.App. 538, 410 P.2d 495 (1966), and State Farm Fire and Casualty Company v. Knapp, 107 Ariz. 184, 484 P.2d 180 (1971). In both Harleysville and Knapp, it was held that since a cause of action for personal injuries is not assignable, a subrogation clause of an insurance policy [Knapp] or subrogation provisions of a policy and a receipt executed by the insured [Harleysville] are unenforceable by the insurer. In Harleysville, the court stated:

“Any rights that the insurance company may have as a subrogee in the instant case, either by virtue of the insurance contract or the receipt and release signed by the defendant Lea, must be based upon the ability in law of the defendant Lea to assign in whole or in part, his cause of action for personal injuries to the insurance company. If the defendant Lea may not in law assign his cause of action to the plaintiff either in whole or in part, then his cause of action may not be subrogated.” 2 Ariz.App. at 540, 410 P.2d at 497.

And:

“We feel and therefore hold, that the better reasoned rule is that even though a cause of action for personal injury may survive, an action still may not be assignable either in whole or in part prior to judgment.” 2 Ariz.App. at 541, 410 P.2d at 498. (Emphasis added)

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Allstate Insurance v. Druke, 576 P.2d 503, 118 Ariz. 315, 1977 Ariz. App. LEXIS 841 (Ark. Ct. App. 1977).

576 P.2d 503 (Allstate Insurance v. Druke) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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