Family & Social Services Administration v. Schluttenhofer

768 N.E.2d 885, 2002 Ind. LEXIS 467, 2002 WL 1038722
CourtIndiana Supreme Court
DecidedMay 23, 2002
Docket91S02-0111-CV-594
StatusPublished
Cited by1 cases

This text of 768 N.E.2d 885 (Family & Social Services Administration v. Schluttenhofer) is published on Counsel Stack Legal Research, covering Indiana Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Family & Social Services Administration v. Schluttenhofer, 768 N.E.2d 885, 2002 Ind. LEXIS 467, 2002 WL 1038722 (Ind. 2002).

Opinion

ON PETITION TO TRANSFER

BOEHM, Justice.

This case addresses the meaning of the word "claim," as it is used in Indiana's lien reduction statute. We hold that each claim to which a lien holder asserts subro-gation rights must be evaluated independently of others that might arise from an injury. That was not done here. Therefore, we grant transfer and remand with instructions to reduce FSSA's lien to $15,824.52.

Factual and Procedural Background

On September 11, 1997, Wayne Scehlut-tenhofer stopped his employer's pickup truck to assist Terry Snodgrass, whose truck had been disabled after striking a deer on State Road 18 in White County. A car driven by James Budreau then collided with Schluttenhofer's vehicle, and pinned Schluttenhofer against a guardrail. Schluttenhofer suffered severe injuries that resulted in an amputation above his right knee. Schluttenhofer filed suit

against Snodgrass, Budreau, and three other defendants associated with Budreau. In the meantime, Schluttenhofer received $63,245.24 in Medicaid payments from the Indiana Family and Social Services Administration ("FSSA"). FSSA filed a Medicaid lien in that amount pursuant to Indiana Code sections 12-15-8-1 and-2 1 Sebhlut-tenhofer also received $10,000 from State Farm Mutual Insurance Company for medical payments under the policy covering his employer's vehicle. The only issue is the treatment of this last $10,000 under the lien reduction statute.

Before trial, Schluttenhofer settled with all of the defendants for a total of $325,000. 2 Schluttenhofer then filed a petition for reduction of the FSSA Hen. Schluttenhofer contended, and FSSA does not dispute, that he settled his case for ten percent of his damages. Because his recovery was diminished by ninety percent, Schluttenhofer contended that the lien reduction statute required that FSSA's Medicaid lien be reduced by ninety percent as well. Initially, FSSA did not respond and the trial court granted Schluttenhofer's motion without a hearing. FSSA then filed a motion to set aside the trial court's order, which was granted. The trial court ruled, after a hearing on the merits, that a ninety percent reduction of the FSSA lien *887 was warranted. The Court of Appeals affirmed. FSSA v. Schluttenhofer, 750 N.E.2d 429 (Ind.Ct.App.2001).

Application of the Lien Reduction Statute

FSSA agrees with Schluttenhofer that, as to the medical expenses included in the $325,000 settlement with the defendants, its lien should be reduced by ninety percent, in effect prorating the shortfall of actual recovery versus total damages between FSSA and Schluttenhofer. However, FSSA contends that there should be no reduction of the $10,000 paid by State Farm. The lien reduction statute states:

If a subrogation claim or other lien or claim that arose out of the payment of medical expenses or other benefits exists in respect to a claim for personal injuries or death and the claimant's recovery is diminished:
(1) by comparative fault; or
(2) by reason of the uncollectibility of the full value of the claim for personal injuries or death resulting from limited liability insurance or from any other cause; ~
the lien or claim shall be diminished in the same proportion as the claimant's recovery is diminished. The party holding the lien or claim shall bear a pro rata share of the claimant's attorney's fees and litigation expenses.

Ind.Code § 34-51-2-19 (1998). FSSA contends that the State Farm payment must be considered independently of the settlement payments for purposes of determining whether that amount was diminished by comparative fault or by reason of uncollectibility. FSSA reasons that the medical payments claim under Schlutten-hofer's employer's policy, viewed separate ly, was not diminished by either comparative fault or uncollectibility, and no lien reduction should apply. Schluttenhofer responds that the statute refers to a claimant's recovery from all sources. He contends that the $10,000 from State Farm is to be aggregated with the $325,000 recovered from the defendants, resulting in a diminished total "claimant's recovery" of $335,000, and a proportional reduction of the lien. The Court of Appeals agreed with Sehluttenhofer. We do not.

In a frequently encountered situation, the medical payments insurer is the party asserting the lien, which is prorated down if the injured party's Hability claim against a third party is not fully paid. Here, however, the lien is against the payment from the medical payments insurer. Medicaid is a taxpayer supported program designed to fund medical expenses for those who eannot afford care. As a part of that program, the lien statute is designed to provide for the recovery of any payments that may later be reimbursed from another source. The net effect of Schluttenhofer's contention is to divert some of those funds from reimbursement of medical expenses to compensation for personal injuries. We do not believe the statute contemplates that result, and its provision that a "claim" must be reduced in order for a lien to be reduced supports the view that the Medicaid lien on the medical benefits reimbursement is not reduced because Scehluttenhofer's claim under that policy was paid in full.

Schluttenhofer argues that the lien reduction statute's use of the terms "comparative fault" and "uncollectibility" refer to the plaintiff's inability to recover "the full value of his case." The statute speaks in terms of the value of a "claim," not "case." A "claim" is an "assertion of an existing right." Black's Law Dictionary 240 (ith ed. 1999). As a result of his injuries, Schluttenhofer acquired rights to compensation that differed as to different parties, i.e., his "case" contained several "claims," as the term is used in the statute. Schluttenhofer expresses his settlement *888 with the defendants as one for $825,000. In actuality, there were five settlements: he settled his claim against Budreau for $100,000, his claim against Snodgrass for $75,000, and his claims against the three remaining defendants for a combined sum of $150,000. There is no basis to conclude that any of these claims was reduced to a greater or lesser extent than any others, so each is reduced in the same proportion, ie. by ninety percent, representing the shortfall of the total of the five to his total damages.

Schluttenhofer also cites Dep't of Pub. Welfare v. Couch, 605 N.E.2d 165 (Ind.1992) for the proposition that the phrase "claimant's recovery," as used in the lien reduction statute, means amounts received by the plaintiff from whatever source. From that, he contends that the statute requires a reduction from the sum of all monies received as a result of his injuries. We do not read Couch as Schluttenhofer suggests. Couch held that the lien reduction statute applied to the proceeds of settlement, as well as judgment.

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Bluebook (online)
768 N.E.2d 885, 2002 Ind. LEXIS 467, 2002 WL 1038722, Counsel Stack Legal Research, https://law.counselstack.com/opinion/family-social-services-administration-v-schluttenhofer-ind-2002.