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Labombard v. Samaritan Health System8/6/1998
DEPARTMENT A
Appeal from the Superior Court of Maricopa County
Cause No. CV 95-02753
The Honorable Rebecca A. Albrecht, Judge
AFFIRMED IN PART; REVERSED AND REMANDED IN PART
This appeal arises from an interpleader action filed by State Farm Mutual Automobile Insurance Company (State Farm) to determine who is entitled to receive $20,674.78 in interpleaded funds. We hold that Tammy LaBombard has failed to show detrimental reliance and therefore Samaritan Health System (Samaritan) is not estopped to assert its medical lien. Because Samaritan holds a medical lien it is entitled to collect all of its "customary charges" from the proceeds of Tammy LaBombard's settlement with State Farm's insured. However, Samaritan must pay a proportionate share of the attorneys' fees incurred in obtaining the settlement. Additionally, we remand to the trial court to determine whether Samaritan's "billed charges" -- i.e., the charges based on the schedule of rates and charges filed with the Department of Health Services -- are the same as its "customary charges."
FACTUAL AND PROCEDURAL HISTORY Because the trial court ruled on cross-motions for summary judgment, the facts generally (though not without exception) are undisputed. Nevertheless, to the extent that the parties disagree or that we are required to draw inferences from the undisputed facts, we view the evidence in the light most favorable to the party against whom the summary judgment was entered, in this case LaBombard. See Pioneer Annuity Life Ins. Co. v. Rich, 179 Ariz. 462, 464, 880 P.2d 682, 684 (App. 1994).
On August 23, 1991, LaBombard was riding in a Jeep driven by Shane Rogers. Rogers lost control of the Jeep, the Jeep ran off the road and overturned, and LaBombard was ejected from the Jeep and injured.
Maricopa County paid some of the initial costs of emergency treatment for LaBombard. LaBombard later was admitted and treated for her injuries at the Samaritan medical facilities, as a patient under the Arizona Health Care Cost Containment System (AHCCCS). AHCCCS pays care providers a percentage of billed charges, based on a statutory formula. The amount paid is generally, but not always, substantially less than Samaritan's billed charges. In this case, Samaritan's total billed charges were approximately $30,000, and AHCCCS paid Samaritan approximately $9500.
AHCCCS, Maricopa County, and Samaritan all filed liens against any judgment or settlement LaBombard might receive in connection with any claim for damages for the injuries necessitating the medical treatment, pursuant to Arizona's lien statutes. Ariz. Rev. Stat. Ann. (A.R.S.) ยงยง 33-931 (health care provider lien statute) and 36-2915 (AHCCCS lien statute). Samaritan perfected liens totaling $20,674.78. AHCCCS perfected liens in the amount of $26,000.00, reflecting amounts paid to Samaritan and others.
LaBombard pursued a personal injury claim against Rogers. LaBombard and Samaritan stipulated in this interpleader action that LaBombard's claim for damages arising out of the Jeep accident was worth $500,000.00. Rogers's State Farm insurance policy, however, provided coverage in the amount of only $50,000.00. In an attempt to ensure that LaBombard would actually receive any sums recovered from Rogers and/or his insurer, LaBombard's attorney worked out compromises with AHCCCS to reduce the amount of its lien before settling LaBombard's claim against Rogers. AHCCCS reduced its lien to $4,000.00. In December 1994, a person from LaBombard's attorney's office contacted Samaritan, and Samaritan stated that there was no balance due on LaBombard's account.
LaBombar
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