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Halverson v. Stamm

May 15, 2002

DIANE HALVERSON, PLAINTIFF-APPELLANT,
v.
AMIE STAMM, DEFENDANT-APPELLEE.
DIANE HALVERSON, PLAINTIFF-APPELLANT,
v.
ALLSTATE INSURANCE COMPANY, DEFENDANT-APPELLEE.



Appeal from the Circuit Court of Jackson County. No. 98-L-170 Honorable E. Dan Kimmel, Judge, presiding. Appeal from the Circuit Court of Saline County. No. 00-L-55 Honorable Bruce D. Stewart, Judge, presiding.

The opinion of the court was delivered by: Justice Welch

Released for publication.

We have before us the consolidated appeal of case Nos. 5-01-0077 and 5-01-0196. Diane Halverson (plaintiff) is the plaintiff-appellant in each case. Her daughter, Amie Stamm is the defendant-appellee in case No. 5-01-0077, and Allstate Insurance Company (Allstate) is the defendant-appellee in case No. 5-01-0196. Both cases arise from an automobile accident involving plaintiff and Stamm wherein plaintiff was injured in the accident. In case No. 5-01-0077, plaintiff sued Stamm in the circuit court of Jackson County, alleging negligence. In case No. 5-01-0196, plaintiff sued Allstate in the circuit court of Saline County, seeking to recover medical expenses allegedly covered under an insurance policy purchased from Allstate. The facts giving rise to both cases are as follow.

On September 8, 1997, plaintiff, Stamm, and Stamm's son were nearing the end of a 10-hour drive from Oklahoma to Illinois when Stamm, who was driving the car, ran a stop sign and collided with a truck. It was nearly 5 o'clock in the morning when the accident occurred. Stamm was driving plaintiff's automobile, while plaintiff was asleep in the passenger seat and Stamm's son was asleep in the backseat. Plaintiff was injured in the accident and taken to a hospital, where doctors discovered that a bone in her foot had been shattered. A cast was placed on her foot and she was eventually sent home on crutches. Ten days after the accident, plaintiff was visiting friends when one of her crutches slipped out from under her and she sustained injuries to her shoulder.

In effect at the time of the accident was an automobile insurance policy that plaintiff had purchased from Allstate. The policy provided plaintiff with several areas of insurance coverage, including automobile liability insurance (covering bodily injury and property damage), uninsured-motorists insurance, auto collision insurance, auto comprehensive insurance, and "Automobile Medical Payments" insurance. Separate premiums were paid for each of these areas of coverage.

According to the terms of the "Automobile Medical Payments" (Medpay) area of coverage, Allstate agreed to "pay to or on behalf of an insured person all reasonable expenses actually incurred for necessary medical treatment, medical services[,] or medical products" when "bodily injury is caused by an accident involving an auto." The description of the Medpay coverage further provided: "[Medpay] benefits, other than funeral service expenses benefits, will be reduced by *** amounts received from others, including their insurers, who may be legally responsible for the injuries. This reduction applies only to amounts that are a duplication of payment for the same loss." (Emphasis added.) Finally, the description of the Medpay coverage contained a subrogation clause providing: "When we pay, an insured person's rights of recovery from anyone else become ours up to the amount we have paid. The insured person must protect these rights and help us enforce them."

On December 31, 1998, plaintiff sued Stamm in the circuit court of Jackson County (case No. 5-01-0077). Plaintiff alleged that Stamm was negligent, and plaintiff sought damages for injuries sustained to her foot and shoulder. Allstate acknowledged that Stamm was an insured person under the provisions of the automobile liability insurance coverage purchased by plaintiff from Allstate. Allstate provided Stamm with an attorney.

