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MARIE BOWEN v. MAGIC MART OF CORINTH

DECEMBER 07, 1983

MARIE BOWEN
v.
MAGIC MART OF CORINTH, MS AND THE LONDON AGENCY, INC.



BEFORE WALKER, BOWLING AND PRATHER

PRATHER, JUSTICE, FOR THE COURT:

This workmen's compensation action is appealed here from the Circuit Court of Alcorn County. The claimant,

Marie Bowen, received a compensable injury while employed with Magic Mart of Corinth, Mississippi. During the hearing on the controverted claim, the claimant Bowen, the employer Magic Mart, and its insurance compensation carrier, the London Agency, Inc., settled the claim, but with one reservation. That reservation concerned reimbursement to the claimant for medical expenses paid from a collateral source by Blue Cross Insurance Company, the claimant's personally secured and paid health and accident insurance company. That one issue was agreed to be submitted to the workmen's compensation administrative judge for decision. Both the administrative judge and the full workmen's compensation commission denied recovery of these medical benefits to the claimant, which gives rise to this appeal. We reverse the commission.

 The issue here is whether the employer/carrier is entitled to credit for medical expenses of the claimant paid by a collateral source.

 I.

 Marie Bowen was injured in the course of her employment. Her employer refused to pay compensation and a motion to controvert was filed. A hearing was held on the merits of the claim during which a compromise settlement was agreed upon by the parties.

 Between the time of the injury and that settlement, claimant incurred medical expenses of $2,888.87. Since the employer had denied liability and had not furnished claimant with any temporary benefits, she filed a claim with Blue Cross under a medical insurance policy which she owned personally and for which she paid the premiums. Upon that claim Blue Cross partially paid the claimant's hospital and drug bills in the total amount of $1,965.43, leaving $923.44 unpaid.

 Before the settlement was agreed upon, the employer discovered that claimant's drug and hospital bills had been partially paid by Blue Cross. However, the employer refused to agree to pay the amount already paid for claimant by Blue Cross. The settlement called for a cash payment of $2,500 and a reimbursement of unpaid medical expenses of $923.44 totalling $3,423.44.

 The settlement order excluded from the settlement:

 Any claim of Blue Cross Insurance for medical expenses paid by said insurance company. The employer and carrier's liability for any medical expenses paid by persons other than the claimant shall be determined by this commission. (Emphasis added).

 A hearing was held at which it was the employer's position that no further claims existed since the only claim excluded in the settlement was any claim by Blue Cross for medical expenses paid by that company. The claimant testified that at the time of her injury she had in effect a private policy of insurance with Blue Cross and Blue Shield on which she paid the premiums. Blue Cross was not represented at this hearing.

 II.

 Should the employer and insurance carrier be allowed credit for the $1,965.43 of claimant's total medical expenses? The employer actually agreed to pay the $923.44 that the Blue Cross Insurance did not cover; the issue here relates only to ...


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