Boneta v. DeSeguros

CourtCourt of Appeals for the First Circuit
DecidedSeptember 11, 1997
Docket97-1354
StatusPublished

This text of Boneta v. DeSeguros (Boneta v. DeSeguros) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Boneta v. DeSeguros, (1st Cir. 1997).

Opinion

USCA1 Opinion



United States Court of Appeals United States Court of Appeals
For the First Circuit For the First Circuit
____________________
No. 97-1354

MANUEL MERCADO-BONETA, ET AL.

Plaintiffs, Coappellants,

DR. ELLIOT M. FERNANDEZ

Codefendant, Coappellant

v.

ADMINISTRACION DEL FONDO DE COMPENSACION AL PACIENTE through the
Insurance Commissioner of Puerto Rico,

Codefendant, Appellee.
____________________

APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Salvador E. Casellas, U.S. District Judge] ___________________
____________________

Before
Lynch, Circuit Judge, and _____________
Hill* and Gibson,** Senior Circuit Judges, _____________________
___________________

Alberto J. Perez-Hernandez, with whom Rafael E. Garcia-Rodon was __________________________ ______________________
on brief, for appellants.
Juan A. Moldes-Rodriguez, Counsel for Administracion del Fondo de ________________________
Compensacion al Paciente (Patient's Compensation Fund Administration),
for appellee.
____________________

September 10, 1997
____________________

____________________

* Hon. James C. Hill, of the Eleventh Circuit, sitting by designation.

** Hon. John R. Gibson of the Eighth Circuit, sitting by designation.

LYNCH, Circuit Judge. This case raises questions LYNCH, Circuit Judge. _____________

under the Contract Clause of the United States Constitution

concerning a government's power to regulate insurance

companies facing insolvency by barring claims asserted after

a particular date by insureds. If that power is upheld, then

Dr. Fernandez is essentially uninsured on the malpractice

claim and it may be that the malpractice plaintiffs will

recover nothing regardless of the merits of their claim.

Manuel Mercado-Boneta brought a medical malpractice

action against Dr. Elliot Fernandez and Fernandez's insurer,

the Patient's Compensation Fund Administration ("PCFA"). Dr.

Fernandez also claimed over against PCFA. PCFA moved for

dismissal on the grounds that, inter alia, PCFA had been __________

dissolved by an act of the legislature and was no longer

liable on Dr. Fernandez's insurance policy. The district

court granted the motion. Dr. Fernandez and Mercado-Boneta

appeal jointly from that dismissal, arguing that the act of

the legislature violates the Contract Clause of the United

States Constitution. We find no constitutional violation,

and affirm.

I.

During the time of the alleged malpractice, Dr.

-2- 2

Fernandez was covered by PCFA under an occurrence policy.1

However, PCFA was abolished before Mercado-Boneta filed his

claim against Dr. Fernandez.2 The Legislature of the

Commonwealth of Puerto Rico abrogated PCFA by Act of Dec. 30,

1986, Act No. 4, 1986 P.R. Laws 869 ("Act No. 4"), stating

____________________

1. An occurrence policy, which provides coverage for
occurrences within the policy period regardless of when the
claim is made, is distinguished from a claims-made policy,
which only covers the insured for claims that are actually
made during the policy period.

2. Manuel Mercado-Boneta and his wife Milagros Molina, on
behalf of their minor daughter Veronica Mercado-Molina, filed
their medical malpractice claim against Dr. Fernandez and his
insurance companies on June 24, 1992, almost eight years
after the alleged malpractice. Veronica was born on January
1, 1983, and was treated by Dr. Fernandez from that point
until the end of June, 1984. Plaintiffs' complaint alleges
that Veronica developed a high fever in early 1984, and was
taken several times to Dr. Fernandez who prescribed
medications, but refused to hospitalize Veronica. Not
satisfied with Dr. Fernandez's treatment of their daughter,
plaintiffs took Veronica to another physician who immediately
hospitalized the child. Plaintiffs allege that Dr. Fernandez
was negligent in failing to properly diagnose Veronica's
condition and in failing to hospitalize her. They claim that
Dr. Fernandez's negligence caused Veronica to suffer severe
physical disability and emotional distress, including the
permanent loss of approximately 75% of her hearing in both
ears, speech impairment, loss of future income, and emotional
problems associated with living with a physical handicap.
(Plaintiff's complaint, appendix pp. 36-37). Plaintiffs
allege total damages in the amount of $1,600,000. Dr.
Fernandez denies the allegations of negligence, and submits
that Veronica's hearing impairment was the likely result of
head trauma Veronica suffered when she fell from a slide in
January of 1986. The record is sparse regarding when
plaintiffs first became aware of Veronica's hearing and
speech problems. It appears, however, that they were aware
of the problem by August of 1986, when Veronica's
pediatrician referred her to a hearing specialist for
evaluation of possible hearing impairment. (report of Dr.
Zapata, record)

-3- 3

that PCFA was not adequately fulfilling its intended purpose

and was at risk of imminent insolvency. The operations of

PCFA were endangered and the insureds and their patients were

at risk of not being compensated for their losses. Id.

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