Dolan v. Utica Mutual Insurance

630 F. Supp. 305, 1986 U.S. Dist. LEXIS 28088
CourtDistrict Court, D. Massachusetts
DecidedMarch 17, 1986
DocketCiv. A. No. 85-0984-C
StatusPublished
Cited by3 cases

This text of 630 F. Supp. 305 (Dolan v. Utica Mutual Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dolan v. Utica Mutual Insurance, 630 F. Supp. 305, 1986 U.S. Dist. LEXIS 28088 (D. Mass. 1986).

Opinion

MEMORANDUM

CAFFREY, Chief Judge.

This is a civil action brought by Nancy Dolan, a citizen of the Commonwealth of Massachusetts, against Utica Mutual Insurance Company (“Utica”), a New York corporation doing business in Burlington, Massachusetts. The plaintiff’s complaint states claims for breach of contract, unfair claim settlement practices under Mass.Gen. Laws Ann. ch. 176D, and unfair or deceptive trade practices under Mass.Gen.Laws Ann. ch. 93A. This Court’s jurisdiction is based upon diversity of citizenship. 28 U.S.C. § 1332.

The matter is now before the Court on the defendant Utica’s motion to dismiss, filed pursuant to Fed.R.Civ.P. 12(b)(6), for failure to state a claim upon which relief can be granted. In support of its motion, Utica argues that the plaintiff has failed to pursue the administrative and judicial remedies provided by Mass.Gen.Laws Ann. ch. 175, § 113D and the defendant claims therefore that this suit is barred by the doctrine of primary jurisdiction. The Court, in reviewing the sufficiency of the complaint in the context of a motion to dismiss, must treat all of the well-pleaded allegations of the complaint as true. Miree v. Dekalb County, Georgia, 433 U.S. 25, 27 [307]*307n. 2, 97 S.Ct. 2490, 2492 n. 2, 53 L.Ed.2d 557 (1977). For the reasons set forth below, I rule that the doctrine of primary jurisdiction does not apply in this case and, accordingly, the defendants motion to dismiss should be denied.

The plaintiff’s complaint alleges that the defendant Utica is a corporation engaged in the business of providing motor vehicle insurance which issued a Massachusetts standard automobile policy to the plaintiff for a 1982 Chrysler Le Baron sedan. The one year policy took effect on February 21, 1983,.and provided coverage for collision damage and personal injuries.

The defendant used a “direct billing” system whereby it sent periodic statements to the plaintiff requesting premium payments. The complaint alleges that the statements were to include the outstanding premium balance, the amount of payment requested, and the finance charge applicable to each payment. The complaint further alleges that the statements sent to the plaintiff requested inconsistent payment amounts and did not advise the plaintiff of her payment obligation under the insurance contract in a clear and conspicuous manner. As a result of the inadequate information provided in these statements, the plaintiff at various times during the term of the policy was unable to ascertain the total balance remaining due on the policy or the amounts of the payments being requested. The plaintiff wrote to the defendant in July of 1983 requesting clarification of the terms of the policy and the amount she owed on it at that time, but received no reply from Utica. Instead, Utica took steps to cancel the plaintiff’s policy and ultimately sent her a cancellation notice on August 8, 1983.

While operating her automobile on September 17, 1983, the plaintiff was involved in a collision which caused her personal injuries and destroyed the automobile. Utica did not investigate the circumstances of the accident or attempt to assess the plaintiff’s injuries or the damage to her automobile. The plaintiff repeatedly has demanded that Utica compensate her for the personal injuries and her loss of the vehicle. Utica has refused to compensate the plaintiff on the grounds that the policy was not in effect at the time of the plaintiff’s accident.

In count I of the complaint the plaintiff seeks $15,000 for actual damages, plus interest, costs, and reasonable attorney’s fees for Útica’s alleged breach of the insurance contract. In count II, the plaintiff seeks $45,000 (treble the amount of her actual damages), plus interest, costs, and reasonable attorney’s fees on the grounds that Utica’s acts and omissions constituted “unfair claim settlement practices” under Mass.Gen.Laws Ann. ch. 176D, and “unfair or deceptive trade practices”, under Mass. Gen.Laws Ann. ch. 93A.

The defendant seeks dismissal of this action on the basis of the doctrine of primary jurisdiction; the defendant maintains that because the plaintiff has failed to pursue the administrative and judicial remedies provided by Mass.Gen.Laws Ann. ch. 175, § 113D, she is barred from obtaining relief in this Court.

Under the doctrine of primary jurisdiction, in certain situations plaintiffs are obliged to seek and exhaust administrative remedies before seeking judicial relief. Kartell v. Blue Shield of Mass., Inc., 384 Mass. 409, 412-414, 425 N.E.2d 313 (1981); Gordon v. Hardware Mut. Cas. Co., 361 Mass. 582, 586-588, 281 N.E.2d 573 (1972). “The principal reason behind the doctrine is recognition of the need for orderly and sensible coordination of the work of agencies and of courts____ [A] court [normally] should not act upon subject matter that is peculiarly within the agency’s specialized field without taking into account what the agency has to offer, for otherwise parties who are subject to the agency’s continuous regulation may become the victims of uncoordinated and conflicting requirements.” Murphy v. Administrator of Div. of Personnel Admin., 377 Mass. 217, 221, 386 N.E.2d 211 (1979), quoting 3 K.C. Davis, Administrative Law § 19.01, at 5 (1958). The recurrent themes that underlie application of the doctrine are “the promotion of [308]*308uniformity and consistency in the regulation of business entrusted to a particular agency” and “reliance on an agency’s special expertise, especially with respect to issues involving technical questions of fact.” Lapierre v. Maryland Cas. Co., 14 Mass.App.Ct. 248, 250, 438 N.E.2d 356 (1982), quoting Kartell, 384 Mass. at 413, 414, 425 N.E.2d 313. The doctrine is not applied “when the issue in controversy turns on questions of law which have not been committed to agency discretion.” Murphy, 377 Mass. at 221, 386 N.E.2d 211. The use of the doctrine in a particular case, the Court notes, rests in the sound discretion of the trial judge. Kartell, 384 Mass, at 412, 425 N.E.2d 313, citing Lehman Bros. v. Schein, 416 U.S. 386, 391, 94 S.Ct. 1741, 1744, 40 L.Ed.2d 215 (1974).

The Court must focus, therefore, on whether the plaintiff’s complaint raises technical questions of fact or questions of law which are within the special expertise of the Massachusetts Commissioner of Insurance.

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Bluebook (online)
630 F. Supp. 305, 1986 U.S. Dist. LEXIS 28088, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dolan-v-utica-mutual-insurance-mad-1986.