Mercado-Boneta v. Administracion Del Fondo De Compensacion Al Paciente Ex Rel. Insurance Commissioner

125 F.3d 9, 1997 WL 547344
CourtCourt of Appeals for the First Circuit
DecidedSeptember 11, 1997
Docket97-1354
StatusPublished
Cited by51 cases

This text of 125 F.3d 9 (Mercado-Boneta v. Administracion Del Fondo De Compensacion Al Paciente Ex Rel. Insurance Commissioner) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mercado-Boneta v. Administracion Del Fondo De Compensacion Al Paciente Ex Rel. Insurance Commissioner, 125 F.3d 9, 1997 WL 547344 (1st Cir. 1997).

Opinion

LYNCH, Circuit Judge.

This ease raises questions under the Contract Clause of the United States Constitution concerning a government’s power to regulate insurance companies facing insolvency by barring claims asserted after a particular date by insureds. If that power is upheld, then Dr. Fernandez is essentially uninsured on the malpractice claim and it may be that the malpractice plaintiffs will recover nothing regardless of the merits of their claim.

Manuel Mercado-Boneta brought a medical malpractice action against Dr. Elliot Fernandez and Fernandez’s insurer, the Patient’s Compensation Fund Administration (“PCFA”). Dr. Fernandez also claimed over against PCFA PCFA moved for dismissal on the grounds that, inter alia, PCFA had been dissolved by an act of the legislature and was no longer liable on Dr. Fernandez’s insurance policy. The district court granted the motion. Dr. Fernandez and Mereado-Boneta appeal jointly from that dismissal, arguing *11 that the act of the legislature violates the Contract Clause of the United States Constitution. We find no constitutional violation, and affirm.

I.

During the time of the alleged malpractice, Dr. Fernandez was covered by PCFA under an occurrence policy. 1 However, PCFA was abolished before Mercado-Boneta filed his claim against Dr. Fernandez. 2 The Legislature of the Commonwealth of Puerto Rico abrogated PCFA by Act of Dec. 30,1986, Act No. 4, 1986 P.R. Laws 869 (“Act No. 4”), stating that PCFA was not adequately fulfilling its intended purpose and was at risk of imminent insolvency. The operations of PCFA were endangered and the insureds and their patients were at risk of not being compensated for their losses. Id. at 871 (“Statement of Motives”).

Despite the legislature’s dissolution of PCFA, Mercado-Boneta sued PCFA 3 as an insurer of Dr. Fernandez. 4 PCFA moved for dismissal on the grounds that it had been dissolved by Act No. 4, that it lacked funds to assume financial responsibility for claims, and that it was immune from suit in Federal Court under the Eleventh Amendment. The district court granted PCFA’s motion to dismiss on the first ground alone. The court found that PCFA was legally extinct, and that Act No. 4 did not permit the Insurance Commissioner, as PCFA’s legal representative, to honor claims filed against PCFA subsequent to its abolition on December 30, 1986. Because Mercado-Boneta filed his claim against Dr. Fernandez later than December 30, 1986, the Insurance Commissioner was held not responsible to Dr. Fernandez for any liability he incurred as a result of Mercado-Boneta’s claim. The court also found that PCFA’s successor for certain purposes, the Insurers’ Syndicate, was not responsible for any claims filed against PCFA.

Both Mercado-Boneta and Dr. Fernandez moved for reconsideration of the dismissal of PCFA on the grounds that Act No. 4, as interpreted by the district court, violated the Contract Clause of the United States Constitution. The district court held that although Act No. 4 did substantially impair a contractual obligation, the Act was reasonable and necessary to an important public purpose, and thus did not violate the Contract Clause.

II.

A. .

As an initial matter, we note that we have jurisdiction to resolve the merits of this ease. *12 PCFA has raised this issue on appeal. PCFA argues that because it is an “arm of the state,” and because the suit is one potentially involving money damages, the Eleventh Amendment bars a federal court from hearing this claim against it. The parties raised this issue in the district court, but that court did not reach the issue, disposing of the suit against PCFA on other grounds. Whether PCFA is an “arm of the state” for Eleventh Amendment (or, for that matter, Contract Clause) purposes is a difficult question. Because we readily find that Act No. 4 bars suit against PCFA for claims filed after Dec. 30, 1986, and that such a result does not violate the Contract Clause, we pretermit resolution of this jurisdictional issue. See Norton v. Mathews, 427 U.S. 524, 530-32, 96 S.Ct. 2771, 2774-76, 49 L.Ed.2d 672 (1976) (where merits can be readily resolved in favor of the party challenging jurisdiction, resolution of complex jurisdictional issue may be avoided); Birbara v. Locke, 99 F.3d 1233, 1237 (1st Cir.1996).

B.

We review de novo orders allowing a motion to dismiss for failure to state a claim. Aulson v. Blanchard, 83 F.3d 1, 3 (1st Cir.1996). It is clear, constitutional issues aside, that Act No. 4 bars the claims of both Dr. Fernandez and Mercado-Boneta. At the time that Mercado-Boneta brought his malpractice claim against Dr. Fernandez, the Legislature of the Commonwealth of Puerto Rico had expressly abolished PCFA by Act No. 4, and replaced it with the Insurers’ Syndicate. Act No. 4 at § 3, 1986 P.R. Laws 871, 885. PCFA was no longer legally capable of fulfilling its obligations under the insurance policy. The Act further provided that the Insurance Commissioner of Puerto Rico would oversee the implementation of the newly formed Insurers’ Syndicate, “it being understood, that the Syndicate shall not assume financial responsibility for any claims filed against the abolished Patient’s Compensation Fund Administration.” Id. According to the plain language of this statute, the Insurers’ Syndicate was not the successor in interest of PCFA for purposes of assuming PCFA’s liabilities, and could not be held hable for claims arising under policies issued by PCFA.

Nor could the Insurance Commissioner be held hable as PCFA’s representative for claims filed against PCFA subsequent to the enactment of Act No. 4. Although the Act provides that the Insurance Commissioner shall continue to be responsible for claims and procedures initiated with PCFA on or before the enactment of Act No. 4, it makes no provision for claims filed with PCFA after the enactment of Act No. 4. Id. Act No. 4 exempts PCFA from habihty on malpractice claims filed after December 30,1986, through the Insurers’ Syndicate, the Insurance Commissioner, or otherwise.

C.

Mercado-Boneta 5 and Dr. Fernandez argue that Act No. 4 nonetheless violates the prohibition in Article 1, § 10, cl. 1 of the United States Constitution, that “[n]o state shall ... pass any ... law impairing the obligation of contracts____” Mercado-Bone-ta and Fernandez assert that under Dr. Fernandez’s occurrence pohcy with PCFA, PCFA was contractually obligated to reimburse Dr. Fernandez for future claims arising out of negligent acts which occurred during the time the policy was in effect. They argue that because Act No.

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125 F.3d 9, 1997 WL 547344, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mercado-boneta-v-administracion-del-fondo-de-compensacion-al-paciente-ex-ca1-1997.