Wilson v. Educators Mut. Ins. Ass'n
2017 UT 69
| Utah | 2017Background
- Jessica Wilson was struck and killed; EMIA paid $78,692.34 in medical expenses covered by insurance.
- Wilson’s parents sued the driver for wrongful death and agreed to settle for the driver’s $100,000 policy limits.
- Before that settlement finalized, EMIA filed a separate subrogation suit in its own name to recover the medical payments.
- The actions were consolidated; the driver’s insurer interpleaded the $100,000 limits and the district court allocated $24,182.31 to EMIA and the remainder to the Wilsons.
- The Utah Court of Appeals dismissed EMIA’s suit for lack of standing, reasoning an insurer may sue for subrogation only in the insured’s name and relying on common-law "made-whole" considerations.
- The Utah Supreme Court granted certiorari and reversed, holding EMIA had contract-based standing under its policy’s explicit subrogation clause.
Issues
| Issue | Wilsons' Argument | EMIA's Argument | Held |
|---|---|---|---|
| Whether an insurer may sue for subrogation in its own name | Statute and precedent limit subrogation to actions brought in the insured’s name; no independent common-law right | Policy expressly grants insurer authority to pursue subrogation in its own name | Insurer may sue in its own name when the policy expressly grants that right |
| Applicability of the "made-whole" doctrine | EMIA cannot assert subrogation because insureds are not yet fully compensated | The policy waives the made-whole requirement; parties can contract around equitable subrogation limits | Contractual terms can modify common-law made-whole requirements; policy controls here |
| Effect of Johanson precedent | Johanson supports prohibition on insurer suing in own name except in narrow circumstances | Johanson was dicta regarding other jurisdictions; does not establish a per se bar here | Johanson was overread by the court of appeals; it does not bar a contractual right to sue in insurer’s name |
| Whether consolidation/claim-splitting bars EMIA’s separate suit | Separate suit risks claim-splitting and inefficiency | Procedural rules (joinder/consolidation) mitigate claim-splitting; parties contracted for insurer’s independent suit | Claim-splitting concerns do not override an express contractual subrogation right, and consolidation remedies inefficiency |
Key Cases Cited
- Johanson v. Cudahy Packing Co., 152 P.2d 98 (Utah 1944) (discusses common-law practice that subrogation suits are generally prosecuted in insured’s name)
- State Farm Mut. Auto. Ins. Co. v. Nw. Nat’l Ins. Co., 912 P.2d 983 (Utah 1996) (defines equitable subrogation as stepping into insured’s shoes after insurer pays claim)
- Educators Mut. Ins. Ass’n v. Allied Prop. & Cas. Ins. Co., 890 P.2d 1029 (Utah 1995) (applies insurer subrogation principles in Utah context)
- Hill v. State Farm Mut. Auto. Ins. Co., 765 P.2d 864 (Utah 1988) (describes the made-whole principle and that it may be modified by contract)
