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IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA
September 2009 Term
No. 34620
ROBERT J. ZALESKI, M.D.,
Plaintiff Below, Appellee,
v.
WEST VIRGINIA MUTUAL INSURANCE COMPANY,
FORMERLY KNOWN AS WEST VIRGINIA PHYSICIANS MUTUAL
INSURANCE COMPANY, A CORPORATION,
Defendant Below, Appellant.
______________________________________________________
Appeal from the Circuit Court of Ohio County
Honorable Arthur M. Recht, Judge
Ohio County Civil Action No. 05-C-172
AFFIRMED IN PART, REVERSED IN PART AND REMANDED
_____________________________________________________
Submitted: September 9, 2009
Filed: November 17, 2009
D.C. Offutt, Jr.
Perry W. Oxley
David E. Rich
Offutt, Fisher & Nord
Huntington, West Virginia
Attorneys for Appellant
|
James F. Companion
Yolanda G. Lambert
Schrader, Byrd & Companion
Wheeling, West Virginia
Attorneys for Appellee |
The Opinion of the Court was delivered PER CURIAM.
JUSTICE WORKMAN dissents and reserves the right to file a dissenting opinion.
JUSTICE KETCHUM concurs and reserves the right to file a concurring opinion.
SYLLABUS BY THE COURT
1. A circuit court's interpretation of a mandate of this Court and whether
the circuit court complied with such mandate are questions of law that are reviewed de
novo. Syllabus Point 4, State ex rel Frazier & Oxley, L.C. v. Cummings, 214 W. Va. 802,
591 S.E.2d 728 (2003).
2. Upon remand of a case for further proceedings after a decision by this
Court, the circuit court must proceed in accordance with the mandate and the law of the case
as established on appeal. The trial court must implement both the letter and the spirit of the
mandate, taking into account the appellate court's opinion and the circumstances it
embraces. Syllabus Point 3, State ex rel Frazier & Oxley, L.C. v. Cummings, 214 W. Va.
802, 591 S.E.2d 728 (2003).
PER CURIAM:
This case is before the Court for a second time. The underlying matter
involves an Ohio County Circuit Court action brought by Dr. Robert J. Zaleski [hereinafter
Dr. Zaleski], an orthopedic surgeon, following the decision of the West Virginia Mutual
Insurance Company [hereinafter the Mutual] to deny renewal of Dr. Zaleski's medical
malpractice insurance coverage.
In the previous appeal, the Mutual appealed the circuit court's grant of partial
summary judgment to Dr. Zaleski and the denial of the Mutual's motions seeking dismissal
of the case or for summary judgment. Therein, we considered the issue of whether the
circuit court erred in finding that the Mutual is a state actor for the purposes of affording
its policyholders procedural due process upon review of policy renewal determinations. We
affirmed the circuit court's ruling granting partial summary judgment to Dr. Zaleski and
determined that the Mutual is a state actor, and thus, held that physicians who have been
afforded the benefit of medical liability insurance coverage through the Mutual are entitled
to due process protection in seeking review of any non-renewal decision made by the
company. In so holding, we reversed the circuit court's denial of the Mutual's dismissal
motion and order to reinstate insurance coverage, and remanded the case to the circuit court
with directions to (1) remand the question of non-renewal to the Mutual for further hearing
in conformity with this Court's opinion, and (2) conduct such further proceedings not
inconsistent with the Court's opinion as may be required, including the resolution of any
disputes which may arise in the course of the Mutual hearing on non-renewal.
The current matter now before the Court involves the Mutual's appeal of a
subsequent order of the circuit court following our decision in Zaleski v. West Virginia
Physicians' Mutual Ins. Co., 220 W. Va. 311, 647 S.E.2d 747 (2007) [hereinafter Zaleski I], entered on April 14, 2008, denying the Mutual's Motion for Reconsideration of its
Motion to Dismiss, or in the Alternative Motion for Summary Judgment and also denying
the Mutual's Motion for Entry of Order Granting Motion to Dismiss Pursuant to Rule
12(b)(6), the Mutual's Motion for Entry of Order Remanding the Non-renewal to the Mutual
for Further Hearing and the circuit court's sua sponte amendment of the Mutual's non-
renewal hearing procedures. Specifically, the parties now dispute whether the circuit court
was required, by virtue of our prior mandate in Zaleski I, to grant the Appellant's motion to
dismiss, and whether the circuit court maintained jurisdiction following remand to address
the actual content of the Mutual's due process hearing procedures for non-renewing
coverage prior to sending the matter back to the Mutual for hearing. For the reasons stated
below, we affirm in part, and reverse in part, the rulings of the circuit court and remand the
matter with directions.
