covered claim in Pennsylvania

2006As our Supreme Court noted in Bell , "once a party is found to possess a covered claim for purposes of the Act, ... it is then the obligation and duty of PPCIGA to pay such claim unless the [Act] provides a basis for [PPCIGA] not being obligated on such claim.” Bell, 571 Pa. at 345 , 812 A.2d at 573 .

2006As our Supreme Court noted in Bell , "once a party is found to possess a covered claim for purposes of the Act, ... it is then the obligation and duty of PPCIGA to pay such claim unless the [Act] provides a basis for [PPCIGA] not being obligated on such claim.” Bell, 571 Pa. at 345 , 812 A.2d at 573 .

2001The statute at the center of this dispute is 40 Pa.C.S. §991.1817, under which “[a]ny amount payable on a covered claim... shall be reduced by the amount of any recovery under other insurance.” 40 Pa.C.S. §991. 1817(a). (emphasis added) Prior to February 10, 1995, the set-off allowance was narrower and permitted payment obligations to be set off only with recovery under another covered claim, then defined as a claim arising “under a property and casualty insurance policy of an insolvent insurer. . . .” 40 Pa.C.S. §§1701.103(5)(a), 1701.503(a), repealed, February 10,1995. 5 Cf. Sands v. Pennsyl

2001The statute at the center of this dispute is 40 Pa.C.S. §991.1817, under which “[a]ny amount payable on a covered claim... shall be reduced by the amount of any recovery under other insurance.” 40 Pa.C.S. §991. 1817(a). (emphasis added) Prior to February 10, 1995, the set-off allowance was narrower and permitted payment obligations to be set off only with recovery under another covered claim, then defined as a claim arising “under a property and casualty insurance policy of an insolvent insurer. . . .” 40 Pa.C.S. §§1701.103(5)(a), 1701.503(a), repealed, February 10,1995. 5 Cf. Sands v. Pennsyl

2007It read the first sentence “to require that a claimant covered by a first-party or third-party insurance contract for the same injury for which the claimant is making a ‘covered claim’ under the PPCIGA Act must first exhaust all benefits available under that policy as provided by the insurance contract.” Carrozza, 866 A.2d at 886 (footnote omitted).

2006"PPCIGA is an agency created by the Pennsylvania legislature to provide limited statutory benefits when there is a covered claim arising under the insurance policy of an insolvent insurer .... ” Carrozza v. Greenbaum, 866 A.2d 369 , 375 n. 6 (Pa.Super.2004), appeal denied, 584 Pa. 698 , 882 A.2d 1004 (2005). .Although VMF and Dr. Crozier filed Motions for Judgment on the Pleadings, the trial court found that there were no factual disputes, and treated the motions as if they requested summary judgment. .

2001Any amount payable on a covered claim under this Act shall be reduced by the amount of recovery under other insurance.” 40 Pa.C.S. §991.1801 Purpose states in relevant part as follows: “to . . . avoid financial loss to claimants or policyholders as a result of the insolvency of an insurer.” The case of McCarthy v. Bainbridge, 739 A.2d 200 (Pa. Super. 1999), decided by our Superior Court, held that the nonduplication provision of the statute in question only prohibits recovering duplicatively, i.e., twice for the same loss, that is, in order to provide a setoff for PPCIGA, there must be some re

2001Any amount payable on a covered claim under this act shall be reduced by the amount of any recovery under other insurance. 40 P.S. § 991.1817(a). ¶ 6 The primary function of PPCIGA is “to provide protection to claimants whose insurers have become insolvent.” McCarthy v. Bairibridge, 739 A.2d 200, 202 (Pa.Super.1999), appeal granted, 563 Pa. 647 , 758 A.2d 1200 (2000).

1989Henninger v. Riley, 317 Pa. Super. 570 , 464 A.2d 469 (1983).

1989Henninger v. Riley, 317 Pa. Super. 570 , 464 A.2d 469 (1983).

2017See Commonwealth v. Breakiron, 781 A.2d 94 (Pa. 2001).

2014See, e.g., Texas Department of Insurance v. American National Insurance Co., 410 S.W.3d 843 (Tex.2012); Edstrom Industries, Inc. v. Companion Life Insurance Co., 516 F.3d 546 (7th Cir.2008), abrogation on other grounds recognized by Affymax, Inc. v. Ortho-McNeil-Janssen Pharmaceuticals, Inc., 660 F.3d 281, 285 (7th Cir.2011); Iowa Contractors Workers’ Compensation Group v. Iowa Insurance Guaranty Assoc., 437 N.W.2d 909 (Iowa 1989).

2014See, e.g., Texas Department of Insurance v. American National Insurance Co., 410 S.W.3d 843 (Tex.2012); Edstrom Industries, Inc. v. Companion Life Insurance Co., 516 F.3d 546 (7th Cir.2008), abrogation on other grounds recognized by Affymax, Inc. v. Ortho-McNeil-Janssen Pharmaceuticals, Inc., 660 F.3d 281, 285 (7th Cir.2011); Iowa Contractors Workers’ Compensation Group v. Iowa Insurance Guaranty Assoc., 437 N.W.2d 909 (Iowa 1989).

