Sotack v. Pennsylvania Property & Casualty Insurance Guaranty Ass'n

104 F. Supp. 2d 471, 2000 U.S. Dist. LEXIS 9169, 2000 WL 892845
CourtDistrict Court, E.D. Pennsylvania
DecidedJune 28, 2000
DocketNo. CIV. A. 99-CV-4709
StatusPublished
Cited by1 cases

This text of 104 F. Supp. 2d 471 (Sotack v. Pennsylvania Property & Casualty Insurance Guaranty Ass'n) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sotack v. Pennsylvania Property & Casualty Insurance Guaranty Ass'n, 104 F. Supp. 2d 471, 2000 U.S. Dist. LEXIS 9169, 2000 WL 892845 (E.D. Pa. 2000).

Opinion

MEMORANDUM & ORDER

ANITA B. BRODY, District Judge.

Before me is defendants’ motion for summary judgment on the basis that defendants are not state actors.1 For the [473]*473following reasons, I conclude that defendant Pennsylvania Property and Casualty Insurance Guaranty Association (“PPCI-GA”) is a government entity and its operatives are state actors, and therefore, I will deny defendants’ motion.

1. FACTS

In 1993, Jess Sotack was severely injured in an automobile accident. After the accident, Sotack was treated for his injuries at Gnaden Huetten Memorial Hospital (the “Hospital”) by Doctors Peter Tey and Athanasios Houides. Sotack died from his injuries on September 4, 1993. At the time of his death, Sotack had various insurance policies, including an automobile insurance policy, a group health insurance policy, an accidental death policy and two life insurance policies. The accidental death and life insurance policies totaled $89,000 and named Sotack’s widow, plaintiff Danica Sotack, as their beneficiary. . The group health insurance and automobile insurance carriers paid Sotack’s medical expenses, which totaled $193,000, and the proceeds of the life insurance and accidental death policies were paid to plaintiff.

On November 2, 1994, plaintiff filed a wrongful death and survival action against the Hospital and Doctors Tey and Houides. Plaintiff settled the disputes with Tey and the Hospital, but did not settle her claims against Houides. Houides had a medical malpractice insurance policy for $200,000 with PIC Insurance Group, Inc. (“PIC”), but PIC had previously been declared insolvent and placed in liquidation by the Commonwealth of Pennsylvania. Because PIC was insolvent, PPCIGA, pursuant to the PPCIGA Act, 40 P.S. § 991.1801 et seq. (“the Act”), became Houides’s primary insurer.

As Houides’s insurer, PPCIGA provided counsel to defend Houides against plaintiffs claims. On June 8, 1998, plaintiffs malpractice claims against Houides proceeded to trial in the Pennsylvania Court of Common Pleas of Monroe County. The jury returned a verdict in favor of plaintiff for $550,000.2 At trial, PPCIGA, as counsel for Houides, moved for the preclusion of medical bills, a motion granted by the trial judge. On January 29, 1999, plaintiff made a demand on PPCIGA for $200,000, Houides’s policy limit under his malpractice policy with PIC.

Three days later, on February 2, 1999, Aaron Tanitsky, a Claims Consultant employed by PPCIGA, informed plaintiff that PPCIGA denied her demand for payment. PPCIGA’s stated reason for rejecting plaintiffs claim was that Section 1817 of the Act directs PPCIGA to offset the amount of its payment by the amount that the claimant has received through other insurance policies and that medical benefits and life insurance had already been paid to plaintiff by other insurers. Because the payments to plaintiff by other insurers totaled more than $200,000, PPCIGA offset its entire payment to plaintiff under Section 1817, and therefore, rejected her claim.

Plaintiff then filed this suit pursuant to 42 U.S.C. § 1983 against PPCIGA, Tanit-sky, and Homer Rhule, director of PPCI-GA, claiming that the defendants acted under the color of state law to deprive her of her constitutionally-protected property right in her insurance policies.3 See PI. Br. at 6. Defendants now move for summary judgment on the basis that they are not state actors, and therefore, they cannot be liable under § 1983. Plaintiff contends that PPCIGA and PPCIGA operatives are state actors and can be liable under § 1983. Thus, the sole issue in this motion for summary judgment is whether [474]*474PPCIGA is a state actor for Section 1983 purposes.

