MELTON, Justice.
After being injured in an automobile accident, Randolph Adams (sometimes referred to as the insured) brought suit against the tortfeasor, who carried a $25,000 insurance policy with Nationwide. Pursuant to a negotiated settlement, Nationwide exhausted its coverage by paying (1) $15,782.34 to Adams and his attorney, and (2) $9,217.66 to Grady Hospital in order to satisfy a hospital lien for unpaid services rendered to Adams to treat his injuries. Because his damages exceeded $25,000, Adams filed a claim with his uninsured motorist carrier, State Farm, with whom Adams carried $100,000 worth of coverage. In response, State Farm paid Adams $75,000, contending that it was entitled to a credit for all of the coverage paid out by Nationwide. Adams, however, maintained that State Farm was not entitled to a credit
The underlying lawsuit ensued, and based on the provisions of the uninsured motorist statute, the trial court granted summary judgment to State Farm. Adams then appealed that decision to the Court of Appeals. In Adams v. State Farm Mut. Auto. Ins. Co., 298 Ga.App. 249, 679 S.E.2d 726 (2009), the Court of Appeals reversed the trial court, finding that State Farm was not entitled to a credit against Adams' coverage for the hospital lien paid by Nationwide. Thereafter, we granted State Farm's petition for certiorari to determine whether the Court of Appeals erred in extending the rationale of Thurman v. State Farm Mut. Auto. Ins. Co., 278 Ga. 162, 598 S.E.2d 448 (2004), to the satisfaction of a hospital lien by the tortfeasor's liability insurer. For the reasons set forth below, we reverse.
Resolution of the issue in this case requires a review of the bedrock principles of uninsured motorist law set forth in OCGA § 33-7-11(b)(1)(D)(ii), as well as the fundamental nature of a hospital lien imposed pursuant to OCGA § 44-14-470. OCGA § 33-7-11(b)(1)(D)(ii) (2000) provides that an uninsured motor vehicle includes one subject to:
In summary, to determine whether a motor vehicle is underinsured, and thereby an uninsured motor vehicle, one must determine whether the injured party's uninsured motorist coverage exceeds the sum of the tortfeasor's full liability coverage minus payments of other claims (e.g., to other parties injured by the tortfeasor) or otherwise.
As recognized by a leading treatise, the purpose of this statute has been previously set forth by this Court.
Ga. Automobile Ins. Law § 32:3 (2010 ed.). It is this underlying purpose, not Georgia's full compensation rule, which must guide this case because no subrogation rights of an insurer are associated with a hospital lien. See Holland v. State Farm Mut. Auto. Ins. Co., 236 Ga.App. 832(2), 513 S.E.2d 48 (1999).
At its most basic level, this statute recognizes that a hospital is entitled to directly bill the patient for its services and to rely solely on the patient to pay for medical services rendered. To ensure payment to the hospital, the statute grants the hospital a lien against a patient's cause of action. This cause of action refers to the patient's recourse against a tortfeasor for causing the patient's injuries. This recourse is represented by a claim brought against a tortfeasor for personal injuries and associated economic damages, such as a hospital bill. In turn, the tortfeasor, where insured, may look to his insurance company to make liability payments to the patient to cover the patient's economic damages. These liability payments, in turn, are subject to the hospital's lien seeking reimbursement for services directly billed to the patient. In short, the lien allows the hospital to step into the shoes of the insured for purposes of receiving payment from the tortfeasor's insurance company for economic damages represented by the hospital bill.
Applied specifically to the facts of this case, the statute works in the following way: Grady Hospital provided medical treatment to Adams and directly billed him $9,217.66 for these services. Adams filed a claim against the tortfeasor for personal injuries and economic damages, including the cost of his treatment at Grady Hospital. To ensure that it would be paid for medical services, Grady Hospital was allowed a statutory lien against Adams' cause of action against the tortfeasor. Because the tortfeasor carried an insurance policy with Nationwide worth $25,000 in coverage payable to Adams as a result of the accident, Grady Hospital's lien attached to this payment. As a result, Nationwide was required to pay Grady Hospital, who stepped into Adams' shoes, the amount necessary to satisfy the hospital bill for which Adams was ultimately responsible.
