Opinion ID: 1759438
Heading Depth: 1
Heading Rank: 5

Heading: Standing to Maintain the Action

Text: Because the question of standing implicates subject-matter jurisdiction, we address it first. See Moore v. John Hancock Life Ins. Co., 876 So.2d 443, 448 (Ala. 2003). BCBS challenges the standing of the three providers, relying on American Automobile Insurance Co. v. McDonald, 812 So.2d 309, 312 (Ala.2001), which holds that the Insurance Code provides no private right of action for a violation of a provision of the Code that prohibits selling insurance without a license. The trial court in this case, citing, among other cases, State Farm Mutual Automobile Insurance Co. v. Scott, 707 So.2d 238 (Ala. Civ.App.1997), rejected the challenge to standing, analogizing the present case to actions against insurance companies involving uninsured-motorist claims where the terms of the policy were not in harmony with the scope of coverage mandated by statute. BCBS seeks to distinguish Scott by pointing to the contractual rights that underlie the claim in Scott. This distinction has merit. However, it does not avail BCBS, because the statutory scheme endows Dr. Hodurski with the status of a third-party beneficiary under the contract between BCBS and its insureds. Section 27-51-1(a) provides that [a]n insurance policy or contract providing for third-party payment or prepayment of health or medical expenses shall include a provision for the payment to a supervising physician for necessary medical or surgical services that are provided by a licensed physician assistant practicing under the supervision of the physician.... (Emphasis added.) Section 27-51-1(f) requires that the supervising physician must have entered into a contract with the medical-service organization in order to render the Physician Assistant Act applicable. Dr. Hodurski provides care to BCBS insureds. Obviously, Dr. Hodurski has the requisite contractual relationship with BCBS mandated by § 27-51-1(f). As previously noted, BCBS has denied his claims for payment for services provided by a licensed physician assistant under his supervision. Statutorily required provisions of an insurance contract are read into the policy, even if the policy itself does not contain the required provisions. See the following passage dealing with uninsured-motorist coverage from 11 Am.Jur. Trials, Uninsured Motorist Claims § 6, p. 86 (1966), quoted in State Farm Automobile Insurance Co. v. Baldwin, 470 So.2d 1230 (Ala.1985), overruled on other grounds, Ex parte Carlton, 867 So.2d 332 (Ala.2003): `Where a statute [an Act] requiring uninsured motorist coverage is broad and comprehensive in scope, it establishes as a matter of public policy that every bodily injury motor vehicle policy should provide uninsured motorist coverage; the code [Act] becomes in effect a part of every policy of insurance to which it is applicable, as if it were written out in full in the policy itself. ' 470 So.2d at 1232 (quoting Higgins v. Nationwide Mut. Ins. Co., 291 Ala. 462, 465, 282 So.2d 301, 303-04 (1973)) (emphasis added). Dr. Hodurski is a third-party beneficiary of the contract between BCBS and its insureds and as such has standing to assert his right, engrafted upon that contract by statute, to secure payment of his claims. BCBS also challenges the standing of Hobbs and Irvine, the physician assistants. The trial court, however, made no finding as to their standing. Because Dr. Hodurski does have standing, that question is academic.