4 No. 16
Allstate Insurance Company, as
Subrogee of Amy M. Walker,
Appellant, v. Daniel J. Stein,
Respondent.
(and two other actions.)
2004 NY Int. 21
February 19, 2004
This opinion is uncorrected and subject to revision before
publication in the New York Reports.
Gregory V. Pajak, for appellant. Norman E.S. Greene, for respondent.
R. SMITH, J.:
This appeal concerns the timeliness of an action by an
insurance company as subrogee of an accident victim to whom the
insurance company has paid Additional Personal Injury Protection
(APIP) benefits. The question presented is whether the statute
of limitations runs from the date of the accident or the date
when the first APIP benefits were paid. We hold that the statute
runs from the date of the accident, and that the insurer's action
is therefore time-barred.
Factual Background
On May 24, 1995, a vehicle operated by Daniel Stein
struck a vehicle being operated by Amy Walker and injured her.
New York's no-fault law required that Walker have insurance
coverage providing "first party benefits" consisting of
reimbursement, to the extent specified by statute, for "basic
economic loss" (health expenses, loss of earnings, and other
reasonable and necessary expenses) (Insurance Law §§ 5102
[a],[b], 5103 [a]). As the term "no-fault" implies, these first
party benefits were payable to Walker regardless of who was at
fault, and neither Walker nor her insurer could recover them from
Stein (Insurance Law § 5104 [a]). As authorized by New York Insurance Department
regulations, 11 NYCRR 65-1.3 (though not required by statute),
Walker had also purchased an APIP endorsement from Allstate
Insurance Company covering her for "extended economic loss" --
i.e., economic loss exceeding the time and dollar limits of the
"basic economic loss" that is subject to mandatory no-fault
coverage. Recovery of "extended economic loss" from third
parties is not restricted by the no-fault statute. On August 2, 1996, Walker began an action against Stein
in Supreme Court, alleging that she had sustained a serious
injury, which would permit her to recover non-economic loss
without violating the no-fault statute, (Insurance Law § 5104
[a], and also seeking to recover economic loss other than her
basic economic loss. Thus, Walker sought to recover from Stein
the same "extended economic loss" that was covered by the APIP
endorsement in her Allstate policy. By June 29, 1998, Walker's basic no-fault coverage had
evidently been exhausted, and Allstate made its first payment of
APIP benefits to Walker. Allstate alleges that by May of 2001 it
had paid more than $42,000 to Walker in APIP benefits. By making
those payments, Allstate became subrogated to a portion of
Walker's claim against Stein. On February 20, 2001, counsel for the parties in
Walker's action against Stein appeared, along with counsel for
Allstate, at a conference before Supreme Court. Walker's counsel
stated that Walker and Stein had agreed on a $300,000 settlement
of the action. Counsel for Stein stated that the release Stein
expected to get from Walker "cuts off any rights that Allstate
would have against either Mr. Stein or [Stein's insurance
carrier]" and requested a "clarification . . . to that effect"
from Allstate's counsel. Allstate's counsel, without commenting
directly on the request for clarification, stated that Walker
"has been made aware of the possible subrogation claim in the
amount of 43 thousand dollars . . . and that she understands that
in entering into this release ...." Counsel for Walker added his
own "clarification" stating that Walker is "giving a general
release to the defendant [and] . . . is reserving whatever
rights or obligations or defenses she or her husband may have to
any party to this proceeding, including Allstate Insurance
Company, and I'm not conceding on the record that there's a right
of subrogation or anything else."
Thus, it seems that the three parties represented at
the conference had three different, and inconsistent,
understandings of the settlement: Stein understood that he was
getting a complete release, good against both Walker and
Allstate; Allstate understood that it was preserving what it
called a "subrogation claim," though its counsel's statement may
be read as implying a claim against Walker for part of the
$300,000, rather than against Stein for some additional amount;
and Walker apparently understood that she would keep the whole
$300,000, and did not recognize that Allstate was entitled to
anything. Walker's counsel added that "We are all going to let
the law . . . determine what rights and obligations, if any,
anyone has," and the Court echoed this comment: "It's clear on
the record that all three parties are saying that they intend to
fully enforce their rights to the full extent of the law and
defenses that they might have."
