The Maine Supreme Judicial Court has remanded for further consideration a case in which a wife sued her husband for damages caused by his negligent operation of a motorcycle on which she was a passenger.
Although it often seems unthinkable outside of family court that spouses might sue one another, this case shows how most of the time, these claims are not personal. In the vast majority of situations in which relatives or friends are on opposites sides in civil litigation, it’s not the individual from whom they are trying to collect. Rather, it is the insurance company.
Here, plaintiff sought payment of medical bills and other expenses from the motorcycle insurance policy carried by her husband. But here in Maine, it is not possible to sue the insurance company for liability in an accident (except for when the insurer acts in bad faith). Instead, one must file a lawsuit against the insured.
Interestingly in this Wood v. Wood, the wife was also a named insured on the same policy. She she was at both times an “other,” injured by her husband’s negligence, and also an “insured,” eligible to receive personal injury protection benefits to cover her medical expenses. That’s been her argument, anyway.
According to court records, it is undisputed plaintiff was a passenger on a motorcycle operated by husband and she was injured in an accident caused by his negligence. Both husband and wife were named insureds on the same policy, which contained provisions for medical coverage of insureds, plus liability coverage for others injured.
The policy allowed for up to $5,000 in medical payment coverage for each insured pursuant to the policy. Over the course of several months after the accident, the insurer paid a total of $5,620 to health care providers who rendered medical services to wife/plaintiff. Some of those checks listed husband as the insured and wife as the claimant. Others made no reference to husband, wife or the claim.
Plaintiff filed a motorcycle accident lawsuit against her husband in district court, alleging one count of negligence in connection with the accident. The insurance company provided husband with legal representation. Jurors ultimately found husband liable and determined wife’s damages were $50,000. Because the insurer had an obligation to provide coverage for that verdict, it was the insurer on the hook for that amount – even though it was not a named defendant.
Insurer did not appeal this verdict. However, it did file a motion to obtain a credit for the $5,620 it had already paid for wife’s medical bills. Trial court granted this motion and then ordered insurer to pay the remaining balance.
Wife appealed this ruling before the Maine Supreme Judicial Court. Her argument was that those payments were rendered as part of the coverage she was owed as an insured on the policy – not as an “other” who was entitled to liability payments. Insurance companies can sometimes render payments or portions of payments while litigation is pending, and courts have held this fact can not be used as a concession of liability on the part of the insurer. The idea is to encourage insurers to pay injured victims’ medical bills as timely as possible.
Insurers are entitled to a set-off when they do this. However, this case was unique because plaintiff argued the payments were technically coming from two different sources.
In reversing the earlier determination to award insurer credit for its payment, the Maine Supreme Judicial Court found the lower court had never made a specific finding of fact as to the nature of those payments. The case was remanded for further fact analysis of this question, which would ultimately answer whether the insurer was indeed entitled to a credit for the money it paid pre-judgment.
If you are the victim of a Bangor car accident, contact Peter Thompson & Associates at 1-800-804-2004 for a confidential consultation to discuss your rights.
Wood v. Wood, Nov. 3, 2015, Maine Supreme Judicial Court