JUSTICE WORKMAN delivered the Opinion of the Court.
JUSTICE ALBRIGHT did not participate.
RETIRED JUSTICE MILLER sitting by temporary assignment.
1. Strict adherence must be given to the express legislative procedures governing the
liquidation of health service corporations found in West Virginia Code §§ 33-24-14 to -44
(1992 & Supp. 1995). Therefore, pursuant to West Virginia Code § 33-24-36(f), where a
proof of claim fails to comport with the requirements mandated by West Virginia Code § 33-
24-25, and is not filed in the manner and within the time provided by statute, the claim shall
not be entitled to filing or allowance, and no action may be maintained with regard to the
claim.
2. Where a proof of claim complies with the statutory requirements of West Virginia
Code § 33-24-25 (1992), but is filed after the claims bar date provided for by statute has
elapsed, the proof of claim is properly classified as a Class VI late-filed claim as directed by
West Virginia Code § 33-24-27(f) (1992).
This case arises out of the formal delinquency proceeding filed in the Circuit Court
of Kanawha County by the Insurance Commissioner of the State of West Virginia
(hereinafter "Appellee" or "Receiver") against Blue Cross/Blue Shield of West Virginia, Inc.
(hereinafter "BCBS"). By order of Liquidation and Injunction (hereinafter "Liquidation
Order") entered October 26, 1990, the circuit court found that BCBS was insolvent as of
December 31, 1989, by almost thirty-three million dollars and had continued to incur
operating losses of millions of dollars during 1990. Accordingly, the circuit court appointed
the Insurance Commissioner as the Receiver of BCBS and directed him to liquidate BCBS'
assets.
The case is now before the Court upon the appeal of Logan Medical Foundation
(hereinafter "Appellant" or "Hospital")See footnote 1 from the circuit court's entry of the April 19, 1994,
final judgment order, where, as part of the liquidation process, the Appellant's claim against BCBS was classified as a Class VISee footnote 2 late-filed claim, for which no distribution is expected due
to the fact that the amount of claims properly submitted against BCBS far exceeded BCBS'
available assets. The Appellant maintains that the circuit court erred in concluding that the
March 5, 1991, letter it sent to the Receiver was not a proof of claim for the purpose of
participating in the subject liquidation and distribution.See footnote 3 Upon a review of the record, the parties' briefs, and all other matters submitted before this Court, we find that the circuit court
was correct in determining that the Appellant's proof of claim was not timely filed and failed
to comply with the relevant statutory provisions.See footnote 4 Accordingly, we affirm the lower court's
decision.
In response to this notice, by letter dated March 5, 1991, the Appellant mailed to
Michelle Beihl, an agent of the Receiver, the Appellant's listing of all claims believed to be
owed to it by BCBS. The listing included new claims in addition to those attached to the
January 29, 1991, notice. Moreover, the Appellant's correspondence and listing of March
5, 1991, stated that the total claim for monies BCBS owed to it amounted to $409,391.64.See footnote 6
After the Hospital submitted its response to the Receiver, the circuit court, by order
entered April 2, 1991, approved the Receiver's liquidation plan. That plan provided:
Persons seeking to receive distribution in the liquidation as
claimants shall file with the Receiver a written Claim. The Claim must be made on the proof of claim Form ("Form")
provided by the Receiver, with, at minimum, the following
detail included or attached:
(i) the amount of the Claim or the basis upon which such
amount can be ascertained;
(ii) the facts upon which the Claim is based;
(iii) the facts upon which a 'secured' or 'special deposit'
Claim, as defined in W. Va. Code § 33-24-26[(1992)], if any
exists, is asserted;
(iv) the classification for 'priority of distribution,' as
defined in W. Va. Code § 33-24-27[(1992)], requested and the
facts which support such request; and
(v) be verified by an unsworn declaration under penalty
of perjury of the claimant, or someone authorized to act on his
behalf and having knowledge of the facts; and,
(vi) be supported by such documents as may be material
thereto.
Further, the April 2, 1991, order set April 8, 1991, as "the date upon which notice of the
filing of a Proof of Claims will be given[,]" and established July 8, 1991, as the final date for
filing a proof of claim.
