Wisconsin Patients Compensation Fund v. Wisconsin Health Care Liability Insurance Plan

547 N.W.2d 578, 200 Wis. 2d 599, 1996 Wisc. LEXIS 46
CourtWisconsin Supreme Court
DecidedMay 8, 1996
Docket95-0865
StatusPublished
Cited by36 cases

This text of 547 N.W.2d 578 (Wisconsin Patients Compensation Fund v. Wisconsin Health Care Liability Insurance Plan) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wisconsin Patients Compensation Fund v. Wisconsin Health Care Liability Insurance Plan, 547 N.W.2d 578, 200 Wis. 2d 599, 1996 Wisc. LEXIS 46 (Wis. 1996).

Opinion

SHIRLEY S. ABRAHAMSON, J.

This case is before the court on appeal from an order of the Circuit Court for Milwaukee County, Frank T. Crivello, judge, granting summary judgment to the defendant, the Wisconsin Health Care Liability Insurance Plan (WHCLIP), and dismissing the complaint of the Wisconsin Patients Compensation Fund (the Fund). The court granted the Fund's petition to bypass the court of appeals. Wis. Stat. § (Rule) 809.60(4) (1993-94). 1 We *604 reverse the order granting summary judgment in favor of WHCLIP and remand the cause to the circuit court.

The primary issue presented is the Fund's authority to sue a health care provider's insurer (here WHCLIP) when the Fund settles a malpractice action against the provider and the provider's insurer refuses to pay any sum toward the settlement. Should we conclude that the Fund has the authority to sue the provider's insurer, we must also address WHCLIP's contention that the complaint in this case should be dismissed on one of three alternative grounds: (1) the Fund fails to state a claim upon which relief can be granted for contribution, indemnification or legal sub-rogation; (2) the Fund's claim for contribution is barred by the statute of limitations; and (3) the Fund's board of governors has a conflict of interest which bars it from suing WHCLIP.

The circuit court concluded that the Fund has no authority to initiate the suit. In contrast, two Dane County circuit courts have held that the Fund does have authority to initiate an action against a provider's insurer in circumstances similar to those presented by this case. 2

We conclude (1) that the Fund has the authority to sue a health care provider's insurer and (2) that the complaint states a claim for legal subrogation when the Fund settles a malpractice action against a health care provider and the provider's insurer refuses to make payment toward the settlement.

*605 f-H

For purposes of this appeal the facts are not in dispute. On January 3, 1991, Andrea Singer, by her guardian ad litem and her parents, filed a medical malpractice action against Dr. John J. Massart, Dr. Thomas Mahoney and their respective insurers, Physicians Insurance of Wisconsin, Inc. and WHCLIP, as well as the Fund. The Singers claimed that the negligence of doctors Mahoney and Massart caused serious physical injury to Andrea during her birth.

The Singers' initial $5 million settlement offer was rejected. Prior to trial the Fund negotiated a settlement with the Singers for $1.9 million. In return, the Singers executed a general release and indemnification agreement releasing all of their claims against all of the defendants. The agreement included a provision preserving any claims that the Fund might have for contribution or indemnification against the other defendants. In the order dismissing the Singers' claim, the parties stipulated to the Fund's preservation of any claims for contribution or indemnification which it might have. Neither WHCLIP nor Dr. Mahoney objected to any of the terms of the agreement or stipulation. Together with the other defendants, they signed the stipulation in May 1993 and the circuit court signed the dismissal order in June 1993.

While Physicians Insurance contributed $300,000 — representing Dr. Massart's policy limit — toward the settlement, WHCLIP refused to make any monetary contribution on behalf of Dr. Mahoney. On June 3,1993, the Singers received a total of $1.9 million from the settling defendants: $300,000 from Physicians Insurance and $1.6 million from the Fund. The Fund filed this action on May 31, 1994, seeking $300,000 from WHCLIP. The circuit court *606 entered an order granting WHCLIP's motion for summary judgment and dismissing the Fund's action on its merits.

II.

We first set forth the standard of review in this appeal. In reviewing an order granting summary judgment, an appellate court applies the same standards set forth in Wis. Stat. § 802.08 as does a circuit court. Swatek v. County of Dane, 192 Wis. 2d 47, 61, 531 N.W.2d 45 (1995).

The issues presented on summary judgment in this case are the nature and scope of the Fund's authority and whether the complaint states a claim upon which relief may be granted. Both are issues of law. Because the Fund is a legislatively created entity, determining the nature and scope of its authority requires an interpretation of the statute conferring that authority. Interpretation of statutes is ordinarily a question of law which this court reviews de novo, benefitting from the analyses of the circuit court and court of appeals. 3 Determining whether the complaint states a claim upon which relief may be granted is also a question of law for this court.

III.

Before turning to the issues presented, we briefly examine the statutes creating the Fund and WHCLIP.

*607 The Fund was created by the legislature in 1975 in response to a perceived medical malpractice crisis. 4 Concerned about what it viewed as the increasing cost and possible decreasing availability of health care in Wisconsin, the legislature promulgated a new system for processing medical malpractice claims. § 1, ch. 37, Laws of 1975.

As part of this statutory scheme, the legislature established the Fund with the intention that it would finance a portion of the liability incurred by health care providers in medical malpractice actions. Health care providers are required to assume financial responsibility for a limited portion 5 of any malpractice claim filed against them, either by purchasing liability insurance, self-insuring, or posting a cash or surety bond. Wis. Stat. § 655.23(3).

Health care providers must also pay annual assessments to the Fund. Wis. Stat. § 655.27(3). From these assessments the Fund pays the portion of a successful claim against a health care provider in excess of either the amount of coverage mandated by the statute or the coverage which a provider actually carries, whichever is greater. Wis. Stat. § 655.27(1).

WHCLIP was established as Wis. Stat. § 619.04 (1975) by the same law that created the Fund. § 9, ch. 37, Laws of 1975. WHCLIP is a mandatory risk-shár- *608 ing plan providing insurance to health care providers who are unable to obtain coverage in the voluntary market.

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Bluebook (online)
547 N.W.2d 578, 200 Wis. 2d 599, 1996 Wisc. LEXIS 46, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wisconsin-patients-compensation-fund-v-wisconsin-health-care-liability-wis-1996.