COURT OF APPEALS DECISION DATED AND RELEASED DECEMBER 27, 1995 |
NOTICE |
A party may file with the
Supreme Court a petition to review an adverse decision by the Court of
Appeals. See § 808.10 and
Rule 809.62(1), Stats. |
This opinion is subject to
further editing. If published, the
official version will appear in the bound volume of the Official Reports. |
No. 95-1693
STATE
OF WISCONSIN IN COURT OF
APPEALS
DISTRICT III
GLORIA J. KREI,
Plaintiff-Appellant-Cross-Respondent,
v.
BLUE CROSS & BLUE
SHIELD
UNITED OF WISCONSIN,
Defendant-Respondent-Cross-Appellant,
WISCONSIN PHYSICIANS
SERVICE INSURANCE
CORPORATION,
Defendant,
CHIPPEWA COMMONS, A
GENERAL
PARTNERSHIP AND AMERICAN
MOTORISTS INSURANCE
COMPANY,
Defendants-Third-Party Plaintiffs,
v.
UTILITY ENTERPRISES
LTD.
and TRANSCONTINENTAL
INSURANCE COMPANY,
A CNA INSURANCE
COMPANY,
Third-Party Defendants.
APPEAL and CROSS-APPEAL
from a judgment of the circuit court for Chippewa County: RODERICK A. CAMERON, Judge. Affirmed.
Before Cane, P.J.,
LaRocque and Myse, JJ.
LaROCQUE, J. Gloria Krei, who settled her personal
injury action against two defendants allegedly liable for negligently causing
her to slip and fall in a mall, appeals a subrogation judgment, following a Rimes
hearing, awarded to Blue Cross & Blue Shield United of Wisconsin for
medical benefits paid Krei following her injury.[1] At the hearing, the circuit court found Krei
100% causally negligent in the accident.
Because we conclude that
the outcome here is controlled by the recent decision, Ives v.
Rhinelander Paper Co. Group Health Plan, No. 95-0932 (Wis. Ct. App.
Oct. 31, 1995, ordered published Nov. 28, 1995), we affirm the judgment. We need not address Blue Cross's
cross-appeal.
We held in Ives:
To
reach an equitable result in subrogation cases, we conclude that an insured who
is greater than 50% contributorily negligent is made whole if the insured
receives his or her total damages discounted by the percentage of contributory
negligence, even if that percentage is greater than 50%.
Id. at
8.
We also noted:
We
believe that under Wisconsin's Rimes-Garrity rules, an insurer
may seek reimbursement out of settlement proceeds only where that sum
compensates the insured for all damages less the percentage of the insured's
contributory negligence, if any. Garrity v. Rural Mut. Ins. Co.,
77 Wis.2d 537, 253 N.W.2d 512 (1977).
Id. at
3.
In Ives,
the insured's total damages were stipulated to be $1.5 million. The Iveses received a settlement from the
alleged tortfeasors of $261,250. We
remanded the matter to the circuit court to determine the percentage, if any, of
the insured, Michael Ives', negligence.
We concluded that the Iveses were "made whole" by payment of
the settlement sum of $261,000 if Michael was 82.58% or greater contributorily
negligent because the Iveses received 17.42% of their damages in the settlement. (100% -17.42% = 82.58%)
Here the circuit court
found the insured, Krei, wholly at fault for her injuries. The court found the value of Krei's losses
as follows:
Medical Expenses: $ 10,291.80
Lost Wages:
1,806.00
Stockings:
224.00
Pain
& Suffering: 30,000.00
Total: $ 42,321.80
Applying the logic of Ives,
we therefore agree with the circuit court's determination that Krei was made
whole in her receipt of $29,500 from the settling defendants and that she must
therefore reimburse Blue Cross the amount of $2,201.15 for insurance benefits
paid to Krei.[2]
By the Court.—Judgment
affirmed.
Not recommended for
publication in the official reports.
[1] Rimes v. State Farm Mut. Auto Ins. Co., 106 Wis.2d 263, 316 N.W.2d 348 (1982). In a Rimes hearing, the circuit court holds a post-settlement circuit to determine whether the settlement made the insured whole.
[2] The trial court characterized the payment to Blue Cross as a "pro-rata share." The record suggests Blue Cross was compensated in full. Blue Cross does not contest the amount of the court's award. The discrepancy between this amount and the medical expenses found by the court is not an issue on appeal.