I. FACTUAL AND PROCEDURAL BACKGROUND
A brief recitation of the underlying facts follows.
(See footnote 1) Dr. Zaleski purchased a
professional liability policy from the West Virginia Board of Risk and Insurance
Management [hereinafter BRIM] providing coverage for claims he made during the period
from December 22, 2001 to December 22, 2004. After Dr. Zaleski's BRIM policy was
transferred to the Appellant along with all other BRIM policies
(See footnote 2) , the Appellant reviewed his
prior loss experience and professional training record and determined that Dr. Zaleski
represented an unacceptable underwriting risk. On September 8, 2004, the Mutual notified
Dr. Zaleski by a certified letter that his existing medical liability insurance policy would not
be renewed upon its original termination date of December 22, 2004.
(See footnote 3) The notification letter
did not state any reasons for the non-renewal. Thereafter, Dr. Zaleski notified the Mutual
that he wished to appeal the non-renewal decision. In response to Dr. Zaleski's request, the
Mutual designated a hearing date and notified Dr. Zaleski that the hearing would be limited
to fifteen minutes in duration.
(See footnote 4) Dr. Zaleski attended the appeal hearing on November 11,
2004, and presented evidence to the Committee and responded to questions. The hearing
was not stenographically recorded. The following day, the Mutual called Dr. Zaleski and
informed him that the decision to deny renewal was upheld. Dr. Zaleski was also given this
same information by way of certified letter dated November 12, 2004. Dr. Zaleski was never
advised of any right to appeal the Mutual's decision.
Following receipt of this information, Dr. Zaleski requested, by letter dated
November 30, 2004, a detailed explanation of why the insurance policy would not be
renewed. He also filed a formal complaint with the West Virginia Insurance Commissioner.
The Mutual responded to the complaint stating that its reason for denying renewal was
because of the frequency of lawsuits in his history.
(See footnote 5) Upon receipt of the Mutual's
response, the Insurance Commissioner determined that no action would be taken against the
Mutual, stating that it did not appear that the Mutual had violated any applicable statute or
rule regarding non-renewal of the doctor's policy. The notification did not provide Dr.
Zaleski any information regarding his right to seek judicial review of the Insurance
Commissioner's determination through the circuit court.
Following the determination of the Insurance Commissioner, Dr. Zaleski filed
the instant action against the Mutual, alleging that the Mutual's non-renewal of his
malpractice insurance policy amounted to breach of the covenant of good faith and fair
dealing, arbitrary and capricious conduct, breach of fiduciary duty, intentional infliction of
emotional distress and negligent infliction of emotional distress. The Mutual filed a Motion
to Dismiss or, In the Alternative, for Summary Judgment which alleged that it did not have
a duty to renew Dr. Zaleski's insurance policy, and even if its decision to deny renewal was
done in an arbitrary and capricious manner, West Virginia law does not recognize an
independent cause of action for arbitrary and capricious conduct on behalf of private
entities. Dr. Zaleski filed a cross-motion for summary judgment claiming that the Mutual
was a quasi-public agency whose decisions denying renewal of professional liability policies
were subject to review under due process standards, and that he was denied proper
procedural due process.
On August 5, 2005, the circuit court held a hearing on the Mutual's motion.
Thereafter, on September 22, 2005, the circuit court denied the Mutual's motion and granted
Dr. Zaleski partial summary judgment, finding that the Mutual was a state actor. In that
order, Judge Recht found that the procedural due process offered by the Appellant to Dr.
Zaleski at best shallow and at worst a sham.
(See footnote 6) The circuit court directed the Mutual to
submit a procedure which would afford due process to policyholders appealing non-renewal
decisions. Under protest, but pursuant to the lower court's direction, the Mutual filed a
mechanism for review of non-renewal decisions on January 16, 2006. It also included
various objections regarding the circuit court's order.
(See footnote 7) The circuit court entered a final
appealable order on April 27, 2006, wherein it reaffirmed the conclusion that the Mutual is
a state actor, and thus, Dr. Zaleski was entitled to the same due process safeguards outlined
in W. Va Code §33-2-13 (1957).
