Heller v. Pennsylvania League of Cities & Municipalities

950 A.2d 362, 2008 Pa. Commw. LEXIS 254, 2008 WL 2261737
CourtCommonwealth Court of Pennsylvania
DecidedJune 4, 2008
Docket1853 C.D. 2007
StatusPublished
Cited by4 cases

This text of 950 A.2d 362 (Heller v. Pennsylvania League of Cities & Municipalities) 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
Heller v. Pennsylvania League of Cities & Municipalities, 950 A.2d 362, 2008 Pa. Commw. LEXIS 254, 2008 WL 2261737 (Pa. Ct. App. 2008).

Opinions

OPINION BY

Senior Judge COLINS.

The Pennsylvania Leagues of Cities and Municipalities, doing business as Penn [363]*363Prime Trust (Penn PRIME), a municipal insurer, appeals an order of the Court of Common Pleas of Venango County that granted a motion for summary judgment filed by Frank and Beverly Heller in their declaratory judgment action seeking a determination from the trial court that a provision in Penn PRIME’S insurance agreement with Sugarcreek Borough that excluded from its underinsured motorist coverage (UIM) claims by persons who would be otherwise eligible for recovery under the policy but for their eligibility for worker’s compensation benefits violates public policy.1 Penn PRIME challenges the trial court’s holding that this policy exclusion of UIM benefits for persons eligible for worker’s compensation benefits violates public policy. The provision at issue, found in the part of the policy relating to underinsured and uninsured motorists, V, B(3)(e), states as follows:

3. Exclusions.

This coverage does not apply to:
(e) Any claim by anyone eligible for workers compensation benefits that are the statutory obligation of the Member.

Penn PRIME raises the following issues: (1) Whether the trial court erred in concluding that the UIM exclusion violates public policy where the legislature chose not to mandate such benefits and the exclusion furthers the dominant public policy of cost containment; and (2) Whether the trial court erred in relying upon cases that do not address public policy considerations and by failing to recognize the significance of amendments to the Motor Vehicle Financial Responsibility Law (MVFRL), 75 Pa.C.S. § 1701-1799.7, and Supreme Court precedent pertaining to public policy considerations.2

The facts pertinent to our review are not disputed and can be summarized as follows. Frank Heller was injured in an automobile accident during the course of his employment as a police officer for Su-garcreek Borough. Heller obtained a maximum recovery of $25,000 from the other driver, and has notified his own personal insurer of a potential UIM claim. He has also received medical expenses and two-thirds of his pay through worker’s compensation benefits. The Borough pays Heller the remainder of his salary. Heller sought UIM benefits from the Borough under its policy with Penn PRIME. As noted above, Penn PRIME denied coverage based upon Section V, B(3)(e) of the policy, which excludes such coverage under the facts presented. The parties agreed that the provision applies to the facts, but Heller argued before the trial court that the provision violates public policy and sought a declaration to that effect and an order voiding the provision on that basis.

The trial court first recognized that a repealed section of the MVFRL, 75 Pa. C.S. § 1735, prohibited insurance companies from excluding UIM benefits with regard to persons receiving worker’s compensation benefits. The General Assembly repealed that provision in 1993 by the Act of July 2,1993, P.L. 190, also known as Act 44. The Supreme Court considered that provision in Selected Risks Insurance Co. v. Thompson, 520 Pa. 130, 552 A.2d 1382 (1989). In that case, an insurance policy covered six vehicles owned and operated by a municipal unincorporated volunteer [364]*364fire department. The policy provided for uninsured motorist coverage as required by the MVFRL. A fireman was injured in an accident in the course of his volunteer duties for the department and was unable to return to his job as an independent truck driver. He received worker’s compensation benefits under the municipality’s policy. He then filed a claim with the department’s auto insurer seeking uninsured motorist benefits. The insurer objected and the matter went to arbitration under the Uniform Arbitration Act, 42 Pa. G.S. §§ 7301-7362. The question before the arbitrator was whether the fireman would be able to stack the $30,000 per vehicle uninsured insurance. A majority of the arbitrators approved that request, thus granting the maximum amount payable under the insurance policy of $180,000.

One of the issues the Supreme Court considered was whether the uninsured motorist coverage “should be reduced or ‘set-off by the amount of worker’s compensation benefits” the fireman received in accordance with the terms of the policy. The Supreme Court, in noting the decisions of other jurisdictions, voided the exclusionary provision, stating as follows:

The rationale of these courts is varied but certain common themes emerge: first, uninsured motorist coverage is paid for by a separate premium, and to give the uninsured motorist carrier a set-off based on the fortuitous existence of a collateral source would result in a windfall to the carrier; second, uninsured motorist coverage is mandated by statute and any variations from that statutory mandate should come from the legislature; third, workmen’s compensation only covers a fraction of what tort damages would cover (e.g. workmen’s compensation does not provide 100% of wage loss coverage, nor pain and suffering, nor other consequential damages) and a dollar-for-dollar set-off does not recognize this reality; and fourth, there is no public policy against an individual purchasing additional uninsured motorist coverage to protect himself and his family against the shortfall, which could result from a dependency on workmen’s compensation benefits.

Id., 520 Pa. at 142-3, 552 A.2d at 1388.

However, the Court further noted that there was a new, post-injury, statutory basis that supported its conclusion that the exclusionary provision was invalid: At that time the then-recently adopted Section 1735 of the MVFRL3 provided that “[t]he coverages required by this [Act] shall not be made subject to an exclusion or reduction in amount because of any worker’s compensation benefits payable as a result of the same injury. 75 Pa.C.S. § 1735.” 520 Pa. at 143, 552 A.2d at 1388.

However, as noted above, the General Assembly repealed Sections 1735 and 1737 of the MVFRL in 1993. After that repeal, the Supreme Court decided Gardner v. Erie Insurance Company, 555 Pa. 59, 722 A.2d 1041 (1999), in which the issue raised was “whether an employee’s receipt of worker’s compensation benefits relating to injuries sustained while driving a co-employee’s automobile and arising out of wrongful third-party conduct bars him from recovering uninsured motorist benefits from the co-employee’s insurance carrier.” Id., 555 Pa. at 61, 722 A.2d at 1041.

In that case, Gardner was driving a car owned by a co-employee when he was injured in an accident in the course of his employment. The other driver fled the scene. Gardner obtained worker’s compensation benefits and also uninsured mo[365]*365torist benefits of $15,000 from his own insurer. Gardner then sought uninsured motorist benefits under the co-employee/owner’s policy with Erie Insurance. Erie denied the request, and Gardner filed a declaratory judgment action. In that proceeding, Erie argued that Gardner’s receipt of worker’s compensation benefits precluded his subsequent receipt of benefits under his co-worker’s insurance plan. Thus, the distinguishing factor between this case and Gardner

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Related

Heller v. Pennsylvania League of Cities & Municipalities
32 A.3d 1213 (Supreme Court of Pennsylvania, 2011)
Petrochko v. Nationwide Mutual Insurance
15 Pa. D. & C.5th 312 (Lackawanna County Court of Common Pleas, 2010)
Heller v. Pennsylvania League of Cities & Municipalities
950 A.2d 362 (Commonwealth Court of Pennsylvania, 2008)

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Bluebook (online)
950 A.2d 362, 2008 Pa. Commw. LEXIS 254, 2008 WL 2261737, Counsel Stack Legal Research, https://law.counselstack.com/opinion/heller-v-pennsylvania-league-of-cities-municipalities-pacommwct-2008.