Franklin v. Healthsource of Arkansas

942 S.W.2d 837, 328 Ark. 163, 1997 Ark. LEXIS 232
CourtSupreme Court of Arkansas
DecidedApril 21, 1997
Docket96-116
StatusPublished
Cited by39 cases

This text of 942 S.W.2d 837 (Franklin v. Healthsource of Arkansas) is published on Counsel Stack Legal Research, covering Supreme Court of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Franklin v. Healthsource of Arkansas, 942 S.W.2d 837, 328 Ark. 163, 1997 Ark. LEXIS 232 (Ark. 1997).

Opinions

W.H.“Dub” Arnold, Chief Justice.

This case involves a dispute between an insured, Curtis Lee Franklin, and his insurer, Healthsource of Arkansas, over allocation of the proceeds of a policy limit settlement in a personal-injury action; both parties claim exclusive right to the proceeds. The trial court ruled that as a matter of law pursuant to Higginbotham v. Ark. Blue Cross & Blue Shield, 312 Ark. 199, 849 S.W.2d 464 (1993), Healthsource was entitled to receive the proceeds because its conventional right of subrogation, which arose from a subrogation agreement, took priority over Franklin’s legal right of subrogation. Franklin appeals requesting that this court overrule Higginbotham.

On March 31, 1994, Franklin was injured in an automobile accident involving James Arlen Ray, Jr. Franklin sustained injuries that were substantial, and he was hospitalized. After being released from the hospital, on May 9, 1994, Franklin was presented with a document from his medical insurance carrier, Healthsource of Arkansas, which was entitled “Right of Recovery/Subrogation Questionnaire.” This document contained general questions regarding the accident and, at the bottom, a section entitled “Assignment of Benefits.” After consulting with his attorney, Franklin answered the questions and signed the document.

Franklin filed suit alleging negligence by Ray. Defendant Ray filed an answer, and later his insurance carrier offered Franklin the liability policy limit of $25,000 in settlement of the claim. After discovery revealed that Ray had no appreciable assets, Franklin accepted the setdement offer.

Ray then filed a third-party complaint requesting that the court allocate the $25,000 among potential claimants, including several medical care providers, Healthsource, and the Jefferson County Child Support Enforcement Unit. All third parties except Healthsource were dismissed by order of the trial court.

The trial court held a hearing to dispose of the $25,000. Healthsource claimed it was entided to the entire $25,000 policy limit because of the subrogation agreement with Franklin. Healthsource, pursuant to the medical insurance policy provided by Franklin’s employer, had paid medical bills incurred by Franklin for the sum of $71,120.65.

Franklin contended that he was entitled to the $25,000 because he had incurred damages for which he had not been compensated. It is undisputed that Franklin incurred medical bills of at least $124,000. Expert testimony was presented at the hearing regarding the potential value of Franklin’s claims; the total value was valued in excess of $400,000.

The trial court ruled that Franklin’s attorneys were entitled to attorney fees to be paid from the settlement and that Health-source was entitled to the remainder pursuant to the subrogation agreement between Healthsource and Franklin. The trial court based this ruling upon this court’s opinion in Higginbotham. In supporting this finding, the trial court ruled that there was a valid contract in the subrogation agreement because Franklin signed the document after consulting counsel which made his consent a “knowing and informed act.” Franklin appeals the trial court ruling requesting that this court overrule Higginbotham.1

The Higginbotham decision was a plurality opinion that illustrates the division on this court concerning the allocation of proceeds of policy-limit settlements through conflicting rights of subrogation. Like the case before us, Higginbotham involved a dispute over whether the insured or the insurer was entitled to the proceeds from a policy-limit settlement when both parties had claims exceeding the amount of the settlement.

In Higginbotham, a three-justice plurality concluded that conventional subrogation rights of an insurer created by contract prevail over an insured’s equitable right of subrogation arising as an operation of law. Specifically, these justices reasoned: “Without discounting the equitable properties of subrogation, we can conceive of no sound reason why broad principles of equity should be imbued with dominance over clear and specific provisions of a contract agreed to by the parties, at least where public policy considerations are wanting.” Id. at 203.

The three dissenting justices in Higginbotham cited Shelter Mut. Ins. Co. v. Bough, 310 Ark. 21, 834 S.W.2d 637 (1992), as the controlling rule. They determined that “subrogation is recognized or denied upon equitable principles without differentiation between ‘legal subrogation’ which arises by application of principles of equity and ‘conventional subrogation’ arising from contract or the acts of the parties.” Id. at 205, citing Garrity v. Rural Mut. Ins. Co., 253 N.W.2d 512 (Wis. 1977).

The deciding vote in Higginbotham was cast by a concurring opinion, which supported the ultimate conclusion reached by the plurality, but departed from the rule espoused by those three justices by expressing an alternative theory of recovery. The concurring opinion closely follows the rule set forth in Bough.

In Bough, we addressed a dispute regarding the subrogation rights of an insurer versus those of an insured for the proceeds of a poHcy-hmit settlement; those factual elements closely resemble both the case before us and the facts in Higginbotham. In this court’s unanimous decision in Bough, this court recited the following rule:

the general rule is that an insurer is not entitled to subrogation unless the insured has been made whole for his loss, [however], the insurer should not be precluded from employing its right of subrogation when the insured has been fully compensated and is in a position where the insured will recover twice for some of his or her damages.

Id. at 641.

In reviewing our decisions Bough and Higginbotham, We take this opportunity to clarify our position on the priority given to subrogation rights of insureds versus those of insurers in instances where both parties have claims against a partial recovery from a third party. It is our determination that Bough is the better rule. A contrary rule relying upon the dominance of one type of subrogation over another is arbitrary and inconsistent with theories of equity. The same facts give rise to both legal and conventional subrogation. In a situation where recovery from the wrongdoer is large enough to make both parties “whole,” no issue exists over which party’s rights prevail or which type of subrogation is controlling. However, it is often the case that it is not possible for one party, or even both parties, to be made “whole.”

In such situations, the equitable principles and objectives of subrogation are controlling. According to Couch, subrogation has dual objectives: “(1) preventing the insured from recovering twice for the one harm, as would be the case if he could recover from both the insurer and from a third person who caused the harm, and (2) reimbursing the surety for the payment which was made.” Couch on Insurance 2d (Rev. ed 1983 and Supp. 1996) Subrogation § 61:18, citing, Shipley v. Northwestern Mut. Ins. Co., 244 Ark. 1159, 428 S.W.2d. 268 (1968).

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Cite This Page — Counsel Stack

Bluebook (online)
942 S.W.2d 837, 328 Ark. 163, 1997 Ark. LEXIS 232, Counsel Stack Legal Research, https://law.counselstack.com/opinion/franklin-v-healthsource-of-arkansas-ark-1997.