General Glass Industries Corp. v. Monsour Medical Foundation

973 F.2d 197, 15 Employee Benefits Cas. (BNA) 2233, 1992 U.S. App. LEXIS 19011, 1992 WL 198911
CourtCourt of Appeals for the Third Circuit
DecidedAugust 17, 1992
DocketNo. 91-3839
StatusPublished
Cited by7 cases

This text of 973 F.2d 197 (General Glass Industries Corp. v. Monsour Medical Foundation) 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
General Glass Industries Corp. v. Monsour Medical Foundation, 973 F.2d 197, 15 Employee Benefits Cas. (BNA) 2233, 1992 U.S. App. LEXIS 19011, 1992 WL 198911 (3d Cir. 1992).

Opinion

OPINION OF THE COURT

GARTH, Circuit Judge.

This appeal by General Glass Industries Corporation (“GGI”) requires us to determine whether a complaint asserting causes of action, some of which are not derivative of the causes of action maintained by the intervenor, the Insurance Commissioner'of the Commonwealth of Pennsylvania (“Commissioner”) in state liquidation proceedings against an insolvent insurer, may be dismissed by the district court on the grounds of abstention pursuant to Burford v. Sun Oil Co., 319 U.S. 315, 63 S.Ct. 1098, 87 L.Ed. 1424 (1943). We will vacate the district court’s abstention order and remand to the district court to stay this action pending conclusion of the state court proceedings.

I.

Keystone Medical Management Company, a named defendant in the action brought by GGI, had established a health care company, Keystone Medical Services, Inc., which had sold employee health insurance coverage to GGI in December, 1987. On September 4, 1990, the Commonwealth Court of Pennsylvania granted the petition of the Commissioner and issued an amended order for the liquidation of the insolvent Keystone Medical Services, Inc. In November, 1990, GGI filed a complaint in the United States District Court for the Western District of Pennsylvania, asserting RICO, ERISA and state tort law claims against Monsour Medical Foundation, Monsour Medical Center individually and as successor to Keystone Medical Management Company, William Monsour, M.D., and A.V. Papa, Jr.1

On February 20, 1991, and thereafter on March 27, 1991, first Monsour, and then the Commissioner who had been granted intervention, moved to dismiss the complaint of GGI, arguing that the district court should abstain from exercising its jurisdiction, so as not to interfere with the liquidation proceedings which were continuing in state court.

GGI opposed these motions on the grounds that abstention was not warranted because GGI’s claims against Monsour were not derivative of the Commissioner’s actions, and were not available to, and could not be prosecuted by, the Commissioner. The Commissioner, while arguing for abstention, nevertheless stated that it had no objection to a stay of the federal action pending resolution of the state court suit.

The district court referred the motions to dismiss to a Magistrate Judge for decision. After discussing abstention under both Burford and Colorado River Conservation District v. United States, 424 U.S. 800, 96 S.Ct. 1236, 47 L.Ed.2d 483 (1976), the Magistrate Judge recommended that the motions to dismiss be granted on the basis of Burford abstention, fearing that if the plaintiff’s action were allowed to continue, it would disrupt the ongoing state court liquidation proceedings.2 Those pro[199]*199ceedings involve the acquisition, marshall-ing, and distribution of assets of the insolvent insurer, Keystone Medical Services, Inc. (“KMS”). The Magistrate Judge held that these same assets were the subject of GGI’s complaint. On November 1, 1991, the district court granted the Commissioner’s and Monsour’s motions to dismiss based on the report and recommendation of the Magistrate Judge.3 GGI filed a timely Notice , of Appeal.

II.

GGI is a manufacturer of sheet glass and employs approximately 300 workers. GGI had purchased employee health insurance from Keystone Medical Services, Inc. The complaint of GGI asserted claims under federal and state law. GGI alleged, among other claims, that the defendants had wasted KMS’ assets, unlawfully converted health insurance premiums, and had breached fiduciary duties owing to employee welfare benefit plans of GGI. GGI also alleged that, by the time that liquidation of KMS was ordered, KMS had unpaid medical claims of $1.7 million, of which $250,000 had been incurred by GGI employees.

