Indiana Insurance Guaranty Ass'n v. Blickensderfer

778 N.E.2d 439, 2002 Ind. App. LEXIS 1893, 2002 WL 31514607
CourtIndiana Court of Appeals
DecidedNovember 13, 2002
Docket20A05-0110-CV-448
StatusPublished
Cited by12 cases

This text of 778 N.E.2d 439 (Indiana Insurance Guaranty Ass'n v. Blickensderfer) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Indiana Insurance Guaranty Ass'n v. Blickensderfer, 778 N.E.2d 439, 2002 Ind. App. LEXIS 1893, 2002 WL 31514607 (Ind. Ct. App. 2002).

Opinion

OPINION

BARNES, Judge.

Case Summary

The Indiana Insurance Guaranty Association (“IIGA”) appeals the judgment entered in favor of Drs. Janelle Blickens-derfer and Alan Bierlein (collectively “doctors”). This case involves a question of first impression regarding the application of the Indiana Insurance Guaranty Law of 1971 (“the Act”), found at Indiana Code Section 27-6-8-1 et seq. We affirm.

Issues

We restate the issues presented by IIGA as follows:

I. whether the trial court erroneously held that proceeds from health insurance policies do not reduce IIGA’s obligation to pay under Indiana Code Section 27-6-8-11(a); 1 and
II. whether the trial court erred in its determination that IIGA owes a continuing duty to defend the doctors under Indiana Code Section 27 — 6—8—7(a) (ii) of the Act.

Facts

IIGA is a statutorily-created entity that operates under the Act to “provide a mechanism for the payment of claims under certain insurance policies” when certain insurers become insolvent. Ind.Code § 27-6-8-2. Blickensderfer and Bierlein are physicians practicing in Indiana. Each purchased malpractice insurance with limits of $100,000 per occurrence from P-I-E Mutual Insurance Company, which subsequently became insolvent. Each physician was sued for malpractice in unrelated cases, and they sought indemnification and defense from IIGA because of the insolvency of their malpractice carrier. The health insurance provider for each of the claimants paid over $100,000 for expenses resulting from the injuries alleged to have been caused by the malpractice. IIGA refused to defend or indemnify the doctors from the claims asserted against them on the basis of the non-duplication of recovery provisions of Indiana Code Section 27-6-8-11.

The doctors each sought declaratory judgment against IIGA to establish its coverage duties and liabilities, which suits were consolidated. In June 2000, the doctors filed a motion for summary judgment, to which IIGA responded and filed a cross-motion for summary judgment. The trial court denied the motions and tried the matter on July 5, 2001. The trial court entered judgment against IIGA and held that the health insurance benefits paid to the claimants did not reduce the indemnification obligations of IIGA and that IIGA was required to defend the doctors in the medical malpractice claims. The trial court determined in relevant part:

*441 10. [IIGA] reviewed the ... claims and concluded that, because the health insurance providers ... paid [the claimants] more than $100,000.00 in health insurance benefits, the non-duplication of recovery provision ... exhausted the liability insurance limits of [IIGA], In reliance upon this non-duplication of recovery provision, [IIGA] refused to provide a defense or indemnify [the doctors] ....
13. ... State courts which have interpreted insurance guaranty law have held that non-duplication of recovery provisions, such as the one found at Indiana Code § 27-6-8-11, do not apply to health insurance benefits.... The non-duplication of recovery provision does not apply to health insurance benefits paid to a claimant because health insurance benefits are forms of insurance expressly excepted by the Model Guarantee [sic] Act. [Alabama Insurance Guaranty Assoc., 514 So.2d 1000, 1002 (Ala.1987).] Similarly, Indiana Code § 27-6-8-3 provides that “This chapter applies to all kinds of direct insurance except life, annuity, health, or disability insurance.”
14. ... In a situation like the one presented in this case, where a claimant receives health insurance benefits, which are expressly excepted, and files a medical malpractice claim against an insured health care provider, the claimant will not receive a windfall judgment or obtain double recovery. The purpose of guaranty law is best fulfilled by excluding health care benefits from the non-duplication of recovery provision of the statute. To ignore this exclusion would defeat the entire purpose of guaranty law in that insured health care providers would get no relief and would suffer extreme financial loss in the event their insurers became insolvent.

Appendix pp. 17-18. IIGA now appeals.

Analysis

At the outset, we note that we apply a de novo standard of review to this case because it involves a pure question of statutory interpretation; the facts are not in dispute. “A question of statutory interpretation is a matter of law to be determined by this court. We are not bound by a trial court’s legal interpretation of a statute and need not give it deference. We independently determine the statute’s meaning and apply it to the facts before us.” Perry-Worth Concerned Citizens v. Board of Comm’rs of Boone Co., 723 N.E.2d 457, 459 (Ind.Ct.App.2000) (citations omitted), trans. denied.

I. Health Insurance Payments

Indiana adopted the Act, with modifications, from the Model Insurance Guaranty Act (“Model Act”). The Model Act has been adopted in one form or another in every state. The purpose of the Act is:

to provide a mechanism for the payment of claims under certain insurance policies to avoid excessive delay in payment and to avoid excessive financial loss to claimants or policyholders because of the insolvency of an insurer, to assist in the detection and prevention of insurer insolvencies, and to provide an association to assess the cost of this protection among insurers.

I.C. § 27-6-8-2. 2 The Act attempts to achieve its stated purpose of avoiding ex *442 cessive financial loss to claimants and/or policyholders by creating an “association” of “member insurers.” See I.C. §§ 27-6-8-4(2), 27-6-8-4(6) & 27-6-8-5.

The essence of IIGA’s argument is that because the health insurance companies of the claimants allegedly injured by the malpractice of the doctors had already paid more than $100,000 each for medical expenses, IIGA was not responsible for any further coverage under the Act. Resolution of this case turns on the interpretation of Indiana Code Section 27-6-8-11, which provides:

(a) Any person having a claim against an insurer under any provision in an insurance policy other than a policy of an insolvent insurer which is also a covered claim, shall be required to exhaust first the person’s right under the policy. Any amount payable on a covered claim under this chapter shall be reduced by the amount of recovery under the insurance policy.

The express language of the statute and the rules of statutory construction apply. See ISTA v. Board of School Comm’rs of Indianapolis, 693 N.E.2d 972

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Bluebook (online)
778 N.E.2d 439, 2002 Ind. App. LEXIS 1893, 2002 WL 31514607, Counsel Stack Legal Research, https://law.counselstack.com/opinion/indiana-insurance-guaranty-assn-v-blickensderfer-indctapp-2002.