II. DESCRIPTION OF PPCIGA

PPCIGA, created by 40 P.S. §§ 991.1801 et seq., is a mandatory association of all property and casualty insurance carriers that are authorized to write policies in Pennsylvania.4 See 40 P.S. § 991.1803(a). Every insurer is required to participate in PPCIGA as a condition of its authority to write property and casualty insurance policies in Pennsylvania. See id.; see also, T & N PLC v. Pennsylvania Insurance Guaranty Assoc., 800 F.Supp. 1259, 1263 (E.D.Pa.1992). The purposes of PPCIGA are (1) to provide a remedy for claimants when the insurance carrier is insolvent, and (2) to assist in the detection and prevention of insolvencies of insurance carriers. See 40 P.S. §§ 991.1801(1), (2). PPCIGA provides a safety-net for insurance claims when the insurance carrier becomes insolvent. When a member insurance carrier becomes insolvent, PPCI-GA steps into the shoes of the insolvent carrier and provides a “last resort” remedy for “covered claims.” See 40 P.S. § 991.1803(b)(2); see also, Bethea v. Forbes, 519 Pa. 422, 428, 548 A.2d 1215, 1218 (1988) (J. Zappala, concurring) (stating that the payment by PPCIGA is a “stopgap measure”).

Because the PPCIGA payment is a last resort, claimants are required to exhaust all other insurance policies before filing a PPCIGA claim, and PPCIGA payment must be offset by amounts already paid to the claimant by other insurance policies. See 40 P.S. § 991.1817(a).5 In addition to the offset in Section 1817, PPCIGA payment is limited to a maximum of $300,000. See 40 P.S. § 991.1803(b)(l)(i)(B).

PPCIGA is also required to notify the Commissioner of the Department of Insurance of the Commonwealth of Pennsylvania (the “Commissioner”) of “any information indicating any member insurer may be insolvent or in such condition that its further transaction of business will be hazardous to its policyholders, to its creditors, or to the public.” 40 P.S. § 991.1803(b)(8). After a member insurer has been declared insolvent, the Act mandates that PPCIGA prepare a report for the Commissioner about the history and causes of the insolvency. See 40 P.S. § 991.1803(b)(9). PPCIGA is also required, at the direction of the Commissioner, to notify the insureds and any other interested parties that an insurer has been declared insolvent. See 40 P.S. § 991.1812(b)(1).

[475]*475In the performance of its duties, PPCI-GA is governed by the PPCIGA Act. See 40 P.S. §§ 991.1801 et seq. The Act provides for extensive supervision and regulation of PPCIGA by the Commissioner. See 40 P.S. § 991.1805. Section 1805 empowers the Commissioner with broad powers over PPCIGA, stating:

The operations of the association shall at all times be subject to the supervision and regulation of the commissioner. The commissioner or any person designated by him shall have the power of visitation of and examination into such operations at any time in the discretion of the commissioner.

See 40 P.S. § 991.1805. In addition to his powers under Section 1805, the Commissioner must approve PPCIGA’s proposed Plan of Operations, which governs “the administration of the association.”6 40 P.S. §§ 991.1808(d)(1), (2); see also, Dep. of Steven Perrone, Def. Supp. Br., App. A (“Perrone Dep.”) at 30. If the Commissioner considers PPCIGA’s proposal unsatisfactory, PPCIGA is required to revise its proposal. See id.

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Sotack v. PENNSYLVANIA PROPERTY & CAS. INS. GUAR. ASS'N.
104 F. Supp. 2d 471 (E.D. Pennsylvania, 2000)

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Bluebook (online)
104 F. Supp. 2d 471, 2000 U.S. Dist. LEXIS 9169, 2000 WL 892845, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sotack-v-pennsylvania-property-casualty-insurance-guaranty-assn-paed-2000.