Gladys Carrion v. Mapfre Insurance Company, et al.

• Court: District Court, D. Puerto Rico
• Decided: June 8, 2026
• Docket: 3:25-cv-01535
• Status: Unknown

Opinion

1 IN THE UNITED STATES DISTRICT COURT 2 FOR THE DISTRICT OF PUERTO RICO

5 GLADYS CARRION, 6

7 Plaintiff, CASE NO. 25-1535 (HRV) 8 v. 9 MAPFRE INSURANCE COMPANY, et al, 10

11 Defendants.

13 OPINION AND ORDER 14 Pending before the Court is defendant MAPFRE Insurance Company’s 15 (hereinafter "MAPFRE") motion to dismiss under Federal Rule of Civil Procedure 16 17 12(b)(1). (Docket No. 12). In its motion, MAPFRE argues that this Court lacks subject- 18 matter jurisdiction because Plaintiff Gladys Carrión (hereinafter “Carrión” or “Plaintiff”) 19 failed to comply with the provisions of the Motor Vehicle Accident Social Protection Act, 20 Law No. 111-20201. The motion also urges the Court to dismiss the complaint based on 21 improper venue and failure to comply with the legal provisions regarding diversity and 22 23 24 25 26 1 Law 111-2020 has not been officially translated and neither Plaintiff nor Defendant has provided a certified translation of Law 111-2020. As such, any reference or citation to the statute 27 throughout this Opinion and Order is by translation of the Court.

28 1 1 jurisdiction. (Docket No. 12). Plaintiff has filed her response in opposition. (Docket No. 2 20). For the reasons set forth below, and after careful consideration of the arguments of 3 the parties as well as the relevant statutory provisions, the motion to dismiss is DENIED. 4 I. FACTUAL AND PROCEDURAL BACKGROUND 5 The complaint avers that on May 9, 2023, Carrión was traveling on State Road 6 7 #17 in San Juan, Puerto Rico, in her motor vehicle, when a Ford Ranger hit her car from 8 the rear. (Docket No. 3, ¶5.2). At the time of the accident, the Ford Ranger was driven by 9 Angel Lugo Silva and the vehicle was owned by Super Asphalt Pavement Corporation 10 (“Super Asphalt”). (Id., ¶5.3). Plaintiff never filed any claims for benefits before the 11 Automobile Accident Compensation Administration (hereinafter “ACAA” for its Spanish 12 13 acronym). (Docket No. 20-2). 14 On October 10, 2025, Plaintiff filed suit against Super Asphalt and MAPFRE, as 15 its insurer, requesting compensation for the alleged damages caused as a result of the 16 collision pursuant to Article 1536 of the Puerto Rico Civil Code, P.R. Laws Ann. tit. 31, § 17 10801. (Docket No. 3). The complaint asserts subject matter jurisdiction under 28 U.S.C. 18 19 § 1332(a), inasmuch as Plaintiff is domiciled in the state of Pennsylvania and the 20 damages suffered are alleged to exceed the threshold amount of $75,000. (Docket No. 3, 21 ¶2.1). On December 18, 2025, MAPFRE answered the complaint. (Docket No. 8). 22 On March 11, 2026, then-presiding District Judge Silvia L. Carreño-Coll 23 transferred the case to me after the parties stated their consent to magistrate judge 24 jurisdiction in the Initial Scheduling Conference Memorandum. (Docket Nos. 13, 14, and 25 26 15). MAPFRE filed its motion to dismiss on March 9, 2026 (Docket No. 12) and Plaintiff 27

