Massachusetts Insurers Insolvency Fund v. Advanced Family Chiropractic

14 Mass. L. Rptr. 342
CourtMassachusetts Superior Court
DecidedJanuary 2, 2002
DocketNo. 010792BLS
StatusPublished

This text of 14 Mass. L. Rptr. 342 (Massachusetts Insurers Insolvency Fund v. Advanced Family Chiropractic) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Massachusetts Insurers Insolvency Fund v. Advanced Family Chiropractic, 14 Mass. L. Rptr. 342 (Mass. Ct. App. 2002).

Opinion

van Gestel, J.

This matter comes before the Court on cross motions by the Massachusetts Insurers Insolvency Fund (the “Fund”) and Advanced Family Chiropractic (“AFC”). The facts are not really in dispute. Rather, the matter presented involves statutory and contractual interpretation by the Court.

BACKGROUND

The Fund, based in Boston, “is a nonprofit, unincorporated entity created by G.L.c. 175D, Sec. 3 (1994 ed.).” Clark Equipment Co. v. Massachusetts Insurers Insolvency Fund, 423 Mass. 165, 167 (1996). G.L.c. 175D is patterned on the Post-Assessment Insurance Guaranty Association Model Bill. Id. at 167, n.2. The Fund is obligated to pay covered claims against an insolvent insurer in place of the insolvent insurer. “The Fund’s obligations and expenses are assessed to a broad range of insurers, including all liability and property insurers who write insurance in the Commonwealth . . . Insurers recoup the amounts which they pay into the fund by increasing their rates and premiums .. . The cost of paying claims against insolvent insurers ‘is thus ultimately passed on to the insurance-buying public.’ ” Id. at 167.

AFC, presumably some form of professional association, is actually a chiropractor named Dr. Jeffrey Anderson, practicing in Hyannis-, Massachusetts.

In March 1999, Josue N. Nasciemento, Jr. (“Nasciemento”) was involved in a motor vehicle accident in which he was injured. At the time, Nasciemento was insured under an automobile policy issued by Trust Insurance Company (“Trust”). The policy included the statutorily mandated personal injury protection (“PIP”) benefits. Trust was an insurer licensed to transact insurance business in Massachusetts.

Nasciemento received treatment for his injuries from AFC.

Trust was determined to be insolvent by the Supreme Judicial Court on July 26, 2000, effective August 2, 2000.

AFC, after the Trust insolvency, made demand on the Fund for payment of medical bills incurred by Nasciemento for treatment of injuries caused in the accident.

AFC asserts, and the Fund denies, that G.L.c. 90, Sec. 34M applies to the Fund. Although Dr. Anderson avers that he does “not personally care if said claim[s are ] paid within thirty days, ” AFC and the Fund remain in disagreement as to whether c. 90, Sec. 34M applies to the Fund. In issue particularly is the part of Sec. 34M that reads:

In any case where benefits due and payable remain unpaid for thirty days, any unpaid party shall be deemed a party to a contract with the insurer responsible for payment and shall therefore have a right to commence an action in contract for payment of amounts therein determined to be due in accordance with the provisions of this chapter . . . If the unpaid party recovers a judgment for any amount due and payable by the insurer, the court shall assess against the insurer in addition thereto costs and reasonable attorneys fees.

The Fund does not seek a declaration that the Fund is not obligated for the payment of Naciemento’s medical bills from AFC. The Fund states that it is processing those bills and to the extent they are valid covered claims, the Fund will pay such bills. See Memorandum in Support of Plaintiffs Motion for Summary Judgment, p. 4, n.2. It is only the costs and attorneys fees that are challenged by this case.

By reason of the insolvency of Trust, the Fund became obligated to pay certain “covered claims" arising out of and within the coverage of certain Trust insurance policies as provided in c. 175D.

When an insurer insolvency is judicially declared, the Fund typically immediately takes over the handling of tens of thousands of covered claims previously administered by the insolvent insurer. Accordingly, here the Fund is burdened by the large number of claims it received from Trust, numbering over 20,000 claims, including 6,000 PIP claims.

DISCUSSION

Summary judgment is granted where there are no issues of genuine material fact, and the moving party is entitled to judgment as a matter of law. Hakim v. Massachusetts Insurers’ Insolvency Fund, 424 Mass. 275, 283 (1997); Kourouvacilis v. General Motors Corp., 410 Mass. 706, 716 (1991); Cassesso v. Commissioner of Correction, 390 Mass. 419, 422 (1983); Mass.R.Civ.P. 56(c). The moving party bears the burden of affirmatively demonstrating that there is no triable issue of fact. Pederson v. Time, Inc., 404 Mass. 14, 17 (1989). Here, there are cross motions, such that both plaintiff and defendant argue that there are no material facts in dispute, and each claims that the Court can, and should, rule in its favor based solely upon an interpretation of the statutory language and the setting in which it exists.

Before reaching the statutory issues, the Court observes AFC’s argument that there is no actual controversy which satisfies the requirements of G.L.c. 231A. This Court disagrees. The purpose of c. 231A is to afford relief from uncertainty and insecurity with respect to rights, duties, status and other legal relations. City of Boston v. Keene Corp., 406 Mass. 301, 304-05 (1989). The Fund has uncertainty and insecurity with regard to each of the 6,000 PIP claims it assumed upon Trust’s insolvency. There is enough of a real dispute here to permit this Court to proceed and address the merits. See Commissioner of Correction v. Ferguson, 383 Mass. 651, 653 (1981).

[344]*344The Court now begins its analysis of the merits by examining the statutory powers granted to the Fund by G.L.c. 175D, Sec. 5(1 )(a) and (b):

(1) The Fund shall:
(a) be obligated to the extent of the covered claims against the insolvent insurer existing prior to the declaration of insolvency and arising within sixty days after the declaration of insolvency . . . but such obligation shall include only that amount of each covered claim which ... is less than three hundred thousand dollars.
(b) be deemed the insurer to the extent of its obligations on the covered claims and shall have all rights, duties and obligations of the insolvent insurer to such extent; . . .

The definition of a “covered claim” in Sec. 1 of c. 175D is: “an unpaid claim, including one for unearned premiums, which arises out of and is within the coverage of an insurance policy to which this chapter applies issued by an insurer, if such insurer becomes an insolvent insurer and (a) the claimant or insured is a resident of the commonwealth; or (b) the property from which the claim arises is presently located in the commonwealth.”

Statutory interpretation presents a question of law for the Court to decide. Annese Elec. Services, Inc. v. City of Newton, 431 Mass. 763, 767 (2000). In so doing, the primary duty of a judge is to give effect to the Legislature’s intent. Pielech v. Massasoit Greyhound, Inc., 423 Mass. 534, 539 (1996); Callan v. Winters, 404 Mass. 198, 202 (1989); Sterilite Corp. v. Continental Cas. Co., 397 Mass. 837, 839 (1986). The legislative intent must be ascertained from all of a statute’s words, construed by ordinary and approved usage of the language, considered in connection with the cause of its enactment, the mischief or imperfection to be remedied and the main object to be accomplished. Acting Superintendent of Bournewood Hospital v. Baker, 431 Mass. 101, 104 (2000); Bombardieri v. Registrar of Motor Vehicles, 426 Mass. 371, 374 (1998).

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