Employee Benefit Plan of Harleysville Mutual Insurance v. Grode

535 A.2d 739, 112 Pa. Commw. 470, 1988 Pa. Commw. LEXIS 17
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 12, 1988
DocketAppeal, No. 2986 C. D. 1986
StatusPublished
Cited by4 cases

This text of 535 A.2d 739 (Employee Benefit Plan of Harleysville Mutual Insurance v. Grode) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Employee Benefit Plan of Harleysville Mutual Insurance v. Grode, 535 A.2d 739, 112 Pa. Commw. 470, 1988 Pa. Commw. LEXIS 17 (Pa. Ct. App. 1988).

Opinion

Opinion by

Judge Barry,

In Harleysville Mutual Insurance Co. v. Catastrophic Loss Trust Fund, 101 Pa. Commonwealth Ct. 215, 515 A.2d 1039 (1986), we sustained preliminary objections filed by the Catastrophic Loss Trust Fund (CAT Fund) and dismissed two petitions for review filed in our original jurisdiction by Harleysville Mutual Insurance Co. (Harleysville) and the Employee Benefit Plan of Harleysville Mutual Insurance Co. (Benefit Plan). In essence, both Harleysville and the Benefit Plan were challenging the CAT Funds denial of benefits to two in[472]*472dividuals who had been seriously injured in automobile accidents.1 We sustained the CAT Funds preliminary objections, primarily relying upon the failure of Harleysville and the Benefit Plan to avail themselves of adequate administrative remedies before the Insurance Commissioner. Following our dismissal of the petitions for review there, appellants Harleysville, the Benefit Plan and DeForrest VonLaufer (one of the two accident victims) appealed to the Insurance Commissioner which upheld the CAT Funds denial of benefits. This appeal followed.

Because of the recitation of facts in our prior opinion, we need give only a very brief factual narrative here. VonLaufer had been issued a no-fault insurance policy by Harleysville prior to October 1, 1984. Marion Lyons (the other individual referred to above) had been issued a no-fault policy prior to October 1, 1984. She was an employee of Harleysville and therefore insured by the Benefit Plan. On October 1, 1984, the Motor Vehicle Financial Responsibility Law, 75 Pa. C. S. §§1701-1798, became effective. Section 1766 provided that except in the case of workmens compensation, the CAT Fund would be the primary source for paying reasonable and necessary medical expenses and rehabilitative services, when they exceeded $100,000, up to a lifetime maximum for an eligible claimant of $1,000,000. VonLaufer s accident occurred on October 30, 1984 while Lyons’ accident occurred on December 8, 1984. At the time of the accidents, each individual’s no-fault policy, issued before the effective date of Financial Responsibility Law, was in effect. Because of the [473]*473no-fault coverage, the CAT Fund denied benefits. After the Insurance Commissioner eventually affirmed the CAT Fund’s denial of benefits, appellants sought relief from this Court.

Before proceeding, we believe it apt to quote the observations of President Judge Cercone of the Superior Court when that court was called upon to review portions of the predecessor to the Financial Responsibility Law.

At the outset we caution anyone who embarks on the high seas of Pennsylvania’s No-Fault Motor Vehicle Insurance Act not to do so without a good compass, a knowledge of reefs and storms and plenty of food and water. Any attempt to choose an alternate route by land in an effort to unlock the secrets of the Act will encounter mazes of paths, pitfalls, underbrush and dead ends.

Heffner v. Allstate Insurance Co., 265 Pa. Superior Ct. 181, 184, 401 A.2d 1160, 1161 (1979).

Section 11 of the Financial Responsibility Law provides, “This Act applies to insurance policies issued or renewed after the effective date of this Act.” No one argues that the no-fault policies in question here were either issued or renewed after October 1, 1984. A literal reading of Section 11 indicates that the Financial Responsibility Law applies only when an automobile insurance policy is issued or renewed after October 1, 1984. In spite of this clear indication of legislative intent, the appellants put forth the following arguments in claiming that they are entitled to CAT Fund benefits.

Subchapter F of the Financial Responsibility Law, 75 Pa. C. S. §§1761-1769 deals specifically with the CAT Fund. Appellants rely upon the following definitions in support of their claim. An “eligible claimant” is defined therein:

[474]*474Except as provided in the definition of ineligible claimant, eligible claimant includes a resident .of this Commonwealth who suffers an injury on or after the effective date of this subchapter arising out of the maintenance of a motor vehicle. . . . Otherwise eligible claimants shall not be disqualified from participating in or receiving benefits from the Catastrophic Loss Trust Fund for injuries suffered after the effective date of this subchapter but prior to their first registration renewal after the effective date of this subchapter.

75 Pa. C. S. §1761. An “ineligible claimant” is. defined as:

(1) a person who is the owner of a motor vehicle who has not complied with the registration requirements of Chapter 13 (relating to the registration of vehicles).
(2) A person who is a driver or occupant of a recreational vehicle not intended for highway use, a motorcycle, a motorized pedacycle,. a motor-driven cycle or like type vehicle required to be registered under this title but not subject to the charge levied in Section 1762 (relating to funding).

Id. Section 1762 of the Financial Responsibility Law requires all registrants of motor vehicles (except those specifically excepted in both Section 1762 and in the definition of ineligible claimant) to pay a five dollar charge at the time, the vehicle is registered.

Appellants argue that the claimants here were injured in an accident arising out of use of a motor vehicle after October 1, 1984. As they did not fall into the definition of an ineligible claimant, appellants argue they are eligible for CAT Fund benefits. While there is a seeming ring of logic to this argument, we cannot agree with it.

[475]*475As already mentioned, Section 11 of the Financial Responsibility Law renders the Law applicable to all insurance policies issued or renewed after October 1, 1984, and here the policies unquestionably were not issued or renewed after that date. We believe that the reference to the five dollar funding fee in the definition of “eligible claimant” recognized that the date for issuance of insurance policies did not necessarily coincide with the date an insureds automobile registration expired. The situation therefore could arise where an insured would be covered by a policy issued or renewed after October 1, 1984 and have an accident before the then current registration expired. To foreclose any argument that the insured was not eligible for CAT Fund benefits, the Legislature explicitly provided for this possibility in its definition of “eligible claimant”. While appellants argue that the Legislature could have specifically excluded those covered by a no-fault insurance policy if that was its intent, we believe the Legislature addressed this problem in Section 11 by stating that the provisions of the Financial Responsibility Law applied only to insurance policies issued or renewed after October 1, 1984, thereby leaving in force any no-fault policies until those policies expired.

Appellants also rely upon 75 Pa. C. S. § 1766(c) which states that CAT Fund benefits shall be primary to any benefits except workmens compensation benefits and any other benefits made primary by the Legislature.

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Bluebook (online)
535 A.2d 739, 112 Pa. Commw. 470, 1988 Pa. Commw. LEXIS 17, Counsel Stack Legal Research, https://law.counselstack.com/opinion/employee-benefit-plan-of-harleysville-mutual-insurance-v-grode-pacommwct-1988.