UNITED SERVICES AUTOMOBILE ASSOCIATION, Plaintiff-Appellee, v. William J. PERRY, Secretary of United States Department of Defense, and United States of America, Defendants-Appellants.
No. 95-50512.
United States Court of Appeals, Fifth Circuit.
Dec. 13, 1996.
Rehearing and Suggestion for Rehearing En Banc Denied Feb. 14, 1997.
Barry A. Chasnoff, Stephan B. Rogers, Polly Jessica Estes, Akin, Gump, Strauss, Hauer & Feld, San Antonio, TX, for plaintiff-appellee. Stephanie Robin Marcus, Barbara C. Biddle, United States Department of Justice, Civil Division, Appellate Staff, Washington, DC, for defendants-appellants.
The opinion originally issued in this case, 92 F.3d 295 (5th Cir. 1996) (per curiam), is hereby withdrawn, and the following opinion is substituted for purposes of clarification:
In this case of first impression, we are called upon to interpret the meaning of Congress‘s 1990 amendment to
I.
This case arises from twelve separate automobile accidents2 involving members of the military who were entitled to receive and did receive medical care in a military hospital and who were also insured by USAA. The service members were treated for their injuries at military hospitals at no cost to the soldiers.
The government filed claims with USAA, seeking reimbursement for costs incurred in treating USAA‘s insureds. The government based its claim on
USAA refused to pay, and instead filed a declaratory judgment action against the government, seeking a determination that it did not owe reimbursement. Specifically, USAA sought a determination that it was not a third-party payer under
The parties stipulated that there were no disputed facts and filed cross-motions for summary judgment. The district court ruled in USAA‘s favor, holding that Medpay is not no-fault insurance and USAA is therefore not a third-party payer liable to the government under
II.
The government contends that USAA is a “third-party payer” under
Before 1990,
We are, of course, not bound by the Seventh Circuit‘s decision. Principles of estoppel, however, preclude the government from re-litigating against the same party an issue upon which another circuit has ruled against the government. United States v. Stauffer Chem. Co., 464 U.S. 165, 171, 104 S. Ct. 575, 578-79, 78 L. Ed. 2d 388 (1984). Thus, if the government is to prevail in its view that USAA is now a third-party payer, it must do so under the 1990 amendments.3 We must, therefore, determine whether USAA is an “automobile liability insurance or no-fault insurance carrier.”
We conclude that USAA is a no-fault insurance carrier because Medpay is a form of no-fault insurance. DOD is entrusted to administer
an insurance contract providing compensation for health and medical expenses relating to personal injury arising from the operation of a motor vehicle in which the compensation is not premised on who may have been responsible for causing such injury. No-fault insurance includes personal injury protection and medical payments benefits in cases involving personal injuries resulting from operation of a motor vehicle.
32 C.F.R. § 220.12(i) (1995). USAA urges us to reject this definition, arguing that “no-fault insurance” refers only to a state-adopted regime of automobile insurance that pays without regard to fault.
When an agency has issued an interpretation of a statute it is entitled to administer, our own interpretation of the statute is not entirely de novo. The Supreme Court has given us guidance, in Chevron, U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 842-43, 104 S. Ct. 2778, 2781-82, 81 L. Ed. 2d 694 (1984), in reviewing such agency regulations:
When a court reviews an agency‘s construction of the statute which it administers, it is confronted with two questions. First, always, is the question whether Congress has directly spoken to the precise question at issue. If the intent of Congress is clear, that is the end of the matter; for the court, as well as the agency, must give effect to the unambiguously expressed intent of Congress. If, however, the court determines Congress has not directly addressed the precise question at issue, the court does not simply impose its own construction, as would be necessary in the absence of administrative interpretation. Rather, if the statute is silent or ambiguous with respect to the specific issue, the question for the court is whether the agency‘s answer is based on a permissible construction of the statute. [Footnotes omitted.]
Accordingly, our first task is to apply the “traditional tools of statutory construction,” id. at 843 n. 9, and determine whether the statute is ambiguous. If we decide that Congress has spoken directly to the precise issue, our job is done; we will “give effect to the unambiguously expressed intent of Congress.” Id. at 843. If, however, we find that Congress has not spoken plainly to the issue and the statute is ambiguous, we then will determine whether the agency‘s construction of the statute is a permissible one.