(See footnote 8) The circuit court found that the Mutual failed to afford
Dr. Zaleski due process, and therefore directed the reinstatement of insurance coverage to
Dr. Zaleski, setting the issue of damages for trial.
On August 25, 2006, the Mutual filed a Petition for Appeal before this Court
which was granted on November 28, 2006. We issued our written opinion on June 27,
2007, wherein we affirmed the circuit court's finding that the Appellant was a state actor for
the purposes of a physician seeking renewal of his professional liability insurance and Dr.
Zaleski was entitled to due process protection of his property interest in that liability policy.
We held that the Mutual was required to make available to parties affected by its non-
renewal decisions a review process that minimally includes: notice of the non-renewal which
conforms with the requirements of W. Va. Code 33-20C-4(a) and which includes the reasons
for non-renewal; hearing before an unbiased hearing examiner; reasonable time in which to
prepare to rebut the charges; opportunity to have retained counsel at any hearings on the
charges; opportunity to present relevant evidence which includes calling and cross-
examining witnesses; and preservation of an adequate record of the review proceedings. We
then remanded the case with direction to the circuit court to remand the matter to the Mutual
in accordance with
Barazi v. West Virginia State College, 201 W. Va. 527, 498 S.E.2d 720
(1997),
(See footnote 9) to conduct a review process on the non-renewal decision which conforms with the
standards we set forth. Specifically, we stated:
In summary, we affirm the lower court's grant of partial summary judgment
to Dr. Zaleski on state action grounds, but reverse the lower court's denial of
Mutual's dismissal motion and order to reinstate insurance coverage.
Therefore, the case is remanded to the Circuit Court of Ohio County with
directions for that court to: (1) remand the question of non-renewal to Mutual
for further hearing in conformity with this opinion, and (2) conduct such
further proceedings not inconsistent with this opinion as may be required,
including the resolution of any disputes which may arise in the course of the
Mutual hearing on non-renewal.
Following the issuance of this Court's opinion, Judge Recht set a status
conference for September 7, 2007. On September 6, 2007, Appellant submitted the hearing
procedures to Dr. Zaleski's counsel. On September 7, 2007, the parties met for a scheduling
conference, wherein Dr. Zaleski was given a deadline to object to the Mutual's Hearing
Procedures for Non-Renewal. According to the Appellant, this was done over it's objection
because it believed that an evaluation of the procedures was outside of the jurisdiction of the
Court on remand and that the matter was not ripe for consideration by the circuit court.
On September 21, 2007, Dr. Zaleski filed a Response to the Appellant's review
process, expressing his objections to its content. Dr. Zaleski raised three concerns with the
Mutual's procedure: 1) the physician, rather than the Mutual, would bear the burden of proof;
2) the section titled Finality of Appeal Hearing, Findings of Fact and Conclusions of Law
did not advise the physician that he may pursue any available appeal of the Mutual's
decision; and 3) a hearing tribunal composed of members of the Mutual's board of directors
is not unbiased. On November 7, 2007, Appellant filed a response, wherein it again voiced
its objection and requested that the matter be remanded to the Appellant for further
proceedings on the basis that an evaluation of the Mutual's Hearing Procedures was not ripe
for consideration. A hearing was held and further briefs were provided by the parties.
On January 9, 2008, the circuit court issued a letter to Appellant's counsel
instructing the Appellant that it had approved the Recommended Protocols for an
Appropriate Review Process of a Decision by the Appellant, with three major changes.
Specifically, the circuit court ordered that: 1) the procedures developed by the Appellant be
changed so that the burden of proof as to the reason for non-renewal would be on the
Appellant; 2) that a provision be added to require the Appellant to inform an affected
physician as to the scope of any appellate review; and 3) that the composition of the tribunal
described in Item VIII of the proposed protocols provide a completely unbiased constituency,
which did not include members of the Board of Directors of the Appellant.
On February 12, 2008, Appellant's counsel responded to the court's letter,
objecting to the circuit court's attempt to alter the Mutual's hearing procedures. At a hearing
on February 19, 2008, the parties and the Court agreed to address the issues which arose from
the Court's January 9, 2008, letter by agreeing on an order to protect the record.
