In a ruling with real implications for claims teams handling auto injury cases, the Georgia Court of Appeals has sided with a hospital that sought payment from Progressive Mountain Insurance Company after treating a minor injured in a crash. The key takeaway? Hospitals in Georgia can enforce their liens against injury settlements - even when the injured person isn’t legally required to pay the medical bill.
The case began after Elizabeth Giles, a minor at the time, was injured while riding as a passenger in a car insured by Progressive. She received treatment at AU Medical Center, which filed a hospital lien in accordance with Georgia’s lien statute. That lien aimed to secure payment from any future compensation related to her injuries.
Over a year later, Giles settled her claims with Progressive’s insured and signed a release. But AU’s lien went unpaid. The hospital sued Progressive to recover its costs. In response, Progressive filed a third-party complaint against Giles, arguing she had agreed in the settlement to cover any liens.
Eventually, all three parties - AU Medical Center, Progressive, and Giles - filed motions for summary judgment. The trial court granted the hospital’s motion, and Progressive appealed.
On April 30, 2025, the Georgia Court of Appeals affirmed that decision. In doing so, the court rejected Progressive’s central argument: that since Giles was a minor when she received care, she wasn’t legally responsible for the bill, and therefore the lien should be unenforceable.
That might sound logical - but not under Georgia law. The court pointed to the state’s hospital lien statute, which clearly states that a hospital’s lien applies to the patient’s cause of action (in this case, Giles’s personal injury claim), not to the patient themselves. In other words, it’s about the money recovered from the injury, not whether the patient personally owes a debt.
Progressive tried to lean on a 1997 case, Southern Guaranty Insurance Co. v. Sinclair, where an insurer wasn’t allowed to recover medical payments from minors through a policy’s reimbursement clause. But the judges pointed out that Sinclair had nothing to do with hospital liens. This case, they noted, involved a different statute with different rules - and in this context, the patient’s legal liability doesn’t control whether a hospital can collect.
Importantly, the court emphasized that Georgia’s statute doesn’t require the injured person to owe the bill in order for the lien to be valid. That principle was already made clear in a 2011 Georgia Supreme Court case, MCG Health v. Owners Insurance Co., which said courts shouldn’t read restrictions into the statute that the legislature didn’t include.
Because of that, AU Medical Center’s lien was enforceable, and the court upheld the judgment in its favor.
No insurance policy clauses were at issue in the case. The entire outcome turned on how the Georgia hospital lien statute - OCGA § 44-14-470 (b) - is interpreted. The statute grants hospitals a lien on settlement proceeds from personal injury claims for the cost of care they provided.
For insurers, especially those writing auto policies in Georgia, the decision serves as a critical reminder: when settling injury claims - particularly those involving minors - it's essential to identify and resolve any outstanding hospital liens. The patient may not be legally on the hook, but that doesn’t mean the lien disappears.
The ruling, issued April 30, 2025, came from a panel of the Georgia Court of Appeals, with Judges McFadden, Hodges, and Pipkin concurring. The opinion did not name the attorneys or law firms involved in the case.
If you’re managing injury settlements in Georgia, this case offers a clear directive - hospital liens are alive and well, even when your claimant is under 18.