Considering all of the foregoing, it is axiomatic that this payment to Grady Hospital was not a payment of "other claims or otherwise" under OCGA § 33-7-11(b)(1)(D)(ii) for services rendered to Adams and for which Adams was personally responsible. Grady Hospital's bill is part of Adams' economic damages caused by the tortfeasor, and these economic damages are a part of Adams' cause of action against the tortfeasor and Nationwide, the tortfeasor's insurance company. Grady Hospital's lien attaches to Adams' cause of action. It does not create a new claim against Nationwide. To the contrary, it is merely a part of Adams' claim, and its payment represents partial satisfaction of Adams' claim. In other words, the payment inures directly to Adams' benefit for payment of a hospital bill for which he is directly responsible.
As stated above, the Georgia uninsured motorist statute "is designed to protect the insured as to his actual loss, within the limits of the policy or policies of which he is the beneficiary." Murphy, supra, 226 Ga. at 714, 177 S.E.2d 257. Subtraction of a hospital lien from a tortfeasor's insurance coverage
Nonetheless, the dissent fails to consider these issues, premising its holding on the following statement:
This conclusion, however, misconstrues both the basic purpose of the UM statute as well as the fundamental nature of a hospital lien. When a tortfeasor's liability carrier pays a hospital lien to a hospital standing in the shoes of the insured, it does so for the direct benefit of the insured. The insured, then, receives all of the benefits from the payment, as his personal responsibilities for the hospital bill are satisfied. Therefore, the insured receives protection for his actual loss, within the limits of the policy or policies of which he is a beneficiary. The fact that the funds are paid to the hospital rather than the insured is irrelevant. The dissent overlooks this basic premise, for while it is true that payment of the lien directly to Grady Hospital does diminish the amount of insurance funds actually passing through Adams' hands, it does not diminish any of the benefit from insurance proceeds to which Adams is entitled under the operative insurance policies.
The clear language of OCGA §§ 33-7-11(b)(1)(D)(ii), 44-14-470(b), and the longstanding rationale for these statutes, mandates that payment of a hospital lien should not be subtracted from a tortfeasor's total liability coverage to determine the underinsured coverage of an insured who has been injured in an accident.
Judgment reversed.
All the Justices concur, except HUNSTEIN, C.J., and BENHAM, J., who dissent.
BENHAM, Justice, dissenting.
I respectfully dissent because I believe State Farm is not entitled to a credit for the amount Nationwide paid Grady Hospital for its treatment of the injuries Mr. Adams sustained due to the negligent acts of the tortfeasor. OCGA § 33-7-11(b)(1)(D)(ii) (2000) provides in pertinent part:
The Court of Appeals construed the language "payment of other claims or otherwise" to include a valid hospital lien paid by the tortfeasor such that State Farm's UM exposure was increased in the amount of the hospital's lien and that it could not offset the full $25,000 of the tortfeasor's liability limit. Adams v. State Farm Mut. Auto. Ins. Co., 298 Ga.App. 249, 251-253, 679 S.E.2d 726 (2009). The Court of Appeals' final conclusion is correct.
Key to statutory construction is giving effect to the legislative intent. Expedia, Inc. v. City of Columbus, 285 Ga. 684(4), 681 S.E.2d 122 (2009) ("A statute must be construed `to give sensible and intelligent effect to all of (its) provisions and to refrain from any interpretation which renders any part of the statute meaningless.' [Cit.]"); Mason v. The Home Depot U.S.A., 283 Ga. 271(3), 658 S.E.2d 603 (2008) (when construing a statute, a court has a duty to give full effect to the legislative intent). The UM statute is remedial in nature and must be broadly construed to accomplish the legislative purpose. Smith v. Commercial Union Assur. Co., 246 Ga. 50, 51, 268 S.E.2d 632 (1980). More specifically, Georgia's uninsured motorist statute should be construed to "protect innocent victims from the negligence of irresponsible drivers." Hinton v. Interstate Guaranty Ins. Co., 267 Ga. 516, 517-518, 480 S.E.2d 842 (1997) (UM statute was construed broadly to include a tractor in the term "motor vehicle" as found in OCGA § 33-7-11(b)(1)(D)). Thus, the phrase "payment of claims or otherwise" must be construed broadly and remedially. Id. at 520, 480 S.E.2d 842.
Since the lien in question arises directly from the negligence of the tortfeasor, the hospital is entitled to recover from the patient's cause of action against the tortfeasor. OCGA § 44-14-470(b). See also Holland v. State Farm Mut. Auto. Ins. Co., 236 Ga.App. 832(1), 513 S.E.2d 48 (1999) (hospital lien may attach to cause of action against tortfeasor's insured).
I am authorized to state that Chief Justice HUNSTEIN joins in this dissent.