28 2 1 opposed on April 22, 2026. (Docket No. 20). No appearance has yet been entered on 2 behalf of Super Asphalt. 3 II. LEGAL STANDARDS 4 Federal courts are “courts of limited jurisdiction” and “[t]hey possess only that 5 power authorized by Constitution and statute.” Exxon Mobil Corp. v. Allapattah Services 6 7 Inc., 545 U.S. 546, 552 (2005) (citing Kokkonen v. Guardian Life Ins. Co. of America, 8 511 U.S. 375, 377 (1994)). “Article III, § 2, of the Constitution delineates ‘[t]he character 9 of the controversies over which federal judicial authority may extend.’” Home Depot 10 U.S.A., Inc. v. Jackson, 587 U.S. 435, 438 (2019) (quoting Insurance Corp. of Ireland v. 11 Compagnie des Bauxites de Guinee, 456 U.S. 694, 701 (1982)). District courts have 12 13 original jurisdiction in federal-question cases, where actions arise under the Constitution, 14 laws, and treatises of the United States, and in diversity cases, where the matters in 15 controversy between citizens of different states exceeds $75,000 in sum or value. 28 16 U.S.C. §§ 1331 and 1332(a). Subject-matter jurisdiction is nonwaivable and serves to keep 17 district courts within the limitations prescribed by the Constitution and the law. Ruhrgas 18 19 AG v. Marathon Oil Co., 526 U.S. 574, 583 (1999). In contrast to personal jurisdiction, 20 where a party must insist that the jurisdictional limitation be observed or forgo that right, 21 subject-matter jurisdiction “must be policed by the courts on their own initiative even at 22 the highest level.” Id. at 583-584. 23 That the Court must be vigilant of its own jurisdiction, raising defects sua sponte 24 if necessary, does not impede parties from also challenging a court’s exercise of its 25 26 authority to hear a case. Under Rule 12(b)(1) of the Federal Rules of Civil Procedure, a 27

28 3 1 party may, in response to an initial pleading, file a motion to dismiss for lack of subject 2 matter jurisdiction. Fed. R. Civ. P. 12(b)(1). Rule 12(b)(1) provides “a large umbrella, 3 overspreading a variety of different types of challenges to subject-matter jurisdiction,” 4 such as “ripeness, mootness, sovereign immunity, and the existence of federal question 5 jurisdiction.” Valentin v. Hospital Bella Vista, 254 F.3d 358, 362-363 (1st Cir. 2001). 6 7 Rule 12(b)(1) motions may be appropriate when a claimant has failed to exhaust 8 administrative procedures established by statute as prerequisite for filing suit. Wright & 9 Miller’s Fed. Prac. & Proc. Civ. § 1350 (4th ed.). Exhaustion requirements serve the 10 purpose of preventing “premature interruption of the administrative process,” especially 11 in circumstances where “agency decisions are frequently of a discretionary nature or 12 13 frequently require expertise.” McKart v. U.S., 395 U.S. 185, 193-194 (1969). See also 14 Achieve Telecom Network of MA, LLC v. Universal Serv. Admin. Co., No. 09-10315- 15 RWZ, 2009 WL 10694438 at *3 (D. Mass. Oct. 29, 2009). When courts evaluate whether 16 exhaustion procedures are mandatory before exercising its jurisdiction, legislative intent 17 is of “paramount importance.” Patsy v. Board of Regents of State of Fla., 457 U.S. 496, 18 19 501 (1982). For instance, “[i]n determining whether exhaustion of federal administrative 20 remedies is required, courts generally focus on the role Congress has assigned to the 21 relevant federal agency, and tailor the exhaustion rule to fit the particular administrative 22 scheme created by Congress.” Id. at 502 n.4 (citing McKart, 385 U.S. at 193-195). 23 Finally, the legal standard for a Rule 12(b)(1) motion is similar to that under Rule 24 12(b)(6) inasmuch the allegations in the complaint should be liberally construed, and all 25 26 well-pleaded facts contained therein should be treated as true, affording the asserting 27

