Appling v. State Farm Fire & Cas. Co.

823 S.E.2d 61, 348 Ga. App. 369
CourtCourt of Appeals of Georgia
DecidedJanuary 11, 2019
DocketA18A1523
StatusPublished
Cited by2 cases

This text of 823 S.E.2d 61 (Appling v. State Farm Fire & Cas. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Appling v. State Farm Fire & Cas. Co., 823 S.E.2d 61, 348 Ga. App. 369 (Ga. Ct. App. 2019).

Opinion

Miller, Presiding Judge.

*369This appeal stems from a vehicle collision between Ricky Appling and an underinsured motorist. After a jury trial, at which the jury awarded Appling $192,000, Appling's insurer, State Farm Fire & Casualty Company ("State Farm"), paid Appling's judgment but requested that the trial court reduce the amount based on medical expenses it had already paid. Appling now appeals from the trial court's post-judgment order, in which the trial court ruled that State Farm was entitled to an offset of $22,490.76, because this money was duplicative of State Farm's pretrial payments for Appling's medical expenses.

Because Appling's insurance policies with State Farm prohibit the duplication of medical benefits, and given our precedent dictating that we are to presume that Appling's verdict included a medical expenses award, the trial court correctly determined that State Farm was entitled to the offset amount. Accordingly, we affirm.

*370"A trial court's ruling on a [motion for entry of satisfaction of judgment] based on a question of law, as here, is reviewed de novo. When reviewing a trial court's ruling on a *63legal question, we owe no deference to that court." (Citation omitted.) State Farm Mut. Auto. Ins. Co. v. Hall , 309 Ga. App. 271, 709 S.E.2d 867 (2011).

Underlying this appeal is a 2013 motor vehicle accident between Appling and an underinsured motorist, Jonathan Rufus Benton, in which Appling was injured. Benton was cited for failing to yield the right-of-way. Appling received $25,000 from Benton's insurance company, in exchange for a limited liability release. At the time of the accident, Appling held insurance policies with State Farm, which provided uninsured/underinsured motorist (UM) coverage.

Appling sued Benton, and State Farm defended the case in Benton's name, pursuant to OCGA § 33-7-11 (d).1 In his amended complaint, Appling claimed, inter alia, that he was entitled to recover "the full value of his past medical expenses in an amount of $107,455.43." At trial, Appling apparently entered into evidence medical bills amounting to more than $106,000.

The jury awarded Appling $192,000, but found that he was five percent contributorily negligent. Accordingly, the trial court subtracted five percent of the verdict to account for Appling's contributory negligence ($9,600), as well as the $25,000 payment that Appling had received from Benton's insurance company. The total judgment amount that Appling received was $157,400.

State Farm paid this judgment in full, and also filed a motion for entry of satisfaction of judgment, informing that it had paid $22,490.76 for Appling's medical expenses before the trial under the medical payments coverage in Appling's insurance policies.2 Attached to State Farm's motion was a payment log reflecting medical payments that State Farm had made from 2013 to 2015 both to Appling and on his behalf, in connection with Appling's insurance claim.3 State Farm also submitted a copy of a "Car Policy" booklet, which contained Appling's policies for medical payments coverage, as well as UM coverage. The UM coverage language contained a nonduplication clause, stating that any amounts State Farm paid as expenses under Appling's medical payments coverage would not be paid again under Appling's UM coverage. Thus, State Farm requested that the trial *371court enter a satisfaction of judgment reflecting payment of $134,909.24, to account for the medical payments which State Farm had made before the trial.

In his own motion for entry of satisfaction of judgment, Appling argued that State Farm did not proffer evidence of its earlier payments of medical expenses or the policy documents during the trial and was thus precluded from asserting it as part of a post-judgment motion. At the hearing on the parties' motions, Appling added that, because the jury had rendered its verdict using a general verdict form, and had not specified which parts of the award were intended to compensate for which losses, it was uncertain whether any portion of the jury's verdict represented damages for incurred medical expenses.

Following the hearing, the trial court ordered that the judgment be marked as satisfied based on State Farm's payment of $134,909.24, and directed that Appling return $22,490.76 to State Farm, which Appling's counsel had been holding in trust until the trial court decided the issue. The trial court found that (1) because Appling presented evidence at trial of incurred medical expenses and sought recovery to that effect, there was a presumption that the verdict included an award for incurred medical expenses; and (2) Appling's insurance policies with State Farm prevented the duplication of benefits that Appling had received under his medical payments coverage. This timely appeal followed.

1. Appling contends that State Farm waived the issue of the nonduplication clause by omitting this from the pretrial order, and *64because this policy language was not stipulated to or produced in evidence. This argument is unavailing.

First, the pretrial order fairly raised the issue of the insurance policy terms. "A pretrial order limits the issues for trial and controls the subsequent course of the action unless modified at trial to prevent manifest injustice. Nonetheless, a pretrial order should be liberally construed to allow the consideration of all questions fairly within the ambit of the contested issues." (Citations and footnotes omitted; emphasis supplied.) Gerschick v. Pounds , 281 Ga. App. 531, 536 (3), 636 S.E.2d 663 (2006).

Here, the pretrial order4 specifically states,

State Farm ... provides certain insurance benefits to [Appling] under insurance policies applicable to [Appling's] claim. In the event the jury finds that [Benton] was at fault, *372State Farm ... agrees that, under the terms of the applicable insurance policies , and subject to applicable provisions of law, it may be obligated to pay [Appling] compensatory damages, as determined by the jury. The order subsequently provides, "[i]f the case is based on a contract, ...

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Cite This Page — Counsel Stack

Bluebook (online)
823 S.E.2d 61, 348 Ga. App. 369, Counsel Stack Legal Research, https://law.counselstack.com/opinion/appling-v-state-farm-fire-cas-co-gactapp-2019.