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Insurance Policy May Not Conflict with State Public Policy
Description Georgia high court held that the terms of a health insurance policy, which required its policyholders to reimburse the insurer for health costs when compensation was received from other sources, violated state policy that favors complete compensation when the insured was compensated for damages from an automobile accident.
Topic Insurance Law
Key Words Complete Compensation; Public Policy
C A S E   S U M M A R Y
Facts Davis was injured in an auto accident. Damages were in excess of $100,000. She collected $15,000 from the other driver and $85,000 from her uninsured motorist carrier. Kaiser, her health insurer, sought reimbursement from Davis for $40,361 to recover what it paid for Davis's medical expenses, as provided in a term of her health policy. The lower courts held for Kaiser; Davis appealed.
Decision Reversed. The complete compensation rule is a public policy of the state, so insurance policies may not contradict state policy. "Georgia public policy strongly supports the rule that an insurer may not obtain reimbursement unless and until its insured has been completely compensated for his losses." The provision in the Kaiser policy is void and Davis does not have to reimburse Kaiser.
Citation Davis v. Kaiser Foundation Health Plan of Georgia, Inc., 521 S.E.2d 815 (Sup. Ct., Ga., 1999)

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