Heim v. Medical Care Availability & Reduction of Error Fund
23 A.3d 506
| Pa. | 2011Background
- Heim sued Detweiler, Carver, and Detweiler Family Medicine for medical negligence causing his wife's death (1992–1996).
- A trial in 2000 produced a verdict over $1 million; the jury apportioned fault and the verdict with delay damages accrued to about $707,000, jointly and severally against all defendants.
- Drs. Detweiler and Carver carried $200,000 per-occurrence primary coverage; PPCIGA insolvency shifted coverage to PPCIGA with a $300,000 per-claimant cap, leaving a $100,000 shortfall attributed to Carver.
- CAT Fund (excess coverage) initially paid judgments beyond basic coverage up to $1,000,000 per occurrence; in 2002, CAT Fund liabilities were transferred to MCARE Fund.
- The Fund determined it owed no response to the $100,000 shortfall; Heim pursued collection against Detweiler and his practice; he later settled with Detweiler and practice and obtained an assignment of claims.
- Commonwealth Court ruled for Heim, applying joint and several liability; the Fund appealed arguing it had no obligation to cover the shortfall under the MCARE Act.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether CAT Fund must cover shortfalls due to primary insurer insolvency | Heim argues CAT Fund liability extends to shortfalls under joint liability. | Fund argues CAT Fund only covers excess above a provider's basic coverage. | CAT Fund liability is limited to excess above the provider's own basic coverage; shortfall falls to MCARE Fund. |
| Whether MCARE Act alters the baseline for excess coverage | Heim relies on Carrozza and earlier framework for joint liability. | Fund relies on MCARE Act plain terms to set the baseline. | Excess coverage is measured from the provider’s own primary coverage; MCARE governs excess beyond that baseline. |
| Whether Gabroy per curiam has precedential value on Fund's obligation | Gabroy supported Fund's view that excess coverage is based on aggregate primary limits. | Per curiam orders have no stare decisis effect. | Gabroy per curiam is not binding precedent; merits evaluated on current statute framework. |
| Policy considerations of protecting public funds vs. provider protection | Statutory language governs balance; CAT Fund's role is fixed by statute, subject to interpretation of baseline. |
Key Cases Cited
- Gabroy v. CAT Fund, 912 A.2d 768 (Pa. 2006) (aff'd per curiam (Pa. 2006); discusses excess coverage framework)
- Storms v. O’Malley, 779 A.2d 548 (Pa. Super. 2001) (CAT Fund pays excess only; not below basic coverage)
- Elliott-Reese v. CAT Fund, 805 A.2d 1253 (Pa. Cmwlth. 2002) (CAT Fund provides only excess coverage)
- Carrozza v. Greenbaum, 916 A.2d 553 (Pa. 2007) (supports joint-and-several liability considerations)
- Hershey Med. Ctr. v. CAT Fund, 821 A.2d 1205 (Pa. 2003) (policy implications of CAT Fund in public health context)
- Maloney v. Valley Med. Facilities, Inc., 984 A.2d 478 (Pa. 2009) (joint tortfeasors generally jointly and severally liable; framework cited)
- Fletcher v. PPCIGA, 985 A.2d 678 (Pa. 2009) (context for CAT Fund and MCARE interaction)