Judge argues ruling puts form over substance

The chief judge of the Indiana Court of Appeals dissented from his colleagues in an insurance dispute because he believes the decision leads to "an inequitable result."

Chief Judge John Baker wrote in his dissent that Judges Melissa May and Michael Barnes elevated form over substance when concluding that American Family Insurance wasn't entitled to a setoff to reduce jury verdicts by the amounts the insurer had previously paid as medical expense coverage for injuries Tamatha and Hannah Nealy suffered in a car accident. The Nealys won a default judgment of liability against the driver and the owner of the car that hit them; neither person had insurance, so American Family provided coverage under the Nealys' uninsured motorist and medical expense coverage.

The Nealys then sued American Family for the uninsured motorist coverage. The trial court granted American Family's motion for a setoff based on the amount of medical expenses it paid before trial.

In Tamatha M. Nealy, et al. v. American Family Mutual Insurance Co., No. 49A02-0812-CV-1096, the majority reversed the grant of the motion for setoff and remanded for the entry of judgment in the amount of the verdicts the jury originally returned. Judges May and Barnes ruled the trial court erred by basing the grant of the setoff on the advance payment statute, Indiana Code Section 34-44-2-3, because the payments the insurer made couldn't be characterized as "advance payments." American Family isn't the defendant's insurance company, as required by statute, and the statute doesn't apply when there is more than one defendant, wrote Judge May. There are three defendants in this action – the driver of the car that hit the Nealys, that car's owner, and American Family.

In addition, there's no language in the Nealys' policy to include setoffs for amounts paid under medical expense coverage to reduce the amount paid under the uninsured motorist coverage. The prior payments made by American Family were made under the medical expense provisions, not the uninsured motorist coverage, which does provide for a deduction of payments from the limits of liability. The majority also ruled the original jury verdict wouldn't give the Nealys a double recovery.

Chief Judge Baker believed the advance payment statute applies to this case. He also wrote that because there were multiple defendants and American Family was the plaintiffs' insurer, this decision "elevates form over substance to a degree that leads to an inequitable result." There were multiple defendants, but only American Family played any role in the litigation whatsoever, he wrote. Although American Family was the Nealys' insurer, it was litigating against them.

"I cannot believe that the legislature intended these facts to stand in the way of the application of the advance payment statute," he wrote. "Here, American Family has already paid over $10,000 for the Nealys' medical expenses; it is inequitable and unjust – and antithetical to the purpose of the advance payment statute – to ask the insurer to pay that amount a second time."

Chief Judge Baker also wrote the majority faulted American Family because it didn't say the "magic words" of "uninsured motorist coverage" when it paid the Nealys' medical expenses.

The chief judge did concur with the majority's resolution of the Nealys' additur argument, in which the majority affirmed the denial of their motion for additur.