On March 6, 2008, the Appellant filed a motion to reconsider the circuit court's
decision which was conveyed to the parties in its January 9, 2008, letter. It also filed a
Motion for Entry of Order Remanding the Non Renewal to the Mutual for Further Hearing
and a Motion for Entry of Order Granting Motion to Dismiss Pursuant to Rule 12(b)(6).
Thereafter, on April 14, 2008, the circuit court issued an order formally amending the
Appellant's hearing procedures and denying Appellant's motion for reconsideration. The
order also denied the Mutual's Motion for Entry of an Order Granting its Motion to Dismiss
and its Motion for Entry of Order Remanding the Non-Renewal to the Mutual for Further
Hearing. It is from that final appealable order that the instant appeal arises.
II. STANDARD OF REVIEW
The parties to this action assert opposing interpretations of this Court's
mandate in the Zaleski I decision. The central issues in dispute are whether the circuit court
erred in refusing to grant the Mutual's motion to dismiss, and in proceeding to address the
content of the Mutual's hearing procedures for non-renewal of coverage before the hearing
was conducted. We have held that [a] circuit court's interpretation of a mandate of this
Court and whether the circuit court complied with such mandate are questions of law that
are reviewed de novo. Syl. Pt. 4, State ex rel Frazier & Oxley, L.C. v. Cummings, 214 W.
Va. 802, 591 S.E.2d 728 (2003). Indeed, it would be contrary to common sense to suggest
that we must defer to what a trial judge inferred about our intent in what we wrote [in our
mandate]. Id. at 810-811, 736-737. With this standard of review in mind, we proceed to
evaluate the parties' arguments.
III. DISCUSSION
Appellant appeals from the circuit court's order 1) denying its motion for
reconsideration of its motion to dismiss, or in the alternative, motion for summary judgment;
2) denying its motion for entry of an order granting its motion to dismiss pursuant to Rule
12(b)(6); and 3) denying its motion for entry of order remanding the non-renewal to
Appellant for further hearing. Appellant also appeals from the circuit court's sua sponte order amending Appellant's non-renewal hearing procedures. Appellant seeks a reversal of
the circuit court's rulings and a removal of Judge Recht from this case. Appellant also seeks
its costs and expenses, including attorney's fees.
In it's assignments of error, Appellant first contends that the circuit court's
refusal to grant any motion in favor of the Appellant or to follow the mandate of this Court's
decision in Zaleski I rises to the level of a violation of the Appellant's due process rights and
calls for the need to reverse the circuit court's order and assign a new judge. It also asserts
that the circuit court committed reversible error because it lacked jurisdiction to address the
content of the Mutual's due process hearing procedures for non-renewing coverage, and
because it prematurely addressed an issue that was not ripe for consideration by the court
since Dr. Zaleski never requested a due process hearing from the Mutual. The Mutual also
contends that the circuit court erred in holding that the due process procedures offered by
the Mutual in response to this Court's June 27, 2007, opinion did not meet the minimum
requirements of our prior decision in Zaleski I.
In response, Dr. Zaleski alleges that because the Mutual never contended at
the circuit court level that Judge Recht should be removed from the case, Appellant has
waived this assignment of error. Alternatively, Dr. Zaleski argues that even if the argument
had not been waived, no evidence exists in the record demonstrating that Judge Recht's
removal is warranted. Dr. Zaleski asserts that the fact that the circuit court has made rulings
adverse to the Mutual's position in this case does not prove that bias exists. Rather, Dr.
Zaleski contends that the record demonstrates that Judge Recht has treated the Mutual with
civility and fairness throughout the duration of the case. Additionally, Dr. Zaleski contends
that the circuit court did not lack jurisdiction to address the content of the Mutual's hearing
procedures, and that the court correctly determined that the Mutual's hearing procedures did
not meet the requirements outlined in Zaleski I.
As an initial matter, we briefly address Appellant's argument that Judge Recht
should be removed from this case. Appellant asserts that from the outset of the case, Judge
Recht has injected issues into motions that were not properly plead by counsel for Dr.
Zaleski, improperly denied the Appellant any sort of procedural due process in the form of
a hearing on key issues before the Court and uniformly found in favor of the Appellee.
Appellant devotes a large portion of its brief to the argument that Judge Recht should be
removed from the case because, as a cumulative effect of all of his actions throughout the
duration of the case, displayed bias against the Mutual. However, the Mutual did not present
this argument to the circuit court or raise any concerns therein. In fact, the Mutual never
filed a motion to disqualify Judge Recht or in any way made the circuit court aware of its
allegations of bias.
