William C. Eriksen, P.S.C. v. Kentucky Farm Bureau Mutual Insurance Co.

336 S.W.3d 909, 2010 Ky. App. LEXIS 155, 2010 WL 3447688
CourtCourt of Appeals of Kentucky
DecidedSeptember 3, 2010
Docket2009-CA-000812-MR, 2009-CA-000879-MR
StatusPublished
Cited by6 cases

This text of 336 S.W.3d 909 (William C. Eriksen, P.S.C. v. Kentucky Farm Bureau Mutual Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
William C. Eriksen, P.S.C. v. Kentucky Farm Bureau Mutual Insurance Co., 336 S.W.3d 909, 2010 Ky. App. LEXIS 155, 2010 WL 3447688 (Ky. Ct. App. 2010).

Opinions

OPINION & ORDER

MOORE, Judge:

William C. Eriksen, a medical services provider, appeals the Hardin Circuit Court’s decision dismissing his counterclaim to recover unpaid interest from Kentucky Farm Bureau Insurance Company (“KFB”) under the Motor Vehicle Reparations Act (“MVRA”) and finding that a medical provider does not have standing under the MVRA to file a direct action against a reparations obligor. We agree with the circuit court and affirm. Because KFB’s cross-appeal is taken from an interlocutory order, we dismiss it.

[911]*911KFB initially filed suit against Eriksen in Hardin District Court to recover $425 for alleged overpayment on a personal injury protection claim. Eriksen asserted a counterclaim against KFB for interest pursuant to Kentucky Revised Statute (KRS) 304.39-210(2) on allegedly late payments made by KFB at the direction of KFB’s insureds. Eriksen claimed damages in excess of the jurisdictional limits of the district court, and the case was removed to Hardin Circuit Court.

Thereafter, KFB filed a motion to dismiss Eriksen’s counterclaim asserting that Eriksen, as a medical provider, lacked standing to assert a direct claim under the MVRA pursuant to the Kentucky Supreme Court’s ruling in Neurodiagnostics, Inc. v. Kentucky Farm Bureau Mut. Ins. Co., 250 S.W.3d 321 (Ky.2008). The trial court granted KFB’s motion to dismiss Erik-sen’s claim for interest on the overdue payments. Eriksen moved the court to reconsider its order, claiming that the trial court has misinterpreted the statute and the Supreme Court’s holding in Neuro-diagnostics. The court denied Eriksen’s motion to reconsider, and Eriksen timely appealed.2

Additionally, Eriksen filed a first amended counterclaim which added claims of fraud and wrongful initiation of civil proceedings against KFB. Thereafter, KFB filed a motion to amend the trial court’s previous order to include dismissal of all of Eriksen’s counterclaims. In substance, that motion should be construed as a motion to dismiss Eriksen’s remaining claims against KFB. The trial court granted leave for Eriksen to file an amended counterclaim and denied KFB’s motion to amend the court’s prior order. Hence, the trial court declined to dismiss Eriksen’s amended counterclaims. KFB thereafter filed a timely crossappeal.

Eriksen’s claim of error reaches us in the context of the trial court’s denial of Eriksen’s motion to alter, amend or vacate, which would normally be analyzed under the abuse of discretion standard of review. Emberton v. GMRI, Inc., 299 S.W.3d 565, 579 (Ky.2009). However, because Erik-sen’s claimed error is that the court erred in construing a statute, which is a question of law and not an exercise of discretion, we will review the alleged’ error of law de novo. Neurodiagnostics, 250 S.W.3d at 325.

The MVRA “provides an exclusive remedy where an insurance company wrongfully delays or denies payment of no-fault benefits.” Foster v. Kentucky Farm Bureau Mut. Ins. Co., 189 S.W.3d 553, 557 (Ky.2006). Further, the MVRA provides that late payments “bear interest at a rate of twelve percent (12%) per annum, except that if delay was without reasonable foundation the rate of interest shall be eighteen percent (18%) per annum.” KRS 304.39-210(2).

The trial court denied Eriksen standing to assert a claim against KFB for interest on the basis of the holding in Neurodiag-nostics. In Neurodiagnostics, the issue was whether, under the MVRA, a medical provider has a direct right of action against an insurer for no-fault or personal injury protection payments by assignment from the insured. In Neurodiagnostics, the insureds had signed an “Assignment of [912]*912Benefits” in which they assigned to the medical provider all benefits payable to the insureds for the medical services rendered. When the medical provider filed suit against the insurance company for payment of the outstanding medical bills from the insured’s no-fault benefits, the insurance company claimed that the medical provider did not have standing under the MVRA.

The Court explained that the MVRA originally contained a provision allowing an insured to assign no-fault benefits to a medical provider, thereby giving the provider a right of action against a reparations obligor. The legislature, however, amended the Act in 1998 and removed the insured’s ability to assign benefits under the MVRA. In reviewing the issue, the Court “conclude[d] that a medical provider ... is an optional payee or incidental beneficiary. ... And, as an incidental beneficiary, [a medical provider] has no direct right of action against the reparation obli-gor.” Neurodiagnostics, 250 S.W.3d at 329. The Court then expressly held that, “[t]he repeal of the assignment provision took away any direct cause of action by the medical provider, and no other current provision of the MVRA can be construed to afford a direct cause of action to medical providers.” Id. at 329-30. The Court found that “the control rests with the insured to direct payment of his or her benefits among the different elements of loss.” Id. at 325. Consequently, the Court decided that “a medical provider has no standing under the MVRA to bring a direct action against the reparation obli-gor/insurer.” Id. at 329.

Eriksen argues that this is not a benefits assignment case; rather, Eriksen seeks to enforce the penalty provision under KRS 304.39-210(2). Accordingly, Eriksen argues that the holding in Neuro-diagnostics does not apply in this case. We disagree. The language and holding in Neurodiagnostics are clear: a medical provider does not have standing to sue under the MVRA. Instead, “the insured is the party that is ultimately responsible for payment. And it is the insured that has the direct right of action against the reparation obligor if he or she disagrees with the way in which his or her benefits were either paid or not paid.” Neurodiagnos-tics, 250 S.W.3d at 329. We agree with the circuit court that “[i]f the interest is available to medical providers, it is not available through direct action against the reparations obligor. It is the prerogative of either the Kentucky Supreme Court or the Kentucky Legislature to create an exception to the Neurodiagnostics rule that would give a medical provider[] a direct action to enforce the statutory interest penalty of KRS 304.39-210(2).” Accordingly, we find no error.

KFB filed a cross-appeal asking this Court to decide that the additional claims raised in Eriksen’s amended counterclaim should have been dismissed by the trial court in its original judgment. KFB argues that because Eriksen lacked standing to assert a direct cause of action against KFB under the MVRA, the additional claims in Eriksen’s amended counterclaim should be barred as well “because there would be no existing cause of action for these derivative claims to arise.”

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William C. Eriksen, P.S.C. v. Kentucky Farm Bureau Mutual Insurance Co.
336 S.W.3d 909 (Court of Appeals of Kentucky, 2010)

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Bluebook (online)
336 S.W.3d 909, 2010 Ky. App. LEXIS 155, 2010 WL 3447688, Counsel Stack Legal Research, https://law.counselstack.com/opinion/william-c-eriksen-psc-v-kentucky-farm-bureau-mutual-insurance-co-kyctapp-2010.