Denekas v. Shalala

943 F. Supp. 1073, 1996 U.S. Dist. LEXIS 19992, 1996 WL 640849
CourtDistrict Court, S.D. Iowa
DecidedOctober 10, 1996
Docket4:95-cv-30017
StatusPublished
Cited by10 cases

This text of 943 F. Supp. 1073 (Denekas v. Shalala) is published on Counsel Stack Legal Research, covering District Court, S.D. Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Denekas v. Shalala, 943 F. Supp. 1073, 1996 U.S. Dist. LEXIS 19992, 1996 WL 640849 (S.D. Iowa 1996).

Opinion

RULING ON CROSS-MOTIONS FOR SUMMARY JUDGMENT AND ORDER FOR JUDGMENT

WALTERS, United States Magistrate Judge.

I.

This matter is before the Court on cross-motions for summary judgment. On January 11, 1995, plaintiffs filed this action for declaratory relief seeking a determination of the parties’ relative rights and interests to funds received under a settlement agreement between plaintiffs and two insurance carriers in connection with a wrongful death action arising out of an automobile accident on August 24, 1990. In that accident another car struck the Denekas automobile head on killing Edith Denekas and seriously injuring her husband, Raymond Dénekas. Mr. Denekas was hospitalized for 266 days before dying on May 17, 1991. This case involves only the claims resulting from the death of Mr. Dene-kas. The principal issue is the extent to which the defendant Secretary may recover Medicare conditional payments from the settlement fund. For ease of reference, the government defendant will be referred to herein as “Medicare.” Plaintiffs James Denekas and Carol De Jong are the surviving children of Mr. and Mrs. Denekas and executors of Mr. Denekas’ estate.

Medicare and defendant Blue Cross and Blue Shield of Iowa (“BCBS”) made substantial payments toward Mr. Denekas’ extensive medical expenses. The parties stipulate Medicare made payments for medical expenses in the amount of $106,325.70, and BCBS made payments in the amount of $170,111.55. The Iowa probate court approved a settlement of the wrongful death claim against the other driver for the driver’s liability policy limits of $100,000.00, and an *1076 underinsurance claim under Mr. Denekas’ automobile policy in the additional amount of $25,000.00. There is, therefore, a settlement fund from insurance proceeds in the total amount of $125,000.00 to pay claims arising out of the death of Mr. Denekas. 1

Jurisdiction is predicated on 28 U.S.C. § 1331. On July 31, 1995 the parties consented to proceed before a United States Magistrate Judge and the ease was referred to the undersigned. See 28 U.S.C. § 636(c). On October 30,1995, plaintiffs filed a motion for summary judgment. They seek a declaration that the settlement proceeds should be apportioned pro rata with a share distributed to the surviving children of Mr. Denekas for their parental consortium claims free of the reimbursemenVsubrogation claims of Medicare and BCBS. They propose two alternatives. The first, which plaintiffs prefer, would also apportion a share of the settlement proceeds to the estate for its nonmedical claims free of the Medicare and BCBS claims. The second makes no apportionment for the estate’s nonmedical claims. See Plaintiffs’ Brief, at 3^1.

On November 30, 1995, defendant BCBS filed a combined resistance to plaintiffs’ motion and a cross-motion for summary judgment. BCBS recognizes that as between them, Medicare’s claim is primary. As a practical matter, BCBS will realize nothing on its subrogation claim unless Medicare’s recovery comes “off the top” of the settlement fund before any apportionment to the consortium claims. If, instead, the children’s consortium claims are apportioned free of Medicare’s right of reimbursement; Medicare will receive all of the remaining money in the fund. Thus, BCBS joins Medicare in arguing Medicare has a statutory right of reimbursement from funds recovered by the estate, including for loss of parental consortium and nonmedical damages.

Defendant Medicare filed a combined resistance to plaintiffs’ motion and a eross-motion -for summary judgment on December 1,1995. Medicare, argues its conditional payments for medical expenses .may not be reduced by apportionment among competing claims to the estate’s recovery and to the extent Iowa law requires apportionment of the parental consortium claims of the surviving children, it is preempted by federal law. Plaintiffs respond that reimbursement of Medicare’s medical payments from the children’s loss of consortium recovery would amount to an unconstitutional taking of the children’s property in violation of the Fifth Amendment to the U.S. Constitution.

Hearing on the motions was held on April 29,1996. Plaintiffs were represented by Des Moines attorney Richard Doyle. Defendant Medicare was represented by Assistant United States Attorney Gary Hayward and BCBS by Des' Moines attorney Michael Ea-son. The motions are fully submitted.

II.

The standards governing the Court’s review of a motion for summary judgment are well-established. A party is entitled to summary judgment only when the “pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” Wabun-Inini v. Sessions, 900 F.2d 1234, 1238 (8th Cir.1990) (citing Fed.R.Civ.P. 56(c)); accord Munz v. Michael, 28 F.3d 795, 798 (8th Cir.1994); Woodsmith Publishing Co. v. Meredith Corp., 904 F.2d 1244, 1247 (8th Cir.1990). Here the parties agree that there are no disputed issues of material fact and that the case may be decided on the cross-motions for summary judgment. They also agree a declaratory judgment determining the rights of the parties to the insurance proceeds is appropriate. 28 U.S.C. § 2201(a). Indeed, *1077 they each ask the Court to determine their rights in the matter.

There is also no dispute about the amount of the claims made by the parties, or the reasonableness of the parental consortium claims. James Denekas and Carol De Jong each claim $37,500.00 for loss of parental consortium. The consortium figures are derived from an arbitrator’s finding that the spousal and parental consortium claims in connection with the estate of Edith Denekas totaled $75,000.00. Exhibit I to Plaintiffs’ Statement of Facts. In addition to the consortium claims, in the first of plaintiffs’ two alternative proposals $125,000.00 is included in the total claims for the estate’s nonmedical damages (pre-death physical and mental pain and suffering, loss of accumulation to the estate, and interest on premature funeral and burial expense). There is also no dispute about the reasonableness of this figure, though Medicare and BCBS maintain the estate’s nonmedical damages are subject to their claims. 2

In plaintiffs’ first proposed apportionment, the total claims are:

Medicare $106,325.70
BCBS $170,111.55

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Bluebook (online)
943 F. Supp. 1073, 1996 U.S. Dist. LEXIS 19992, 1996 WL 640849, Counsel Stack Legal Research, https://law.counselstack.com/opinion/denekas-v-shalala-iasd-1996.