Leingang v. Pierce County Medical Bureau, Inc.

131 Wash. 2d 133
CourtWashington Supreme Court
DecidedJanuary 23, 1997
DocketNo. 62222-1
StatusPublished
Cited by257 cases

This text of 131 Wash. 2d 133 (Leingang v. Pierce County Medical Bureau, Inc.) is published on Counsel Stack Legal Research, covering Washington Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Leingang v. Pierce County Medical Bureau, Inc., 131 Wash. 2d 133 (Wash. 1997).

Opinions

Guy, J.

In this case, a health care service contractor appeals a trial court’s grant of summary judgment in favor of one of its insureds on a Consumer Protection Act cause of action. We find that there is no evidence of an unfair or deceptive act on the part of the health care contractor and reverse the order of summary judgment. We grant summary judgment to the health care service contractor on [137]*137the Consumer Protection Act cause of action. The health care service contractor also appeals the trial court’s award of attorney fees for the declaratory judgment portion of the insured’s action which involved a dispute about coverage under an exclusion in the medical insurance contract. We affirm the trial court’s award of attorney fees under the rule announced in Olympic S.S. Co. v. Centennial Ins. Co., 117 Wn.2d 37, 811 P.2d 673 (1991) (Olympic Steamship). We order the award of reasonable attorney fees for the portion of the action in this court which concerned the award of attorney fees in the declaratory judgment action. We affirm the trial court’s order of summary judgment in favor of the health care service contractor on the cause of action for intentional interference with a contract.

FACTS

In May 1989, Dennis Leingang was injured in an automobile accident. At the time of the accident, Mr. Le-ingang had medical insurance under a health care service contract which his employer had with Pierce County Medical Bureau, Inc. (PCM). PCM is a "health care service contractor” licensed under RCW 48.44. At the time of the accident, Mr. Leingang also had automobile insurance, including uninsured and underinsured motorist (UIM) coverage, with Farmers Insurance Company. The driver of the other vehicle involved in the accident was underin-sured.

The "Exclusions” portion of the PCM medical insurance contract contained the following language:

No benefits will be provided any subscriber . . . for any of the following . . .
Benefits to the extent benefits are payable under the terms of any automobile medical, automobile no-fault, underinsured or uninsured motorist or similar contract of insurance, when such contract or insurance is issued to . . . the subscriber

[138]*138Clerk’s Papers at 102-03.1

In July 1989, Mr. Leingang’s attorney wrote to PCM demanding payment of the medical bills incurred due to the accident. PCM responded that it was sending Mr. Leingang a copy of their standard subrogation agreement for his signature and would begin making payment on the medical bills on receipt of that agreement. PCM sent with that letter a subrogation agreement which stated in part:

The benefits of this contract will be available to a subscriber . . . who is injured by another party. If [PCM] provides benefits under this contract for the treatment of the injury, [PCM] shall (a) be subrogated to the rights of the subscriber ...(b) have the right to collect damages from the other party, and (c) have a security interest in any damage recoveries from the other party.
. . . If a settlement is made or a judgment is recovered that is equal to or greater than the amount of the other party’s "reachable assets,” [PCM’s] subrogation right shall be limited to the excess of the amount necessary to fully compensate the subscriber . . . .[2]

Clerk’s Papers at 22. At the bottom of that subrogation agreement, PCM also stated:

Quoted below is the contract wording of an exclusion covering all types of automobile insurance.
Benefits to the extent benefits are payable under the terms [139]*139of any automobile medical, automobile no-fault, underin-sured or uninsured motorist or similar contract of insurance, when such contract or insurance is issued to or on behalf of the subscriber or dependent.
We are calling your attention to this exclusion for in the event we agree to subrogate and any benefits are payable under automobile insurance, we expect full reimbursement to the extent of that payment or benefit received.

Clerk’s Papers at 22.

Mr. Leingang refused to sign the agreement. In spite of Mr. Leingang’s refusal to sign, PCM paid Mr. Leingang’s medical bills. However, PCM did continue to maintain that it had a right to be reimbursed if the UIM carrier subsequently paid Mr. Leingang because there was no coverage to the extent of UIM payment.

After paying Mr. Leingang’s medical bills, PCM’s attorney wrote a letter to Farmers Insurance, Mr. Lein-gang’s UIM carrier, and to Allstate Insurance, the insurance carrier for the other driver. That letter informed them that PCM was asserting a security interest and subrogation claim against any future settlement or judgment for reimbursement for the medical bills it had paid on behalf of Mr. Leingang.

Mr. Leingang filed an action against the alleged tortfea-sors (the dealership that had sold him a defective car and the driver of the other car), their insurers, Farmers Insurance and PCM. In that action, Mr. Leingang sought declaratory relief against PCM, requesting a ruling that PCM was not entitled to be reimbursed for payment of the medical bills from any recovery under the UIM insurance. Mr. Leingang also alleged that PCM tortiously interfered with his contract with Farmers, that PCM’s conduct had violated the Consumer Protection Act, RCW 19.86, and that he should recover his emotional distress damages from PCM.

After first disputing the claim, Farmers Insurance ultimately paid the $100,000 limits of the UIM policy into [140]*140the registry of the court pending resolution of the issue whether the funds were due directly to Mr. Leingang or to PCM for reimbursement of the medical bills it had already paid.

Mr. Leingang filed a motion for summary judgment asking the trial court to rule that PCM had no claim against the UIM proceeds and was not entitled to be reimbursed the amounts PCM had paid for his medical bills. PCM made a cross motion for summary judgment.

The trial court granted summary judgment in favor of PCM. The trial court held that PCM’s exclusion was enforceable. The trial court stated:

Pierce County Medical has drafted a clear and unambiguous provision which excludes benefits to their subscribers if the same benefits are payable under the terms of any automobile underinsured or uninsured motorist policy provision. There is nothing in statute or judicial decision that would indicate such a provision should not be enforced.

Clerk’s Papers at 134. The trial court concluded PCM was entitled to judgment as a matter of law on its right to reimbursement of medical bills from the UIM proceeds even before Mr. Leingang had been fully compensated for all of his damages. The trial court explained that it was fair that PCM had paid the bills initially, but that if the UIM carrier did make payment, then the exclusion in the health care contract would allow reimbursement to PCM.

Mr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
131 Wash. 2d 133, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leingang-v-pierce-county-medical-bureau-inc-wash-1997.