Calderon-Sitiriche v. Educators Mut. Life Ins. Co.

101 F. Supp. 2d 61, 2000 U.S. Dist. LEXIS 4512, 2000 WL 332691
CourtDistrict Court, D. Puerto Rico
DecidedMarch 21, 2000
Docket98-1130 SEC
StatusPublished
Cited by1 cases

This text of 101 F. Supp. 2d 61 (Calderon-Sitiriche v. Educators Mut. Life Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, D. Puerto Rico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Calderon-Sitiriche v. Educators Mut. Life Ins. Co., 101 F. Supp. 2d 61, 2000 U.S. Dist. LEXIS 4512, 2000 WL 332691 (prd 2000).

Opinion

OPINION AND ORDER

CASELLAS, District Judge.

This is an action to enforce coverage under an insurance policy. Pending is the defendant’s motion to dismiss for lack of personal jurisdiction under Fed.R.Civ.P. 12(b)(2). (Docket # 4). Because the Court concludes that the plaintiff has alleged facts which suggest that personal jurisdiction exists, it denies the defendant’s motion.

Rule 12(b)(2) Standard

Once it has been challenged on a Fed.R.Civ.P. 12(b)(2) motion to dismiss, it is incumbent upon the plaintiff to prove that personal jurisdiction over the defendant exists. See Massachusetts School of Law at Andover, Inc. v. American Bar Association, 142 F.3d 26, 34 (1st Cir.1998) *63 (hereinafter “Massachusetts School of Law”); Alers Rodriguez v. Fullerton Tires Corp., 115 F.3d 81, 83 (1st Cir.1997). While the plaintiff must ultimately shoulder the burden of proving the existence of personal jurisdiction, when, as now, the district court considers the motion to dismiss without a hearing, the plaintiff need only make a prima facie showing of jurisdiction. See Sawtelle v. Farrell, 70 F.3d 1381, 1386 n. 1 (1st Cir.1995).

Under the prima facie standard, the plaintiff “must make a showing as to every fact required to satisfy both the forum’s long-arm statute and the due process clause of the Constitution.” Alers Rodriguez, 115 F.3d at 84 (citation and quotation marks omitted). This showing “must be based on evidence of specific facts set forth in the record.” Boit v. Gar-Tec Products, Inc., 967 F.2d 671, 675 (1st Cir.1992) (citing Kowalski v. Doherty, Wallace, Pillsbury & Murphy, 787 F.2d 7, 9 (1st Cir.1986)). The plaintiff “must go beyond the pleadings and make affirmative proof.” Id. (quoting Chlebda v. H.E. Fortna & Bro. Inc., 609 F.2d 1022, 1024 (1st Cir.1979)). He or she “may not rely on unsupported allegations in [his or her pleadings].... ” However, “[i]n determining whether a prima facie showing has been made, the district court is not acting as factfinder.” Id. The Court must “take specific facts affirmatively alleged by the plaintiff as true (whether or not disputed) and construe[ ] them in the light most congenial to the plaintiffs jurisdictional claim.” Massachusetts School of Law, 142 F.3d at 34 (citing Ticketmaster-New York v. Alioto, 26 F.3d 201, 203 (1st Cir.1994) (hereinafter “Ticketmaster”)). The court may then “add to the mix the facts put forward by the defendant! ], to the extent that they are uncontradicted.” Id. (citation omitted). In any event, the court need not credit “ ‘conclusory allegations or draw farfetched inferences.’ ” Id. (quoting Ticketmaster, 26 F.3d at 203).

Background

The plaintiff, Samuel Calderón-Sitiriche, is a physician residing in the Commonwealth of Puerto Rico. (Docket # 6, at ¶ 3.a). The defendant, Educators Mutual Life Insurance Company (hereinafter “EMLI”), is a corporation organized under the laws of the Commonwealth of Pennsylvania, with its principal place of business in Lancaster. Pennsylvania. (Docket # 4, Kimberly A. Rankin’s Unsworn Statement Under Penalty of Perjury ¶ 1). At a convention of the American College of Physicians held in Puerto Rico in 1994, Calderón-Sitiriche applied for coverage under a group policy held by the American College of Physicians Trust, and underwritten by EMLI. (Docket # 7, Samuel Calderón-Sitiriche’s Unsworn Declaration Under Penalty of Perjury, at ¶ 2; Docket # 4, at ¶ 13, Kimberly A. Rankin’s Un-sworn Statement Under Penalty of Perjury ¶ 12, and Exhibit 2). In essence, the policy provides coverage for office overhead expense in the event of, and during, total disability of the insured. (Docket # 4, Exhibit 1).

Calderón-Sitiriche’s application was processed by Group Insurance Administrators (hereinafter “GIA”), a business entity separate and distinct from EMLI, at it offices in Havertown, Pennsylvania. GIA in turn forwarded the application to EMLI who, after review, notified GIA of the acceptance of the application and appropriate premium. GIA then issued a certificate of individual coverage to Calderón-Sitiriche. (Docket# 4, Kimberly A. Rankin’s Un-sworn Statement Under Penalty of Perjury ¶¶ 13-16). The group policy covering Calderón-Sitiriche was delivered in, and is governed by the laws of, the State of Delaware. (Id., Exhibit 1).

In 1995, Calderón-Sitiriche became totally disabled to perform the material and substantial duties of his occupation. (Docket # 1, at ¶¶ 8-9). EMLI began payments under the policy to Calderón-Sitiriche in June, 1995, but continuously requested “an ever increasing amount of *64 documents and/or information to ‘substantiate’ certain items contained in the ... insurance claim, particularly information about bank loans and salary payments.” (Id. at ¶¶ 13, 14). Calderón-Sitiriche complied with EMLI’s requests, but after August, 1996, EMLI refused to make any further payments under the policy. (Id. at ¶ 15). Calderón-Sitiriche kept applying for benefits until EMLI’s counsel “informed [him] [through a letter dated November 6.1997,] that his claim had been denied[,] and that [EMLI] would continue to refuse to cover and/or reimburse” the expenses claimed. 1 (Id. at ¶ 20). Calder-ón-Sitiriche also affirms that “twice during 1997, [EMLI] sent Jim Daley, a claims adjuster who was acting on behalf and for the benefit of [EMLI], to evaluate him.” (Docket # 7,. Samuel Calderón-Sitiriche’s Unsworn Declaration Under Penalty of Perjury, at ¶ 6). On February 11, 1998, Calderón-Sitiriche filed this action seeking enforcement of coverage under the policy, and to recover all the expenses accrued since the alleged refusal of coverage, plus damages.

On May 29, 1999, EMLI moved to dismiss this action for want of personal jurisdiction under Fed.R.Civ.P. 12(b)(2). (Docket # 4). As arguments for dismissal, EMLI asserts, and Calderón-Sitiriche concedes, 2

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Bluebook (online)
101 F. Supp. 2d 61, 2000 U.S. Dist. LEXIS 4512, 2000 WL 332691, Counsel Stack Legal Research, https://law.counselstack.com/opinion/calderon-sitiriche-v-educators-mut-life-ins-co-prd-2000.