State Ex Rel. Department of Human Services v. Allstate Insurance Co.

1987 OK 91, 744 P.2d 186, 1987 Okla. LEXIS 242
CourtSupreme Court of Oklahoma
DecidedOctober 13, 1987
Docket56675
StatusPublished
Cited by8 cases

This text of 1987 OK 91 (State Ex Rel. Department of Human Services v. Allstate Insurance Co.) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Ex Rel. Department of Human Services v. Allstate Insurance Co., 1987 OK 91, 744 P.2d 186, 1987 Okla. LEXIS 242 (Okla. 1987).

Opinion

SIMMS, Justice.

The ultimate issue presented in this action is whether the Department of Human Services, as lien claimant under 56 O.S. 1981, § 200, is liable for a pro rata share of the attorney fees incurred in obtaining a settlement from the tortfeasor’s insurer? We answer in the negative.

The underlying facts in this case are these. Ellen Bledsaw and her two minor children were injured in a collision with Barbara Jones, Allstate’s insured. Mrs. *187 Bledsaw was a recipient of Aid to Families with Dependent Children, and was thereby eligible to have her medical bills and those of the children paid by the Department through its medicaid program, which it did in the amount of $6,070.75.

As part of the administration of the federal medicaid program, the states are required under federal law to seek reimbursement for payment made on behalf of injured or sick recipients from third parties who are liable for medical expenses. Section 200, supra, provides in pertinent part:

“(a) Whenever the State Department of Public Welfare pays medical expenses for or on behalf of a person who has been injured, or who has suffered a disease, as a result of the negligence or act of another person, the Department shall, if such injured or diseased person asserts or maintains a claim against such other person or tortfeasor for damages on account of such injury or disease, have a lien to the extent of the amount so paid upon that part going or belonging to such injured or diseased person of any recovery or sum had or collected or to be collected * * * whether by judgment or by settlement or compromise to the extent of the amount so paid by the Department; provided, however, that this lien shall be inferior to any lien or claim of any attorney or attorneys for handling the claim on behalf of such injured or diseased person, * * *.”

It is undisputed that the Department gave proper notice of its liens in the amount of $6,070.75, to Mrs. Bledsaw and to Allstate. Mrs. Bledsaw retained an attorney to represent her and the children on a 50% contingency contract. Through this attorney Mrs. Bledsaw and her children filed suit against Barbara Jones, and the action was settled for $15,000.00.

To satisfy the settlement, Allstate issued two drafts. The first was in the amount of $8,929.25 payable to Ellen Bledsaw and her attorney. From this draft counsel paid court costs, took his contingency percentage and paid the remaining $3,879.00 to his client, Mrs. Bledsaw. The Department received nothing. The second draft was for the amount of $6,070.75 and made payable to Mrs. Bledsaw, individually and as mother and guardian of the injured children, the Department of Human Services, and her attorney.

The attorney and the Department both claimed rights to these funds and the draft, which became void on its face with the passage of 180 days, was never negotiated. Allstate is holding the proceeds pending the outcome of this litigation.

The attorney contended that the remaining court costs and his contingency share should first be paid from that draft, and then the remaining balance should go to the Department.

The Department then brought this suit to determine these competing claims. Its petition stated two alternative theories of recovery to foreclose its lien and one sounding in conversion seeking damages, including punitive damages for intentionally failing to protect its interest in the proceeds of the settlement after notice of its lien. The Department alleged that Allstate’s actions in issuing the first draft payable only to the attorney and the client and not naming the Department as payee after receiving notice of its lien, constituted a conversion of their funds. Department argued that its lien applies to the second check and should be enforced.

Allstate demurred to the petition asserting it failed to state a cause of action and the trial court sustained that position, dismissing the suit. On appeal the Court of Appeals, Division No. 2, affirmed the trial court, relying primarily on an interpretation of our decision in Vinzant v. Hillcrest Medical Center, Okl., 609 P.2d 1274 (1980), as supporting, by implication, the notion that a lien claimant should share pro rata with the patient in the cost of attorney fees necessary to obtain a settlement. The Court of Appeals also found that a conflict existed between Vinzant and a decision by the Court of Appeals, Division No. 1, in Hillcrest Medical Center v. Fleming, Okl.App., 643 P.2d 868 (1982), as to the interpretation of the hospital lien statute, 42 O.S.1981, § 43, which is closely related to the statute involved here. We do not agree *188 with the Court of Appeals’ interpretation of Vinzant nor do we agree that a conflict is presented between the holdings in Vinzant and Fleming. We have previously granted Certiorari, and we vacate the Court of Appeals opinion.

In both Vinzant and Fleming, competing claims to settlement funds were raised by attorneys and hospitals claiming under § 43, supra, which provides:

“Every hospital in the State of Oklahoma, which shall furnish emergency medical or other service to any patient injured by reason of an accident not covered by the Workmen’s Compensation Act, shall, if such injured party shall assert or maintain a claim against another for damages on account of such injuries, have a lien upon that part going or belonging to such patient of any recovery or sum had or collected or to be collected by such patient, or by his heirs, personal representatives or next of kin in the case of his death, whether by judgment or by settlement or compromise to the amount of the reasonable and necessary charges of such hospital for the treatment, care and maintenance of such patient in such hospital up to the date of payment of such damages: Provided, however, that this lien shall be inferior to any lien or claim of any attorney or attorneys for handling the claim on behalf of such patient, his heirs or personal representatives; * *

In Vinzant, the Court was concerned with a question of priority of liens in a suit brought by the hospital agaifist the lawyer for the injured party. Unlike the instant case, that action involved only questions of priority, for the settlement was not large enough to pay both liens. There was no issue raised there as to the liability of either the patient or the insurer, but only the question of priority of the attorney’s lien.

The Court of Appeals’ characterization of Vinzant as supporting Allstate’s disbursal of these funds and imposing a duty of pro rata payment of attorney fees on the Department, is erroneous. So too, is its determination that a conflict exists between Vinzant and the Court of Appeals decision in Hillcrest Medical Center v. Fleming, supra, as to the interpretation of § 43.

The facts in Fleming are very similar to the case before us. Unlike Vinzant,

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Bluebook (online)
1987 OK 91, 744 P.2d 186, 1987 Okla. LEXIS 242, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-department-of-human-services-v-allstate-insurance-co-okla-1987.