Opinion ID: 867565
Heading Depth: 3
Heading Rank: 1

Heading: Double recoverywindfall

Text: ¶ 32 Allstate argues that permitting the Samsels to recover under their medical payments provision the amount of medical expenses covered by their HMO would constitute a duplicate, windfall recovery. We are unable to see any greater windfall to the insured when he or she recovers expenses paid by the insured's HMO as compared to recovery permitted from any other collateral source. Allstate has offered no evidence that its premiums for medical payments coverage were reduced by reason of the expectation that it would be relieved of coverage for expenses paid by HMOs for their enrollees. Thus, we see no windfall when insureds who paid for a separate coverage collect just what they have paid for. Recovery of expenses from both medical payments coverage and other sources has long been both recognized and accepted in Arizona and elsewhere. As one commentator has written: [T]he tendency has been to allow double recovery where collection of the first benefits has been from a completely different source, such as a hospitalization policy or Medicare ... it might be borne in mind that it is unlikely that one would undergo serious injury merely for the purpose of recouping duplicate expenses. In addition, there are so many costs not recouped under any type of policy, but which do represent losses to the injured person, that he is unlikely to emerge with a profit in any event. If this were considered against public policy, then insurers would be forbidden to sell contracts guaranteeing payment of a fixed sum per day while one is hospitalized when it is known that the hospital expense will be paid by Blue Cross or Medicare. 8A APPLEMAN ON INSURANCE LAW & PRACTICE § 4902.7 (1997). ¶ 33 Arizona adopted this view long ago. See Aetna Cas. & Surety Co. v. Scott, 107 Ariz. 609, 611, 491 P.2d 463, 465 (1971) (notwithstanding other insurance clause, insured was entitled to medical payment reimbursement despite duplicate recovery from second source); Schultz v. Farmers Ins. Group, 167 Ariz. 148, 150-51, 805 P.2d 381, 383-84 (1991).