Judge Cynthia M. Rufe
PHILADELPHIA – U.S. District Court Judge Cynthia M. Rufe on Sept. 12 dismissed a lawsuit by Excel Pharmacy against Liberty Mutual Insurance.
Excel sued Liberty Mutual alleging failure to reimburse Excel for providing medications to injured workers and that Liberty Mutual violated the Pennsylvania Worker’s Compensation Act. It first sought relief first in the Philadelphia Court of Common Pleas. However, Liberty Mutual had the case removed to the U.S. District Court for the Eastern District of Pennsylvania.
In her eight-page ruling, Rufe outlined her rationale for the dismissal. This rested on three factors. First, there was “no independent basis by which this Court may assert jurisdiction over such claims” as such claims fell within the jurisdiction of the Bureau of Worker’s Compensation under the Pennsylvania Department of Labor and Industry, she wrote.
Her second point involved the Unfair Insurance Practices Act. Excel asserted that Liberty Mutual had violated the act 11 times. These included not determining within a certain timeframe coverage, claiming that medications were “not appropriate prescribed or reimbursable under the WCA,” and “failing to effectuate prompt and equitable settlements of claims.”
However, Rufe said that “the claims under the UIPA cannot be independently decided as a declaratory judgment.”
Finally, Rufe referenced the Declaratory Judgement Act. She noted that even if the Court found that Liberty Mutual should pay Excel, the Bureau of Worker’s Compensation and the law would still be responsible for enforcement.
Rufe quoted Williams v. National Sch. of Health Tech by saying what Excel was seeking “does not constitute a real and substantial controversy admitting of specific relief through a decree of a conclusive character, but rather seeks to foreclose consideration of insurance reimbursements that the state courts are best positioned to address on an individual basis."