Danowski by Danowski v. United States

924 F. Supp. 661, 1996 U.S. Dist. LEXIS 8281, 1996 WL 224502
CourtDistrict Court, D. New Jersey
DecidedMay 3, 1996
DocketCivil Action 94-4267
StatusPublished
Cited by9 cases

This text of 924 F. Supp. 661 (Danowski by Danowski v. United States) 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
Danowski by Danowski v. United States, 924 F. Supp. 661, 1996 U.S. Dist. LEXIS 8281, 1996 WL 224502 (D.N.J. 1996).

Opinion

OPINION

ORLOFSKY, District Judge:

Ryan Danowski (“Ryan”), a minor, and his father, Stanley Danowski, filed this action seeking to recover for personal injuries suffered by Ryan as the result of a collision between his bicycle and a United States Postal Service (“Postal Service”) vehicle. This Court has jurisdiction under 28 U.S.C. § 1346(b) and the Federal Tort Claims Act (“FTCA”). 1

Defendant, The United States of America, has filed a motion to dismiss for failure to state a claim, or, alternatively, for partial summary judgment, raising the following issues: (1) Should the claim of Stanley Danowski for the reimbursement of medical expenses be dismissed for.his alleged failure to comply with the notice requirements of the FTCA?, and, (2) Does the Employee Retirement Income Security Act 2 (“ERISA”) preempt the New Jersey Collateral Source *664 Rule 3 which would otherwise preclude plaintiffs from recovering the medical expenses which have already been paid by Stanley Danowski’s employer-provided health care reimbursement plan? Because this Court answers the first of these questions in the negative, and the second in the affirmative, the Government’s motion will be denied in its entirety.

I. Facts and Procedural History

' On September 17, 1992, Ryan Danowski was seriously injured when the bicycle he was riding collided with' a Postal Service vehicle. The disputed facts surrounding the accident itself are not material to this motion.

It is undisputed, however, that at the time of the accident, Ryan had health care coverage under the Pfizer Medical Plan (the “Plan”), which Stanley Danowski obtained through his employer. The Plan is a self-funded employee welfare benefit plan governed by ERISA. Medical benefits under the Plan are administered by Metropolitan Life Insurance Co. See Affidavit of Robert M. Silverman, Esq. (“Silverman Aff.”), exhibit E.

The Plan documents submitted by Stanley Danowski in opposition' to this motion, contain an exclusion for “services or supplies for which payment or reimbursement is received by or for the account of the individual as a result of a legal action or settlement.” Affidavit of Stanley Danowski (“Danowski Aff.”), exhibit B at 49. Pursuant to this exclusion, the Plan has made claims for reimbursement of certain sums paid on Ryan’s behalf, should there be a recovery in, or settlement of, the instant action. See id. Getter from J. Hickey, dated June 22, 1993; letter from William M. Petrie, dated Nov. 4, 1992); Silverman Aff., exhibit E. Nevertheless, neither the Plan, nor the Plan’s administrator, Metropolitan Life Insurance Company, has sought to intervene in this action, and neither is a party to these proceedings.

On June 25, 1993, a notice of claim was submitted to the Postal Service based on the September 17, 1992 accident. 4 Danowski Aff., exhibit A. The claim form was received by the Postal Service on June 30, 1993. See Declaration of Dorothy Donnelly, attachment. Box 2 of the Standard Form 95 (“SF-95”), which seeks to elicit the name and address of the claimant, reads, “Ryan Danowski, a minor by his guardian” and, on a new line, “Stanley Danowski.” Danowski Aff., exhibit A. Box 8 of the SF-95 states that the “[cjlaimant was struck by a postal vehicle while on his bicycle.” The remainder of the SF-95 describes the nature of Ryan’s injuries (Box 10), and sets forth a claim for $250.00 in property damage, for the value of the bicycle (Box 12g), and a claim for $2,000,-000.00 for personal injury (Box 12b). Id. Finally, Ryan’s accident insurance coverage is described (Box 15), and Box 18 of the SF-95 declares that the “[ijnsürer has placed us on notice of a subrogation claim for all medical expenses paid.” Id. The SF-95 is signed by Stanley A. Danowski.

Along with the completed SF-95, counsel for plaintiffs enclosed a copy of the police report of the September 17, 1992 accident, and an itemization of medical expenses which had been incurred in treating Ryan. This itemization of Ryan’s medical “Specials” set *665 forth 18 different amounts paid to physicians, physical therapists, hospitals and pharmacies, totalling $56,255.78 as of June 25, 1993. DanowsM Aff., exhibit A.

Almost a year later, on June 2,1994, plaintiffs’ counsel was contacted, for the first time regarding this claim, by a Ms. Julia Scott of the Postal Service Claims Division “requesting medical specials.” Silverman Aff. ¶4. In response to Ms. Scott’s request, on June 2, 1994, plaintiffs’ counsel sent Ms. Scott a letter, enclosing an up-dated itemization of Ryan’s “medical specials” totalling $72,-889.49, for amounts paid through December, 1993. Silverman Aff. ¶ 3, exhibit D. Plaintiffs’ counsel received no further communication from the Postal Service.

On September 2,1994, plaintiff's filed their complaint in this action, having allowed far more than the requisite six months to elapse from the time the Postal Service received their notice of claim, on June 30,1993. 5

On February 21, 1996, the Government filed its notice of motion “to dismiss the claim of Stanley DanowsM for medical expenses pursuant to Fed.R.Civ.P. 12(b)(1) or alternatively for summary judgment under Rule 56.” Defendant’s Notice of Motion. 6 . The Government argues that Stanley DanowsM’s claim for reimbursement of medical expenses is barred because the SF-95 does not indicate that he, or his insurer, filed a “notice of claim.” Simply put, the Government’s position is that the SF-95 “does not list Stanley DanowsM as a claimant and the injuries listed do not include medical expenses.” Letter Brief in Support of United States’ Motion to Dismiss, or, alternatively, for Partial Summary Judgment (“United States’ Brief’) at 3-4. Moreover, according to the Government, even if the claim is not barred by the FTCA, the New Jersey Collateral Source Rule, as embodied in N.J.StatAnn. § 2A:15-97, operates to foreclose the recovery of any medical expenses already paid by the Plan on Ryan’s behalf.

II. Standard for Dismissal Under Rule 12(b)(1).

The Government has moved to dismiss Stanley DanowsM’s claim for reimbursement of medical expenses for lack of subject matter jurisdiction pursuant to Fed.R.Civ.P. 12(b)(1). This Court must, as a threshold matter, conduct an independent analysis to determine whether subject matter jurisdiction exists. Fed.R.Civ.P. 12(h)(3). A district court may also grant a defendant’s motion to dismiss for lack of subject matter jurisdiction pursuant to Fed.R.Civ.P.

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924 F. Supp. 661, 1996 U.S. Dist. LEXIS 8281, 1996 WL 224502, Counsel Stack Legal Research, https://law.counselstack.com/opinion/danowski-by-danowski-v-united-states-njd-1996.