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EMPLOYEE BENEFIT PLAN HARLEYSVILLE MUTUAL INSURANCE COMPANY AND HARLEYSVILLE MUTUAL INSURANCE COMPANY AND DEFORREST VONLAUFER v. GEORGE F. GRODE (01/12/88)

decided: January 12, 1988.

EMPLOYEE BENEFIT PLAN OF HARLEYSVILLE MUTUAL INSURANCE COMPANY AND HARLEYSVILLE MUTUAL INSURANCE COMPANY AND DEFORREST VONLAUFER, PETITIONER
v.
GEORGE F. GRODE, IN HIS CAPACITY AS INSURANCE COMMISSIONER FOR THE COMMONWEALTH OF PENNSYLVANIA AND CHAIRMAN OF THE CATASTROPHIC LOSS TRUST FUND BOARD, RESPONDENT



Appeal from the Order of the Insurance Commissioner of the Commonwealth of Pennsylvania in the case of In Re: Marion Lyons, No. CF85-1, and In Re: DeForrest VonLaufer, No. CF85-2.

COUNSEL

Jane Dalton Elliott, with her, James J. McCabe, and Amy E. Wilkinson, Duane, Morris & Heckscher, for petitioners.

Richard J. Enterline, Assistant Counsel, with him, M. Hannah Leavitt, Chief Counsel, for respondent

Judges Barry and Colins, and Senior Judge Barbieri, sitting as a panel of three. Opinion by Judge Barry.

Author: Barry

[ 112 Pa. Commw. Page 471]

In Harleysville Mutual Insurance Co. v. Catastrophic Loss Trust Fund, 101 Pa. Commonwealth Ct. 215, 515 A.2d 1039 (1986), we sustained preliminary objections filed by the Catastrophic Loss Trust Fund (CAT Fund) and dismissed two petitions for review filed in our original jurisdiction by Harleysville Mutual Insurance Co. (Harleysville) and the Employee Benefit Plan of Harleysville Mutual Insurance Co. (Benefit Plan). In essence, both Harleysville and the Benefit Plan were challenging the CAT Fund's denial of benefits to two individuals

[ 112 Pa. Commw. Page 472]

    who had been seriously injured in automobile accidents.*fn1 We sustained the CAT Fund's preliminary objections, primarily relying upon the failure of Harleysville and the Benefit Plan to avail themselves of adequate administrative remedies before the Insurance Commissioner. Following our dismissal of the petitions for review there, appellants Harleysville, the Benefit Plan and DeForrest VonLaufer (one of the two accident victims) appealed to the Insurance Commissioner which upheld the CAT Fund's denial of benefits. This appeal followed.

Because of the recitation of facts in our prior opinion, we need give only a very brief factual narrative here. VonLaufer had been issued a no-fault insurance policy by Harleysville prior to October 1, 1984. Marion Lyons (the other individual referred to above) had been issued a no-fault policy prior to October 1, 1984. She was an employee of Harleysville and therefore insured by the Benefit Plan. On October 1, 1984, the Motor Vehicle Financial Responsibility Law, 75 Pa. C.S. ยงยง 1701-1798, became effective. Section 1766 provided that except in the case of workmen's compensation, the CAT Fund would be the primary source for paying reasonable and necessary medical expenses and rehabilitative services, when they exceeded $100,000, up to a lifetime maximum for an eligible claimant of $1,000,000. VonLaufer's accident occurred on October 30, 1984 while Lyons' accident occurred on December 8, 1984. At the time of the accidents, each individual's no-fault policy, issued before the effective date of Financial Responsibility Law, was in effect. Because of the

[ 112 Pa. Commw. Page 473]

    no-fault coverage, the CAT Fund denied benefits. After the Insurance Commissioner eventually affirmed the CAT Fund's denial of benefits, appellants sought relief from this Court.

Before proceeding, we believe it apt to quote the observations of President Judge Cercone of the Superior Court when that court was called upon to review portions of the predecessor to the Financial Responsibility Law.

At the outset we caution anyone who embarks on the high seas of Pennsylvania's No-Fault Motor Vehicle Insurance Act not to do so without a good compass, a knowledge of reefs and storms and plenty of food and water. Any attempt to choose an alternate route by land in an effort to unlock the secrets ...


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