2011See Besaclc v. Rouselle Corp., 706 F.Supp. 385, 386 (E.D.Pa.), aff'd 879 F.2d 855 (3d Cir.1989) (under Pennsylvania workers’ compensation law, where a third-party claimant recovers from another solvent insurer, the claim is not unpaid and is, therefore, not a covered claim).

2011See Besack v. Rouselle Corp., 706 F.Supp. 385, 386 (E.D.Pa.), aff'd 879 F.2d 855 (3d Cir.1989) (under Pennsylvania workers' compensation law, where a third-party claimant recovers from another solvent insurer, the claim is not unpaid and is, therefore, not a covered claim).

2011See Besaclc v. Rouselle Corp., 706 F.Supp. 385, 386 (E.D.Pa.), aff'd 879 F.2d 855 (3d Cir.1989) (under Pennsylvania workers’ compensation law, where a third-party claimant recovers from another solvent insurer, the claim is not unpaid and is, therefore, not a covered claim).

2011See Besack v. Rouselle Corp., 706 F.Supp. 385, 386 (E.D.Pa.), aff'd 879 F.2d 855 (3d Cir.1989) (under Pennsylvania workers' compensation law, where a third-party claimant recovers from another solvent insurer, the claim is not unpaid and is, therefore, not a covered claim).

2005Pappas v. Asbel, 564 Pa. 407, 418 , 768 A.2d 1089,1095 (2001) (citations omitted). ¶ 7 PPCIGA is an agency created by the Pennsylvania legislature under the Guaranty Act to provide limited statutory benefits when there is a covered claim arising under the insurance policy of a property or casualty insurer deemed to be insolvent.

2005Pappas v. Asbel, 564 Pa. 407, 418 , 768 A.2d 1089,1095 (2001) (citations omitted). ¶ 7 PPCIGA is an agency created by the Pennsylvania legislature under the Guaranty Act to provide limited statutory benefits when there is a covered claim arising under the insurance policy of a property or casualty insurer deemed to be insolvent.

2004In all other respects, PPCIGA “is placed in the stead of the insolvent insurer, with all of that insurer’s rights and duties and obligations,” Donegal Mutual Insurance Co. v. Long, 528 Pa. 295, 300-301 , 597 A.2d 1124, 1127 (1991), including the duty under 40 P.S. §991.1803(b)(4) to investigate, compromise, settle and pay covered claims.

2004In all other respects, PPCIGA “is placed in the stead of the insolvent insurer, with all of that insurer’s rights and duties and obligations,” Donegal Mutual Insurance Co. v. Long, 528 Pa. 295, 300-301 , 597 A.2d 1124, 1127 (1991), including the duty under 40 P.S. §991.1803(b)(4) to investigate, compromise, settle and pay covered claims.

2002See Panea, 773 A.2d at 797 (Del Sole, concurring). [5] See also Rhode Island Insurers' Insolvency Fund v. Benoit, 723 A.2d 303, 307 (R.I.1999) ("we agree with the jurisdictions that have held that `[t]he language is ambiguous if not contradictory,' [and] that `the interrelationship of the clauses and phrases is confusing'" (citations omitted)); Cimini v. Nevada Ins.

2002See Panea, 773 A.2d at 797 (Del Sole, concurring). [5] See also Rhode Island Insurers' Insolvency Fund v. Benoit, 723 A.2d 303, 307 (R.I.1999) ("we agree with the jurisdictions that have held that `[t]he language is ambiguous if not contradictory,' [and] that `the interrelationship of the clauses and phrases is confusing'" (citations omitted)); Cimini v. Nevada Ins.

2001In Chester Extended Care Center v. DPW, 526 Pa. 350, 354 , 586 A.2d 379, 382 (1991), our Supreme Court explained the doctrine of estoppel as follows: The doctrine of estoppel is an equitable remedy that may be asserted against the government in this jurisdiction.

2001In Chester Extended Care Center v. DPW, 526 Pa. 350, 354 , 586 A.2d 379, 382 (1991), our Supreme Court explained the doctrine of estoppel as follows: The doctrine of estoppel is an equitable remedy that may be asserted against the government in this jurisdiction.

1998To illustrate, a section of the Act specifically prohibits insurers from using the category “covered claim” to mean amounts due them from other insurers: A covered claim shall not include any amount due any insurer ... as a subrogation recovery or otherwise. 573 A.2d at 1143 (citations omitted) (quoting Blackwell v. Pennsylvania Insurance Guaranty Assoc., 390 Pa.Super. 31 , 567 A.2d 1103 , 1106 (Pa.Super.1989)).

1944See also Mulheirn v. Brown, 322 Pa. 171 , *529 176, 185 A. 304 ; Miller v. Southern Asphalt Company et al., 314 Pa. 289, 297 , 171 A. 472 .

1944See also Mulheirn v. Brown, 322 Pa. 171 , *529 176, 185 A. 304 ; Miller v. Southern Asphalt Company et al., 314 Pa. 289, 297 , 171 A. 472 .