Healthcare provider action to recover insurance benefits; Res judicata; Whether the dismissal of a prior case was a decision on the merits; Standing to pursue reimbursement for any unpaid benefits; Supplementing the complaint; Assignment of rights; Whether a requested jury instruction was supported by the evidence; Home-Owners Insurance Company (HOIC)

The court held that res judicata did not apply and that the trial court was correct in denying some jury instructions requested by defendant-insurer (HOIC). But it also held that plaintiff-healthcare provider (Riversbend) did not have “any assigned right to pursue a portion of the benefits” at issue. Thus, it vacated the judgment for plaintiff as to that portion of its recovery and remanded for entry of a corrected judgment and any other necessary proceedings. HOIC’s insured, B, was injured in an auto accident and was treated at Riversbend. HOIC argued that res judicata precluded this case due to the dismissal of a 2018 action by plaintiff. If the order of dismissal “had only stated that the 2018 case was dismissed with prejudice, that language would be dispositive as a resolution on the merits.” But the court noted that the order also contained a provision ordering “‘that all claims for unpaid medical’” before 7/30/18 made in the case here were barred by the one-year back rule. “This provision must also be given effect.” The court found that while “not an express statement that there would be further proceedings, . . . there would be no reason to include a statement explicitly addressing some of the potential claims here unless this case was to remain pending. Otherwise, the second provision in the order would be nugatory and irrelevant. In any event,” its presence made the order ambiguous and allowed the court “to consider extrinsic evidence to resolve” its meaning. Extrinsic evidence clearly showed “that both parties and the trial court expected that this case would remain ongoing.” The court held that “the trial court properly (1) concluded that this case was left undisturbed by its order dismissing the 2018 case and (2) denied HOIC’s motion to dismiss.” In addition, Riversbend had “standing, because it had a valid assignment of some rights when it filed its complaint in this case. And the trial court did not err by permitting [it] to supplement its complaint, irrespective of the label given to that supplementation. However, the assignments of rights ultimately failed to convey to Riversbend any right to recover for benefits that went unpaid between” 7/30/19 and 3/2/21. Because B had “filed a claim against HOIC on [3/2/22] for the same benefits at issue as in the 2022 assignment, she had a right to recover benefits up to a year before this date. Therefore, she could have assigned rights to recover benefits that went unpaid as far back as [3/2/21], but no further.”