Sometimes in personal injury law, it becomes necessary to initiate litigation against people you love or care about. The goal is not necessarily to collect money from that individual, but rather to obtain compensation from his or her insurance company.
Because insurance companies cannot be named as defendants in injury lawsuits until liability has been established, one must name the insured. Sometimes, that individual is someone to whom plaintiff is close.
Many times, those sparring in the courtroom retain no ill feelings outside the doors. What takes place is a formality that allows the injured person to receive compensation for medical bills, lost wages and pain and suffering. Plaintiff must show defendant owed a duty of care to plaintiff and then breached that duty, causing plaintiff’s injury.
In the recent case of Wood v. Wood, a wife in Maine sued her husband for injuries she sustained as a passenger on a motorcycle he was operating. The case was recently heard on appeal before the Maine Supreme Judicial Court.
What made this case complicated was that husband and wife were both covered as insureds under the same motorcycle accident insurance policy. However, wife also technically qualified as an “other” harmed by the negligent conduct of the insured (i.e., her husband). So she essentially could collect under both provisions. At least this was her assertion.
According to court records, the pair were on a motorcycle in April 2010, husband in control, when husband’s negligent operation of the bike caused a crash that resulted in injuries to his wife. This was never disputed by either party.
Wife suffered injuries that prompted her to seek multiple medical treatments. Over the course of the next seven months, the insurer made a series of payments to health care providers who had rendered care to wife for her crash-related injuries. In total, these payments amounted to $5,620, which was $620 more than what she was owed as an insured for medical services under the policy.
However, when the insurer would not settle with her as an “other” for her bodily injuries and other losses, she had no choice but to sue her husband. The auto insurer provided representation to the husband during the proceedings. At trial, jurors found husband was negligent, and awarded wife $50,000 in damages.
Husband’s attorney, provided by the insurer, requested a judgment to obtain credit for the $5,620 already paid. Trial judge granted the order.
Plaintiff appealed. Her argument was that the $5,620 payment was received by her health care providers to cover costs pursuant to the policy she personally held with the company, and that it had no bearing whatsoever on the judgment against her husband.
The state high court noted the insurer would be entitled a credit if five criteria are met. Both sides agreed that four of the five criteria were met, but disagreed on one issue: That the prepayment was made “on account of bodily injury or death or damage to or loss of property of another.” Plaintiff argued the payments were issued to her pursuant to her own protection under the policy, not under her the provision of her husband’s policy’s obligation to “another.”
The high court ruled the lower court hadn’t properly weighed this issue because it had not made a factual determination on the nature of the payments – whether they were medical payments that covered the wife under the policy or whether they were liability payments made on behalf of husband’s plan.
Therefore, it reversed and remanded.
Call Allred & Allred P.C. at 1-866-942-9315 to speak with a Montgomery personal injury lawyer.
Wood v. Wood, Nov. 3, 2015, Maine Supreme Judicial Court
More Blog Entries:
State Farm v. Brown – Insurer Fights Punitive Damages in Accident Claim, Oct. 23, 2015, Montgomery Injury Attorney Blog