Watters v. State, Department of Transportation & Development

768 So. 2d 733, 25 Employee Benefits Cas. (BNA) 1531, 2000 La. App. LEXIS 2199, 2000 WL 1409625
CourtLouisiana Court of Appeal
DecidedSeptember 27, 2000
DocketNo. 33,870-CA
StatusPublished
Cited by3 cases

This text of 768 So. 2d 733 (Watters v. State, Department of Transportation & Development) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Watters v. State, Department of Transportation & Development, 768 So. 2d 733, 25 Employee Benefits Cas. (BNA) 1531, 2000 La. App. LEXIS 2199, 2000 WL 1409625 (La. Ct. App. 2000).

Opinion

L GASKINS, J.

The intervenor, Morehouse General, Hospital Employee Benefit Plan (Plan), appeals from a trial court decision granting summary judgment in favor of the plaintiffs, Ronald Watters, his wife Carolyn and their daughter Caroline, and dismissing the Plan’s claim of subrogation for medical expenses for Caroline following a serious auto accident. For the following reasons, we affirm.

FACTS

On November 24, 1993, around 8:00 p.m., Caroline Watters, minor daughter of Ronald and Carolyn Watters, was a guest passenger in a Chevrolet Blazer owned by Larry A. Greenwood and operated by Kelli Lynn Coley. Ms. Coley was driving on U.S. Highway 165, about 6.4 miles north of Mer Rouge. The right tires of the vehicle went off the roadway into a pile of loose asphalt. In pulling the vehicle back onto the roadway, Ms. Coley lost control. The vehicle then went off the left side of the road and flipped over several times. Ms. Coley was killed and Caroline was severely injured. She suffered permanent brain damage and will never be able to care for herself. Upon reaching the age of majority, she was interdicted and Ronald Wat-ters was approved as curator.

Mrs. Watters was a full time employee of Morehouse General Hospital and under her health insurance, the Plan paid more than $370,000.00 in medical expenses for Caroline. The Plan sought to recover those expenses from all parties who were liable to the Watters.

In February 1995, a settlement agreement was reached between the plaintiffs, the Plan and two insurance companies, State Farm, insurer of Kelli Coley, and Farm Bureau, insurer of the owner of the vehicle. Under that agreement, the Plan received $60,000.00 in reimbursement for medical expenses rendered on behalf of Caroline. In the agreement, the Plan reserved its subrogation rights.

| ¡¿Prior to the settlement with State Farm and Farm Bureau, the Watters had filed the present suit against the State, Department of Transportation and Development, and General Motors Corporation (GMC), the maker of the vehicle. They continued with this suit after the settlement with the other parties. The Plan filed a petition of intervention to recoup the medical expenses not otherwise recovered. The Watters then dismissed their claims against GMC and reached a settlement agreement with the state, which was paid through the state’s Office of Risk Management (ORM).

On November 10,1999, the Watters filed a motion for summary judgment to dismiss the Plan’s petition of intervention. They argued that the insurance policy in effect at the time of the accident provided that the Plan was entitled to reimbursement or subrogation only against a negligent party’s liability insurer. The plaintiffs argue' that the state and its ORM are not insurance companies. Therefore, the Plan had no right of reimbursement or subrogation from the settlement made with the state.

A hearing on the motion for summary judgment was held on December 10, 1999. Even though the Plan had received $60,000.00 after the settlement with State Farm and Farm Bureau insurance companies, it argued that it is entitled to receive money from any insurance plan that might [736]*736pay the Watters. The Plan contended that the state is self-insured, and therefore, the ORM is essentially an insurance company. The Plan also asserted that the terms of the reservation of subrogation rights in the settlement agreement with State Farm and Farm Bureau apply to any party that may pay proceeds of any kind to the Watters as a result of a settlement or judgment in this litigation, regardless of whether it is an insurer. Finally, the Plan argues that it is an entity of the state and it cannot enter into an agreement foregoing subrogation because that would result in a prohibited donation of public funds to private individuals.

|3On December 22, 1999, the trial court signed a summary judgment in favor of the plaintiffs, rejecting the Plan’s arguments. In reasons for judgment, the court found that the Plan is not entitled to recover any funds received by the plaintiffs from the state. The court found that the state is self-insured for certain risks but that the ORM is not a liability insurer under the laws of this state. Therefore, under the medical insurance policy with Mrs. Watters, the Plan is not entitled to subrogation from the proceeds of the settlement with the state. The court also found that the first settlement agreement with State Farm and Farm Bureau, by which the Plan purported to reserve its rights of subrogation, did not expand the rights of the Plan beyond the scope of the policy language. The court further ruled that the denial of the Plan’s right of subro-gation does not lead to an unconstitutional donation of funds of a political subdivision. The Plan appealed devolutively, arguing that the trial court erred in granting summary judgment in favor of the plaintiffs.

SUMMARY JUDGMENT

Summary judgments are subject to de novo review under the same criteria applicable to the district court’s considerations of whether summary judgment is appropriate. Smith v. Our Lady of the Lake Hospital, Inc., 93-2512 (La.7/5/94), 639 So.2d 730; Schroeder v. Board of Supervisors of Louisiana State University, 591 So.2d 342 (La.1991). A motion for summary judgment should be granted if the pleadings, deposition, answers to interrogatories, admissions on file, and affidavits show that there is no genuine issue of material fact and that the mover is entitled to judgment as a matter of law. La. C.C.P. art. 966(B); Mixon v. Progressive Specialty Co., 29,698 (La.App.2d Cir.6/18/97), 697 So.2d 662.

Where the moving party will not bear the burden of proof at trial on the matter before the court on summary judgment, La. C.C.P. art. 966 requires only that the moving party point out that there is an absence of factual support for one |4or more of the essential elements to the adverse party’s claim, action, or defense. If the nonmoving party then fails to produce factual support sufficient to establish that he will be able to satisfy his evidentiary burden at trial, there is no genuine issue of material fact. La. C.C.P. art. 966(C)(2); Berzas v. OXY USA, Inc., 29,835 (La.App.2d Cir.9/24/97), 699 So.2d 1149.

Further, La. C.C.P. art. 967 provides that when a motion for summary judgment is made and supported as provided above, an adverse party may not rest on his pleadings, but his responses, by affidavits or as otherwise provided above, must set forth specific facts showing that there is a genuine issue for trial. If the adverse party does not so respond, summary judgment, if appropriate, shall be rendered against him. La. C.C.P. art. 967. Holloway v. Midland Risk Insurance Company, 33,026 (La.App.2d Cir.5/15/00), 759 So.2d 309.

RIGHT TO SUBROGATION

On appeal, the Plan argues that the trial court erred in finding that it was not entitled to subrogation from the settlement between the state and the plaintiffs, for the unreimbursed medical expenses expended on behalf of Caroline Watters. The Plan contends that under the terms of [737]*737the medical insurance contract with Mrs. Watters, and under its reservation of sub-rogation rights in the settlement with the insurance companies, it is entitled to reimbursement for uncompensated medical expenses. These arguments are without merit.

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Bluebook (online)
768 So. 2d 733, 25 Employee Benefits Cas. (BNA) 1531, 2000 La. App. LEXIS 2199, 2000 WL 1409625, Counsel Stack Legal Research, https://law.counselstack.com/opinion/watters-v-state-department-of-transportation-development-lactapp-2000.