On February 23, 2001, Walker's counsel delivered to
Stein's counsel an unqualified general release in Stein's favor,
executed by Walker and her husband, but not by Allstate. Stein
resisted paying Walker the full $300,000 in return for this
release. He paid Walker $200,000, and sought to require Walker
and Allstate to resolve the allocation of the remaining $100,000
between themselves: first, Stein offered a $100,000 draft payable
to both Walker and Allstate; he later began an interpleader
action. Walker rejected the $100,000 draft and caused a judgment
in the amount of $100,000 to be entered against Stein. Stein
moved to vacate the judgment. Despite its counsel's comments at the settlement
hearing, Allstate apparently made no effort to recover from
Walker any portion of the $300,000 settlement. However, on May
4, 2001 Allstate, "as subrogee of Amy M. Walker," began its own
action against Stein. This action, the third to be brought
(after Walker's original lawsuit and Stein's interpleader
action), is the one whose timeliness is now in issue. Allstate's
complaint alleged that Walker had been injured through Stein's
negligence; that as a result of those injuries, she had suffered
losses for which Allstate paid her compensation in the form of
APIP benefits; that Allstate had become Walker's subrogee under
the terms of its policy and the applicable insurance regulations;
and that Allstate was therefore entitled to recover from Stein
the APIP benefits it had paid. Stein moved to dismiss Allstate's
action based on, among other grounds, the statute of limitations. Supreme Court resolved the three-cornered dispute by
allowing Walker's judgment against Stein to stand, dismissing
Stein's interpleader complaint and denying Stein's motion to
dismiss Allstate's action. Stein appealed to the Appellate
Division, which, by a three-two vote, reversed the denial of
Stein's motion to dismiss, holding that Allstate's claim was
barred by the statute of limitations. Allstate appeals as of
right (CPLR 5601 [a]).
Discussion
Stein contends that Allstate, as Walker's subrogee,
stands in Walker's shoes and was therefore required to bring suit
by May 24, 1998, three years after the date of Walker's accident,
and almost three years before Allstate in fact sued.[1]
Allstate
contends that, by making APIP payments to Walker, it acquired a
new cause of action against Stein on June 29, 1998 and was
permitted to sue until three years after that date.[2]In deciding the issue in Stein's favor, the Appellate
Division majority analyzed the question, we think correctly, as
follows:
"Allstate's subrogation action is governed by
the same statute of limitations applicable to
action No. 1, the personal injury action
commenced by the Walkers against Stein. That
is consistent with the principles that a
subrogation claim is derivative of the
underlying claim and that the subrogee
possesses only such rights as the subrogor
possessed, with no enlargement or diminution.
It is likewise consistent with the principle
that a defendant in a subrogation action has
against the subrogee all defenses that he
would have against the subrogor, including
the same statute of limitations defense that
could have been asserted against the
subrogor"
(305 2 at 974 [citations omitted]). Allstate does not dispute that the above quotation
correctly states the law applicable to subrogation generally. It
contends, however, that the right asserted by Allstate in this
case is not an ordinary subrogation right, but a creature of
statute (as implemented by Insurance Department regulation), and
that this case is therefore analogous toMotor Veh. Acc. Indem.
Corp. (MVAIC) v Aetna Cas. Ins. Co., (, 89 NY2d 214 [1986]) andAetna Life & Cas. Co. v Nelson (, 67 NY2d 169 [1986]). MVAIC concerned the right of the Motor Vehicle Accident
Indemnity Corporation to recover from the insurer of a vehicle
no-fault benefits that MVAIC had paid after the vehicle's insurer
denied coverage. In that case, the defendant insurer claimed
that MVAIC's right was "in the nature of subrogation" and that
MVAIC thus had no greater rights than its insured and was subject
to the same statute of limitations ( MVAIC, 89 NY2d at 220). This
Court held otherwise, stating that MVAIC's entitlement to
reimbursement was "created or imposed by statute, but for which
[it] would not exist" (id. at 221). The MVAIC court relied onAetna Life & Cas. Co. vNelson, which concerned the attempt of a no-fault insurer to
enforce a statutory lien pursuant to Insurance Law § 673(2) (now
§ 5104 [b]). Noting that the statute of limitations contained in
CPLR 214 (2) "only governs liabilities which would not exist but
for a statute" (67 2 at 174), this Court in Aetna held that
the liability there at issue was in that category. We stated
that the statute creating that liability
"does not codify common-law principles; it
creates new and independent statutory rights
and obligations in order to provide a more
efficient means for adjusting financial
responsibilities arising out of automobile
accidents"
( id. at 175 [citation omitted]). This case is different from MVAIC andAetna because it
involves a traditional equitable subrogation, not a liability
created by statute. Indeed, no statute even refers to APIP
benefits, much less a subrogation claim by an APIP carrier
against a tortfeasor. Allstate relies not on a statute but on an
Insurance Department regulation, 11 NYCRR 65-1.3, which sets
forth a form of APIP endorsement which is "approved and
promulgated" by the Department of Insurance. The APIP
endorsement approved by the Department includes a subrogation
clause, as follows:
"In the event of any payment for extended
economic loss, the Company is subrogated to
the extent of such payments to the rights of
the person to whom, or for whose benefit,
such payments were made. Such person must
execute and deliver instruments and papers
and do whatever else is necessary to secure
such rights. Such person shall do nothing to
prejudice such rights."