In compliance with the April 2, 1991, order, the Receiver mailed two proof of claim
forms to the Hospital on or about April 8, 1991.See footnote 7 Moreover, the circuit court found that notice was properly given of the requirement to file a prescribed proof of claim form, said
notice being published in The Charleston Gazette.See footnote 8 Despite the Receiver having given the proper notice to the Appellant, according to the April 19, 1994, circuit court order, the
Appellant admitted that it did not timely file a proof of claim on the prescribed form.
On June 22, 1992, the Receiver mistakenly sent a notice of determination to each
claimant, advising the claimant of the Receiver's classification of the claims presented in
compliance with an order entered June 16, 1992. The Appellant's notice of determination
letter for its claim stated that the claim had been classified as a Class VI claim.See footnote 9 After the Appellant's counsel contacted the Receiver regarding the notice of determination letter,
Robert Greer, the Assistant Deputy Receiver, by an undated letter, requested that the
Appellant disregard the notice of determination because it had not filed a proof of claim.
Additionally, the Deputy Receiver enclosed a proof of claim form for the Appellant to
complete if it so desired with the following caveat: "However, if returned, your claim will
not be considered a timely returned Proof of Claim." The Appellant's completed proof of
claim form was submitted to the Receiver on July 28, 1992, but in a letter accompanying the
form, the Appellant objected to the Receiver's determination regarding the Appellant's claim
because "the information provided in the hospital's letter of March 5, 1991, should suffice
to be considered a timely filing of the hospital's proof of claim."
By letter dated August 11, 1992, the Deputy Receiver informed the Appellant that it
had received the proof of claim; however, "[o]ur records reflect that you have a late filed
Proof of Claim. Late filed claims are in Priority Class VI. . . . Unfortunately, it is not
anticipated that any distribution will be made to claims which were not timely filed."
The Appellant requested a hearing with regard to the Receiver's determination, and
said hearing was conducted before a referee on September 23, 1993. The referee found that
the Appellant first filed a proof of claim after the claims bar date. The circuit court upheld
this finding and approved the Appellant's proof of claim in the amount of $409,391.64, assigning said claim Class VI priority. It is this ruling which forms the basis of the present
appeal.
It is helpful to begin by examining the pertinent statutory framework established for
dealing with insolvent health service corporations such as BCBS. When a health service
corporation becomes insolvent, West Virginia Code § 33-24-15(a) (1992) vests exclusive
original jurisdiction of any delinquency proceedings instituted within the purview of West
Virginia Code §§ 33-24-14 to -44 (1992 & Supp. 1995) with the circuit courts of this state,
and authorizes the circuit courts to "make all necessary and proper orders to carry out the
purposes of this article." See W. Va. Code § 33-24-15(a). As part of these delinquency
proceedings, West Virginia Code § 32-24-25(a) and (b) mandate that
(a)[a]ll claims against a corporation against which
delinquency proceedings have begun shall set forth in
reasonable detail the amount of the claim, or the basis upon
which such amount can be ascertained, the facts upon which the
claim is based, and the priorities asserted, if any. All such
claims shall be verified by the affidavit of the claimant, or
someone authorized to act on his behalf and having knowledge
of the facts, and shall be supported by such documents as may
be material thereto.
(b) All claims filed in this state shall be filed with the
receiver, . . . on or before the last date for filing as specified in
this article.
Id. "Unless such claim is filed in the manner and within the time provided in section twenty-
five [§ 33-24-25], it shall not be entitled to filing or allowance, and no action may be maintained thereon." W. Va. Code § 33-24-36 (f)(emphasis added). Further, "[n]o claim
by a policyholder or other creditor shall be permitted to circumvent the priority classes
through the use of equitable remedies." W. Va. Code § 33-24-27 (emphasis added). Finally,
West Virginia Code § 33-24-37(a) provides the time within which claims are to be filed and
specifically directs the Receiver to give notice of the filing deadline.