GGI’s complaint also charged Monsour with various misrepresentations of fact. These misrepresentations, it. is alleged, caused GGI to incur higher health insurance premium costs for the remainder of its contract with KMS, and also caused damage to GGI’s reputation. It was alleged as well that GGI employees suffered damages by having to pay medical claims that should have been paid by KMS, and by having health insurance benefits decrease and premium contributions increase, in order to pay for health benefits of a lesser quality.

The RICO and ERISA counts of GGI’s complaint essentially stem from the activities of Monsour in its conduct of KMS’ business. Similarly, the state law claims refer to the various intentional actions of Monsour which GGI contends resulted in the legal and equitable claims for which relief is sought.

The district court, adopting the Report and Recommendation of the Magistrate Judge, rejected the arguments for abstention based on Colorado River abstention. The district court recognized that GGI raised claims under ERISA, RICO and the Pennsylvania Unfair Trade Practices and Consumer Protection Law, that may not be raised by the Commissioner in state court proceedings4, and thus the federal and state court proceedings were not truly du-plicative as required for a district court to abstain under Colorado River. The district court held, however, that Monsour and the Commissioner had met the requirements for Burford abstention and thus dismissed GGI’s complaint. It found that the regulation of an insolvent insurer and its rehabilitation presented the type of complex regulatory scheme, reflecting a policy of substantial state concern, which is among the prerequisites for Burford abstention.

Turning to other factors supporting Bur-ford abstention, the district court contrasted GGI’s claims with those presented by University of Maryland v. Peat Marwick Main & Co., 923 F.2d 265 (3d Cir.1991), which the district court found “instructive since it sets forth a framework for determining when a suit poses a danger of inter[200]*200fering with a state’s efforts to regulate matters of public concern.” (A 263). In Peat Marwick, we reversed the decision of the district court to abstain under Burford. We held, among other things, that the claims against the independent auditor, which had certified financial statements of the insurer on which the insureds had relied to their detriment, did not threaten to disrupt the regulatory scheme at issue in the ongoing liquidation proceedings.

In Peat Marwick, the plaintiffs’ claims were held to be non-derivative because they were brought against an auditor of the insurance company and were based on breaches of duty to the plaintiffs and not to the insolvent insurer, id. at 274. Although the district court conceded (A 267-68) that GGI had raised claims in federal court that could not be raised in the state proceeding, and GGI sought relief to which the Commissioner was not entitled5, it also found that GGI was seeking the same funds pursued by the Commissioner. The district court, by adopting the Magistrate Judge’s report, held that any funds improperly converted from KMS were part of the “estate” of KMS, and GGI’s action would thus interfere with the ongoing state proceedings. It concluded, therefore, that abstention was appropriate and dismissed GGI’s complaint.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Barnthouse v. City of Edmond
2003 OK 42 (Supreme Court of Oklahoma, 2003)
C.H. Ex Rel. Z.H. v. Oliva
990 F. Supp. 341 (D. New Jersey, 1997)
Richardson v. Lloyds of London
896 F. Supp. 428 (E.D. Pennsylvania, 1995)
Todd v. DSN Dealer Service Network, Inc.
861 F. Supp. 1531 (D. Kansas, 1994)
Motor Club of America v. Weatherford
841 F. Supp. 610 (D. New Jersey, 1994)
Riley v. Simmons
839 F. Supp. 1113 (D. New Jersey, 1993)

Cite This Page — Counsel Stack

Bluebook (online)
973 F.2d 197, 15 Employee Benefits Cas. (BNA) 2233, 1992 U.S. App. LEXIS 19011, 1992 WL 198911, Counsel Stack Legal Research, https://law.counselstack.com/opinion/general-glass-industries-corp-v-monsour-medical-foundation-ca3-1992.