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Judges send insurance case back to trial court

July 18, 2012

The Indiana Court of Appeals reversed the trial court’s grant of summary judgment in favor of an insurer in a dispute over whether it should pay a claim for underinsured motorist coverage.

American Family Mutual Insurance denied Howard Justice’s claim under his policy for underinsured motorist coverage. Justice, an Indianapolis city bus driver, was injured in an accident with another driver. That driver’s insurer paid the policy limit of $25,000 to Justice. He also was paid more than $77,000 in benefits in workers’ compensation coverage under his employer’s policy.

Justice’s policy limits with American Family were $50,000 per person and $100,000 per accident in underinsured motorist coverage.

American Family argued at the trial level that the workers’ compensation setoff provision reduced the limits of the liability policy so that its liability under the policy was zero.

The appellate judges cited Beam v. Wausau, 765 N.E.2d 524, 528 (Ind. 2002), a similar case from the Supreme Court, to support their ruling reversing summary judgment. The justices held the trial court erred by reducing the damages award by the gross amount of workers’ compensation benefits paid. The Supreme Court held that the exclusion called for a reduction of damages by any amount of workers’ compensation benefits received for the same element of damages insured by the policy.

“In this case, the trial court’s order granting summary judgment reflects, without opinion, its agreement with AFI that the setoffs should result in a reduction from the UIM policy limits. Under the rationale of Beam, however, this is incorrect as a matter of law. After a determination of liability and damages, Justice’s damages award should be reduced by the $25,000.00 recovery from Wagner and the percentage of worker’s compensation benefits paid to Justice based upon Wagner’s percentage of comparative fault, up to a maximum of $25,000.00,” wrote Judge James Kirsch.

 

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