In interpreting the above-referenced statutory framework, the Appellant, relying on
the substantial compliance standard utilized in estate, bankruptcy and mechanic's lien cases,See footnote 10
argues that a proof of claim need not be in any particular form. We reject the Appellant's
argument for two reasons. First, estate, bankruptcy, and mechanic's lien cases are quite
different from liquidation proceedings by virtue of the sheer volume of claims involved
alone.See footnote 11
The more significant reason for not adopting a substantial compliance standard is that
strict compliance with all filing requirements is the rule in insurance insolvency cases. For
instance, in Cannelton Industries, Inc. v. Aetna Casualty & Surety Co. of America, ___ W.
Va. ___, 460 S.E.2d 18 (1994), an analogous case which involved a claim against the West
Virginia Insurance Guaranty Association (hereinafter "WVIGA"), we strictly construed the
provisions of the WVIGA ActSee footnote 12 pertaining to the time frame for filing claims in certain
insurance insolvencies. ___ W. Va. at ___, 460 S.E.2d at 24 n.4. Relying on West Virginia
Code § 33-26-8(1)(a) which mandates that "'a covered claim shall not include any claim filed
with the guaranty fund after the final date set by the court for the filing of claims against the
liquidator or receiver of an insolvent insurer[,]'" we found that "Cannelton received timely
notice of the insolvencies, Cannelton did not become aware of the claims in question until
after the expiration of the bar dates for filing proofs of claims . . . , [and] [u]nder the
language of the statute . . . the claims would clearly not have been covered." ___ W. Va.
at ___, 460 S.E.2d at 24-25 and n.4 (quoting, in part, W. Va. Code § 33-26-8(1)(a) (1985)).
Similarly, other jurisdictions adhere to the concept of strict compliance where it
concerns legislative directives regarding the procedure to be utilized when liquidating an insurance company. In State ex rel. McReynolds v. United Physicians Insurance Risk
Retention Group, No. 01-A-01-9409-CH00452, 1995 WL 111645 (Tenn. Ct. App. March
15, 1995), the Tennessee Court of Appeals reviewed whether the chancellor erred in
upholding the disallowance of a claim by an individual policyholder of an insurance
company in liquidation. The receiver had notified the policyholder that they had to file a
proof of claim form by a certain date if they had claims against the receivership. Slip op. at
1. The policyholder failed to file the proof of claim by the deadline and, therefore, the
receiver denied coverage on a claim. Id. The policyholder objected and a special master
recommended that his claim be considered timely filed because, "prior to the deadline for
filing a proof of claim form, there was already a voluminous file relevant to the . . . claim in
the possession of the Receiver . . . [and, thus, the] file already contained all the information
that could have been obtained by completion of the required proof of claim form." Id. at 2.
In reversing the special master's decision, the McReynolds court noted that
the Legislature has created a comprehensive scheme for the
liquidation of insolvent insurance companies. The procedure for
filing proofs of claim is an integral part of that scheme, and the
controlling statute gives specific instructions for the treatment
of late filers.
. . . .
. . . The proof of claim requirement is meant to impose
an organizing principle upon the voluminous files that the
Receiver necessarily inherits form the insolvent insurer. Any exemptions from its requirements would tend to undermine its
function of providing the Receiver with a single comprehensive
form of notice of all the claims that must be satisfied out of the
assets of the estate.
Id. at 3; see generally In re Great Falls Ins. Co., No. A048715 (Cal. Ct. App. July 18,
1991)(finding that Receiver was correct in strictly construing that no late filing of claim
would be permitted where claimant failed to file proof of claim prior to time filing deadline);
Chandler v. Gutierrez, No. 03-94-00683-CV, ___ S.W.2d ___ (Texas Ct. App. August 30,
1995)(finding that claims filing deadline in statute must be strictly construed even though
such construction penalizes claimants who do not and cannot know of claims by filing
deadline which will later be asserted against them).
We find persuasive the rationale used by the McReynolds court and, accordingly, hold
that strict adherence must be given to the express legislative procedures governing the
liquidation of health service corporations found in West Virginia Code §§ 33-24-14 to -44.
