United States v. St. Paul Mercury Indemnity Company, a Corporation

238 F.2d 594, 1956 U.S. App. LEXIS 4066
CourtCourt of Appeals for the Eighth Circuit
DecidedDecember 4, 1956
Docket15499_1
StatusPublished
Cited by47 cases

This text of 238 F.2d 594 (United States v. St. Paul Mercury Indemnity Company, a Corporation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. St. Paul Mercury Indemnity Company, a Corporation, 238 F.2d 594, 1956 U.S. App. LEXIS 4066 (8th Cir. 1956).

Opinion

JOHNSEN, Circuit Judge.

A veteran of World War II became afflicted with poliomyelitis and was admitted to a Veterans Hospital under the authority of 38 U.S.C.A. § 706. He remained as a patient for about a year and was then released.

He had insurance at the time, in the form of a "poliomyelitis expense policy”, issued by an insurance company, under which the insurer agreed to pay him, in case he was striken with poliomyelitis, “for expenses actually incurred” by him in required hospital care, medical care and other enumerated treatment incidents, “the amount of the expenses actually incurred by the Insured”, not exceeding the aggregate sum of $5,000.

The Veterans’ Administration had taken an assignment from him of his rights under the policy, upon his admission to the hospital. And during the time that he continued to be a patient, it submitted statements periodically to the insurer for the reasonable value of the care and treatment which it was providing to him. The statements were in a total of $3,796.69.

The insurer refused to recognize the purported charges as “expenses actually incurred by the Insured”, within the terms of the policy, upon the grounds that the insured had sought and qualified for admission, under 38 U.S.C.A. § 706, as a veteran entitled to free care and treatment for his ailment; that in this situation the Veterans’ Administration was without authority under the statute to make any charge against him for the care and treatment furnished him; that any charge attempted to be made would therefore not constitute legally an obligation against him; that it could accordingly not be claimed to represent “expenses-actually incurred by the Insured” 1 that the insured himself thus would be without any recovery right upon the policy for-this care and treatment; and that necessarily in these circumstances the insurer equally could have no liability to the-Veterans’ Administration as assignee of the insured’s rights.

The Government subsequently brought this suit against the insurer, under the-assignment taken by the Administrator of Veterans’ Affairs, to recover on the.policy, as “expenses actually incurred by the Insured”, the value of the care and treatment which the Veterans’ Administration had thus provided to the insured. After a trial, the court dismissed the.action, D.C., 133 F.Supp. 726, and tho Government has appealed. We think the-judgment is entitled to be affirmed.

The material portion of 38 U.S.C.A. §" 706, in the application of the statute to the situation involved, is as follows: “ * * * the Administrator of Veterans’" Affairs is authorized under such limitations as he may prescribe, and within the- *596 limits of existing Veterans’ Administration facilities, to furnish to * * * veterans of any war *• * * medical and hospital treatment for diseases or injuries: Provided, That any veteran of any war who was not dishonorably discharged, suffering from disability, disease or defect, who is in need of hospitalization or domiciliary care and is unable to defray the necessary expenses therefor (including transportation to and from the Veterans’ Administration facility), shall be furnished necessary hospitalization or domiciliary care (including transportation) in any Veterans’ Administration facility, within the limitations existing in such facilities, irrespective of whether the disability, disease, or defect was due to service. The statement under oath of the applicant on such form as may be prescribed by the Administrator of Veterans’ Affairs shall be accepted as sufficient evidence of inability to defray necessary expenses.”

The provisions of the section, commencing with the word “Provided” and including the sentence which follows the proviso, were not contained in the statute as originally enacted. They came into § 706 a year later, as an addition made by Congress to the previous general terms of the section, in grant of a specifically expressed veteran beneficence. The language used seems to us, as it did to the trial court, to mandate unequivocally that the Administrator of Veterans’ Affairs should thereafter, within the bounds of such Veterans’ Administration facilities as existed, and within the scope of such operation of them as the Administrator deemed administratively feasible and possible under the funds provided by Congress therefor, furnish necessary hospitalization or domiciliary care to any veteran who had not been dishonorably discharged, when he. was suffering from any disability, disease or defect and was in need of hospitalization or domiciliary care by reason thereof, and when he was financially unable to defray the expenses therefor. And as to the last condition mentioned, the Administrator was left with no power of determination or judgment, but it was expressly mandated that he should accept as sufficient evidence of the veteran’s inability to defray necessary expenses, the veteran’s own statement under oath, upon a form prescribed by the Administrator, that he was unable to defray such expenses.

The insured here had duly stated under oath, upon a form prescribed by the Administrator, that he was financially unable to pay the expenses of necessary hospital or domiciliary care. The Government’s brief says as to the statutory provision : “We do not question that the veteran making such a sworn statement must be admitted if facilities permit.” But it argues that, because the Administrator had seen fit to require the veteran further to indicate upon the form supplied to him whether he carried any insurance covering hospital care and the veteran had revealed in answer thereto that he had the policy which is involved, the Administrator was entitled to make a charge in relation to the insurance and to enforce collection thereof against the insurer on the basis of the assignment which the insured had given him.

The argument does not go the length of contending that any attempt by the Administrator to make a charge generally against a veteran, admitted to a Veterans Hospital on the basis of his statement under oath, as provided for by § 706, that he was unable to defray the necessary expenses of hospitalization or domiciliary care, would be capable legally of giving rise to a personal obligation on the part of the veteran for the value of the care furnished to him. Nor does the regulation. which the Administrator has adopted, 38 C.F.R. § 17.48(d), as to situations where a veteran, admitted under the affidavit provided for by the statute, happens to be carrying insurance or may otherwise be entitled to the cost of hospital or medical care from a third party, appear to constitute an attempt by the Administrator to make a charge in fact against the veteran, notwithstanding § 706, so that the veteran thus is not being *597 accorded free services but is intended by the Administrator to have a personal obligation therefor.

Rather, when the regulation is read as a whole, it would seem that it was designed merely as a vehicle for putting the Administrator in a position facially to seek reimbursement, for the care furnished to a veteran, from any third party who might have a liability, whether direct or contingent, to the veteran in relation thereto.

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Bluebook (online)
238 F.2d 594, 1956 U.S. App. LEXIS 4066, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-st-paul-mercury-indemnity-company-a-corporation-ca8-1956.