Because this argument is now being raised for the first time on appeal, we
must necessarily find that the argument as to this record has been waived. The Appellant
was required to bring any issue of possible bias before the circuit court so that it could
evaluate its actions to determine the credibility of the allegations and respond to them
accordingly.
(See footnote 10) This Court has long held that theories raised for the first time on appeal are
not considered.
Clint Hurt & Assoc. v. Rare Earth Energy, Inc., 198 W. Va. 320, 329, 480
S.E.2d 529, 538 (1996). This Court will not consider nonjurisdictional questions that have
not been considered by the trial court.
Id. See also Crain v. Lightner, 178 W. Va. 765, 771,
364 S.E.2d 778, 784 (1987).
(See footnote 11) The rationale behind this rule is that when an issue has not
been raised below, the facts underlying that issue will not have been developed in such a
way so that a disposition can be made on appeal.
Clint Hurt & Assoc. v. Rare Earth Energy,
Inc., 198 W. Va. at 329, 480 S.E.2d at 538
. [T]here is also a need to have the issue refined,
developed, and adjudicated by the trial court, so that we may have the benefit of its
wisdom.
Id. (See footnote 12)
That aside, we now proceed to the two key issues that are at the heart of this
controversy, whether, following our decision in Zaleski I, the circuit court erred in (1)
refusing to grant the Mutual's motion to dismiss, and in (2) proceeding to address the
content of the Mutual's hearing procedures for non-renewal of coverage before the non-renewal hearing on remand is conducted. Appellant believes that the Zaleski I decision
dismissed the Appellee's damage claims and remanded the case back to the Appellant to
conduct a non-renewal hearing under the Appellant's current hearing procedures, which it
believes contains the due process safeguards required by Syllabus Point 8 of Zaleski I. Appellant alleges that based upon the outcome of that hearing, Dr. Zaleski, if dissatisfied,
could then proceed to appeal the decision of the Appellant to the circuit court and the appeal
process could begin. Conversely, Dr. Zaleski and the circuit court expansively interpret our
prior decision to grant the court jurisdiction to evaluate, and if necessary, alter the hearing
procedures of the Appellant before such hearing is conducted to ensure that the Mutual's
procedures comply with Syllabus Point 8, and permit Dr. Zaleski to continue to pursue his
damage claims. We find that the circuit court has, at least in part, committed reversible error
on remand.
In our conclusion in Zaleski I, we specifically stated:
In summary, we affirm the lower court's grant of partial summary judgment
to Dr. Zaleski on state action grounds, but reverse the lower court's denial of
Mutual's dismissal motion and order to reinstate insurance coverage.
Therefore, the case is remanded to the Circuit Court of Ohio County with
directions for that court to: (1) remand the question of non-renewal to Mutual
for further hearing in conformity with this opinion, and (2) conduct such
further proceedings not inconsistent with this opinion as may be required,
including the resolution of any disputes which may arise in the course of the
Mutual hearing on non-renewal.
Appellant now contends that because this Court reversed the lower court's
denial of the Mutual's dismissal motion and order to reinstate insurance coverage, we
essentially directed the lower court to dismiss the entire lawsuit filed by Dr. Zaleski, and
thus, Judge Recht did not have jurisdiction to review the Appellant's due process hearing
procedures. This argument fails for several reasons.
Although this Court's mandate expressly reverse[d] the lower court's denial
of Mutual's dismissal motion and order to reinstate insurance coverage, this Court
specifically remanded this case to the circuit court, with direction that it conduct such
further proceedings not inconsistent with this opinion as may be required, including the
resolution of any disputes which may arise in the course of the Mutual hearing on non-
renewal. Thus, the specific direction was that, instead of proceeding immediately to trial,
the Mutual was to be given the opportunity to conduct a non-renewal hearing that comported
with due process in accordance with the requirements of Syllabus Point 8 of our decision.
Although the procedural posture of the case on appeal required that we effectively reverse
the circuit court's decision denying the dismissal motion in order to remand the case, at no
time did this Court make a dispositive ruling granting the Mutual's motion to dismiss.
