The Wisconsin Supreme Court held in Muller v. Society Insurance Co., decided May 30, 2008, that when an insured and an insurer separately settle claims with a responsible third party, the insured may not seek to recover funds obtained by the insurer from the insurer, even if the insured wasn’t “made whole” by their settlement.

While disclaimer of the Made Whole Doctrine is not a new occurrence for self-funded plans coming within the purview of ERISA, this case came within the purview of state law, where rules such as the Made Whole Doctrine and Common Fund Doctrine terrorize insurer rights to recovery and encourage double recovery by the insured.  As such, this is a victory for the health insurance industry worthy of note.

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This entry was posted by Adam V. Russo on Thursday, June 5th, 2008 at 8:08 am and is filed under Made Whole Rule, Wisconsin. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.