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Country Preferred Insurance Co. v. Groen

Court of Appeals of Illinois, Fourth District

January 27, 2017

COUNTRY PREFERRED INSURANCE COMPANY, Plaintiff-Appellee,
v.
LORI GROEN, Defendant-Appellant.

          Rule 23 order filed November 16, 2016

          Rule 23 order withdrawn January 27, 2017

         Appeal from the Circuit Court of Sangamon County, No. 14-MR-580; the Hon. Chris Perrin, Judge, presiding.

         Judgment Affirmed.

          Gregory P. Sgro (argued) and Benjamin M. Sgro, of Sgro, Hanrahan, Durr & Rabin, L.L.P., of Springfield, for appellant.

          Keith G. Carlson (argued), of Carlson Law Offices, of Chicago, and Kurt M. Koepke, of Koepke & Hiltabrand, of Springfield, for appellee.

          JUSTICE HARRIS delivered the judgment of the court, with opinion. Presiding Justice Turner and Justice Appleton concurred in the judgment and opinion

          OPINION

          HARRIS JUSTICE

         ¶ 1 Following an accident that occurred during the course of her employment, defendant, Lori Groen, received benefits under the Illinois Workers' Compensation Act (Act) (820 ILCS 305/1 to 30 (West 2010)) in excess of $400, 000. In addition, she sought benefits from plaintiff, Country Preferred Insurance Company, under an uninsured motorist policy, which contained a provision entitling plaintiff to reduce the amount of its liability by any payments made or due under the Act (setoff provision). Ultimately, the trial court granted summary judgment in favor of plaintiff. Defendant appeals, arguing that the court erred in granting summary judgment because plaintiff is prohibited from reducing the amount of its available uninsured motorist coverage by the amount of medical expenses paid by her employer. Specifically, she argues (1) medical payments made pursuant to the Act are not "for" an insured and, therefore, are not subject to setoff under her uninsured motorist policy; (2) alternatively, the setoff provision is ambiguous as to whether medical payments made by an employer under the Act are subject to setoff and, therefore, should be construed in her favor; and (3) the setoff provision "is unenforceable because it violates the *** Act." We affirm.

         ¶ 2 I. BACKGROUND

         ¶ 3 On October 7, 2013, defendant was struck as a pedestrian by an uninsured motor vehicle and suffered injuries. At the time of the accident, defendant was working and was acting within the scope of her employment. As a result, defendant sought and received workers' compensation benefits under the Act. Specifically, she received temporary total disability benefits in the amount of $328.33 per week beginning on October 7, 2013, and up to at least July 28, 2014, the date defendant signed an affidavit in the within action. In addition, as of July 22, 2014, defendant's employer had paid $410, 266.63 in medical bills pursuant to the Act.

         ¶ 4 In addition to receiving workers' compensation benefits, defendant sought benefits from plaintiff under an uninsured motorist policy with limits of $250, 000 per person and $500, 000 per occurrence.

         ¶ 5 In June 2014, plaintiff filed a complaint for declaratory judgment, seeking a declaration of the parties' rights and obligations under the uninsured motorist policy, which, in relevant part, provides as follows:

"Amounts payable for damages under Uninsured-Underinsured Motorists, CoverageU, will be reduced by the present value of all amounts paid or payable under any workers' compensation, disability benefits or any ...

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