Ryan ex rel. Bye v. Sigmund

528 N.W.2d 43, 191 Wis. 2d 178, 1995 Wisc. App. LEXIS 49
CourtCourt of Appeals of Wisconsin
DecidedJanuary 18, 1995
DocketNo. 94-2190-FT
StatusPublished
Cited by1 cases

This text of 528 N.W.2d 43 (Ryan ex rel. Bye v. Sigmund) is published on Counsel Stack Legal Research, covering Court of Appeals of Wisconsin primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ryan ex rel. Bye v. Sigmund, 528 N.W.2d 43, 191 Wis. 2d 178, 1995 Wisc. App. LEXIS 49 (Wis. Ct. App. 1995).

Opinion

LaROCQUE, J.

Danielle Ryan, by her guardian ad litem, appeals a judgment awarding General Casualty Company of Wisconsin's subrogation claim, thereby reimbursing it for medical expense payments made to her following a personal injury accident.1 Danielle contends that General Casualty waived its right to subrogation. She contends, alternatively, that case law bars a subrogation claim because a jury found her solely responsible for her injuries. We disagree with both contentions and affirm.

Karen Sigmund struck and injured Danielle, age seven, who was crossing a street near a school shortly after exiting a school bus. Danielle was reimbursed for all of her medical expenses, $6,650.88 from her parents' health insurer, Employers Health Insurance Company (which waived its subrogation rights), and $5,000 under the medical pay provisions of her parents' General Casualty Company of Wisconsin auto policy. Danielle and her parents filed suit against Sigmund, Sigmund's insurer, various school bus drivers and the school district's insurer, Wausau Underwriters Insurance Company. General Casualty was also named [181]*181because it claimed to be subrogated for its payments under its policy. Wausau Underwriters obtained a "Pierringer release" from the lawsuit for $20,000.2 The claim against Sigmund and her insurer went to trial, and a jury found only Danielle negligent. It found her damages to be $11,500, and the court added the sum equal to Danielle's past health care expenses of $11,485.95, for a total verdict of $22,985.95.3 General Casualty sought and obtained recovery of its $5,000 medical payments on grounds that Danielle's recovery of more than $31,000 in medical insurance coverage and settlement funds exceeded her damages as established by the trial verdict.

THE WAIVER ISSUE

Danielle maintains that General Casualty failed to comply with § 803.03(2)(b), STATS., and thereby waived any subrogation claim.4 We disagree.

[182]*182Danielle relies upon Radloff v. General Cas. Co., 147 Wis. 2d 14, 432 N.W.2d 597 (Ct. App. 1988). That case upheld the trial court's discretionary declaration that a subrogated insurer lost its subrogation rights when it was named as party defendant but declined to exercise one of the three options under the statute: (1) to participate in the prosecution of the action; (2) to agree to have its interest represented by the party who caused the joinder; or (3) to move for dismissal.

Radloff is inapposite. Although the subrogee was named a party defendant, it did not respond to the complaint, entered no appearance in the action and did not participate in the prosecution; "In short, it did nothing." Id. at 16, 432 N.W.2d at 598. Prior to trial, the plaintiff settled its claim against the principal defendants; the subrogee refused to sign the settlement check needed to complete the settlement because the plaintiffs refused to reimburse for the money paid toward medical expenses; the trial court declared that the subrogated insurer had lost its subrogation rights for failing to act. Its decision was affirmed on appeal. Id.

The express rationale for the Radloff holding is the promotion of judicial economy and that judicial discretion to compel compliance with § 803.03, Stats., is essential to fulfill the legislative purpose. Id. at 19-20, [183]*183432 N.W.2d at 599. Issues may arise regarding the right to subrogation that should be addressed beginning with the pleadings. The subrogee in Radloff utterly failed to assert its rights at the same time it held up a settlement of the case on grounds that it had such rights.

Here, General Casualty did no such thing. It filed an answer, counterclaim and cross-claim asserting its subrogation interest. It served a formal request upon all parties asking them to admit General Casualty's insurance policy, admit that it paid $5,000 for Danielle's medical expenses and that the sums were reasonably and necessarily incurred as a result of her accident. It appeared by counsel on the first day of trial and, during a chambers conference, put its policy into evidence and confirmed that there was no dispute concerning its payment of medical expenses. It sought and obtained the trial court's permission to be excused from further participation in the trial. It then filed a postverdict motion and brief in support of its rights and appeared to argue its motion. Its request not to participate in the trial under these circumstances did nothing to impair the efficient and orderly disposition of the case. It obtained formal admissions relating to any factual disputes that could arise concerning the medical bills it had paid. It pursued its legal position in a timely and proper fashion. The trial court did not erroneously exercise its discretion by entertaining the postverdict motion for relief based upon the record.

MERITS OF THE SUBROGATION CLAIM

Danielle argues that even if the issue were not waived, General Casualty loses on the merits. Again we disagree.

[184]*184Danielle's damages totaled $22,985.95. Danielle recovered over $31,000. If subrogation principles were not applied, she would receive a double recovery of her medical expenses.

Under circumstances where an insured has received full damages from the tortfeasor and has also been paid for a portion of those damages by the insurer, he receives double payment — -he has been made more than whole. Only under those circumstances is the insurer, under principles of equity, entitled to subrogation. Subrogation is to be allowed only when the insured is compensated in full by recovery from the tortfeasor. The insured is to be made whole, but no more than whole.

Rimes v. State Farm Mut. Auto. Ins. Co., 106 Wis. 2d 263, 282, 316 N.W.2d 348, 353 (1982). Whether an insurer is claiming rights under the insurance contract, or under rules of equity, the entire law of subrogation is based upon equitable principles. Id. at 271, 316 N.W.2d at 353. The purpose of subrogation is to prevent a double recovery by the insured. Id. at 272, 316 N.W.2d at 353. General Casualty's policy incorporated a subrogation provision.

Danielle pursues her appeal based upon language found in Sorge v. National Car Rental System, 182 Wis. 2d 52, 512 N.W.2d 505 (1994). In Sorge, the court merely held that a plaintiff was "made whole" for purposes of subrogation where recovery is reduced by the extent of her negligence but where she was otherwise fully compensated for her losses. Id. at 62, 512 N.W.2d at 509.

It is true that Sorge rebuts an argument made by the plaintiff in that case that incorporates a circum[185]*185stance whereby the subrogee is denied recovery. That circumstance, however, is not present in this case.

The argument to which Danielle refers is Sorge's general recognition that subrogated insurers stand in the shoes of the insured and may recover that percentage of their payments attributable to the tortfeasor's negligence. Id. at 63, 512 N.W.2d at 509.

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Bluebook (online)
528 N.W.2d 43, 191 Wis. 2d 178, 1995 Wisc. App. LEXIS 49, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ryan-ex-rel-bye-v-sigmund-wisctapp-1995.