The regulation, however, does not create a new right
which did not exist at common law, but merely prescribes the form
of a clause that declares Allstate's pre-existing right. On the
facts of this case, Allstate would have a right of subrogation
against Stein if there were no applicable regulation, and indeed
even if there were no explicit subrogation clause in the
insurance policy. Subrogation is a venerable equitable doctrine,
not a recent invention of the Insurance Department. Almost 80
years ago, our Court explained the doctrine of subrogation as
follows:
"It is so well settled as not to require
discussion that an insurer who pays claims
against the insured for damages caused by the
default or wrongdoing of a third party is
entitled to be subrogated to the rights which
the insured would have had against such third
party for its default or wrongdoing. This
right of subrogation is based upon principles
of equity and natural justice. We recognize
at once the fairness of the proposition that
an insurer who has been compelled by his
contract to pay to or in behalf of the
insured claims for damages ought to be
reimbursed by the party whose fault has
caused such damages . . ."
( Ocean Acc. & Guar. Corp. v Hooker Electrochemical Co., 240 NY
37,47 [1925];see also Aetna Casualty and Surety Co. v Jackowe,96
AD2d 37, 44 [2d Dept 1983] [quoting, in the context of an APIP
carrier's subrogation rights, the statement inKozlowski v Briggs
Leasing Corp., 96 Misc 2d 337, 342 [Sup Ct Kings County 1978]:
"Subrogation is equitable in nature, not dependent on
contract"]). Allstate protests that, if the statute of limitations
on its subrogation claim runs from the date of the accident, the
claim may be time-barred before the right of subrogation exists,
so that the subrogee would never have an opportunity to bring
suit on the claim. But this sort of risk is inherent in
subrogation; the subrogee acquires only the rights that the
subrogor had, and so any subrogee may find its claim defeated by
a defense based on the subrogor's action or inaction. In such a
case, the subrogee's remedy is against the subrogor, for conduct
that has prejudiced the subrogee's right. The APIP endorsement
quoted above specifically provides that the subrogor shall "do
nothing to prejudice" the insurer's rights of subrogation. This
provision too is merely declaratory of longstanding equitable
principles ( See e.g. Ocean, 240 NY at 47). As the Appellate Division majority pointed out,
Allstate's plight here results from its own failure "to insist on
the resolution of its subrogation claim against the tort-feasor
for APIP payments as part of a global settlement of the personal
injury claims" ( Walker 305 AD2d at 975). Nothing required
Allstate to acquiesce, as it did, in a settlement between Walker
and Stein in which all the consideration went to Walker and none
to Allstate. Allstate was, by virtue of subrogation, entitled to
the portion of Walker's recovery that is allocable to her claim
for "extended economic loss." At the February 20, 2001
conference Allstate's counsel seemed to recognize this, stating
to the court that "the plaintiff has been made aware of the
possible subrogation claim in the amount of 43 thousand dollars."
But Allstate never followed up the implied threat to recover its
$43,000 from the settlement proceeds that Walker received,
choosing instead to bring a time-barred action against Stein. Accordingly, the order of the Appellate Division should
be affirmed, with costs.
Footnotes
1CPLR 214 (5) imposes a three-year statute of limitations for
most personal injury actions.
2 Allstate relies on CPLR 214 (2), providing a three-year
limitation period for "an action to recover upon a liability,
penalty or forfeiture created or imposed by statute."