Brian Anderson, D.C. v. State Farm ( 2022 )

RENDERED: APRIL 8, 2022; 10:00 A.M.
NOT TO BE PUBLISHED
Commonwealth of Kentucky
Court of Appeals
NO. 2021-CA-0005-MR
BRIAN ANDERSON, D.C.,
INDIVIDUALLY AND AS OWNER OF
KENTUCKY INJURY CHIROPRACTIC
& REHAB APPELLANT
APPEAL FROM JEFFERSON CIRCUIT COURT
v. HONORABLE BRIAN C. EDWARDS, JUDGE
ACTION NO. 19-CI-004169
STATE FARM MUTUAL
AUTOMOBILE INSURANCE
COMPANY APPELLEE
OPINION
AFFIRMING
** ** ** ** **
BEFORE: CALDWELL, COMBS, AND L. THOMPSON, JUDGES.
THOMPSON, L., JUDGE: Brian Anderson, D.C., individually and as owner of
Kentucky Injury Chiropractic & Rehab (“Appellant”) appeals from an opinion and
order of the Jefferson Circuit Court granting summary judgment in favor of State
Farm Mutual Automobile Insurance Company (“Appellee”). Appellant argues that
the circuit court erred in failing to conclude that Appellee should have directed
payment of insurance benefits to himself as a medical provider rather than to the
injured party. Finding no error, we affirm the opinion and order on appeal.
FACTS AND PROCEDURAL HISTORY
On May 16, 2016, Dallas Harris was driving an automobile insured by
Appellee when it struck a pedestrian named Deidre Johnson. After reporting the
incident to Appellee and initiating a Motor Vehicle Reparations Act1 (“MVRA”)
claim, Johnson began receiving chiropractic services from Appellant as a result of
the accident. Appellant provided $5,310.00 in services.
In payment for the chiropractic services she received, Johnson initially
assigned to Appellant her right to any proceeds she might receive as a result of her
claim against Appellee. Before any payment was made to Appellant, Johnson’s
counsel, Hon. Mark Smith, directed Appellee to make payment jointly to Johnson
and himself. Appellee then paid Johnson and Smith. No funds were paid to
Appellant. As a result, Appellant instituted the instant action against Appellee
alleging a breach of its statutory duty to pay Appellant.2
1
Kentucky Revised Statutes (“KRS”) 304.39 et seq.
2
Appellant also alleged that attorney Smith engaged in fraud, conversion, and misrepresentation.
Appellant was granted summary judgment against Smith when Smith did not file a responsive
pleading. That matter is not now before us.
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The matter proceeded in Jefferson Circuit Court, whereupon Appellee
filed a motion for summary judgment. In support of the motion, Appellee argued
that Appellant lacked standing to prosecute a direct action against Appellee based
on Neurodiagnostics, Inc. v. Kentucky Farm Bureau Mutual Insurance Company,
250 S.W.3d 321 (Ky. 2008). Appellee also asserted that Appellant’s claim was
barred by the anti-assignment provision of the policy.
On December 8, 2020, the Jefferson Circuit Court entered an opinion
and order granting Appellee’s motion for summary judgment. Based on
Neurodiagnostics, Inc., supra, the court determined that Johnson’s assignment of
benefits was unenforceable because the MVRA does not provide for a direct cause
of action by a treatment provider against a reparation obligor. This appeal
followed.
ARGUMENTS AND ANALYSIS
Appellant argues that the Jefferson Circuit Court erred in granting
Appellee’s motion for summary judgment. He maintains that the public policy
considerations underlying the MVRA are undermined by payment of benefits to
the wrong party. He asserts that he has suffered damages as a result of Appellee’s
payment of benefits to Johnson, and argues that he is entitled to a declaratory
ruling that benefits were not properly paid to him by Appellee and remain due.
While acknowledging that Neurodiagnostics, Inc., prohibits a direct cause of action
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by a medical provider against a reparations obligator, he contends that nothing
prohibits a trial court from entering a declaratory judgment that a reparations
obligor improperly failed to pay no-fault benefits to a medical provider.
