Williams v. Missouri Property & Casualty Guaranty Ass'n

904 S.W.2d 10, 1995 Mo. App. LEXIS 938
CourtMissouri Court of Appeals
DecidedMay 16, 1995
DocketNo. WD 49968
StatusPublished
Cited by3 cases

This text of 904 S.W.2d 10 (Williams v. Missouri Property & Casualty Guaranty Ass'n) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Williams v. Missouri Property & Casualty Guaranty Ass'n, 904 S.W.2d 10, 1995 Mo. App. LEXIS 938 (Mo. Ct. App. 1995).

Opinion

HANNA, Judge.

The plaintiff, Willie C. Williams, was injured by a tortfeasor while on the job. He is entitled to make a claim under the workers’ compensation law and to pursue a claim for damages against the negligent tortfeasor. He has received $181,987.60 in workers’ compensation benefits and claims in this lawsuit that he is entitled to recover money damages from the Missouri Property and Casualty Guaranty Association (MIGA) since both the tortfeasor and its insurer have been declared insolvent. This case presents an issue as to whether a claimant who has received workers’ compensation benefits for his work-related injuries may seek recovery from MIGA when the compensation carrier has asserted a subrogation lien in an amount exceeding MIGA’s maximum liability.

In December 1981, plaintiff, Willie C. Williams, was injured as a result of a work-related motor vehicle accident. The accident occurred when a tractor-trailer driven by an employee of Orscheln Brothers Trucklines, Inc. (Orscheln Brothers) struck Williams as he was standing on the shoulder of Interstate 70 in Independence. At the time of the accident, Orscheln Brothers was insured by Transit Casualty Company (Transit Casualty). As a result of his injuries, Williams filed a claim under the Illinois Workers’ Compensation Act and received a total of $181,987.60 in workers’ compensation benefits. He also filed a negligence action against the driver of the truck and Orscheln Brothers. The workers’ compensation carrier asserted a lien against Orscheln Brothers and Transit Casualty for reimbursement of any and all sums that workers’ compensation had paid or would pay to Williams in the future.1

In March 1984, Orscheln Brothers filed bankruptcy. In December 1985, Transit Casualty was declared insolvent and ordered liquidated. Williams timely filed a proof of claim which was received by the Commissioner of Claims office on March 2,1987. MIGA received the proof of claim on November 23, 1987. On August 1, 1991, Williams filed this action to enforce his claim against MIGA for damages in excess of the amount of the workers’ compensation lien.2 He seeks to recover the statutory maximum amount of $50,000.3 The circuit court entered judgment in favor of MIGA. Williams appeals.

MIGA is a non-profit unincorporated legal entity which was established under [12]*12§ 375.785, RSMo 1986.4 Clements v. Pittman, 765 S.W.2d 589, 590 (Mo. banc 1989). The primary purpose of MIGA is to protect insureds from the effects of insolvent insurers. Qualls v. Missouri Ins. Guar. Ass’n, 714 S.W.2d 732, 734 (Mo.App.1986). “To protect policyholders and beneficiaries, MIGA is required to pay benefits and provide coverage, with limitations, to those whose insurance companies become insolvent.” Department of Mental Health v. Continental Sec. Life Ins. Co., 835 S.W.2d 349, 351-52 (Mo.App.1992). A maximum claim of $50,000 is allowed. § 375.785.3(2).

The question presented in this case is whether MIGA is obligated to pay damages to a claimant who has received workers’ compensation benefits in an amount which exceeds MIGA’s statutory maximum and if so, what is the proper measure of MIGA’s liability. The circuit court determined that MIGA had no obligation to pay Williams because the compensation carrier would be entitled to MIGA’s statutory limit as a subrogor. The court concluded that Williams did not have a “covered claim” because § 375.785.3(2) specifically excludes “any amount due any rein-surer, insurer, insurance pool or underwriting association, as subrogation recoveries or otherwise.”

Williams contends the court erred in concluding that his claim for damages in excess of the workers’ compensation award was not a “covered claim” under § 375.785.3(2). That statute provides, in pertinent part:

‘Covered claim’ means an unpaid claim ... presented within the time specified ... which arises out of and is within the coverage of an insurance policy to which this section applies issued by a member insurer, if such insurer becomes an insolvent insurer after September 28, 1971, and the claimant or insured is a resident of this state at the time of the insured event....
‘Covered claim’ shall not include any amount due any reinsurer, insurer, insurance pool, or underwriting association, as subrogation recoveries or otherwise.

MIGA argues that since Williams received workers’ compensation benefits in an amount exceeding MIGA’s statutory limit, there is no “unpaid claim.” MIGA further argues that because the compensation carrier has asserted a lien against the employer and its insolvent insurer, Williams’ claim is necessarily excluded from the category of “covered claims” under § 375.785.3(2). MIGA bases this argument on the assertion that the compensation carrier would be entitled to any funds Williams could recover from MIGA.

In support of its argument that Williams does not have a “covered claim,” MIGA cites Latter v. Autry, 853 S.W.2d 836 (Tex.Ct.App.1993), and Ferrari v. Toto, 383 Mass. 36, 417 N.E.2d 427 (1981). In both Latter and Ferrari, the guaranty fund was excused from liability because the workers’ compensation carrier had paid the claimant more than he would have received under the tortfeasor’s insurance policy had its insurer not become insolvent. Thus, the basis for the guaranty fund’s nonliability was that the subrogation lien exceeded the tortfeasor’s policy limit. In this case, MIGA has not advanced the argument that the workers’ compensation award exceeded the amount Williams would have received from Transit Casualty had it remained solvent. Rather, MIGA’s argument is that it has no liability because the workers’ compensation award exceeded the guaranty fund’s statutory limit, and the compensation carrier would be entitled to any funds that Williams might recover from MIGA.

Both parties cite Garrett v. Overland Garage & Parts, Inc., 882 S.W.2d 188 (Mo.App.1994). Garrett involved a claimant who had received $6,586.89 in workers’ compensation benefits as a result of his work-related injuries. The claimant brought suit against the tortfeasor and received a judgment for $14,-850. The issue before the court was whether the damage award should be reduced by the subrogation amount due the compensation carrier. Id. at 192. In determining the extent of MIGA’s liability, the court construed § 287.150, RSMo 1986, of the Workers’ Compensation Act and § 375.772.2(2), RSMo [13]*13Supp.1993, of the Missouri Guaranty Act.5 Id. at 193. In construing the plain meaning of § 375.772.2(2), the court made the following determination with respect to the right to subrogation:

[W]hen a tortfeasor’s insurer is insolvent, any insurer who has paid a claim that would ordinarily entitle it to subrogation will not be reimbursed by MIGA and ...

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904 S.W.2d 10, 1995 Mo. App. LEXIS 938, Counsel Stack Legal Research, https://law.counselstack.com/opinion/williams-v-missouri-property-casualty-guaranty-assn-moctapp-1995.