TURNER EX REL. TURNER v. Turner

672 S.E.2d 242, 223 W. Va. 106
CourtWest Virginia Supreme Court
DecidedDecember 30, 2008
Docket33892
StatusPublished
Cited by5 cases

This text of 672 S.E.2d 242 (TURNER EX REL. TURNER v. Turner) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
TURNER EX REL. TURNER v. Turner, 672 S.E.2d 242, 223 W. Va. 106 (W. Va. 2008).

Opinions

MAYNARD, Chief Justice.1

The plaintiffs below and appellants herein, Dylan Turner, Rhiannon Turner, and Ronan Turner, by their next friend and parent Diane Turner, and Diane Turner, individually, brought a petition in the Circuit Court of Berkeley County, pursuant to W.Va.Code § 44-10-14 (2002), for approval of proposed minor settlements reached with the defendants below, Charles Turner, Sr., Charles Turner, Jr., and Laurie Turner, arising from an automobile accident in which Ms. Turner’s three minor children were injured. The intervenor below and appellee herein, City Hospital, Inc., intervened in the settlement proceedings to assert subrogation rights to any settlement proceeds collected by Ms. Turner. The appellants are now appealing the circuit court’s order of September 26, 2007, that ruled that the court has no jurisdiction under the Employee Retirement Income Security Act (“ERISA”) to decide City Hospital’s subrogation rights under the proposed settlement. After careful consideration of this matter, we affirm the circuit court.

I.

FACTS

On October 4, 2004, Defendant Charles Turner, Jr., was operating a vehicle with the permission of the vehicle’s owners, his father, Defendant Charles Turner, Sr., and his stepmother, Defendant Laurie Turner. Mr. Turner, Jr.’s children, Rhiannon, who was seven years of age at the time, Dylan, then age five, and Ronan, then age four, were passengers in the vehicle. Mr. Turner, Jr., wrecked the vehicle when he ran it into a utility pole.2 All three children were injured with Ronan suffering the most severe injuries. According to the appellants, it is anticipated that Ronan will incur future medical costs as a result of injuries to his colon.

Ronan’s total medical bills to date as a result of the accident are $111,088.19; Dylan’s medical bills total $5,473.85; and Rhiannon’s medical bills total $688.27. The children’s medical bills were paid first by Charles Turner, Sr.’s insurance coverage in the amount of $5,000 for each child. The balance of the children’s medical bills was paid, for the most part, by the employee benefit plan provided to Diane Turner, the children’s mother, through her employer and intervenor herein, City Hospital, Inc.3 Ms. Turner’s children are beneficiaries under the [109]*109City Hospital Group Benefit Plan. According to the plan’s reimbursement/subrogation provisions, in part:

RIGHT OF REIMBURSEMENT AND SUBROGATION
To the extent The Plan pays or reimburses any medical or other expense for a Covered Person, it shall have the right to be reimbursed for those expenses from any recovery that any Covered Person may obtain from or against any individual ... or any other entity which may be liable for such payment as the result of negligence, contract, or otherwise, including, but not limited to, that Covered Person’s own insurance company (for example, that Covered Person’s own uninsured or under-insured motorist coverage for automobile insurance medical payments provisions or homeowner’s coverage) (hereinafter referred to as “Responsible Party”); this is known as The Plan’s right of reimbursement.
... If the Plan Administrator determines, in its sole discretion, that the Covered Person is not adequately protecting the Plan’s interests in connection with his or her pursuit of a claim against any Responsible Party, then the Plan Administrator, on behalf of the Plan, shall have the right to intervene in the civil action, lawsuit, or claim which the Covered Person has filed or made against any Responsible Party to the extent the Plan has paid or reimbursed any medical or other expenses for that Covered Person under The Plan; this is known as the Plan’s right of subrogation.
The Plan’s rights of reimbursement and subrogation are hereinafter referred to as “Right of Subrogation.”
The Plan’s Right of Subrogation shall constitute an equitable lien against the proceeds (no matter how they are characterized) of any: (1) settlement or compromise between a Covered Person and any Responsible Party; or (2) judgment or award obtained by any Covered Person against any Responsible Party. Further, the Plan’s Right of Subrogation shall constitute such lien notwithstanding any allocation or apportionment that purports to dispose of portions of the Covered Person’s cause of action not subject to the Plan’s Right of Subrogation. Any settlement, compromise, judgment, or award which excludes or limits or attempts to exclude or limit the cost of medical care or services, or medical products ... shall not preclude the Plan from enforcing its Right of Subrogation and/or subrogation lien. The Plan’s Right of Subrogation and/or subrogation lien shall not be eliminated or limited in any way should the settlement, compromise, judgment, or award fail to fully compensate or “make whole” the Covered Person on his or her total claim against any Responsible Party.
* * * * * *
A Covered Person and/or his or her legal counsel shall promptly pay to the Plan Administrator all amounts recovered as a result of any settlement, compromise, judgment, or award to the extent that any medical or other expenses for that Covered Person have been paid under the Plan---The Plan has no obligation or duty to pay any legal fees or expenses incurred by such Covered Person in reaching a settlement or compromise or obtaining a judgment or award.

The appellants thereafter reached a tentative settlement agreement with the defendants’ insurer, Westfield Insurance Company, and Ms. Turner’s underinsurer, Nationwide Insurance Company, on behalf of her children. Under the proposed settlement, Ms. Turner agreed to waive her interest in the settlements and settle the children’s cases within the policy limits so long as City Hospital would be precluded by the circuit court from asserting a lien on the settlement proceeds that is inconsistent with state law. The policy limits on the Westfield policy are $100,000 per person and $300,000 per accident. The policy limits on the Nationwide policy are $15,000 per person. Because Ms. Turner’s children are minors, she was required to seek the circuit court’s approval of the settlement [110]*110pursuant to W.Va.Code § 44-10-14.4

City Hospital, as fiduciary of its employee benefit plan, subsequently filed an objection to the proposed settlements and a motion for continuance in order to assert its plan’s reimbursement/subrogation rights. In this objection and motion, City Hospital requested that the circuit court,

reschedule [a previously scheduled] hearing on the Petitions before it so as to allow counsel for [City Hospital] to attend the hearing. [City Hospital] also respectfully requests that the Court deny the Petitions as currently presented inasmuch as said Petitions make no provision for reimbursement of [City Hospital’s] health insurance benefits plan for the health insurance benefits expended on behalf of Diane Turner’s children, Dylan, Rhiannon and Ronan.

The circuit court considered the objection as a motion to intervene pursuant to Rule 24(a) of the West Virginia Rules of Civil Procedure, and granted the motion.

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Cite This Page — Counsel Stack

Bluebook (online)
672 S.E.2d 242, 223 W. Va. 106, Counsel Stack Legal Research, https://law.counselstack.com/opinion/turner-ex-rel-turner-v-turner-wva-2008.