Greenwood Mills, Inc. v. Burris

130 F. Supp. 2d 949, 2001 U.S. Dist. LEXIS 868, 2001 WL 92117
CourtDistrict Court, M.D. Tennessee
DecidedJanuary 10, 2001
Docket2:99-0005
StatusPublished
Cited by7 cases

This text of 130 F. Supp. 2d 949 (Greenwood Mills, Inc. v. Burris) is published on Counsel Stack Legal Research, covering District Court, M.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Greenwood Mills, Inc. v. Burris, 130 F. Supp. 2d 949, 2001 U.S. Dist. LEXIS 868, 2001 WL 92117 (M.D. Tenn. 2001).

Opinion

MEMORANDUM

TRAUGER, District Judge.

This case comes before the court on Plaintiff Greenwood Mills, Inc.’s Motion for Summary Judgment (Docket No. 27), *952 to which Defendants James R. Omer, Sr. & Associates (hereinafter “Omer & Associates”) and Estate of Gus Wood, III have filed a Response and a Counter-Motion for Summary Judgment (Docket No. 37). Plaintiff has filed a Reply to the defendants’ response and a Response to their motion for summary judgment (Docket No. 44), to which these defendants have filed a Reply (Docket No. 46). Plaintiff Greenwood Mills, Inc. has also filed a Motion for Judgment on the Administrative Record (Docket No. 17) and a Motion for Summary Judgment (Docket No. 42) against Defendant Burris, to which no responses have been filed.

STATEMENT OF FACTS and PROCEDURAL HISTORY

Plaintiff Greenwood Mills, Inc. (hereinafter “Greenwood Mills”) is the Plan Administrator for the Health and Accident Plan for Employees of Greenwood Mills, Inc. and Associated Companies (hereinafter “the Plan”), which is covered by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. (Docket No. 45 at ¶¶ 1-2) Defendant Hayden E. Burris was a “covered person” under the Plan. (Docket No. 45 at ¶1)

The Plan, written by Greenwood Mills, contains a provision entitled “Subrogation,” that provides:

When benefits are paid to or for a person covered under this Plan the Employer will be subrogated, unless prohibited by law, to the rights of recovery of such person against any person who might be acknowledged liable or found legally liable by a Court of competent jurisdiction for the injury that necessitated the hospitalization, medical or surgical treatment for which benefits were paid. Such subrogation rights will extend only to the recovery by the Employer of benefits paid for hospitalization and treatment. The Employer will pay fees and costs associated with, such recovery.

(Docket No. 45 at ¶¶ 7-9) Neither Burris nor his lawyer, Gus Wood, III, 1 signed any additional subrogation or reimbursement agreement with Greenwood Mills. (Docket No. 45 at ¶ 10)

Burris was injured in a motor vehicle accident with a Ms. Myers on approximately January 19, 1995. (Docket No. 45 at ¶ 3; Docket No. 29, Ex. 9) The Plan paid $33,249.44 in medical expenses incurred by Burris due to that accident. (Docket No. 45 at ¶ 5) Burris apparently paid 20% of the medical expenses out of his own pocket. (Docket No. 37, Ex. 1 (Burris Dep.) at 11, 28) In addition, he may have had an $8,500 “wage claim.” (Docket No. 37, Ex. 4A)

Burris signed a “contingent fee contract” on January 23, 1995, “retain[ing] and employing] JAMES R. OMER and ASSOCIATES as [his] attorneys to represent” Burris in his suit against Ms. Myers. (Docket No. 29, Ex. 10) Burris received “Instructions to Client,” printed on the letterhead of “Law Offices of James R. Omer/An Association of Attorneys,” that instructed him, among other things, to “not talk to your own insurance company.” (Docket No. 29, Ex. 11)

Gus Wood, III was the attorney who personally handled Burris’ representation in his suit for damages relating to the 1995 accident. (Docket No. 40 at ¶ 4) According to James R. Omer, Sr., Wood was not an “employee” but was an “associate” in the firm of Omer & Associates, and had worked in that capacity for at least five years. (Docket No. 37, Ex. 2 (Omer Dep.) at 6, 9) Wood’s income consisted of “a percentage of his cases plus he had a draw against .... work performed,” drawn monthly from “a common fund.” (Docket No. 37, Ex. 2 (Omer Dep.) at 7-8)

*953 On July 18, 1995, Wood wrote to Burris, informing him that his medical expenses exceeded $25,000 as of that date and that his wage claim was over $8,500. Wood also mentioned that, as he had indicated to Burris earlier, Ms. Myers appeared to have maximum liability insurance coverage of $25,000. (Docket No. 87, Ex. 4A) Also dated July 18, 1995, is a letter sent to Burris from Subro Audit, Inc., Greenwood Mills’ subrogation administrator, containing a request for information regarding Burris’ accident and the progress of his claim. (Docket No. 29, Ex. 12)

On September 7, 1995, Wood settled Burris’ claim against Ms. Myers for $50,000. (Docket No. 29, Ex. 9; Docket No. 45 at ¶ 12) Wood dispersed $32,888.27 to Burris, after deducting an attorney fee of $16,666.67, Omer & Associates expenses of $837.06 and a physician’s assignment in the amount of $108.00. (Docket No. 29, Ex. 9; Docket No. 45 at ¶ 15)

In November 1995, Subro Audit again contacted Burris, who told the representative that he had not retained an attorney, was not sure if he would retain one, and believed that the third party did not have insurance coverage. (Docket No. 29, Ex. 13) This, of course, was not true; his attorney had settled the claim with the other driver’s insurance company for $50,000.

By letter written on Omer & Associates letterhead and dated February 29, 1996, Wood informed Burris that “we” were contacted by a representative of Provident Life & Accident Insurance Company regarding “their claimed subrogation.” (Docket No. 29, Ex. 6) Wood wrote that he had sent the representative a copy of the accident report but would not provide any further information to the insurance company until Burris gave him authorization to do so. In a letter dated May 3, 1996, Wood thanked Burris for his correspondence of the previous month and told Burris: “I would inform the Subro Audit Inc. lady that you sustained medical expenses in the amount of $26,671.86 2 and recovered only $25,000.00 which was the full amount of insurance coverage of the adverse party and as a result your [sic] were not ‘made whole’.” Wood further stated that “Tennessee Law provides there is no subrogation and you will not have to pay them anything.” (Docket No. 29, Ex. 7)

Greenwood Mills filed its Complaint on January 15, 1999, seeking equitable relief under ERISA and enforcement of the terms of the Plan against Burris (Docket No. 1). Burris filed an Answer on March 19, 1999 (Docket No. 6). With the court’s leave, Greenwood Mills filed a First Amended Complaint, naming additional Defendants James R. Omer, Sr. & Associates and Estate of Gus Wood, III (Docket No. 21).

SUMMARY JUDGMENT STANDARD

Rule 56(c) of the Federal Rules of Civil Procedure provides that summary judgment may be rendered if “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 a judgment as a matter of law.” FED. R. CIV. P. 56(c).

To prevail, the moving party must meet the burden of proving the absence of a genuine issue of material fact as to an essential element of the opposing party’s claim. See Celotex v. Catrett,

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Cite This Page — Counsel Stack

Bluebook (online)
130 F. Supp. 2d 949, 2001 U.S. Dist. LEXIS 868, 2001 WL 92117, Counsel Stack Legal Research, https://law.counselstack.com/opinion/greenwood-mills-inc-v-burris-tnmd-2001.