Jefferson-Pilot Life Insurance v. Fraker

Beasley, Judge.

Can an insurance company require its insured, who has received only partial compensation from the tortfeasor for his injuries, to reimburse the company for medical bills where the insurance contract requires the insured to pay one-third of his net recovery to the company as reimbursement? That is, does such policy language avoid the complete compensation rule by constituting “an express provision to the contrary?”1

After Jerry Fraker was involved in an automobile accident, his employer’s medical insurance carrier (Jefferson-Pilot Life Insurance Company) paid out nearly $900,000…