Pursuant to Neb. Rev. Stat. § 25-21,149 et seq. (Reissue 1989) (Uniform Declaratory Judgments Act), Shelter Insurance Co. (Shelter) brought an action for a declaratory judgment against Alice M. Frohlich concerning funds held in trust under an escrow agreement pertaining to distribution of settlement proceeds from Frohlich’s settlement of her personal injury claim against Gini and Harlan Denbeste. After the *113 district court for Lancaster County granted summary judgment to Shelter, Frohlich appealed.
BACKGROUND
On August 12,1984, Frоhlich was a passenger in a car driven by Frankie Tipton, a policyholder insured by Shelter. Tipton’s car collided with a car driven by Gini Denbeste. Farmers Mutual of Nebraska had the liability insurance coverage on the Denbeste automobile. As a result of the collision, Frohlich suffered severe and permanent injuries which left her partially disabled and which resulted in medical expenses exceeding $50,000.
On September 6, 1984, since Tipton’s policy сontained a “medical pay” provision, Frohlich’s lawyer telephoned Shelter regarding reimbursement of medical expenses paid by Frohlich on account of the accident. In a September 14 letter to Frohlich’s lawyer, Shelter stated that Tipton’s policy provided $10,000 in medical payment coverage in the following policy provision:
Coverage C — Medical Payments — The Company will pay all reasonable expenses which are incurred within one year from the date of accident for necessary medical, surgical, x-ray, and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services, for bodily injury caused by accident and sustained by:
(b) Any other person while occupying (1) the described automobile, while being used by the named insured----
Shelter’s letter also called attention to a subrogation clause in Tipton’s policy:
In the event of any payment under Coverage C [Medical Payments] of this policy, the Company shall be subrogated to all the rights of recovery therefor which the injured person or anyone receiving such payment may have against any person or organization, and such person shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. Such person shall do nothing after loss to prejudice such rights.
*114 On October 26, Frohlich’s lawyer wrote in response to Shelter’s letter, disputing Shelter’s claimed subrogation interest resulting from any payment made under the medical pay provision of Tipton’s policy: “At this time we are not prepared to concede that point as we believe that the Nebraska Supreme Court will resolve that issue with a contrary interpretation.” Moreover, in the Octоber 26 letter, Frohlich asserted that she was entitled to the entire $10,000 medical payment coverage because her medical expenses at that time exceeded $31,000. Shelter paid Frohlich $10,000 under Tipton’s policy and, in a letter accompanying the payment, stated: “This letter is also to advise we will pursue our own subrogation for medical payments against Farmers Mutual of Nebr.”
Later, Frohlich sued Gini Denbeste and her father, Harlan Denbeste. As a result of compromise and settlement of Frohlich’s claim against Denbestes, Farmers Mutual paid Frohlich $212,500. Shelter did not participate in the settlement process. The record does not contain the actual settlement agreement or release for Frohlich’s claim against Denbestes. However, as an aspect of the settlement, Frohlich, Denbestes, and Farmers Mutual, but not Shelter, signed an escrow agreement whiсh required that $10,000 of the $212,500 settlement be deposited in escrow and which further provided: (1) Farmers Mutual acknowledged receipt of Shelter’s subrogation claim; (2) the $10,000 escrow fund would be released when Shelter withdrew its subrogation claim, the statute of limitations barred Shelter’s claim, or the subrogation claim was resolved; and (3) Frohlich would hold harmless the escrow agent, Denbestes, and Farmers Mutual from any claim by Shelter concerning its subrogation claim and the escrow fund. The escrow agreement expressly stated that the escrow fund resulted from “a compromise settlement of [the] litigation” between Frohlich and Denbestes.
Shelter subsequently filed its declaratory judgment action against Frohlich, asserting entitlement to the $10,000 escrow fund by virtue of Shelter’s payment to Frohlich under Tipton’s policy and the doctrine of subrogation. Both Shelter and Frohlich moved for a summary judgment. The court entered summary judgment for Shelter and ordered that the $10,000 *115 escrow fund be paid to Shelter.
ASSIGNMENTS OF ERROR
Frohlich asserts that the district court erred by (1) finding that Shelter has a subrogation interest in the $10,000 escrow fund and ordering that the fund be paid to Shelter, (2) finding that Shelter was not required to prove that Frohlich was fully compensated for her injuries sustained in the automobile accident, (3) ruling that Shelter’s action was properly brought against Frohlich rather that against Denbestes and Farmers Mutual, and (4) failing to find that Shelter waived its subrogation intеrest in the escrow fund.
STANDARD OF REVIEW
A summary judgment is properly granted when the pleadings, depositions, admissions, stipulations, and affidavits in the record disclose that there is no genuine issue concerning any material fact or the ultimate inferences deducible from such fact or facts and that the moving party is entitled to judgment as a matter of law. [Citations omitted.] In appellate review of a summary judgment, the court views the evidence in a light most favorable tо the party against whom the judgment is granted and gives such party the benefit of all reasonable inferences deducible from the evidence.