The Jefferson Circuit Court granted summary judgment in favor of
Appellee based on the court’s conclusion that Appellant – as a third party medical
provider – did not have standing to bring an action against Appellee for recovery
of benefits under the policy entered into by Harris and Appellee. In finding that
Appellant did not have standing, the Jefferson Circuit Court relied on
Neurodiagnostics, Inc., supra. In Neurodiagnostics, Inc., the Kentucky Supreme
Court considered a fact pattern similar to the one before us, and examined the
question of whether the MVRA gave medical providers a cause of action against
insurance providers. In finding that it did not, the court stated that,
[a]mong the goals of the MVRA are to provide prompt
payment of basic reparation benefits to victims of motor
vehicle accidents and to help guarantee the continued
availability of motor vehicle insurance at reasonable
prices by a more efficient, economical, and equitable
system of motor vehicle accident reparations. In 1998,
the legislature instituted the process of allowing the
insured to direct the payment of benefits among the
different elements of loss. At the same time, the
legislature repealed the provision of the MVRA that
allowed an assignment of any right to benefits under the
Act. The repeal of the assignment provision took away
any direct cause of action by the medical provider, and no
other current provision of the MVRA can be construed to
afford a direct cause of action to medical providers.
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Neurodiagnostics, Inc., 250 S.W.3d at 329-30 (emphasis added).
Summary judgment “shall be rendered forthwith if the pleadings,
depositions, answers to interrogatories, stipulations, and admissions on file,
together with the affidavits, if any, show that there is no genuine issue as to any
material fact and that the moving party is entitled to a judgment as a matter of
law.” Kentucky Rules of Civil Procedure (CR) 56.03. “The record must be
viewed in a light most favorable to the party opposing the motion for summary
judgment and all doubts are to be resolved in his favor.” Steelvest, Inc. v.
Scansteel Service Center, Inc., 807 S.W.2d 476, 480 (Ky. 1991). Summary
judgment should be granted only if it appears impossible that the nonmoving party
will be able to produce evidence at trial warranting a judgment in his favor. Id.“Even though a trial court may believe the party opposing the motion may not
succeed at trial, it should not render a summary judgment if there is any issue of
material fact.” Id. Finally, “[t]he standard of review on appeal of a summary
judgment is whether the trial court correctly found that there were no genuine
issues as to any material fact and that the moving party was entitled to judgment as
a matter of law.” Scifres v. Kraft, 916 S.W.2d 779, 781 (Ky. App. 1996).
When viewing the record in a light most favorable to Appellant and
resolving all doubts in his favor, we conclude that the Jefferson Circuit Court
correctly found that there were no genuine issues as to any material fact and that
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Appellee is entitled to a judgment as matter of law. The Kentucky Supreme
Court’s holding in Neurodiagnostics, Inc., disposes of Appellant’s claim of error.
Appellant is a medical provider as envisioned by the MVRA, and Appellee is a
reparations obligor. Based on Neurodiagnostics, Inc., Appellant does not have
standing to maintain an action under the MVRA against Appellee. Appellant is not
entitled to a declaratory judgment, as he has no standing to enforce such a
judgment. Further, we are not persuaded by Appellant’s argument that the
payment of benefits to injured parties, rather than to medical providers, undermines
the public policy of the MVRA. Per Neurodiagnostics, Inc., the public policy of
the Legislature, as expressed in the MVRA, includes the goal of “provid[ing]
prompt payment of basic reparation benefits to victims of motor vehicle
accidents[.]” Neurodiagnostics, Inc., 250 S.W.3d at 329. Johnson is the victim of
the motor vehicle accident and she received basic reparations benefits.
CONCLUSION
The Kentucky Supreme Court’s holding in Neurodiagnostics, Inc.,
disposes of Appellant’s claim, and the Jefferson Circuit Court properly so found.
Appellant, as a third party medical provider, does not have standing to maintain an
action against Appellee. For these reasons, we affirm the opinion and order of the
Jefferson Circuit Court.
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ALL CONCUR.
BRIEFS FOR APPELLANT: BRIEF FOR APPELLEE:
Damon B. Willis Richard W. Edwards
Louisville, Kentucky Antonio R. Fernandez
Louisville, Kentucky
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