Cruz v. Wausau Insurance

866 A.2d 1237, 2005 R.I. LEXIS 30, 2005 WL 283212
CourtSupreme Court of Rhode Island
DecidedFebruary 8, 2005
Docket2004-65-Appeal
StatusPublished
Cited by18 cases

This text of 866 A.2d 1237 (Cruz v. Wausau Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cruz v. Wausau Insurance, 866 A.2d 1237, 2005 R.I. LEXIS 30, 2005 WL 283212 (R.I. 2005).

Opinion

OPINION

PER CURIAM.

The plaintiff, David Cruz, appeals from the Superior Court’s denial of his petition for declaratory relief. He maintains that the doctrines of collateral estoppel and res judicata support his position in the declaratory judgment action and that the hearing justice erred as a matter of law when he declined to grant declaratory relief. The defendants, Wausau Insurance Company and Liberty Mutual Insurance Company, challenge the position taken by Cruz; they maintain that the grant or denial of declaratory relief is a discretionary decision and that the hearing justice did not abuse that discretion when he denied the petition for declaratory relief.

The underlying controversy arises out of an automobile collision that occurred on April 28, 2000, between vehicles operated by Cruz and by an individual named Stephen Woodruff. At the time of the collision, plaintiff was operating a vehicle belonging to his employer, Kelly and Picerne. Upon examination of plaintiff after the collision, it was discovered that he previously had been- suffering from a preexisting asymptomatic brain tumor (referred to as a “medulloblastoma”) and that the tumor has since become symptomatic. As a result, plaintiff has become unemployable and requires continuing medical treatment.

Cruz’s employer, Kelly and Picerne, carried both automobile insurance and workers’ compensation insurance. The automobile insurance policy had an uninsured/underinsured motorist coverage provision in the amount of one million dollars. 1 The plaintiff filed claims for benefits pursuant to both the Workers’ Compensation Act and the underinsured motorist coverage section of the automobile insurance policy.

The Workers’ Compensation Court conducted hearings and issued a decision on October 2, 2003. In its decision, the Workers’ Compensation Court stated:

“[I]t is the opinion of the Court that the motor vehicle accident of April 28, 2000 aggravated the [plaintiffs] preexisting medulloblastoma causing it to become symptomatic and ultimately causing the [plaintiff] to become disabled.”

*1239 In its findings of fact, the Workers’ Compensation Court found that Cruz’s injury arose “out of and in the course of the [plaintiffs] employment, connected therewith and referable thereto, of which the employer had notice.” It then concluded that plaintiff was entitled to collect workers’ compensation benefits and other payments and reimbursements. No appeal was taken from the decision of the Workers’ Compensation Court.

The claim for underinsured motorist benefits was referred to an arbitration panel. The arbitration hearings commenced on July 9, 2003, but the panel has not yet made an award.

It is undisputed that, at the time of the collision, Cruz was acting within the scope of his employment. The central issue to be resolved by the Workers’ Compensation Court was whether he was entitled to workers’ compensation benefits. To make such a determination, the Workers’ Compensation Court simply had to determine (1) whether plaintiff was incapacitated as a result of his injury; and (2) whether there was a causal relationship between plaintiffs employment and his injury. See Mulcahey v. New England Newspapers, Inc., 488 A.2d 681, 684 (R.I.1985).

By contrast, before plaintiff may be awarded damages pursuant to the underin-sured motorist coverage section of his employer’s automobile insurance policy, the arbitration panel will have to determine the liability (if any) of the alleged tortfea-sor, Woodruff. To do so, the arbitration panel must conclude that plaintiffs injuries were proximately caused by the collision; he must prove to the arbitration panel that but for the negligence of the alleged tort-feasor, the plaintiffs injury would not have occurred. See Skaling v. Aetna Insurance Co., 742 A.2d 282, 288 (R.I.1999). Even a cursory comparison of these two causation standards reveals that the causal relationship standard “is less exacting than what is required for proximate cause.” Tavares v. Aramark Corp., 841 A.2d 1124, 1128 (R.I.2004).

On October 22, 2003, plaintiff filed the instant declaratory judgment action pursuant to the Uniform Declaratory Judgments Act, G.L. 1956 chapter 30 of title 9, asking the Superior Court to declare that the arbitration panel 2 dealing with the under-insured motorist claim should be bound by the factual findings of the Workers’ Compensation Court pursuant to the doctrines of collateral estoppel and res judicata. 3 Specifically, plaintiff, in his complaint, requested the Superior Court to require the arbitration panel to accept as factual the following proposition:

“that the collision of April 28, 2000, aggravated the plaintiffs pre-existing me-dulloblastoma causing it to become symptomatic and ultimately causing [him] to become disabled.” (Emphasis added.)

On December 9, 2003, after hearing the arguments of the parties, the Superior Court denied plaintiffs petition for declaratory relief. At that time, the hearing justice stated that he was “not convinced that the same standard, same quantum of proof, same analysis that would take place in a workers comp matter are in a general tort matter.” Also, and significantly, the hearing justice indicated that he was hesitant about interfering with a matter in arbitration immediately before the arbitra *1240 tion panel issued its decision, particularly given the fact that plaintiff would be able to explore “other avenues ⅜ * * should the result of the arbitration not be satisfactory to [him].”

On December 15, 2003, the motion justice signed an order nunc pro tunc memorializing his denial of plaintiffs petition for declaratory relief. After his petition was denied, plaintiff timely appealed to this Court.

This matter came before the Supreme Court for oral argument on October 6, 2004, pursuant to an order directing the parties to appear and show cause why the issue raised in this appeal should not be summarily decided. After hearing the arguments of counsel and examining the memoranda submitted by the parties, we are of the opinion that cause has not been shown and that this case should not be summarily decided.

The Uniform Declaratory Judgments Act confers broad discretion upon the trial justice as to whether he or she should grant declaratory relief. See Employers’ Fire Insurance Co. v. Beals, 103 R.I. 623, 628, 240 A.2d 397

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866 A.2d 1237, 2005 R.I. LEXIS 30, 2005 WL 283212, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cruz-v-wausau-insurance-ri-2005.