A statute is ambiguous if it is susceptible of more than one accepted meaning. See MCI Telecommunications Corp. v. American Tel. & Tel. Co., 512 U.S. 218 (1994); National R.R. Passenger Corp. v. Boston & Maine Corp., 503 U.S. 407, 418-19, 112 S. Ct. 1394, 1402-03, 118 L. Ed. 2d 52 (1992); see also NORMAN J. SINGER, 2A SUTHERLAND STATUTORY CONSTRUCTION § 45.02 (5th ed. 1992). In interpreting a statute, we begin with its plain language. White v. INS, 75 F.3d 213, 215 (5th Cir. 1996); Phillips v. Marine Concrete Structures, Inc., 895 F.2d 1033, 1035 (5th Cir. 1990). Our attempt to ascer
At first glance, either USAA‘s or the government‘s interpretation of
Both parties can (and do) claim assistance from a third reference, which defines “no-fault auto insurance” as the
[t]ype of automobile insurance in which claims for personal injury ... are made against the claimant‘s own insurance company (no matter who was at fault) rather than against the insurer of the party at fault. Under such state ‘no-fault’ statutes only in cases of serious personal injuries and high medical costs may the injured bring an action against the other party or his insurer. No-fault statutes vary from state to state in terms of scope of coverage, threshold amounts, etc.
BLACK‘S LAW DICTIONARY 723 (5th ed. 1979). Still another authority defines “no-fault” as “designat[ing] a form of motor vehicle insurance.” OXFORD ENGLISH DICTIONARY 462 (2d ed. 1989). In its examples of usage, however, it leans toward USAA‘s definition. Id. at 462 (“[A] no-fault compensation system in being discussed.... [a] strong no-fault insurance bill.“). A final source lends credence to the government‘s position, defining “no-fault” as “a form of automobile insurance enabling the policyholder in case of an accident to collect a certain basic compensation ... from his own insurance company without determination of liability.” RANDOM HOUSE COLLEGE DICTIONARY 902 (1982).
Based on this review of definitions of “no-fault,” we determine that the word is commonly used in both ways, to denote either (1) an insurance policy or (2) a state-imposed insurance system that pays regardless of fault. Thus, the “battle of the dictionaries” does not resolve the ambiguity.
Because “no-fault” is an insurance term and can be a term of art, we also consider how the word is used in the insurance field. A leading insurance treatise uses “no-fault” to refer to a state system of insurance without regard to fault. 12A COUCH ON INSURANCE §§ 45:661-678 (2d ed. 1981); see also R. LONG, THE LAW OF LIABILITY INSURANCE § 27.01 at 27-3 (1994). Another treatise, however, refers to insurance policies paying without regard to fault as “nonfault insurance.” ROBERT E. KEETON, BASIC TEXT OF INSURANCE LAW, § 4.10 at 246 (1971). Therefore, we can see that while “no-fault” is more commonly used in the insurance area to mean a state system paying regardless of fault, it can also be used to refer to a policy that pays regardless of fault.
This analysis leads us to conclude that, as used in
The judgment is REVERSED, and summary judgment is RENDERED for the government on the cross-motion for summary judgment.
DeMOSS, Circuit Judge, dissenting:
I agree with the majority that the controlling issue in this case is “whether USAA is an ‘automobile liability insurance1 or no-fault insurance carrier.‘” Majority Opinion at 146. I, however, come to a different conclusion than that reached by the majority.
I read
I.
The government argues that, under the regulations, USAA is a no-fault insurance carrier with respect to Medpay. No-fault insurance, the government maintains, is any insurance policy which pays regardless of fault. Department of Defense regulations define “no-fault insurance” as:
[A]n insurance contract providing compensation for health and medical expenses relating to personal injury arising from the operation of a motor vehicle in which the compensation is not premised on who may have been responsible for causing such injury. No-fault insurance includes personal injury protection and medical payments benefits in cases involving personal injuries resulting from operation of a motor vehicle.
32 CFR § 220.12(i). USAA argues that the regulations are incorrect. USAA contends that no-fault insurance in
The Supreme Court has given us guidance in reviewing agency regulations which interpret statutes. Chevron, 467 U.S. at 837. “[T]he Supreme Court established a two-step method for judicial review of an agency‘s interpretation of a statute that it administers.” Mississippi Poultry Ass‘n, Inc. v. Madigan, 31 F.3d 293, 299 (5th Cir. 1994) (en banc). The court first must use the “traditional tools of statutory construction” to determine “whether Congress has directly spoken to the precise question at issue.” Chevron, 467 U.S. at 842-43 & n. 9. If so, the court and the agency “must give effect to the unambiguously expressed intent of Congress.” Id. at 842-43. However, “[i]f the statute is silent or ambiguous” on the particular issue, the court must determine “whether the agency‘s answer is based on a permissible construction of the statute.” Id. at 843.
