John Steffens, a client of PBC Attorneys John Peterson and Amy Risseeuw, will have his case heard by the Wisconsin Supreme Court.
The WI Supreme Court’s website summarizes the case here. Mr. Steffens’ case is also subject of a WHBY news article here.
Mr. Steffens was injured in an automobile accident, and his insurance plan, BlueCross BlueShield, paid some of his medical bills. During the course of the case, it was hotly contested whether Mr. Steffens’ back surgery was due to the accident or a pre-existing degenerative condition.
Steffens sued and received compensation for his injuries from the negligent driver and the driver’s insurer, AIG National.
After Mr. Steffens settled his case against the negligent driver, he attempted to reimburse his health insurance carrier, BlueCross. Mr. Steffens and BlueCross were unable to agree upon the amount of the reimbursement. Mr. Steffens asked the circuit court to hold a hearing or trial to review the proper amount to be reimbursed. BlueCross argued that it is entitled to determine the amount of reimbursement without review by any other entity.
The circuit court agreed with BlueCross and found that Mr. Steffens had taken contradictory positions during the course of his case. Based upon that, the legal theory of “judicial estoppel” blocked him from arguing that certain medical bills were not related to his automobile accident. The Court of Appeals reversed this decision, and found the circuit court incorrectly applied judicial estoppel because the position Steffens took (that the accident caused the back problems that necessitated the surgery) was never taken in court.
BlueCross has appealed to the Wisconsin Supreme Court, which is expected to decide whether the first (trial) court correctly determined judicial estoppel applied, and whether such an insurer is entitled to reimbursement