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NASP 2009 Annual Conference. Made Whole in a Nutshell: A Case Study Presented b y Matthew R. Falk, Esq.

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Presentation on theme: "NASP 2009 Annual Conference. Made Whole in a Nutshell: A Case Study Presented b y Matthew R. Falk, Esq."— Presentation transcript:

1 NASP 2009 Annual Conference

2 Made Whole in a Nutshell: A Case Study Presented b y Matthew R. Falk, Esq.

3 Introduction Presentation of Facts Presentation of Made Whole in a Nutshell memo Health Recovery in Anti-Subrogation States

4 Belinda Baker is rear-ended by Maxine Miller. Liability is not a real dispute. Policy limits are not an issue. Wage loss is minimal. Permanency and future medical care and treatment claimed

5 Summons and complaint (Tab No. 1) alleges: Negligence of Defendant Maxine Miller Obligation of Miller ’ s insurance company to pay damages Obligation of Baker ’ s insurance company to pay UIM benefits Seeks a determination of subrogation rights of health insurance companies, namely ABC Health Ins. (additionally 123, 456, and Ace)

6 Plaintiff claims medical specials of $4,495.00 Treating facilities are Allied Health of WI, Lakeview Medical Center, and Marshfield Clinic Subrogee ABC ’ s Request to Admit (Tab No. 2) requests all parties admit: ABC paid $1,122.00 (subsequently increased) Claims forms back-up these payments Ins. policy covers Baker ABC is subrogated to Baker ’ s rights

7 Plaintiff serves an offer of Settlement on Defendant’s Liability insurer for $22,500 (Tab No. 4) Plaintiff and Defendant reach a settlement that cuts off ABC’s subrogation rights without including ABC. Plaintiff offers ABC $800.00 to settle (Tab No. 5), but that won’t fly with ABC! Plaintiff was indeed made whole Plenty of policy proceeds are available

8 Offers of settlement are made between Plaintiff and ABC (Tab Nos. 6 and 7) with no success... … Plaintiff seeks a hearing to extinguish lien.

9 Plaintiff’s argument against made whole (Tabs Nos. 8 and 9) Baker needed to be compensated in an amount in excess of $22,500 to be made whole

10 (Tab No. 10) Wholeness: The Wild West!

11 (Tab No. 11) A Different World

12 Chicago Office: Two First National Plaza 20 South Clark Street Suite 1900 Chicago, Illinois 60603 Phone: 312-922-5800 Fax: 312-922-3990 Milwaukee Office: 1223 North Prospect Avenue Milwaukee, WI 53202 Phone: 414-226-2139 Fax: 414-226-2147


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