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State Automobile Mutual Insurance Co. v. Hurley12/7/2000
Mailed August 31, 2000
This workers' compensation appeal has been referred to the Special Workers' Compensation Appeals Panel of the Supreme Court in accordance with Tenn. Code Ann. § 50-6-225(e)(3) for hearing and reporting to the Supreme Court of findings of fact and conclusions of law. The plaintiff, State Automobile Mutual Insurance Company (State Auto), appeals the judgment of the Circuit Court of Shelby County which ordered State Auto to pay to the defendant, Natalie Hurley (Hurley), $28,873.91 being the total of her medical bills. For the reasons stated in the opinion, we find the trial court erred and reverse the judgment of the trial court.
Tenn. Code Ann. § 50-6-225(e) (1999) Appeal as of Right; Judgment of the Circuit Court Reversed
W. Michael Maloan, Sp . J., delivered the opinion of the court, in which Janice M. Holder, J., and Henry D. Bell, Sp. J., joined.
MEMORANDUM OPINION
The relevant facts are not in dispute. State Auto filed suit to determine to what, if any, workers' compensation benefits Hurley would be entitled as a result of a July 24, 1998, automobile accident. State Auto denied Hurley's claim and did not pay any benefits. Hurley filed a counterclaim for benefits. At trial, the parties stipulated that Hurley's medical bills of $28,873.91 were reasonable and necessary. Hurley individually paid a portion of her medical bills. The balance of $26,141.19 was submitted by her health care providers to her health insurance carrier, which paid $8,174.88 in full settlement of the total billed. On May 10, 1999, the trial court found Hurley's injury to be compensable and awarded permanent partial disability benefits of forty percent (40%) to the right arm. The trial court granted Hurley's post- trial motion and ordered State Auto to pay to Hurley $28,873.91, the total of her medical bills. State Auto appeals only that part of the trial court's order requiring it to pay Hurley the total of her medical bills and allowing Hurley to retain the difference between the amount the health care providers billed and the amount they accepted from her health insurance carrier. Hurley filed a motion for this panel to find this appeal to be frivolous and to award her damages.
ANALYSIS
The scope of review of issues of fact is de novo upon the record of the trial court, accompanied by a presumption of correctness of the findings, unless the preponderance of the evidence is otherwise. Tenn. Code Ann. § 50-6-225(e)(2), Lollar v Wal-Mart Stores, Inc., 767 S.W.2d 43 (Tenn. 1989). Questions of law are reviewed de novo with no presumption of correctness. Cunningham v Shelton Sec. Services, Inc., 958 S.W.2d 338, 340 (Tenn. 1997). The sole issue presented for review is whether the trial court erred in ordering the employer to pay medical expenses directly to the employee rather than the health care providers.
On appeal, State Auto relies on Tenn. Code Ann. § 50-6-204(a)(1) to support its argument that the trial court lacked authority to order it to pay medical expenses to Hurley. Hurley submits the following arguments to support the trial court's order: 1) that State Auto is liable for the entire amount of Hurley's medical bills because State Auto stipulated Hurley's medical expenses were reasonable and necessary; ; 2) allowing State Auto to pay only the discounted medical bills would violate Tenn. Code Ann. § 50-6-114; 3) State Auto's position is against public policy; and 4) the collateral source rule should be applied in workers' compensation cases.
Effect of Stipulation of Medical Bills As Reasonable and Necessary
Ordinarily, in a workers' compensation case in which compensability is acce
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