Chandler v. Omnicare/The HMO, Inc.

756 F. Supp. 187, 13 Employee Benefits Cas. (BNA) 1464, 1990 U.S. Dist. LEXIS 18180, 1990 WL 259381
CourtDistrict Court, D. New Jersey
DecidedDecember 5, 1990
DocketCiv. A. 90-1859 (JFG)
StatusPublished
Cited by5 cases

This text of 756 F. Supp. 187 (Chandler v. Omnicare/The HMO, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chandler v. Omnicare/The HMO, Inc., 756 F. Supp. 187, 13 Employee Benefits Cas. (BNA) 1464, 1990 U.S. Dist. LEXIS 18180, 1990 WL 259381 (D.N.J. 1990).

Opinion

OPINION

GERRY, Chief Judge.

FACTS & PROCEDURAL HISTORY

Plaintiff Roberta Chandler [hereinafter, “plaintiff”] is a private citizen, formerly employed by defendant Spencer Gifts. Through her former employer, Chandler obtained health insurance coverage from defendant Omnicare/The HMO, Inc. [hereinafter, “Omnicare”].

On March 31, 1988, Kenneth D. Merin, former Commissioner of the New Jersey Department of Insurance, found Omnicare to be insolvent within the meaning of N.J. S.A. § 17B:32-l(a) (West 1971). Accordingly, on April 22, 1988, the Honorable Paul R. Porreca, J.S.C., entered an Order of Rehabilitation of Domestic Health Maintenance Organization with respect to Omni-care. The court further appointed former Commissioner Merin and his successors in office (currently Commissioner Samuel For-tunato) to act as Rehabilitator for Omni-care. Finally, the court, pursuant to its authority under N.J.S.A. § 17B:32-5(b), included in the Order of Rehabilitation an injunction prohibiting the maintenance or further prosecution of any legal action against Omnicare. 1

Plaintiff’s employment terminated on or about June 6, 1989. Following her termination, defendant Omnicare denied plaintiff's application for continued benefits because she allegedly did not meet the application deadline. On March 8, 1990, plaintiff brought suit in the Law Division *189 against Omnicare and Spencer Gifts to compel continuation of her Omnicare health coverage and for damages. Chandler v. Omnicare, et al., Docket No. CUM-L-000419-90.

On May 2, 1990, the court granted defendant Spencer Gifts’ Petition for Removal to the Federal Court (Chandler v. Omnicare, et al., C.A. No. 90-1859) on the basis that plaintiffs demands for recovery of benefits under the employee benefit plan, and enforcement of rights under the plan, are controlled by the Employee Retirement Income Security Act (ERISA). 29 U.S.C. §§ 1001, et seq. (1974). On behalf of Commissioner Fortunato, Deputy Attorney General [“DAG”] Tasy filed a motion to dismiss Omnicare from the Law Division proceeding. On May 25, 1990, evidently unaware that the action had already been removed to the United States District Court, the Law Division issued an Order dismissing Omnicare from the case.

On May 21, 1990, Spencer Gifts filed a motion in the Omnicare receivership proceeding pending before the Chancery Division of the Superior Court of New Jersey. In its motion, Spencer Gifts sought leave to intervene in the Omnicare receivership proceeding pursuant to N.J.Ct.R. 4:33-1 and/or R. 4:33-2. Spencer Gifts sought intervention in that proceeding so that it could simultaneously move to vacate that portion of the Omnicare Rehabilitation Order which enjoins litigation against Omni-care while it is in receivership. Spencer Gifts further moved for leave to file its cross-claims against Omnicare for contribution and indemnification in Chandler v. Omnicare, et al., C.A. No. 90-1859. On behalf of Commissioner Fortunato, Omni-care’s Receiver, DAG Stephen Tasy filed papers with the Chancery Division opposing Spencer Gift’s motion in all respects.

On July 18, 1990, The Honorable Samuel DeSimone, A.J.S.C., issued an Order declining to grant Spencer Gifts either leave to intervene or leave to file cross-claims against Omnicare at that time. Judge De-Simone also declined to vacate the injunction against litigation contained in the Om-nicare Rehabilitation Order at that time. Judge DeSimone further declined to definitely resolve Spencer Gifts' motion but instead adjourned the motion.

This court will consider Omnicare’s Fed.R.Civ.P. 12(b)(6) motion to dismiss Chandler v. Omnicare, et al., which is presently before this court upon its removal from the Law Division.

DISCUSSION

Commissioner Fortunato has argued that prosecution of this action is “so contrary to the public interest and so detrimental to Omnicare’s creditors, that this act must not be permitted to proceed.” DAG Letter Brief, July 3, 1990, pp. 4-5. We believe that this court should consider a slightly different question: Whether this court should, sua sponte, abstain under the doctrine of Burford v. Sun Oil Co., 319 U.S. 315, 63 S.Ct. 1098, 87 L.Ed. 1424 (1943), to avoid disruption to an important, complex state regulatory system. For the reasons that follow, we believe that this court should do so; hence, we dismiss the action.

The general thrust of Burford abstention permits a court, on its own motion, to abstain in order to avoid needless conflict with the administration by a state of its own affairs. 17A Wright, Miller and Cooper, Federal Practice and Procedure, § 4245 (1988). Or, as the Third Circuit has stated, Burford abstention is appropriate where the state has created a complex regulatory scheme central to state interests and federal jurisdiction would be disruptive of the state’s efforts. Lac D’Amiante du Quebec v. American Home Assur. Co., 864 F.2d 1033, 1043 (3d Cir.1988) [hereinafter, sometimes referred to as “American Home Assur.”].

In order to adjudicate this issue, we must first discuss the regulatory scheme the New Jersey Legislature has put in place. The New Jersey Legislature, along with over 31 other states, has substantially adopted the Uniform Insurers Liquidation Act. N.J.S.A. § 17B:32-1 et seq. (West *190 1971) [hereinafter, “Statute”]. 2 This comprehensive statute governs Omnicare’s receivership proceeding.

1. The Statutory Framework — Uniform Insurers Liquidation Act — “The Act”

A. Nuts and Bolts of the Uniform Act

The commissioner monitors the financial health of all domestic insurance companies. The commissioner may institute a delinquency proceeding in superior court seeking a rehabilitation or other appropriate order. N.J.S.A. § 17B:32-2 et seq. Grounds for an order include insurer insolvency, refusal to submit its affairs to the examination of the commissioner, or a finding that further transaction of business would be hazardous to its creditors or the public. N.J.S.A. § 17B:32-6.

The court may direct the commissioner to take possession of the property of the insurer, to conduct the business of the insurer, and to take such steps to remove the causes and conditions which have made rehabilitation necessary. N.J.S.A. § 17B:32-7. The commissioner may also apply to the court for an order directing him to liquidate the business of a domestic insurer. N.J.S.A. §§ 17B:32-8, -9.

The liquidation order directs the commissioner to take possession of the insurer’s property and to liquidate the business. N.J.S.A. § 17B:32-9.

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Bluebook (online)
756 F. Supp. 187, 13 Employee Benefits Cas. (BNA) 1464, 1990 U.S. Dist. LEXIS 18180, 1990 WL 259381, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chandler-v-omnicarethe-hmo-inc-njd-1990.