2000 - Medical Payments

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="04a085a3.jpg"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Kreiner & Peters Co., L.P.A.</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="Kreiner Peters Co., L.P.A."><U><B>home</B></U></A></div> <div> <A HREF="id46.htm" TARGET="_top" TITLE="December 2004 Subrogation under Legisla"><U>December 2004 - Subrogation under Legislative Scrutiny</U></A>   |   <A HREF="id41.htm" TARGET="_top" TITLE="November 2004 Lawson"><U>November 2004 - Lawson</U></A>   |   <A HREF="id40.htm" TARGET="_top" TITLE="November 2004 Restitution"><U>November 2004 - Restitution</U></A>   |   <A HREF="id45.htm" TARGET="_top" TITLE="August 2004 Rental"><U>August 2004 -  Rental</U></A>   |   <A HREF="id37.htm" TARGET="_top" TITLE="February 2002 ERISA"><U>February 2002 - ERISA</U></A>   |   <A HREF="id36.htm" TARGET="_top" TITLE="November 2001 ERISA"><U>November 2001 - ERISA</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="November 2001 Evidence"><U>November 2001 - Evidence</U></A>   |   <A HREF="id34.htm" TARGET="_top" TITLE="June 2001 Intentional Acts"><U>June 2001 - Intentional Acts</U></A>   |   <A HREF="id33.htm" TARGET="_top" TITLE="May 2001 Fiduciary"><U>May 2001 - Fiduciary</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="April 2001 ERISA provisions"><U>April 2001 - ERISA  provisions</U></A>   |   <A HREF="id31.htm" TARGET="_top" TITLE="January 2001 ERISA"><U>January 2001- ERISA</U></A>   |   <A HREF="id30.htm" TARGET="_top" TITLE="2000 ERISA Fiduciary"><U>2000 - ERISA Fiduciary</U></A>   |   <B>2000 - Medical Payments</B>   |   <A HREF="id28.htm" TARGET="_top" TITLE="2000 ERISA"><U>2000 - ERISA</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" background="04bd2e83.jpg"> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>2000 - Medical Payments</I></div> <div> <B>MEDICAL PAYMENTS SUBROGATION RIGHTS MAY NOT EXIST WITH A PASSENGER</B></div> <bR> <div> Ohio has long recognized subrogation rights of an insurance company under medical payments coverage found in their policies. See <U>Smith v. Travelers Ins. Co.</U> (1977), 50 Ohio St. 2d. 43. In <U>Smith</U>, the Ohio Supreme Court established the right where the parties have contracted for subrogation as part of the policy. This point has not been revisited by courts in some time.</div> <bR> <div> However, the Eleventh District Court of Appeals for Ohio recently revisited medical payments subrogation with shocking results for insurers. See <U>Johnson v. Progressive Ins. Co.</U> (1999), 1999 WL 1313672. In <U>Johnson</U>, the Appellate court faced a claim for subrogation in connection with a passenger in their insured's automobile. In reversing the trial court, the Appellate court stated they could find neither a contractual right to subrogation nor an equitable right to subrogation on the part of Progressive. The trial court rejected Progressive's reliance on the contract of insurance as Johnson was not a party to the contract. The court rejected arguments by Progressive that by accepting the medical benefits the passenger was subject to the terms of the contract.</div> <bR> <div> The <U>Johnson</U> appellate court likewise refused to rule on whether Progressive has an equitable right of subrogation or not for its medical payments. The court remanded the action to the trial court for evidence on whether or not the injured party was fully compensated. Progressive, paying the medical payments as provided in its contract, may ultimately have no right to recover any of its payments back from the responsible party.</div> <bR> <div> The <U>Johnson</U> case is not legal precedent for the entire state of Ohio. However, it does represent potential problems for medical payments subrogation within the Eleventh District (Lake, Ashtabula, Trumbull, Portage and Geauga counties). Also, it will be used as authority in other districts to claim no subrogation exists. <I>An insurance company can attempt to correct this problem through a written agreement. If possible, a claim for medical payments will be paid only if the injured party signs an agreement to repay the carrier in full from any settlement regardless of whether the injured party is made-whole. A carrier should try to revise its medical payments provisions to require such executed agreement before the payment of any claims is made. Insurers need to pay careful attention to the steps taken by the medical payments claim department as their actions may limit subrogation potential.</I></div> <bR> <div> ©2000 Kreiner & Peters Co., L.P.A.</div> <bR> <div> <B>This is an advertisement</B></div> <bR> <bR> </td> </tr></table></body>