Comment

Posner on Sotomayor

763
vxbush5/26/2009 2:39:34 pm PDT

Regarding this ruling:

• Health Insurance (Reimbursement of insurance benefits): In 2005, Sotomayor ruled against a health insurance company that sued the estate of a deceased federal employee who received $157,000 in insurance benefits as the result of an injury. The wife of the federal employee had won $3.2 million in a separate lawsuit from those whom she claimed caused her husband’s injuries. The health insurance company sued for reimbursement of the benefits paid to the federal employee, saying that a provision in the federal insurance plan requires paid benefits to be reimbursed when the beneficiary is compensated for an injury by a third party. The Supreme Court upheld Sotomayor’s ruling in a 5-4 opinion. Justices Breyer, Kennedy, Souter, and Alito dissented. Empire Healthchoice Assurance, Inc. vs. McVeigh, 396 F.3d 136 (2005)

(from the CNN link above)

I would be interested in reading more on this. Subrogation liens are very common, and in normal circumstances the insurance company has a right to be reimbursed. More details on the cause of the injuries would be quite helpful. If the contract is clear on this (and it is very common in many medical insurance contracts and car insurance contracts), then I can’t understand how she could rule that the insurance company had no right to the money. It may have to do with whether the money came from an insurance firm or not.