Section 242.20. Formal and informal complaints; procedure

Under 1 Pa. Code § 31.1 (relating to scope of part), 1 Pa. Code Part II (relating to general rules of administrative practice and procedure) is applicable to the activities of and proceedings before the fund. These provisions will govern the procedure to be followed in handling formal and informal complaints addressed to the Fund.

The provisions of this § 242.20 adopted August 7, 1981, effective August 8, 1981, 11 Pa.B. 2760.

Notation

Authority

The provisions of this § 242.20 issued under sections 206 and 506 of The Administrative Code of 1929 (71 P. S. § § 66 and 186); section 701(e)(4) of the Health Care Services Malpractice Act (40 P. S. § 1301.701(e)(4)); and 2 Pa.C.S. § 102(a).

Notes of Decisions

Doctrine of exhaustion of administrative remedies was inapplicable where question was whether Medical Professional Liability Catastrophe Loss Fund was liable over to malpractice defendant’s excess insurer since the key question of whether there was one or two occurrences of medical malpractice was not within the Fund’s specialized knowledge since the Fund regulations, 31 Pa. Code § § 242.1—242.20 do not address the claims and since the Health Care Services Malpractice Act makes no specific provision regarding claims between insurance companies and the Fund but does contemplate the Fund’s involvement in litigation concerning the claims (40 P. S. § 1301.702(f)). Ohio Cas. Group of Ins. Companies v. Argonaut Ins. Co., 500 A.2d 191 (Pa. Cmwlth. 1985).

These provisions provide for resolution of complaints of adverse agency action, and as such, do not provide adequate remedy or preclude litigant from seeking relief in court, where issue is Cat Fund’s failure to pay share of malpractice claim settlement, which places Fund in position of defendant, as opposed to its designed position of participant and/or arbiter. Ohio Cas. Group of Ins. Companies v. Argonaut Ins. Co., 525 A.2d 1195 (Pa. 1987).