Union Pacific RR. Co. v. Kaiser Ag. Chem. Co.,
SHELTER’S SUBROGATION INTEREST
Frohlich contends that Shelter has no subrogation right as the result of the medical payments provision of Tipton’s policy. However, Tipton’s policy expressly stated that Shelter “shall be subrogated to all the rights of recovery therefor which the injured person or anyone receiving such payment may have against any person or organization.”
In Milbank Ins. Co. v. Henry,
Although the subrogation clause in Shelter’s policy differs verbally from the clause presented in Milbank Ins. Co., the difference is immaterial for the purpose of determining whether Shelter’s subrogation provision is valid. Both the subrogation provision in Shelter’s policy and the provision examined in Milbank Ins. Co. state, in substance, that an insurer has a right of subrogation for a recovery from a tort-feasor when the insurer has made payments tо the insured under the medical payments coverage of an insurance policy. Thus, the subrogation clause in the insurance agreement between Tipton and Shelter is valid.
The question remains, however, whether Shelter’s subrogation right applies when Shelter, under its medical payment coverage, pays medical expenses of one other than its insured. The fact that Frohlich was not one of Shelter’s policyholders does not detеrmine whether Shelter is entitled to subrogation. Frohlich became a third-party beneficiary of the policy or insurance contract between Tipton and Shelter when Shelter paid Frohlich’s medical expenses as required by the policy which Shelter had issued to Tipton. Therefore, Frohlich, by accepting a contractual benefit, is bound by the subrogation
*117
clause contained in the insurance policy. See
Haakinson & Beaty Co. v. Inland Ins. Co.,
General Principles of Subrogation.
“Subrogation is substitution of one person who is not a volunteer, a subrogee, for another, a subrogor, as the result of the subrogee’s payment of a debt owed to the subrogor so that the subrogee succeeds to the subrogor’s right to recover the amount paid by the subrogee.”
Ehlers v. Perry,
“To be entitled to subrogation, one must pay a debt for which another is liable.”
Ehlers v. Perry,
Generally, subrogation is unavailable until the debt owed to a subrogor has been paid in full. See
Skinkle
v.
Huffman, 52
Neb. 20,
Subrogation and Insurance.
In the context of insurance, the right of subrogаtion is based on two premises: (1) an insured should not be allowed to recover twice for the same loss, which would be the result if the insured recovers both from the insured’s insurer and the tort-feasor, and (2) a wrongdoer should reimburse an insurer for payments that the insurer has made to its insured. See,
Shelter Mut. Ins. Co.
v.
Bough,
subrogation is in its nature equitable .... [T] he insurance contract setting up and declaring the rights between the parties preserves the unity and control of the insured over his cause of action for personal injury and property damage against the tort-feasor, and yet fully protects the insurer’s subrogation right.
Krause v. State Farm Mut. Auto. Ins. Co.,
Thus, an insurance policy reaffirms the rights of parties relative tо subrogation but, in the absence of an express provision to the contrary, does not alter fundamental principles pertaining to subrogation. Although Shelter’s subrogation right arises under its insurance policy issued to Tipton, the exact nature and extent of Shelter’s subrogation right is determined by the circumstances of Frohlich’s settlement and the resulting equities.
IS TOTAL COMPENSATION OF A SUBROGOR REQUIRED?
The Argument.
Frohlich contends that Shelter, in order to prevail and recover on the basis of subrogatiоn, must prove that she has been fully compensated for her loss resulting from the automobile accident. However, Shelter contends that, under
Milbank Ins. Co.
v.
Henry,
*120 In Milbank Ins. Co., this court simply held that a subrogation clause in a medical payments provision of an insurance policy is valid and binding as the result of paymеnts for covered medical expenses. Additionally, in Milbank Ins. Co., we held that a settlement between the insured and a third party did not destroy the insurer’s subrogation right when the third party had notice of the insurer’s subrogation interest and claim. However, in Milbank Ins. Co., we did not address the issue whether a subrogation right is conditioned on full compensation of a subrogor.
Is Full Compensation a Prerequisite to Subrogation?
Although we have not previously addressed the precise issue presented in Frohlich’s case, we have stated that
“[w]hеre the assured, as in case of partial insurance, sustains a loss, in excess of the reimbursement or compensation by the underwriter, he has an undoubted right to have it satisfied by action against the wrong-doer. But if, by such action, there comes into his hands, any sum for which, in equity and good conscience, he ought to account to the underwriter, reimbursement will, to that extent, be compelled in an action by the latter, based on his right in equity to subrogation. But the аssured will not, in the forum of conscience, be required to account for more than the surplus, which may remain in his hands, after satisfying his own excess of loss in full, and his reasonable expenses incurred in its recovery, unless the underwriter shall, on notice and opportunity given, have contributed to, and made common cause with him, in the prosecution.”
(Emphasis supplied.)