28 4 1 party with “the benefit of all reasonable inferences.” Soto v. Puerto Rico, 24-cv-1405 2 (GMM), 2025 U.S. Dist. LEXIS 196715, 2025 WL 2806762 at *6 (D.P.R. Sept. 30, 2025) 3 (citing Murphy, 45 F.3d at 522); Arroyo-Ruiz v. Triple-S Management Group, 206 F. 4 Supp. 3d 701, 706 (D.P.R. 2016). The burden to prove that the court has subject-matter 5 jurisdiction rests on the party asserting it. Hertz Corp. v. Friend, 559 U.S. 77, 96 (2010); 6 7 Murphy v. U.S., 45 F.3d 520, 522 (1st Cir. 1995); Dalmau Rodriguez v. Hughes Aircraft 8 Co., 781 F.2d 9, 10 (1st Cir. 1986). When faced with a Rule 12(b)(1) motion, “court[s] may 9 consider documents outside the pleadings, such as exhibits and affidavits attached to the 10 motion to dismiss, and the opposition.” Mercado Arocho v. U.S., 455 F. Supp. 2d 15 11 (D.P.R. 2006) (citing Gonzalez v. U.S., 284 F.3d 281, 288 (1st Cir. 2002)). 12 13 III. DISCUSSION 14 In its motion to dismiss, MAPFRE argues that this Court lacks subject-matter 15 jurisdiction because Plaintiff failed to comply with the provisions of Law No. 111-2020. 16 Specifically, MAPFRE contends that Law No. 111-2020 “expressly prevent an injured 17 party from filing a claim before the term that the agency has to subrogate itself expires.” 18 19 (Docket No. 12). MAPFRE further claims that Plaintiff must have presented an 20 administrative claim before the ACAA and waited until the agency’s determination 21 regarding benefits became final and enforceable, in order to clear the way for a judicial 22 claim before this Court. MAPFRE’s interpretation of the statute is grounded on the 23 specific provisions conveying ACAA’s subrogation rights: Because “ACAA cannot 24 renounce its rights in advance”, the injured person must file its claim in order for ACAA 25 26 to pay, to allow ACAA to subrogate itself in the injured person’s position, and request 27

28 5 1 reimbursement from the insurer. (Docket No. 12). Thus, in construing MAPFRE’s 2 arguments as alluding to the doctrinal framework pertaining to lack of subject-matter 3 jurisdiction for failure to exhaust administrative remedies, I must decide whether Law 4 No. 111-2020 imposes such exhaustion requirement. 5 Plaintiff opposes the request for dismissal, arguing that the statutory scheme 6 7 under Law No. 111-2020 affirmatively contradicts MAPFRE’s argument that dismissal 8 for lack of jurisdiction is required for failure to comply with ACAA by seeking benefits 9 under it as a prerequisite to filing suit in federal court. (Docket No. 20). In support of its 10 opposition, Plaintiff submits documentation to prove that a claim before ACAA was 11 never filed and that the statutory benefits were unavailable to her since the medical 12 13 treatment at issue was performed outside Puerto Rico. (Docket Nos. 20-1 and 20-2). 14 Furthermore, Plaintiff also attaches her government-issued identification card in 15 support of her claim for diversity jurisdiction. (Docket No. 20-3). As to the argument of 16 improper venue, Plaintiff points out that MAPFRE invokes Fed. R. Civ. P. 12(b)(3) but 17 offers no analysis under the federal venue statute as to why dismissal is warranted. 18 19 A. Law No. 111-2020 20 The Puerto Rico Motor Vehicle Accident Social Protection Act (Law No. 111-2020) 21 establishes a no-fault compensation system, designed to provide certain economic 22 benefits and medical coverage to individuals injured in motor vehicle accidents in Puerto 23 Rico, regardless of fault. Such statutory benefits are issued and administered through the 24 ACAA, an entity itself created through Law No. 111-2020. Under this compensation 25 26 system, the primary beneficiary of the statutory scheme is the injured person. 27

28 6 1 Law No. 111-2020 derogates and supersedes what was previously the Automobile 2 Accident Social Protection Act, P.R. Laws Ann. tit. 9, §§ 2051-2065, in order to address 3 and adapt to the changing needs of the modern Puerto Rican society without abandoning 4 its core focus of reducing the economic and social impact of traffic accidents on injured 5 persons, their families, and dependents. Ortiz Morales v. A.C.A.A., 16 P.R. Offic. Trans. 6 7 474, 477 (1985). The new statute addresses outdated definitions, delineates certain 8 statutory limitations, and, most relevantly to the instant case, outlines ACAA’s role and 9 rights with respect to reimbursements by insurers and judicial claims. Specifically, 10 article 7(A)(4) establishes ACAA’s subrogation rights: 11 The Administration shall have the authority to be subrogated 12 to the rights of an injured person or that person’s beneficiaries 13 to file a legal claim for damages against third parties in cases where the Administration, pursuant to the terms of 14 this Act, is obligated to compensate them in any manner. 15