“In determining whether Congress has directly spoken to the issue, the court may consider not only the plain meaning of the statute, but also any pertinent legislative history.” Doyle v. Shalala, 62 F.3d 740, 745 (5th Cir. 1995) (citing Chevron, 467 U.S. at 845). The Supreme Court has made clear that the judiciary retains its right “to say ‘what the law is,’ that is, to interpret statutes.” Mississippi Poultry, 31 F.3d at 299 (quoting Chevron, 467 U.S. at 843 n. 9).
Accordingly, our first task is to determine whether the statute is ambiguous. If we determine that Congress has spoken to the issue, then our job is done; we will “give effect to the unambiguously expressed intent of Congress.” Chevron, 467 U.S. at 843. If, however, we find that Congress has not clearly spoken to the issue and the statute is ambiguous on its face, we then will look to legislative history to clarify the purpose. If legislative history is ambiguous, we will defer to the agency‘s interpretation if it is “based on a permissible construction of the statute.” Id. at 843.
II.
I agree with the majority that the statute is susceptible to more than one reasonable meaning and, thus, is ambiguous on its face. Therefore, we must consider the legislative history of the 1990 amendment. The committee reports of the House and Senate provide no additional guidance, as they merely restate the text of the amendment. See H.REP. NO. 923, 101st Cong., 2d Sess., reprinted at 1990 U.S.C.C.A.N. 3110; H.REP. No. 665, 101st Cong., 2d Sess., reprinted at
In construing an amendment to a statute, however, it is important to understand the reason behind the amendment, or, as the Second Circuit has explained it, the “mischief” Congress sought to remedy with the amendment. United States v. Clemente, 608 F.2d 76, 79 (2d Cir. 1979) (“The amendment must be interpreted in terms of the mischief it was intended to rectify.“) (citing In re Letters Rogatory, 385 F.2d 1017, 1020 (2d Cir. 1967)); 2A SUTHERLAND STATUTORY CONSTRUCTION § 45.09. A review of the history of the military‘s attempts to collect from third-parties in general, and of
Members of the United States military and their dependents are entitled to free medical care in military hospitals.
For 15 years Congress declined the Court‘s invitation to create liability for tortfeasors injuring soldiers. In 1960, however, a Comptroller General report revealed that the United States was losing significant sums of money due to unreimbursed healthcare expenditures provided to injured soldiers. COMPTROLLER GENERAL OF THE UNITED STATES, REVIEW OF THE GOVERNMENT‘S RIGHTS AND PRACTICES CONCERNING RECOVERY OF THE COST OF HOSPITAL AND MEDICAL SERVICES IN NEGLIGENT THIRD PARTY CASES (1960) (cited in Medical Care Recovery at 51). Responding to the report, Congress in 1962 passed the Federal Medical Care Recovery Act (“FMCRA“),
Because tort liability is required for FMCRA recovery, the government could not recover in states which adopted no-fault automobile insurance laws. In states where no-fault automobile insurance laws have been adopted,3 there is no tort liability for injuries sustained in automobile accidents. Instead, all individuals have insurance which pays regardless of who is at fault. 12A Couch on Insurance § 45:661, at 245-46 (2d ed. 1981).4
[S]ome states have ... passed no-fault insurance laws that generally allow for recovery by individuals from their own insurance companies irrespective of `fault. Since no-fault laws by definition do not establish an at-fault or liable party, [the government‘s] legal ability to conduct recoveries under [the FMCRA] varies according to the no-fault statutes in these states.
GAO report at 4. The GAO report recommended “that the Congress enact legislation to enable recovery by the government in states with no-fault automobile insurance laws.”6 Id.
The Department of Defense (“DOD“), when it promulgated its regulations to amended
Thus, we see that Congress (1) was given a report detailing problems with collecting reimbursements in states with no-fault insurance systems; (2) was given a recommendation that the law be changed to allow the government to obtain reimbursements in states with no-fault insurance systems; and (3) then passed a law providing that the government can collect from “no fault insurance carriers.” Based on these facts, it is clear that by the phrase “no fault insurance carriers,” Congress meant insurance companies providing coverage in states with no-fault systems of automobile insurance. Congress was not referring to insurance companies providing automobile liability policies which contain coverages that pay regardless of fault. I found nothing in the legislative history which refers to the “medpay” coverage involved in the policies in this case.
In passing the 1990 amendments to
Additional evidence that Congress was referring to no-fault systems when it amended
Based on the foregoing, it is apparent that the harm Congress sought to remedy with its 1990 amendments to
III.
Medpay is not no-fault insurance. Therefore, USAA is not a “third-party payer” under