Indeed, if Appellant's motion to dismiss were to have been granted, the case
would have concluded, and there would have been no need for this Court to ascertain
whether the Mutual was a state actor, no need to remand the question of non-renewal to the
Mutual, and no need for the circuit court to retain jurisdiction to conduct further proceedings
or resolve disputes between the parties as necessary. Accordingly, based upon the express
language of this Court's mandate in
Zaleski I, we conclude that the circuit court did not
commit reversible error in denying Appellant's reconsideration of its motion to dismiss, or
in the alternative, motion for summary judgment, and in denying Appellant's motion for
entry of an order granting its motion to dismiss pursuant to Rule 12(b)(6). The case should
have remained, and is currently stayed on, the circuit court's active docket.
We do, however, find fault with the manner in which the circuit court has
expansively interpreted this Court's mandate regarding it's scope of jurisdiction on remand.
Notwithstanding this Court's clear mandate directing the circuit court to remand the question
of non-renewal to the Mutual for further hearing, and to resolve disputes which may
arise
in the course of the Mutual hearing on non-renewal, the circuit court has exceeded its
jurisdiction by requiring the parties to submit proposed hearing procedures and by amending
the procedures prior to allowing the Mutual's non-renewal hearing to even take place. The
delay occasioned by such actions is apparent. Well over two years after our decision in
Zaleski I, there still has been no hearing.
The mandate of an appellate court in its order formally advising the lower
court of its decision marks the end of appellate jurisdiction and the return of the case to the
lower tribunal for such proceedings as may be appropriate.
State ex rel Frazier & Oxley,
L.C. v. Cummings, 214 W. Va. at 808, 591 S.E.2d at 734. Moreover, [a] circuit court has
no power, in a cause decided by the Appellate Court, to re-hear it as to any matter so
decided, and, though it must interpret the decree or mandate of the Appellate Court, in
entering orders and decrees to carry it into effect, any decree it may enter that is inconsistent
with the mandate is erroneous and will be reversed.
Id. (
quoting Syl. Pt. 1,
Johnson v.
Gould, 62 W. Va. 599, 59 S.E. 611 (1907)). Upon remand of a case for further proceedings
after a decision by this Court, the circuit court must proceed in accordance with the mandate
and the law of the case as established on appeal. The trial court must implement both the
letter and the spirit of the mandate, taking into account the appellate court's opinion and the
circumstances it embraces.
Id. at Syl. Pt. 3. Furthermore, we have traditionally held that
courts will not. . . adjudicate rights which are merely contingent or dependent upon
contingent events, as distinguished from actual controversies.
Farley v. Graney, 146 W.
Va. 22, 29-30, 119 S.E.2d 833,838 (1960). Likewise, courts [will not] resolve mere
academic disputes or moot questions or render mere advisory opinions which are unrelated
to actual controversies.
Id.
Indeed, a matter must be ripe for consideration before the court may review
it. Courts must be cautious not to issue advisory opinions. In this case, the circuit court's
abstract review of and decision to alter the Mutual's hearing procedures prior to the non-
renewal hearing taking place violates this Court's long-standing principles of ripeness and
the requirement that an actual case in controversy exist before a matter can be reviewed. In
other words, the circuit court put the cart before the horse.
(See footnote 13)
On remand, the non-renewal hearing has not yet been conducted. Thus, as the
Appellant correctly points out, the outcome of the non-renewal hearing is unknown at this
time. After the hearing is conducted, Dr. Zaleski's professional liability policy could in fact
be renewed, in which case no abstract objection to the procedures could ever become ripe
for consideration by the circuit court. On the other hand, if the Mutual would decide not to
renew Dr. Zaleski's insurance, the procedure could be addressed if the objection might
change the outcome of the procedures. For these reasons, any review by the circuit court of
the due process issues should occur only after the hearing has occurred. As anticipated, this
case has been stayed on the circuit court's docket by virtue of the remand to the Mutual for
further hearing. However, after Dr. Zaleski is provided with a non-renewal hearing and a
renewal decision is made, any issues concerning whether the hearing comported with due
process requirements and the viability of the Complaint would have to be assessed at that
juncture, if necessary.
IV. CONCLUSION
Accordingly, for the reasons stated above, the April 14, 2008, order of the
Circuit Court of Ohio County is affirmed in part and reversed in part. The circuit court's
denials of the Appellant's motion for reconsideration of its motion to dismiss, or in the
alternative, motion for summary judgment, and the Appellant's motion for entry of an order
granting its motion to dismiss pursuant to Rule 12(b)(6) are hereby affirmed. The circuit
court's denial of the Appellant's motion for entry of order remanding the non-renewal to
Appellant for further hearing is hereby reversed and remanded with directions. Appellant's
request for costs and expenses, including attorney's fees, is denied.