On August 9, 2000, the attorney provided by Allstate and representing Stamm filed an amended affirmative defense denying any negligence of Stamm. Stamm's attorney claimed that plaintiff was more negligent than defendant or that plaintiff's negligence was the proximate cause of plaintiff's injuries because plaintiff allowed Stamm "to drive the plaintiff's car when she knew or should have known that [Stamm] had been driving for several hours late at night on an unfamiliar roadway" and because plaintiff "failed to assist [Stamm] in watching for road signs and navigation when she knew that [Stamm] was driving late at night on an unfamiliar roadway." The affirmative defense also sought a setoff of $5,429.61 against any judgment for plaintiff. The arguments in support of the affirmative defense claimed that plaintiff had already been paid $5,429.61 on behalf of Stamm for medical bills incurred as a result of the accident.

The trial began on August 9, 2000. At the trial, Stamm testified that she ran a stop sign during the early morning hours of September 8, 1997, and collided with a truck. Stamm testified that when this occurred, plaintiff was asleep. Stamm stated that the accident was not plaintiff's fault and that Stamm was entirely responsible for the accident. Stamm further testified that the attorney representing her was not speaking for her when during opening statement he said that the accident was not her fault. After Stamm testified, plaintiff moved for a directed verdict on the issue of liability. The circuit court granted plaintiff's motion for a directed verdict, and the trial continued on the issue of damages.

After hearing evidence of damages, the jury returned a verdict awarding plaintiff $51,500 in damages. The jury award consisted of $30,000 for "[t]he reasonable expense of necessary medical care, treatment, and services received and the present cash value of the reasonable expenses of medical care, treatment[,] and services reasonably certain to be received in the future," $5,000 for disability, $1,500 for disfigurement, and $15,000 for pain and suffering.

On August 25, 2000, Stamm's attorney filed a "motion for a setoff" against any judgment, in the amount of $5,429.61, "represent[ing] payments made by Allstate Insurance Company on behalf of [Stamm] for medical bills incurred by the plaintiff." Plaintiff filed a response claiming that defendant was not entitled to a setoff because none of the $5,429.61 paid by Allstate was paid on behalf of Stamm. Plaintiff claimed that the $5,429.61 was paid pursuant to plaintiff's Medpay coverage in the insurance policy plaintiff purchased from Allstate. Plaintiff suggested that the court enter a judgment without a setoff and then "there would likely be a contractual obligation by [plaintiff] to reimburse Allstate for money received by way of judgment." However, plaintiff argued, because the $5,429.61 was not paid on behalf of Stamm but was paid pursuant to plaintiff's own Medpay policy, a setoff would be inappropriate.

On September 22, 2000, while Stamm's motion for a setoff was pending in the circuit court of Jackson County, plaintiff filed a complaint against Allstate in the circuit court of Saline County (case No. 5-01-0196). Plaintiff sought reimbursement for medical expenses in the amount of $24,948.01 (less the $5,429.61 that had already been paid) for injuries that occurred in the automobile accident involving Stamm. Plaintiff was seeking these expenses pursuant to her Medpay coverage of the policy. Plaintiff also claimed that Allstate's refusal to pay her medical expenses under the policy was vexatious and unreasonable.

On October 19, 2000, the circuit court of Jackson County (case No. 5-01-0077) granted Stamm's motion for a setoff and entered a judgment on the jury's verdict less a setoff of $5,429.61 for "payments made to plaintiff." Plaintiff filed a posttrial motion arguing that the setoff was inappropriate. That motion was denied. The sole issue plaintiff raises on appeal in this case is whether the circuit court of Jackson County erred in granting Stamm's motion for a setoff.

On December 13, 2000, in the circuit court of Saline County (case No. 5-01-0196), Allstate filed a motion to dismiss plaintiff's complaint pursuant to subsections (a)(3), (a)(4), and (a)(9) of section 2-619 of the Code of Civil Procedure (735 ILCS 5/2-619(a)(3), (a)(4), (a)(9) (West 2000)), claiming that the issue raised by plaintiff as to "the extent of medical bills incurred as a proximate result of the automobile accident of September 8, 1997," had been litigated in the Jackson County lawsuit. Allstate claimed ...


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