Alabama Insurance Guaranty Ass'n v. Reliance Insurance Co. in Liquidation

100 A.3d 702, 2014 Pa. Commw. LEXIS 446
Commonwealth Court of Pennsylvania·Decided September 12, 2014·Published·Cited by 1 cases

Opinions

OPINION BY

Judge LEADBETTER.

We are called upon here to determine whether a claim against the Reliance estate in liquidation arises from a policy of direct insurance so as to be entitled to distribution from estate assets at priority level (b) or a policy of reinsurance entitled to priority level (e). The Liquidator assigned priority level (e) to the claim by the Alabama Insurance Guaranty Association (AIGA) for reimbursement of funds it paid to cover liability under a Reliance policy after the Alabama Supreme Court, in Alabama Insurance Guaranty Association v. Association of General Contractors Self-Insurer’s Fund, 80 So.3d 188 (Ala.2010), ruled that the claim arose under a policy for direct insurance. We conclude that the Liquidator did not err.

AIGA paid a claim by the Association of General Contractors Self-Insurer’s Fund (AGCSF) after the Alabama Supreme Court rejected AIGA’s argument that the claim against AIGA was not covered1 un[704] der the applicable guaranty association statute (“Alabama GA Act”). Thereafter, AIGA sought reimbursement by submitting its proof of claim to the Liquidator for $1,206,156.00 plus post-judgment interest on the Alabama judgment in accord with Pa.R.A.P. 3781(a). After the Liquidator issued a notice of determination (NOD) that allowed the claim at priority level (e) for benefits paid under a reinsurance policy, and disallowed the claim for post-judgment interest, AIGA filed an objection in accordance with Pa.R.A.P. 3781(c). AIGA asserted that the entire amount, including the post judgment interest, should be allowed and assigned priority level (b).2

This Court assigned a referee, who opined that, in Pennsylvania, the characterization of the Reliance policy as either direct insurance or reinsurance is governed by the recent decision in CSAC Excess Insurance Authority v. Reliance Insurance Co., (Pa.Cmwlth., No. 1 REL 2007, filed November 8, 2012) (single judge opinion), aff'd, 621 Pa. 424, 78 A.3d 1058 (2013) (per curiam order) (holding that a policy nearly identical to that at issue in the present case was reinsurance). The referee rejected as waived AIGA’s argument that the Full Faith and Credit doctrine required adherence to the Alabama court’s ruling that the policy was for direct insurance. He also rejected as meritless AIGA’s contention that the Liquidator is estopped from challenging the Alabama court’s ruling. He further opined that, if a choice of law analysis is called for, Pennsylvania prevails, as the state with the greater interest in prioritizing the claim under its liquidation statute. The referee issued a recommended decision to sustain the NOD, concluding that the Liquidator properly found the coverage under the Reliance policy to be reinsurance. AIGA then filed the instant exceptions, reasserting the contentions made in its objection to the NOD.

AGCSF is a group self-insurer pursuant to Ala.Code § 25-5-9(a), a provision of the Alabama Workers’ Compensation Act that allows two or more employers to enter agreements to pool their liabilities for purposes of qualifying as self-insurers.3 As a self-insured employer group, AGCSF and other similar groups established the Alabama Reinsurance Trust Fund (Reinsurance Trust Fund) pursuant to AIa.Code § 25-5-9(b) to pool their liabilities for purposes of each group’s responsibility to provide excess coverage above the self-insured retention levels maintained by the individual employer groups.4 In an Inden[705] ture between the Reinsurance Trust Fund and the member groups, the Trust declared its purpose to be “providing excess coverage” above the respective self-insured retention of each group and promised to “issue an appropriate Policy to each” group. The Indenture further provided that: “the Trustees may, at their discretion, obtain appropriate insurance, or reinsurance, from such insurance carrier or carriers as [they] may from time to time deem appropriate.” Purchase of such reinsurance is specifically permitted under applicable regulations that state: “[specific and Aggregate Reinsurance is permitted for a reinsurance trust fund, but is not required.” Ala. Admin. Code r.480-5-1-.04(3)(b). Electing to purchase reinsurance, the Reinsurance Trust Fund entered into a contract entitled “Certificate of Reinsurance” (Certificate) pursuant to which Reliance agreed to indemnify the Trust for losses it incurred under its promises to cover the excess liability above each group’s self-insured retention.

After an injured employee’s claim exceeded AGCSF’s self-insured retention, AGCSF notified the Reinsurance Trust Fund, which filed a claim with Reliance5 and, in view of Reliance’s insolvency at the time, AGCSF also filed a claim with AIGA. After AIGA refused to pay the claim on the ground that it was for benefits under a reinsurance policy and thus, not a covered claim under the Alabama GA Act, AGCSF sued AIGA in the Circuit Court of Montgomery County seeking a declaration that AIGA was required to pay the claim.

The Alabama Circuit Court entered summary judgment in favor of AGCSF but failed to specify the amount of the judgment. AIGA appealed and the Supreme Court of Alabama remanded for a determination of the damages owed. On remand before the Circuit Court, the AIGA and AGCSF jointly stipulated to the amount of damages, filing a written stipulation that included a statement that is at odds with the terms of the Reliance Certificate issued to the Trust Fund. The stipulation indicates that Reliance issued a policy to the members of the Reinsurance Trust Fund calling for indemnity payment to individual members.6 The Circuit Court [706] entered judgment for the stipulated amount. Thereafter, the Supreme Court of Alabama affirmed.

Free access — add to your briefcase to read the full text and ask questions with AI

Alabama Insurance Guaranty Ass'n v. Reliance Insurance Co. in Liquidation, 100 A.3d 702, 2014 Pa. Commw. LEXIS 446 (Pa. Ct. App. 2014).

100 A.3d 702 (Alabama Insurance Guaranty Ass'n v. Reliance Insurance Co. in Liquidation) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

J.K. Altman v. D. Kyler
Commonwealth Court of Pennsylvania, 2019