Affirmed in part, reversed in part.
Footnote: 1
The facts and circumstances surrounding the underlying action are more thoroughly
discussed in our prior opinion in
Zaleski I.
Footnote: 2
The Mutual is a West Virginia domestic, private, nonstock, nonprofit corporation
formed in 2004 for the purpose of temporarily alleviating the medical liability insurance
crisis by creating programs to provide medical liability coverage through BRIM. W. Va.
Code §33-20F-2 [Repl. Vol. 2003]. The Mutual accepted the transfer of all existing BRIM
medical liability policies on July 1, 2004.
Footnote: 3
It is undisputed that pursuant to W. Va. Code §33-20F-9(f)(4)[Repl. Vol. 2006], the
Mutual had the right to decline to renew the policies of physicians whose prior loss
experience or current training and capabilities created an unacceptable risk.
Footnote: 4
The written description of the appeal process provided by the Mutual to Dr. Zaleski
stated that 1) coverage was declined by underwriting; 2) an appeal was requested by the
Physician; 3) the Physician was requested to make a brief statement to the Underwriting
Committee, could ask questions of the Committee, and could entertain questions from
Committee members; 4) the Committee would review the application for coverage and the
information gathered during the appeal and make a decision immediately following the
Physician's appearance before the Committee; and 5) the Physician would receive a
telephone call from a representative of the Committee the day following the appeal and a
follow-up letter by mail.
Footnote: 5
This included nineteen medical malpractice claims during twenty-five years of
practice, totaling payment of over $2,000,000.00 in indemnity settlements.
Footnote: 6
Later, during a hearing conducted on November 15, 2005, Judge Recht commented
regarding his characterization of the Appellant's hearing procedures.
The Court: I did - maybe I got carried away - that's maybe the only fun you
have as a judge - where I said that the procedural due process
offered by defendant was shallow at best and sham at worst.
That probably was going a little too far. I apologize. But it just
felt. . .
Mr. Johnson: You said that kind of low. I don't know if the court reporter -
The Court: Well, she knows what to take down and what not to.
Footnote: 7
The objections included lack of subject matter jurisdiction; improper consideration
of claims not asserted in the complaint; grant of relief not requested and not the product of
evidentiary hearing; improper ruling that the Mutual was a state actor; and the review
performed in Dr. Zaleski's case satisfied all due process concerns.
Footnote: 8
West Virginia Code §33-2-13 [Repl. Vol. 1990] sets forth a procedure to be used
by the Insurance Commissioner to review allegations involving any act, omission, rule,
regulation or order of the Commissioner.
Footnote: 9
See Syl. Pt. 4, Barazi v. West Virginia State College, 201 W. Va. 527, 498 S.E.2d
720 (the proper remedy for reversible due process procedural defects in administrative
proceedings is to remand the case to the appropriate tribunal with directions to order the
administrative institution to remedy the defect.)
Footnote: 10
We observe that West Virginia Trial Court Rule 17.01 requires that motions
seeking the disqualification of a trial judge in a given matter be filed within 30 days after
discovering the ground for disqualification. WVTCR 17.01 (2003). Obviously, this rule was
not followed by Appellant herein.
Footnote: 11
Notwithstanding, assuming the argument had not been waived, we still find no
merit to the Appellant's allegations of bias. There is simply not sufficient evidence currently
in the record supporting Appellant's contention that Judge Recht has displayed bias in this
matter depriving the Appellant of any due process and necessitating his removal from the
case.
Footnote: 12
Were we to decide otherwise, a trial judge such as Judge Recht would be deprived
of the opportunity to address claims seeking such judge's removal from a case and we would
be deprived of such a response. We envision that such a scenario would turn disqualification
into a strategic tool of enterprising attorneys to the detriment of our justice system.
Footnote: 13
To the extent that we find that the circuit court's review and alteration of the
Mutual's hearing procedures was premature, it is not, at this juncture, necessary for this
Court to address the remaining substantive issue presented by Appellant regarding whether
the Mutual's proposed hearing procedures sufficiently meet the due process requirements set
forth by this Court in Zaleski I. That issue may be properly addressed, if necessary, in a
subsequent appeal following the Mutual's non-renewal hearing process.