PaTLA, defense bar file joint Amicus brief in subrogation case
(7/20/2004) -- Recently, Scott B. Cooper, of Harrisburg, on behalf of the PaTLA Amicus Committee co-authored an Amicus Brief along with the Pennsylvania Defense Institute in Wirth v. AETNA, which is on appeal to the Third Circuit. To see the joint Brief, click on the 'Related File' below.
The case arises on appeal from the United States District Court for the Eastern District of Pennsylvania where individuals filed a class action against Aetna U.S. Healthcare. All the individuals seeking class certification sustained injuries as a result of car accidents. Aetna U.S. Healthcare is an ERISA plan and health maintenance organization, which paid part of the medical benefits for injuries under provisions of the health care maintenance organization plan. After the injured (including Wirth) obtained settlements from the third party tortfeasors, Aetna asserted a lien against the settlement proceeds to obtain reimbursement for medical bills expended.
There was no dispute that the terms of the of the Aetna health maintenance organization plan authorized a lien, however, Wirth contended that the lien violates the terms of the Pennsylvania Motor Vehicle Financial Responsibility Law, specifically, 75 Pa.C.S.A. §1720, which precludes subrogation of a car accident.
The Court for the Eastern District of Pennsylvania held that pursuant to FMC Corp. v. Holliday, 498 U.S. 54 (1990) that §1720 does not abrogate the subrogation provision in the Aetna Healthcare Agreement which is not subject to the anti-subrogation clause in §1720. This allows plaintiffs to plead, prove and recover medical bills in motor vehicle accident cases.
PaTLA and the Pennsylvania Defense Institute filed the brief jointly because of their concern that the lower courtâ€™s decision to permit HMOs subrogation rights as an exception to Section 1720 of the Pennsylvania Motor Vehicle Financial Responsibility Law will subvert the interests of the judicial system to provide fair and equitable compensation to injured parties for their loss, create inequities in the insurance industry, and defeat the purpose of the MVFRL.
PaTLA PDI Joint Amicus Brief