Appeal from the Order of the Court of Common Pleas, Civil Division, of Montgomery County, No. 82-19106
Catherine Miraglia-Lecky, Norristown, for appellant.
Gregory S. Thomas, Norristown, for appellee.
Rowley, Del Sole and Beck, JJ.
[ 352 Pa. Super. Page 192]
On December 15, 1985, Metropolitan Life Insurance Company (Metropolitan) commenced by complaint an action for declaratory judgment seeking a determination of the respective rights of the parties to the proceeds of a no-fault automobile insurance policy issued by Concord Mutual Insurance Company, (Concord), and processed and adjusted by the Pennsylvania Assigned Claims Plan, (PAC).*fn1
This is an appeal from the trial court's orders granting Metropolitan's motion for summary judgment and denying Appellant's cross-motion for summary judgment. The court in granting the motion determined that Metropolitan is entitled to recover from Appellant in her representative capacity as Guardian of the Person and Estate of her daughter, Catherine Theresa Bodge, (Terri), any medical bills and expenses paid by Metropolitan that were subsequently paid pursuant to the Concord policy. The order concluded with the statement that, "[t]he exact amount of said recovery . . . shall be determined by an appropriate proceeding, if necessary." In this respect, the trial court opinion stated, "[w]e note a possible factual question may exist as to the amount Metropolitan would be entitled to recover should we find in favor of its right to reimbursement. However, . . . we may still determine and declare by partial summary judgment the rights of the parties to recover in this proceeding." (Trial Court Opinion at 7).
[ 352 Pa. Super. Page 193]
The relevant facts are not in dispute. In April or May of 1979, Terri, an adult, while residing apart from her mother became employed and through this employment was covered by a Group Health Insurance Policy issued by Metropolitan. In September of 1979, Appellant, without Terri's knowledge, secured and paid the premiums on a no-fault automobile insurance policy issued by Concord. The trial court found that pursuant to the express terms of the Concord policy, Terri automatically became an insured when she moved into Appellant's home in January 1980.
On or about March 2, 1980, Terri suffered severe disabling injuries as a result of an automobile accident with an uninsured motorist. Appellant submitted Terri's various medical bills and expenses to Metropolitan which paid in excess of $100,000 either directly to the respective health care providers, or to them through Appellant. Appellant subsequently submitted these same bills and expenses to PAC for payment and PAC issued a check in the amount of $105,892.44. Pending resolution of this litigation, the proceeds of this check were placed in an escrow account.
In its motion for summary judgment, Metropolitan asserts entitlement to the proceeds of the PAC check based on a coordination of benefits provision within the Metropolitan policy. The provision in question states in part:
(8) If an overpayment is made under the Group Policy because of failure to report other coverage or otherwise, the Insurance Company shall have the right to recover such overpayment . . .
On appeal from the trial court's order granting Metropolitan's motion for summary judgment, ...