Therefore, pursuant to West Virginia Code § 33-24-36(f), where a proof of claim fails to
comport with the requirements mandated by West Virginia Code § 33-24-25, and is not filed
in the manner and within the time provided by statute, the claim shall not be entitled to filing
or allowance, and no action may be maintained with regard to the claim. However, where
a proof of claim complies with the statutory requirements of West Virginia Code § 33-24-25,
but is filed after the claims bar date provided for by statute has elapsed, the proof of claim is properly classified as a Class VI late-filed claim as directed by West Virginia Code § 33-
24-27(f).
Consequently, it is clear that the March 5, 1991, letter submitted by the Appellant to
the Receiver failed to comport with not only the requirements of West Virginia Code § 33-
24-25, but also the April 2, 1991, order of the circuit court. The letter failed to contain a
verified affidavitSee footnote 13 and to assert a priority. Moreover, the record indicates that the Appellee
mailed the Appellant two notices, in addition to a notice which appeared in The Charleston
Gazette, informing the Appellant that the statutorily-mandated proof of claim form had to
be submitted in order for the Hospital's claims to be considered. Unfortunately, even with
the proper notice, the Appellant failed to comply with the statutory and court-ordered
requirements in submitting its claim until after the time deadline for presenting proofs of
claims had passed.See footnote 14 If claims are not timely filed despite proper notice, late filing is not excused under the statute. See W. Va. Code § 33-24-36(f). Finally, even though the
Appellant eventually filed a proper proof of claim, this filing occurred after the claims bar
date had past. Thus, the circuit court properly classified the filing as a Class VI late-filed
claim. As the Tennessee Court of Appeals noted in State ex rel. McReynolds v. United
Physicians Insurance Risk Retention Group, No. 01-A-01-9412-CH-00585, 1995 WL
316256 (Tenn. Ct. App. May 25, 1995):
This court derives no satisfaction from denying what
might otherwise be a legitimate claim, because of the claimant's
failure to conform to the formal requirements of the claims
process . . . .
. . . .
[However,] [w]hen a claimant fails to avail himself of the
procedures available for his protection, but insists that he is
nonetheless entitled to have his claims considered as if he had
complied with those procedures, then this court must
respectfully reject his contentions.
Slip op. at 3.
Having concluded that no error was committed by the lower court in its classification
of the Appellant's claim against BCBS as a Class VI late-filed claim, we affirm the decision
of the Circuit Court of Kanawha County.
W. Va. Code § 33-24-27.
The evidence presented by the claimant was
insufficient to rebut the . . . [Receiver's] assertion and
supporting business records and testimony entered as
evidence at the hearing that two Proof of Claim Forms were
timely provided to the claimant having been mailed to
claimant from the West Virginia Office of the Receiver,
Charleston, West Virginia as required by the order approving
the Plan of Liquidation.
As we have previously indicated in National Grange Mutual Insurance Co. v. Wyoming
County Insurance Agency, Inc., 156 W. Va. 521, 195 S.E.2d 151 (1973), evidence that a
notice was mailed creates an evidentiary presumption of receipt. Id. at 527, 195 S.E.2d at
155.
a. Notice
The Receiver shall give or cause to be given notice of the
method of filing Claims pursuant to this Order, as follows:
(1) by notice in a newspaper of general circulation in a
majority of counties in the state;
(2) by notice in a newspaper in such other locations as may
be necessary;
(3) by mailing to known claimants, as determined by a
reasonable review of the records of BCBS; and,
(4) in such additional formats as the Receiver deems
appropriate.
The claim of Logan General Hospital comes on for
hearing today based on a Notice of Determination that was
sent on June 22[], 1992, which adjudicated their claim to be
Class VI. That Notice of Determination was sent without
benefit of having received a proof of claim form. The record,
I believe, will show that it was the Liquidator's position that
Logan General just happened to be one of the test claimants
that was placed into the system during testing, and those tests
were placed in the mail. . . .
. . . .
. . . The test showed that they were a Class VI
claimant, which is what they would have been had they filed
a proof of claim form at any time after this [June 22, 1992,]
communication.
Other than the June 22, 1992, letter being introduced in evidence as an exhibit, there was no other evidence presented by either party as to why this notice of determination was erroneously made.