Thursday, March 7, 2013

MARYLAND COURT OF APPEALS UPDATE (MCOA BLOG): Travco Ins. Co. v. Crystal Williams, MCOA Misc. No. 7

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Travco Insurance Company v. Crystal Williams, Misc. No. 7, Opinion by Greene, J.

INSURANCE– MOTOR VEHICLE INSURANCE LAW – LIMITATIONS ON RECOVERY OF BENEFITS

Maryland’s motor vehicle insurance law includes certain limitations on an insured’s recovery of benefits. Md. Code (1996, 2011 Repl. Vol.), § 19-513(e) of the Insurance Article requires that benefits payable under the personal injury protection and uninsured motorist statutes be reduced to the extent that the recipient has recovered un-reimbursed workers’ compensation benefits [Opinion written by Justice Greene].
Excerpt from Opinion:

"We have before us questions of law certified by the United States District Court for the District of Maryland pursuant to the Maryland Uniform Certification of Questions of Law Act, Md. Code (1973, 2006 Repl. Vol.), §§ 12-601 to 12-613 of the Courts and Judicial Proceedings Article and Maryland Rule 8-305. The District Court has asked us to determine whether Md. Code (1996, 2011 Repl. Vol.), § 19-513(e) of the Insurance Article (or “§ 19- 513(e)”) requires an insurance company to deduct recovered workers’ compensation (“WC”) benefits from the benefits payable to an insured for uninsured motorist coverage (“UM”) and personal injury protection (“PIP”) when the insured has not reimbursed its WC provider, the WC provider claims the insured will need to reimburse it from any UM or PIP recovery, and the insured intends to reimburse the WC provider in the future. As an extension of this question, we are asked to determine the appropriate means for resolving a dispute between a PIP or UM insurer and insured regarding a WC provider’s subrogation right. Finally, we are asked whether § 19-513(e) permits an insurer to reduce its benefits payable for medical bill “write-downs,” assuming that the “write-downs” are considered a WC benefit under the applicable WC law.

We shall hold that, under the plain meaning of § 19-513(e), an insured’s benefits payable under UM and PIP coverage “shall be reduced” to the extent that the insured recovered benefits under WC and the WC provider has not been reimbursed. Further, we hold that if the applicable WC law treats “write-downs” of medical bills as WC benefits, and the WC benefits have not been reimbursed, then the insurer shall deduct those benefits, calculated as discounts, from its benefits payable to the insured under § 19-513(e)."



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