United Services Automobile Assn. v. Hills,
This brings us to the question: Is an insured’s full compensation for a loss a prerequisite to subrogation?
Shelter cites only one appellate decision to support its contention that full compensation is unnecessary for an
*121
insurer’s right of subrogation.
Set Alabama Farm Bureau Mut. Cas. Ins. Co.
v.
Anderson,
Although courts have expressed various rationales for the conclusion that an insured must be fully compensated for a loss before the insurer is entitled tо subrogation, the underlying premise seems to be that, under principles of equity, an insurer is entitled to subrogation only when the insured has received, or would receive, a double payment by virtue of an insured’s recovering payment of all or part of those same damages from the tort-feasor. As observed in
Rimes
v.
State Farm Mut. Auto. Ins. Co.,
“ [WJhere either the insurer or the insured must to some extent go unpaid, the loss should be borne by the insurer for that is. a risk the insured has paid it to assume.” [Quoting Garrity v. Rural Mut. Ins. Co.,77 Wis. 2d 537 ,253 N.W.2d 512 (1977).]
*123 . . . [W]e find it difficult to justify the position of the insurer, which has already been paid a premium for the risk it assumed and which would have been obligated to make the medical payments irrespective of its insured’s negligence and irrespective of whether or not a culpable third party could have been found.
Also, in
Rimes
the court noted that “[s]ubrogation is to be allowed only when the insured is compensated in full by recovery from the tortfeasor. The insured is to be mаde whole, but no more than whole.”
Moreover, as the court expressed in
Oss v. United Services Auto. Ass’n,
“ [T]he subrogation clause would not be regarded, even by a careful and intelligent reader, as qualifying the basic promise to pay, and to give it that effect is to enforce provisions drafted by the insurer that are inherently deceptive.” This is good reason for holding that the “[subrogation] clause must be subordinated to the basic insurance promise” and that the insurer should not “recover sums received by the insured frоm the tort source until the insured has been fully indemnified.”
Allowing an insurer to subrogate against an insured’s settlement when an insured has not been fully compensated would mean that all the insured’s settlement could be applied to a medical payment subrogation claim with nothing left to compensate the insured for excess medical bills or personal injuries. Insurance companies accept premiums in exchange for medical payment coverage and may be obligated to pay medical expenses regardless of their insured’s negligence or whether a third-party tort-feasor is liable and, therefore, must pay damages. In addition, there is little empirical substantiation that possible reimbursement through successful subrogation is considered in determining insurance premiums for medical payment coverage. See Rimes, supra.
Because the record in Frohlich’s case fails to answer the quеstion whether Frohlich has been fully compensated as the *124 result of the settlement with the Denbestes and Farmers Mutual, there is a genuine issue of material fact concerning compensation for Frohlich’s loss from the automobile accident; hence, the court erred by granting summary judgment to Shelter.
Whether Shelter’s subrogation right can be enforced against Frohlich requires resolution of factual issues, such as the amount of medical costs inсurred by Frohlich and other damages sustained by her. See, Skauge v. Mountain States Tel. & Tel., supra; Oss v. United Services Auto. Ass’n, supra. Additionally, other factors affecting enforceability of a subrogation right may include the tort-feasor’s ability to pay beyond the amount of the subrogor’s settlement and whether the settling parties have stipulated that the settlement satisfies all damages sustained by the subrogor. See Rimes, supra. If Frohlich’s damages, as later determined at the trial level, exceed the amount which she received in settlеment of her claim against Denbestes, Frohlich has not been fully compensated for her loss, and, consequently, Shelter is not entitled to any part of the proceeds from settlement of Frohlich’s claim against the Denbestes.
PROPER PARTIES?
Frohlich contends that the trial court erred in ruling that Shelter’s claim was properly brought against Frohlich instead of Denbestes and Farmers Mutual. However, Frohlich does not discuss this assignment of error.
“To be considered by an appellate court, an error must be assigned and discussed in the brief of the one claiming that prejudicial error has occurred.”
Maack v. School Dist. of Lincoln,
WAIVER
Finally, Frohlich contends that by stating that “we will pursue our own subrogation for medical payments against *125 Farmers Mutual of Nebr.,” Shelter waived its right to proceed against Frohlich.
“A waiver is the voluntary and intentional relinquishment of a knоwn right, privilege, or claim, and may be demonstrated by or inferred from a person’s conduct.”
State v. Kennedy,
Although Shelter’s statement mаy indicate an intention to proceed against Farmers Mutual, that statement, by itself, cannot be characterized as “clear, unequivocal, and decisive action” constituting a “voluntary and intentional relinquishment” of its right to proceed against Frohlich. Thus, Frohlich’s contention that Shelter waived its subrogation right is without merit.
CONCLUSION
Since the district court erred in granting summary judgment to Shelter, we reverse the judgment of the district court and remand this cause for further proceedings.
Reversed and remanded for FURTHER PROCEEDINGS.