16 (Emphasis added) (Translation Ours). ACAA’s subrogation rights, as outlined in article 17 7(A)(4), essentially mirror those afforded to the State Insurance Fund (“CFSE” for its 18 Spanish acronym) through the Workmen’s Accident Compensation Act, P.R. Laws Ann. 19 tit. 11, § 32. There, the legislative intent in granting subrogation rights to CFSE was to 20 not allow the worker “to recover twice for the same injury” or “to exempt third parties.” 21 Alvarado v. Calaino Romero, 4 P.R. Offic. Trans. 178, 184 (1975) (citing Sanstad v. Ind. 22 23 Acc. Com., 339 P.2d 943 (Cal. 1959)). The main purpose for affording subrogation rights 24 to CSFE, as is the case of ACAA, is “to reimburse to the insurer what has been paid, which 25 in turn reduces the premiums, and allows the injured person to obtain any sum recovered 26 against the third party in excess of what has been paid by the insurer […].” Alvarado, 4 27

28 7 1 P.R. Offic. Trans. at 185. Allowing the ACAA to pursue a separate claim against a third- 2 party tortfeasor in benefit of the injured person is aligned with the statutory scheme 3 throughout Law No. 111-2020, where the injured person remains the beneficiary. 4 Here, MAPFRE points to specific provisions of the statute to argue that the injured 5 person is limited to bringing suit only after ACAA has exercised its subrogation rights. 6 7 Article 7(A)(4)(c) sets forth an injured person’s limitation on bringing suit prior to 8 ACAA’s decision becoming final and enforceable: 9 Neither the injured person nor their beneficiaries may file a 10 lawsuit or settle any cause of action they may have against the third party responsible for the damages until ninety (90) days 11 have elapsed from the date on which the Administration’s decision becomes final and enforceable. 12

13 (Translation Ours). As such, in instances where ACAA is in a position to decide, that is, 14 when a claim for benefits has been, in fact, submitted before the agency, the injured 15 person is limited to file suit once the 90-day period has elapsed. Moreover, although 16 article 7(A)(4)(c) precludes the injured person from filing suit before the expiration of 17 the 90-day period, the Supreme Court of Puerto Rico has construed this requirement 18 19 with enough flexibility to prevent dismissal on prematurity grounds. In Diaz Hernandez 20 v. Mapfre Praico, 2024 WL 2249379 (May 3, 2024), the Supreme Court of Puerto Rico 21 addressed a similar controversy to the one presented by MAPFRE in the instant case, 22 with the significant difference that the injured person had, in fact, received ACAA 23 benefits, in stark contrast to the present case where no administrative claim was 24 25 26 27

28 8 1 submitted by Plaintiff.2 There, the Diaz Hernandez court declined to rule that dismissal 2 was appropriate when the injured person’s judicial claim was prematurely file because 3 the 90-day period for ACAA to file its subrogation action had not expired. 4 Plaintiff was not required to file a claim before the ACAA. In fact, no injured 5 person is. The benefits provided by Law No. 111-2020 cannot be interpreted as 6 7 mandatory and the statute does not bind an injured person to present a claim before the 8 ACAA prior to filing suit against the insurer of the third-party tortfeasor. MAPFRE has 9 not cited any authority to the contrary. What’s more, Plaintiff never filed a claim before 10 ACAA for benefits under Law 111-2020 because, as the record shows, she was ineligible 11 to receive them as she is not a resident of Puerto Rico. (Docket Nos. 20-1 and 20-2).3 12 13 Thus, to assert that Plaintiff had to submit a claim for benefits to the ACAA, wait until a 14 decision was issued with respect to benefits, hold out for an additional ninety (90) days, 15 and then present her judicial claim in order for this Court to acquired subject-matter 16

18 2 In Diaz Hernandez v. Mapfre Praico, the plaintiffs sued MAPFRE and other defendants 19 for damages arising from an automobile accident. Since the plaintiffs had received medical benefits from the ACAA, the trial court held that the suit had been filed prematurely because the 90-day period during 20 which ACAA could exercise its subrogation rights had not expired. The Puerto Rico Court of First Instance dismissed the complaint without prejudice, and the court of appeals affirmed. The Supreme Court of 21 Puerto Rico reversed. It held that although ACAA has a statutory right to subrogate itself to the injured person’s claim against a third-party tortfeasor for the benefits it has paid, the complaint filed by the injured 22 person is not null or premature if filed before the 90-day period has run. Dismissal would be appropriate only if the ACAA timely filed its own subrogation action and therein seeked annulment of the prematurely 23 filed complaint. In so holding, the Diaz Hernandez Court compared Law No. 111-2020’s provisions on ACAA’s subrogation rights with the provisions afforded to the State Insurance Fund (“CFSE” for its 24 Spanish acronym) through the Workmen’s Accident Compensation Act, P.R. Laws Ann. tit. 11 § 32, and concluded that the filing of a separate action by the injured person is not automatically premature if filed 25 prior to the 90-day period.

