Tesfamariam v. District of Columbia Department of Consumer & Regulatory Affairs, Insurance Administration

645 A.2d 1105, 1994 D.C. App. LEXIS 130, 1994 WL 424218
CourtDistrict of Columbia Court of Appeals
DecidedAugust 11, 1994
Docket93-AA-33
StatusPublished
Cited by7 cases

This text of 645 A.2d 1105 (Tesfamariam v. District of Columbia Department of Consumer & Regulatory Affairs, Insurance Administration) is published on Counsel Stack Legal Research, covering District of Columbia Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Tesfamariam v. District of Columbia Department of Consumer & Regulatory Affairs, Insurance Administration, 645 A.2d 1105, 1994 D.C. App. LEXIS 130, 1994 WL 424218 (D.C. 1994).

Opinion

SCHWELB, Associate Judge:

Petitioner Almaz Tesfamariam seeks review of a decision by the Insurance Administration of the Department of Consumer and Regulatory Affairs denying her compensation from the Uninsured Motorist Fund. We reverse and remand for further proceedings by the agency.

I.

FACTS AND PROCEDURAL HISTORY

On January 17,1988, at approximately 3:00 a.m., Ms. Tesfamariam, a housekeeper at a Holiday Inn, was a passenger in a taxicab 1 which was being operated by her husband, Selemun Woldu. According to Ms. Tesfa-mariam, Mr. Woldu failed to stop at a flashing red traffic light, and the cab was struck on the passenger side by an oncoming vehicle owned and operated by Kenneth P. Barzey. Ms. Tesfamariam suffered injuries, some of them permanent, to her head, neck, back and knee. Ms. Tesfamariam required prolonged medical treatment and missed almost a year of work. She claimed before the agency that she incurred medical expenses of $14,522.50 and that she lost wages in the amount of $13,950.00.

The taxicab in which Ms. Tesfamariam was riding was registered in Mr. Woldu’s name; Ms. Tesfamariam has never had an operator’s license and does not drive at all. Mr. Woldu carried no liability insurance. Ms. *1107 Tesfamariam had health insurance through her employer with Kaiser Permanente, a health maintenance organization (HMO), under a plan which entitled her to benefits only if her treatment was provided by Kaiser-affiliated health care providers. Ms. Tesfa-mariam apparently believed that the plan only covered illness and not accidental injuries, and she was treated by physicians who were not affiliated with Kaiser. As a result, her medical expenses have not been reimbursed by Kaiser.

Following the accident, Ms. Tesfamariam filed suit in the Superior Court against Mr. Barzey. See Civil Action No. 88-CA-010188 (Super.Ct.D.C.). Mr. Barzey filed a third party claim against Mr. Woldu, claiming that Mr. Woldu was responsible for the accident. Mr. Woldu defaulted, and Ms. Tesfamariam won a judgment against him in the amount of $128,472.00. 2 Except for a successfully garnished bank account in the amount of $412.62, however, Ms. Tesfamariam was unable to collect the judgment.

Ms. Tesfamariam next filed a claim against the District of Columbia’s Uninsured Motorist Fund (“the Fimd”) pursuant to D.C.Code § 35-2114 (1993). By letter dated March 2, 1992, her application for benefits was denied on the ground that she was insured by Kaiser Permanente at the time of the accident and that her alleged wage loss was not properly documented. The initial denial was not based on any claim that she was an owner of the vehicle.

Ms. Tesfamariam requested an administrative hearing. On May 11,1992, the presiding Administrative Law Judge (ALJ) convened a hearing, but he aborted it because he became concerned about Ms. Tesfamariam’s limited ability to communicate in English. On June 2, 1992, a second hearing was held, and an Ethiopian interpreter was made available to translate the proceedings from and into Ms. Tesfamariam’s native Tigrane. After the hearing, the ALJ issued a written decision in which he held that Ms. Tesfamariam was not entitled to reimbursement from the Fund either for her medical expenses or for her lost wages. The ALJ reasoned that because Ms. Tesfamariam was married to Mr. Woldu and contributed to the expenses of household, and because she would have been entitled to a share of the family’s assets, including the vehicle, in the event of a divorce proceeding, she was an “owner” of the motor vehicle and thus ineligible for benefits. The ALJ further concluded that Ms. Tesfamar-iam was an “insured” within the meaning of the Uninsured Motorist Fund statute. The agency upheld the ALJ’s decision, and Ms. Tesfamariam sought judicial review in this court.

II.

LEGAL DISCUSSION

A. The Statute.

The Uninsured Motorist Fund was established in 1986 to provide compensation for victims of automobile accidents in the District of Columbia who “would not otherwise be compensated for [their] loss[es].” D.C.Code § 35-2114(a). 3 The Fund, which is maintained by assessments on all automobile insurers, is a deposit account in the District’s treasury. D.C.Code § 35-2114(a).

A victim is ineligible for compensation from the Fund if he or she “is at fault, is an insured, owns a registered motor vehicle, or operated a motor vehicle in the accident upon which the claim is based.” D.C.Code § 35-2114(c) (emphasis added). The Compulsory/No-Fault Motor Vehicle Insurance Act of 1982, to which the Fund legislation was added in 1986, defines “owner” as a person “having the property or title to a vehicle ... used or operated in the District-” D.C.Code § 35-2102(21). The statute defines “insured” as “a named insured or any other person insured in an insurance policy.... ” The ALJ held, in effect, that Ms. Tesfamar-iam was both an “owner” and an “insured.”

*1108 B. Scope of Review.

In Tenants of 738 Longfellow Street, N.W. v. District of Columbia Rental Hous. Comm’n, 575 A.2d 1205 (D.C.1990), we explicated the applicable standard of review as follows:

This court accords great deference to the interpretation by an agency of a statute or regulation which it administers.... We will reject the [agency’s] interpretation of its regulations only if it is plainly wrong or incompatible with the statutory purposes. The deference which courts owe to agency interpretations of statutes which they administer is, of course, at its zenith where the administrative construction has been consistent and of long standing, and plummets substantially when these attributes are lacking.

Id. 575 A.2d at 1213 (citations omitted).

Courts defer to an agency’s interpretation, in substantial part, because of its presumed expertise in the subject matter with which it administers and with which it is familiar. Accordingly, we give less weight to an agency’s construction where the statute which it is construing is one which it does not administer, and as to which it therefore lacks special knowledge and expertise. District of Columbia Metro. Police Dep’t v. Perry, 638 A.2d 1138, 1144 (D.C.1994).

C. The Meaning of “Owner.”

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645 A.2d 1105, 1994 D.C. App. LEXIS 130, 1994 WL 424218, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tesfamariam-v-district-of-columbia-department-of-consumer-regulatory-dc-1994.