Fletcher v. PROPERTY & CAS. INS.

914 A.2d 477
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 4, 2007
StatusPublished

This text of 914 A.2d 477 (Fletcher v. PROPERTY & CAS. INS.) 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
Fletcher v. PROPERTY & CAS. INS., 914 A.2d 477 (Pa. Ct. App. 2007).

Opinion

914 A.2d 477 (2007)

Johanna FLETCHER, Administratrix of the Estate of Timothy Fletcher, Petitioner
v.
PENNSYLVANIA PROPERTY & CASUALTY INSURANCE GUARANTY ASSOCIATION and Commonwealth of Pennsylvania, Medical Care Availability and Reduction of Error Fund, Respondents.

Commonwealth Court of Pennsylvania.

Argued November 14, 2006.
Decided January 4, 2007.
Reargument Denied February 2, 2007.

*478 Daniel L. Thistle and Thomas M. Thistle, Philadelphia, for petitioner.

Tawny K. Mummah, Harrisburg, for respondent, Medical Care Availability and Reduction of Error Fund.

BEFORE: SIMPSON, Judge, LEAVITT, Judge, and KELLEY, Senior Judge.

Reargument Denied En Banc February 2, 2007.

OPINION BY Judge SIMPSON.

This original jurisdiction case involves complicated insurance coverage issues for a large medical malpractice judgment, and it requires interpretation of Pennsylvania's recent excess malpractice insurance scheme embodied in the Medical Care Availability and Reduction of Error Act (MCARE Act).[1] The successful plaintiff in *479 the medical malpractice case, Joanna Fletcher (Fletcher), administratrix of the estate of Timothy Fletcher, brought a declaratory judgment action in this Court to resolve the coverage issues. Before us now are the preliminary objections of the MCARE Fund, questioning our original jurisdiction. For the reasons that follow, we overrule the MCARE Fund's preliminary objections.

We glean the following facts from Fletcher's petition for review.[2] The origin of this litigation is an underlying medical malpractice action filed by Fletcher in the Court of Common Pleas of Philadelphia County (court of common pleas) against Kominsky Kubacki Medical Associates and its employee physicians Drs. Solomon Kominsky and Thomas Kubacki. Drs. Kominsky and Kubacki died prior to commencement of the suit; thus, Fletcher's suit named the representatives of the doctors' respective estates as defendants.

In 2005, a jury returned a verdict of $7 million in favor of Fletcher and against the estates of Drs. Kominsky and Kubacki. The court of common pleas molded the verdict to include delay damages for a total award of $7,727,808.20 against the defendants.

According to Fletcher's petition, PHICO Insurance Company (PHICO) insured the physicians, as well as their professional corporation. Because PHICO was placed into liquidation, the Pennsylvania Property and Casualty Insurance Guaranty Association (Guaranty Association)[3] had a statutory obligation to indemnify PHICO's claims. Pet. for Review at SS 25, 30-31. The petition avers the Guaranty Association refused to honor claims made against the physicians' estates. Id. at 25.[4]

The petition alleges the MCARE Fund is the excess carrier under the PHICO policies and, therefore, it is responsible for excess liability beyond the amount paid by the Guaranty Association up to an aggregate amount of $1.2 million for Dr. Kominsky, and up to and including the aggregate amount of $1.2 million for Dr. Kubacki. Id. at 33. The petition alleges the Guaranty Association and the MCARE Fund are also responsible for their proportionate share of delay damages.

In March 2006, Fletcher filed a petition for review in the nature of a declaratory judgment action against the MCARE Fund and the Guaranty Association. Essentially, the petition seeks a declaration that the Guaranty Association is obligated to pay $300,000 per claim and a share of *480 delay damages, and the MCARE Fund is obligated to pay excess coverage of $1.2 million and its share of delay damages. According to the petition, the estates of Drs. Kominsky and Kubacki assigned their rights to Fletcher to pursue claims against PHICO, the Guaranty Association and the MCARE Fund.

The MCARE Fund filed preliminary objections asserting that since enactment of the MCARE Act, this Court lacks jurisdiction over the petition for review, and Fletcher failed to exhaust her administrative remedies by first seeking relief with the Insurance Department.[5] The Guaranty Association filed an answer and new matter.

After argument in July 2006, a single judge of this Court issued an opinion and order sustaining the MCARE Fund's preliminary objections. Based on the changes to the MCARE Act, he determined, the Insurance Department, rather than this Court, had original jurisdiction over this action. Therefore, he transferred the action against the MCARE Fund to the Insurance Commissioner. As to the remaining defendant, the Guaranty Association, he noted resolution of the MCARE Fund's preliminary objections did not relate to claims against the Guaranty Association, which is not itself a state agency subject to this Court's original jurisdiction. See Greenfield v. Pa. Ins. Guar. Ass'n, 24 Pa. Cmwlth. 127, 353 A.2d 918 (1976). Thus, he transferred the action against the Guaranty Association to the court of common pleas.

About a week later, Fletcher filed an application for reargument, which was granted. As a result, the order sustaining the MCARE Fund's preliminary objections was stayed pending reargument.[6] The MCARE Fund's preliminary objections are once again before this Court for disposition.

The MCARE Fund argues this Court lacks original jurisdiction over this action because the Insurance Department now possesses exclusive subject matter jurisdiction over the MCARE Fund's written determinations. It asserts this Court properly exercised original jurisdiction over its predecessor, the CAT Fund;[7] however, the MCARE Act transferred the Fund within the purview of the Insurance Department and, in so doing, relieved this Court of its original jurisdiction.

The MCARE Fund contends that the CAT Fund was an executive agency with a Director appointed by the Governor. In contrast, the MCARE Fund is administered by the Insurance Department. Although this Court previously exercised *481 original jurisdiction over the CAT Fund, such jurisdiction was necessary because the CAT Fund was a "stand alone," executive agency without a formal administrative hearing process.

The MCARE Fund's argument continues as follows. As a result of the statutory mandate placing the MCARE Fund within the purview of the Insurance Department, the MCARE Fund's written determinations, like all other Insurance Department determinations, are appealed to the Department's Administrative Hearings Office and then to the Insurance Commissioner. It maintains such adjudications may then be appealed to this Court in its appellate jurisdiction.

Further, where exclusive jurisdiction is vested in a state agency, this Court generally lacks original jurisdiction. Here, the Insurance Department's Administrative Hearings Office is a tribunal other than a court, and Fletcher does not raise any challenges that would divest that tribunal of jurisdiction.

Fletcher responds this Court continues to possess exclusive jurisdiction over disputes involving MCARE Fund coverage just as it did for CAT Fund coverage. She asserts the MCARE Act contains many of the same provisions of the former Malpractice Act, and no provision absolves this Court of its original jurisdiction over coverage disputes.

Fletcher also points out, although Section 712(d)(3) of the MCARE Act, 40 P.S.

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