In re Estate of Ries

2021 IL App (2d) 191027
Appellate Court of Illinois·Decided January 19, 2021·No. 2-19-1027·Published·Cited by 1 cases

Opinion

2021 IL App (2d) 191027 No. 2-19-1027 Opinion filed January 19, 2021 ______________________________________________________________________________

IN THE

APPELLATE COURT OF ILLINOIS

SECOND DISTRICT ______________________________________________________________________________

In re ESTATE OF ) Appeal from the Circuit Court LOIS K. RIES, Deceased ) of Winnebago County. ) ) No. 16-P-367 (James Ries and Joseph Ries, ) Petitioners-Appellees v. ) Honorable The Department of Healthcare and ) Donald P. Shriver, Family Services, Respondent-Appellant). ) Judge, Presiding. ______________________________________________________________________________

JUSTICE JORGENSEN delivered the judgment of the court, with opinion. Justices McLaren and Brennan concurred in the judgment and opinion.

OPINION

¶1 Respondent, the Department of Healthcare and Family Services (Department) had paid

medical expenses on behalf of the decedent, Lois K. Ries. Respondent now appeals the trial court’s

decision barring its claim for those expenses against Lois’s estate (the Estate), which is executed

by petitioners, James and Joseph Ries, her sons and heirs.

¶2 Specifically, pursuant to section 5-13 of the Illinois Public Aid Code (Code) (305 ILCS

5/5-13 (West 2018)), the Department brought a claim against the Estate to recover benefits it had

paid on Lois’s behalf. The Estate, however, argued that the Department’s claim was barred because

the Department had already settled a lien it had filed against the Estate pursuant to section 11-22

of the Code (id.§ 11-22). The settled lien involved personal-injury litigation. The Estate argued,

and the trial court agreed, that, where the only funds remaining in the Estate derived from the 2021 IL App (2d) 191027

personal-injury lawsuit, the Department could not again recover from the same source of funds.

The Department argues on appeal that the court’s ruling was incorrect because its settlement

concerned only personal-injury expenses, not the expenses that the Department had paid on Lois’s

behalf prior to the personal injury. For the following reasons, we reverse and remand.

¶3 I. BACKGROUND

¶4 Lois was a public-aid recipient. The Department paid her medical expenses for almost 11

years: specifically, from October 5, 2005, until her death on July 17, 2016. In total, the Department

paid on Lois’s behalf $212,567.94 in medical benefits.

¶5 In November 2011, Lois’s spinal cord was injured during an epidural injection, rendering

her a quadriplegic. The Department paid her medical expenses related to the injury.

¶6 In January 2013, Lois filed a personal-injury lawsuit against the treating hospital and

certain doctors. In August 2013, the Department, pursuant to sections 11-22 and 11-22b of the

Code (id. §§ 11-22, 11-22b), asserted a lien against any potential recovery Lois obtained from the

personal-injury litigation, seeking to recover expenses it had paid on her behalf that were

specifically attributable to her tort injury. The Department noted that the amount of the lien could

not yet be determined because it was still paying for Lois’s medical treatment, including that

resulting from her injury.

¶7 In July 2016, Lois died while the lawsuit remained pending. Consequently, the Estate was

opened and it continued to prosecute the lawsuit, with James and Joseph serving as Estate

executors. Critical here, the lawsuit was the Estate’s sole asset.

¶8 In December 2016, the Department filed against the Estate a claim for the entirety of the

medical expenses it had paid on Lois’s behalf during her lifetime, i.e., $212,567.94.

-2- 2021 IL App (2d) 191027

¶9 In 2018, the Estate sought to settle the lawsuit and approached the Department about

reducing its claim. In short, the Department reduced its personal-injury lien from $124,679.63 to

$20,000, and the lawsuit settled. Thereafter, the Department filed a modified claim against the

Estate, reducing the claim from $212,567.94 to $87,929.87, to reflect that the expenses attributable

to the personal injury had been satisfied by virtue of the settlement.

¶ 10 Apparently in response to the modified claim, the Estate, in June 2019, filed a petition to

adjudicate the Department’s claim under section 11-22 of the Code. The Estate asserted that,

because various lienholders, including the Department, had reduced their claims related to the

personal injury, the lawsuit had settled for $415,000. Further, having paid the lawsuit expenses,

the remaining $80,819.04 was to be distributed to James and Joseph. The Estate argued that the

Code did not authorize the Department to recover twice from the same settlement pool of money,

and it claimed that it did not know that the Department would seek reimbursement for the amounts

it had paid for Lois’s medical care prior to her injury. The Estate further argued that, if the court

determined that the Department was entitled to recovery for preinjury medical expenses, those

expenses should be reduced to $14,068.78, to reflect an offset for the Department’s fair share of

the attorney fees that had been expended to obtain the personal-injury award.

¶ 11 In response, the Department argued that it had agreed to settle only its claim for

reimbursement for the medical expenses related to Lois’s injury and that its acceptance of $20,000

for those expenses did not act to extinguish its claim for the expenses it paid for her preinjury care.

The Estate replied that the Department should not be allowed to assert a second claim on the same

settlement proceeds and that, had it known that the Department would do so, the Estate would not

have settled the personal-injury lawsuit.

-3- 2021 IL App (2d) 191027

¶ 12 At oral argument on the petition, the Estate argued that “the only reason” it settled the

personal-injury lawsuit was its understanding that the Department would be taking only $20,000

from the “medical malpractice pot.” The Department’s counsel disputed this understanding,

commenting, “I think what our disagreement with [the Estate’s)] counsel would be [is] that there

wasn’t ever a representation that we were going to settle our entire claim. Only that we were going

to settle our personal-injury [claim].” The Estate’s counsel disagreed:

[THE ESTATE’S COUNSEL]: “And I could get you the letter, Judge. I mean, I, I

can remember the conversation I had with Kevin Thornton [(presumably a Department

representative)]. I called Kevin, I’ve known Kevin for years. I’ve dealt with many, many

cases and I said, Kevin, look, here’s the deal. I have this medical malpractice case. You’ve

sent me your itemization and you’re telling me I’ve got problems with this case. There’s a

serious causation problem in this case. I need help from Medicare and I need help from

you, otherwise we’re going to go to trial and we’re going to lose. *** That’s what happened

and then he, he sent me a letter saying the personal injury lien is settled for—” (Emphases

added.)

¶ 13 The referenced letter, dated May 21, 2018, from the Department to the Estate’s counsel,

reads as follows:

“Dear MEYERS & FLOWERS

In follow up to your recent inquiry, this letter will confirm that the Department has

a lien in the amount of $124,679.63, and the Department is willing to accept $20,000.00,

in settlement for the injuries related to the accident of November 23, 2011. If my

understanding is incorrect, please contact me.

-4- 2021 IL App (2d) 191027

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