Gemini Physical Therapy and Rehabilitation, Inc. v. State Farm Mutual Automobile Insurance Company

40 F.3d 63, 1994 WL 638592
CourtCourt of Appeals for the Third Circuit
DecidedDecember 14, 1994
Docket94-1395
StatusPublished
Cited by60 cases

This text of 40 F.3d 63 (Gemini Physical Therapy and Rehabilitation, Inc. v. State Farm Mutual Automobile Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gemini Physical Therapy and Rehabilitation, Inc. v. State Farm Mutual Automobile Insurance Company, 40 F.3d 63, 1994 WL 638592 (3d Cir. 1994).

Opinions

OPINION OF THE COURT

ROSENN, Circuit Judge.

Gemini Physical Therapy and Rehabilitation, Inc. (“Gemini”) is a health care provider who treated various individuals who were injured in automobile accidents and insured by State Farm Mutual Automobile Insurance Company (“State Farm”). Gemini and other health care providers who are no longer parties to this action (“the plaintiffs”) filed a complaint in the United States District Court for the Eastern District of Pennsylvania.1 The plaintiffs claimed to be the assignees of the insureds’ rights under their automobile insurance policies, and alleged that State Farm unreasonably refused to pay the insureds’ bills in full in violation of the insureds’ contracts and the Pennsylvania Motor Vehicle Financial Responsibility Law, 75 Pa.C.S. §§ 1701, et seq. (“MVFRL”). The complaint sought payment in full, compensatory and punitive damages for tortious interference with contractual relations, and punitive damages pursuant to 42 Pa.C.S. § 8371.

State Farm filed a motion to dismiss plaintiffs’ claims for punitive damages under 42 Pa.C.S.A. § 8371 and for intentional interference with contractual relations, which the district court granted. The plaintiffs subsequently filed a first amended complaint which included new claims pursuant to the Pennsylvania Unfair Trade Practices and Consumer Protection Law, 73 P.S. §§ 201-1, et seq. (“CPL”). The district court granted [65]*65State Farm’s motion to dismiss the plaintiffs’ CPL claims for lack of standing.

Plaintiffs filed a second amended complaint. State Farm filed a motion for partial summary judgment seeking dismissal of all breach of contract claims under the MVFRL for reimbursement of medical bills submitted to State Farm after April 15, 1990, because of plaintiffs’ alleged failure to exhaust their remedies under the MVFRL. The district court denied the motion. State Farm renewed its motion for partial summary judgment in light of a recent Pennsylvania Superior Court decision in Terminato v. Pennsylvania Nat’l Ins. Co., 422 Pa.Super. 92, 618 A.2d 1032 (1998), rev’d and remanded — Pa. -, 645 A.2d 1287 (1994). The district court granted the motion and dismissed all claims for reimbursement of medical bills submitted to State Farm after April 15,1990.

In a bifurcated trial, the jury returned a verdict in favor of State Farm, finding that none of the treatment rendered by Gemini to the State Farm insureds was medically necessary. The district court denied Gemini’s motion for a new trial. Gemini filed a timely appeal from those parts of the district court’s orders dismissing Gemini’s claim for punitive damages and intentional interference with contract claims, dismissing its claim under the CPL, and granting partial summary judgment for State Farm. We affirm in part and reverse in part.

I.

As a preliminary matter, State Farm concedes that in light of the Pennsylvania Supreme Court’s recent decision in Terminato v. Pennsylvania Nat’l. Ins. Co., — Pa. —, 645 A.2d 1287 (1994), the order of the district court granting State Farm’s motion for partial summary judgement must be vacated. In Terminato, the court held that exhaustion of Peer Review Organization procedures under the MVFRL is not a prerequisite of bringing suit in a court of law for nonpayment of medical bills. Therefore, we will remand this case for a trial on Gemini’s breach of contract claims under the MVFRL for reimbursement of medical bills submitted to State Farm after April 15, 1990.

II.

Gemini’s challenges primarily involve legal determinations by the district court, and therefore we exercise plenary review. See Louis W. Epstein Family Partnership v. KMart Corp., 13 F.3d 762, 766 (3d Cir.1994). Gemini first argues that it has a valid claim under the Pennsylvania Unfair Trade Practices and Consumer Protection Law, 73 P.S. §§ 201-1, et seq. The CPL provides in pertinent part:

Any person who purchases or leases goods or services primarily for personal, family or household purposes and thereby suffers any ascertainable loss of money or property, real or personal, as a result of the use or employment by any person of [unfair or deceptive acts or practices] may bring a private action, to recover [damages].

73 P.S. § 201-9.2(a).

The district court dismissed Gemini’s claims under the CPL because it lacked standing. The court reasoned that Gemini, a provider of health care to purchasers of insurance policies, is not a member of the class protected by the statute. It rejected Gemini’s argument that it has standing by virtue of its status as assignee under the insurance policies. The court held that Gemini is only an assignee of the limited right to receive payment under the policies.

The CPL contemplates as the protected class only those who purchase goods or services, not those who may receive a benefit from the purchase. See Zerpol Corp. v. DMP Corp., 561 F.Supp. 404, 415 (E.D.Pa.1983) (dismissing corporate plaintiffs claim because private cause of action under the CPL is limited to purchasers or lessors of goods used primarily for personal, family, or household purposes). Accord Klitzner Industries Inc. v. H.K. James & Co., 535 F.Supp. 1249, 1258 (E.D.Pa.1982); Permagrain Products, Inc. v. U.S. Mat & Rubber Co., 489 F.Supp. 108, 111 (E.D.Pa.1980). Although Gemini may have been indirectly injured, it is not a purchaser or consumer of goods or services under the CPL and therefore has no private right of action under the statute.

[66]*66Gemini relies on Hedlund Manufacturing Company v. Weiser, Stapler & Spivak, 517 Pa. 522, 539 A.2d 357 (1988) in support for its argument that the insureds’ CPL claims are assignable. In Hedlund, the Pennsylvania Supreme Court acknowledged Pennsylvania’s well-established policy of permitting causes of actions to be assigned and held that a claim for damages based upon legal malpractice is assignable. This case is distinguishable for two reasons. First, Gemini has sued under a specific statute intended to restrict fraud against consumers. However, Gemini is a commercial purchaser of the insureds’ claims; its- complaint does not allege that it is a purchaser or consumer of goods or services irom State Farm. Second, in Hedlund, the assignor expressly “assigned all rights and causes of action” pursuant to a patent application. Id. 539 A.2d at 358. Here, the complaint alleges that the patients assigned only their rights under their insurance contracts. It does not follow consequentially that the patients also assigned their rights to bring suits under the CPL. Because the CPL focuses narrowly on the protection of consumers in the purchase of goods or services, we predict that the Pennsylvania Supreme Court would not infer an assignment of claims under the CPL. Accordingly, we perceive no error in the district court’s holding that Gemini lacks standing to bring an action against State Farm under the CPL.

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40 F.3d 63, 1994 WL 638592, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gemini-physical-therapy-and-rehabilitation-inc-v-state-farm-mutual-ca3-1994.