Hunter v. OOIDA Risk Retention Group, Inc.

79 A.D.3d 1, 909 N.Y.S.2d 88
CourtAppellate Division of the Supreme Court of the State of New York
DecidedOctober 5, 2010
StatusPublished
Cited by6 cases

This text of 79 A.D.3d 1 (Hunter v. OOIDA Risk Retention Group, Inc.) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hunter v. OOIDA Risk Retention Group, Inc., 79 A.D.3d 1, 909 N.Y.S.2d 88 (N.Y. Ct. App. 2010).

Opinion

[3]*3OPINION OF THE COURT

Dickerson, J.

Introduction

The plaintiff, driving a truck registered in New York, was involved in a motor vehicle accident in Connecticut with a car that was registered in Connecticut, driven by nonparty Chelsea L. Gubbins, and owned by nonparty Robin L. Lesinski. As a result of the accident, the defendant OOIDA Risk Retention Group, Inc. (hereinafter OOIDA) paid to the plaintiff certain first-party benefits (see Insurance Law § 5102 [b]). We now consider whether OOIDA is entitled to so-called inter-company loss-transfer arbitration pursuant to Insurance Law § 5105 (a). We hold that, under the applicable provisions of New York’s no-fault insurance law (see Insurance Law art 51), and under the circumstances presented here, it cannot be said that the alleged tortfeasors “would have been liable, but for the provisions of’ Insurance Law article 51 (Insurance Law § 5105 [a]). Accordingly, by its terms, Insurance Law § 5105 (a) is inapplicable, and inter-comp any loss-transfer arbitration is not available to OOIDA.

Factual Background

The plaintiff, who characterizes himself as an “independent trucker,” was involved in a motor vehicle accident in Connecticut on February 3, 2006, with a car driven by nonparty Chelsea L. Gubbins, and owned by nonparty Robin L. Lesinski. According to the plaintiff, as a result of the accident he sustained injuries to his knees, neck, and lower back, requiring, among other treatments, arthroscopic surgery to his left knee.

Both Gubbins and Lesinski were Connecticut residents, and Lesinski’s car was registered in Connecticut. The car was insured by the defendant USAA Casualty Insurance Company (hereinafter USAA), which is licensed and authorized to do business and issue insurance policies in both New York and Connecticut. The record contains a one-page document issued by USAA, entitled “Connecticut Auto Policy Renewal Declarations,” which indicates that the policy issued to Lesinski provided bodily injury liability insurance coverage of up to $100,000 per person and $300,000 per accident. The full policy itself is not included in the record.

At the time of the underlying accident, the plaintiff was driving a Freightliner tractor-trailer “by agreement with its owner,” [4]*4Fleego Delivery Systems. The truck was registered to Fleego Delivery Systems in New York, and was insured under a commercial motor carrier liability policy issued by OOIDA. The policy included a mandatory personal injury protection endorsement and optional enhanced basic economic loss coverage, according to which OOIDA agreed to reimburse a covered claimant for basic economic loss up to $75,000, with the last $25,000 representing the optional enhanced basic economic loss coverage. The policy also provided that OOIDA was subrogated to the rights of the insured to the extent of OOIDA’s payment of benefits under the policy.

OOIDA claimed that, based on the occurrence of the accident, as of approximately June 2007, it had paid to the plaintiff first-party benefits in the amount of $72,710 under the policy. The payments, for the most part, constituted reimbursement for medical expenses, with the sum of $28,000 allocated to payment of lost wages. OOIDA sent a letter1 to USAA, dated December 7, 2006, indicating that it had determined that USAA’s insured was responsible for the plaintiffs damages, and notifying USAA of OOIDA’s “subrogation rights” to the benefits OOIDA paid to the plaintiff as a result of the accident.

According to USAA and the plaintiff, they reached an agreement to settle the plaintiffs claim against Gubbins and Lesinski. The record contains a letter written to the plaintiff’s attorney from USAA, confirming its offer of $100,000 in settlement of the claim. The letter further states: “If CTCM waives subrogation, please advise.” According to the plaintiff, OOIDA’s demand for recoupment of the benefits it paid to the plaintiff, either from the settlement proceeds, or directly from USAA, prevented the plaintiff and USAA from consummating the settlement.

The Instant Action

The plaintiff commenced this action against OOIDA and USAA, inter alia, for a judgment declaring that OOIDA is not entitled to recoup the first-party benefits it paid to him, either by lien against any settlement proceeds he recovers from Gubbins, Lesinski, and/or USAA, by subrogation to his rights to recover from those parties, or by any direct claim against USAA. Both defendants served answers to the complaint.

[5]*5The plaintiff moved for summary judgment on the complaint. He argued that, under the relevant provisions of the Insurance Law, OOIDA could only assert a lien for first-party benefits where the tortfeasor was not a “covered person” within the meaning of Insurance Law § 5102 (j). Since the USAA policy provided coverage in excess of New York’s minimum coverage requirements, the plaintiff contended that Gubbins and Lesinski (hereinafter together the tortfeasors or USAA’s insureds) were each a “covered person” within the meaning of the Insurance Law. Additionally, the plaintiff maintained that “OOIDA’s claim for recovery of its first-party payments from USAA is controlled by Connecticut law,” and “such claims are specifically barred by Connecticut’s anti-subrogation law.”

OOIDA opposed the motion. It acknowledged that, if USAA’s insureds were “covered persons” under New York law, then OOIDA was not entitled to a statutory lien against any settlement proceeds recovered by the plaintiff. However, OOIDA asserted that, to the extent that USAA’s insureds were “covered persons” under New York law, it was entitled to mandatory inter-company loss-transfer arbitration with USAA pursuant to Insurance Law § 5105 (a). OOIDA contended that the plaintiff could not seek to apply New York law to avoid a lien, while at the same time asserting that choice-of-law rules require the application of Connecticut law with respect to the issues of subrogation and mandatory arbitration.

OOIDA further argued that, if USAA’s insureds were covered persons, and Connecticut law was controlling, there was no actual conflict of law because the relevant Connecticut statute only barred subrogation “[ujnless otherwise provided by law.” OOIDA claimed that this exception contemplated provisions in the laws of other states, such as New York, which do permit subrogation. Further, OOIDA contended that, under Connecticut law, subrogation was barred only with respect to “collateral source” payments, but that personal injury protection payments made pursuant to a no-fault policy were not “collateral source” payments. Lastly, OOIDA asserted that, even if there were a conflict, the choice-of-law rules favored application of New York law.

USAA agreed with the plaintiff that “the law of Connecticut applies.” It asserted that it wrote its contract of insurance in Connecticut with the expectation that Connecticut law would apply. Further, it contended that the policy premiums were based upon that expectation. Connecticut law, according to [6]*6USAA, did not “allow for th[e] type of loss transfer” sought by OOIDA because it barred subrogation.

The Order and the Judgment

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Cite This Page — Counsel Stack

Bluebook (online)
79 A.D.3d 1, 909 N.Y.S.2d 88, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hunter-v-ooida-risk-retention-group-inc-nyappdiv-2010.