26 3 A certification from ACCA attached to Plaintiff’s opposition shows that injured persons are eligible for coverage under Law 111-2020 for benefits and services that are available in Puerto Rico, 27 and that these services “shall be provided only in Puerto Rico.” (Docket No. 20-1).

28 9 1 jurisdiction, is not only inapposite to Law No. 111-2020’s purposes, but is also contrary 2 to the doctrinal frameworks of diversity jurisdiction. 3 I find that Law No. 111-2020 imposes no such exhaustion requirements upon 4 Plaintiff making the instant claim either premature or non-cognizable for lack of subject 5 matter jurisdiction. ACAA’s subrogation rights under Law No. 111-2020 cannot be 6 7 construed to impose additional obstacles or requirements that would hinder the injured 8 person’s ability to seek and obtain redress in federal court for damages allegedly 9 sustained in a motor vehicle accident. Rather, ACAA’s subrogation provisions apply to 10 any actions commenced by ACAA, seeking reimbursements on behalf of the injured 11 person, where such expenses are covered under an applicable insurance policy issued in 12 13 favor of the third-party tortfeasor, and which were disbursed or granted by ACAA in 14 any way. To adopt MAPFRE’s position that article 7 of Law No. 111-2020 “expressly 15 prevent[s] an injured party from filing a claim before the term that the agency has to 16 subrogate itself expires” (Docket No. 12), would be to rule against the very purpose of the 17 statute: “[t]he social protection character of the statute supports any reasonable and 18 19 equitable interpretation which may favor the beneficiary.” Ortiz Morales, 16 P.R. Offic. 20 Trans. at 478. And again, MAPFRE has not cited any authority standing for the 21 proposition that subject matter jurisdiction is lacking because a diverse Plaintiff in 22 federal court, failed to avail herself of Law No. 111-2020’s remedies. 23 B. Improper Venue 24 As to venue, I will refrain from discussing in-depth MAPFRE’s cursory mention 25 26 of improper venue under Fed. R. Civ. P. 12(b)(3) as the argument was not sufficiently 27

28 10 1 developed in the motion to dismiss. As such, the argument has been waived. See United 2 States v. Zannino, 895 F.2d 1, 17 (1st Cir. 1990) (“[I]ssues adverted to in a perfunctory 3 manner, unaccompanied by some effort at developed argumentation, are deemed 4 waived.”). In any event, even if not waived, the argument fails on the merits. “A civil 5 action may be brought in […] a judicial district in which a substantial part of the events 6 7 or omissions giving rise to the claim occurred […].” 28 U.S.C. § 1391(b)(2). “Objections 8 to venue typically stem from a failure to adhere to the requirements specified in the 9 general venue statute, Section 1391 of Title 28 of the United States Code, or some other 10 statutory venue provision.” Wright & Miller, Fed. Prac. & Proc. Civ. § 1352 (4th ed.). In 11 this case, Plaintiff’s claim for compensation under article 1538 of the Puerto Rico Civil 12 13 Code, Puerto Rico Civil Code, P.R. Laws Ann. tit. 31, § 10803stems from operative facts 14 that took place within the judicial district of Puerto Rico: the alleged damages resulted 15 from a motor vehicle collision that occurred on State Road #17 in San Juan, Puerto Rico. 16 (Docket No. 12, ¶5.2). Thus, an objection to this Court’s exercise of its jurisdiction due to 17 improper venue is unfounded since the requirements for the general venue statute are 18 19 met, and no other statutory venue provisions apply to the facts of this case. 20 IV. CONCLUSION 21 In view of the foregoing, MAPFRE’s motion to dismiss at Docket No. 12 is 22 DENIED. 23 IT IS SO ORDERED. 24 In San Juan, Puerto Rico this 8th day of June 2026. 25 26 s/Héctor L. Ramos-Vega____ United States Magistrate Judge 27

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