Baxter v. I.S.T.A. Insurance Trust

749 N.E.2d 47, 26 Employee Benefits Cas. (BNA) 1140, 2001 Ind. App. LEXIS 746, 2001 WL 463232
CourtIndiana Court of Appeals
DecidedMay 3, 2001
Docket10A01-0009-CV-318
StatusPublished
Cited by15 cases

This text of 749 N.E.2d 47 (Baxter v. I.S.T.A. Insurance Trust) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Baxter v. I.S.T.A. Insurance Trust, 749 N.E.2d 47, 26 Employee Benefits Cas. (BNA) 1140, 2001 Ind. App. LEXIS 746, 2001 WL 463232 (Ind. Ct. App. 2001).

Opinion

OPINION

BROOK, Judge.

Case Summary

Appellants-defendants Fraternal Insurance Company, Inc. (“Fraternal”) and GAB Robins North America, Inc. (“GAB”) appeal the trial court’s order denying their respective motions for summary judgment. We affirm in part and reverse in part.

Issues

We restate the three issues presented for our review as follows:

I. whether the trial court erred in denying Fraternal’s motion for summary judgment regarding whether appellee-plaintiff I.S.T.A. Insurance Trust (“ISTA”) has a right to subrogation;
II. whether the trial court erred in denying Fraternal’s and GAB’s summary judgment motions on the fraud claim brought by ISTA; and
III. whether the trial court erred in denying Fraternal’s motion for summary judgment on ISTA’s breach of duty of subrogation claim.

Facts and Procedural History

On October 8, 1996, Eddy Baxter, Sr. (“Eddy”) was severely burned by hot grease from a fryer in an accident at the *50 Moose Lodge' # 1757 (“Moose Lodge”). Fraternal, which insured Moose Lodge, hired GAB to provide limited services in adjusting Eddy’s claim against Moose Lodge. ISTA is an employee benefit trust regulated by the Employee Retirement Income Security Act of 1974 (“ERISA”). See 29 U.S.C. § 1001 et seq. Eddy and his wife, Carolyn Baxter (“Carolyn”), (collectively, “the Baxters”), are beneficiaries of ISTA’s group health benefit plan.

The Baxters submitted to GAB documents, which indicated that they had received $3,192.34 in benefits from ISTA. Consequently, Fraternal paid the Baxters $5,000 for medical expenses without requiring that they sign a release. Mthough the Baxters made a demand against the Moose Lodge for a far greater amount, Fraternal eventually paid them $50,000 for pain and suffering and required them to sign a release containing the following language:

In making this Release it is understood and agreed the undersigned relies wholly upon the undersigned’s judgment, belief, and knowledge of the nature, extent, effect, and duration of said injuries and liability therefore and is made without reliance upon any statement or representation of the Lodge or its representatives or by any physician or surgeon by them employed.

ISTA eventually paid approximately $130,000 for Eddy’s medical expenses arising from his injury at Moose Lodge. Despite the existence of a subrogation clause in ISTA’s group health benefit plan, the Baxters have not reimbursed ISTA with any portion of the $55,000 received from Fraternal.

Upon learning of the $55,000 payment and the failure to reimburse ISTA for any amounts it had paid, ISTA sued the Bax-ters in March 1998. In an amended complaint, ISTA added Fraternal and GAB as defendants, alleged a theory of fraud and misrepresentation against both, and asserted breach of duty to protect subrogation interest against Fraternal. Fraternal and GAB filed motions for summary judgment. On June 13, 2000, the court held a hearing on the motions, and ISTA filed another amended complaint. In an order without explanation, the court denied summary judgment. Fraternal and GAB filed an interlocutory appeal of this order.

Discussion and Decision

I. Right of Subrogation

Fraternal asserts that the trial court erred by denying its motion for summary judgment regarding ISTA’s claimed contractual right of subrogation. We address this issue first because if ISTA had no right to subrogation it would have no claim for fraud or breach of duty against Fraternal or GAB since it would have suffered no injury. See Gonderman v. State Exchange Bank, Roann, 166 Ind.App. 181, 191, 334 N.E.2d 724, 730 (1975) (noting that fraud without injury does not give rise to cause of action); Fast Eddie’s v. Hall, 688 N.E.2d 1270, 1272 (Ind.Ct.App.1997) (“absent a duty, there can be no negligence”), trans. denied.

We recently set forth the summary judgment standard of review:

The purpose of summary judgment is to end litigation where no factual dispute exists and which may be determined as a matter of law. On review of a trial court’s decision to deny summary judgment, our standard of review is well settled. We apply the same standard of review as the trial court: we must decide whether there is a genuine issue of material fact and whether the moving party is entitled to judgment as a matter of law.
Summary judgment is appropriate only if “the evidence sanctioned by Ind. *51 Trial Rule 56(C) shows that there is no genuine issue of material fact and the moving party deserves judgment as a matter of law.” The party moving for summary judgment has the burden of making a prima facie showing that there is no genuine issue of material fact and that the moving party is entitled to a judgment as a matter of law. Once these two requirements are met by the moving party, the burden then shifts to the non-moving party to show the existence of a genuine issue by setting forth specifically designated facts. Any doubts as to any facts or inferences to be drawn therefrom will be resolved in favor of the non-moving party.

Ling v. Stillwell, 732 N.E.2d 1270, 1273-74 (Ind.Ct.App.2000) (citations omitted), tram, denied.

We analyze insurance contracts as follows:

The interpretation of an insurance policy, as with other contracts, is primarily a question of law for the court,- even if the policy contains an ambiguity needing resolution. A court may not rewrite an insurance contract. If an insurance contract is clear and unambiguous, the language must be given its plain meaning. However, if there is an ambiguity, the policy should be interpreted most favorably to the insured, and construed to further the policy’s basic purpose of indemnity. Ambiguity in an insurance policy exists when the language is susceptible to more than one interpretation and reasonably intelligent persons could honestly differ as to the meaning of the policy language.

Estate of Eberhard v. Illinois Founders Ins. Co., 742 N.E.2d 1, 2 (Ind.Ct.App.2000) (citations omitted). “Courts will make all attempts to construe the language in a contract so as not to render any words, phrases, or terms ineffective or meaningless.” Id. at 3.

ISTA’s group health benefit plan contains the following provision:

SUBROGATION
In the event of any payment under the plan to any Covered Person, the Plan may, as set forth in the Schedule of Benefits, to the extent of such payment be subrogated, unless otherwise prohibited by law, to all the rights of recovery of the Covered Person arising out of any claim or cause of action which may accrue because of alleged negligent conduct of a third party.

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Bluebook (online)
749 N.E.2d 47, 26 Employee Benefits Cas. (BNA) 1140, 2001 Ind. App. LEXIS 746, 2001 WL 463232, Counsel Stack Legal Research, https://law.counselstack.com/opinion/baxter-v-ista-insurance-trust-indctapp-2001.