Opinion ID: 198249
Heading Depth: 2
Heading Rank: 3

Heading: Whether the Insurance Trust was a PRMP

Text: 32 Employers argues that the record before the special master, whose report and findings were confirmed by the district court, does not support the master's finding that the Insurance Trust was a PRMP within the meaning of N.H.Rev.Stat. Ann. § 5-B:5. Stratford first raised the defense of the Insurance Trust's PRMP status in its supplemental brief filed after the special master's hearing. Previously, Stratford had simply argued in more general terms that the Insurance Trust's Endorsement was not other insurance. As soon as Stratford raised in its post-hearing brief the issue of PRMP status, Employers objected in its own brief on the ground that Stratford had not tendered any evidence to confirm that the Insurance Trust was, in fact, a PRMP. Notwithstanding this objection, the special master determined in his report that New Hampshire School Board's [sic] Insurance Trust is a pooled risk management program organized under N.H.Rev.Stat. Ann. 5-B (1988). Employers presented a similar objection to the district court, which nonetheless confirmed the special master's report without comment on the point. 33 Our review of the record supports Employers' contention that there is insufficient record support from which to find that the Insurance Trust is a PRMP. About all that appears on this score is the parties' apparent acceptance that the Insurance Trust was some kind of entity comprised of participating school districts (Stratford being one) formed for the purpose of acquiring and managing insurance for its member districts. While this suggests PRMP status, it falls short of establishing it. Neither Stratford nor anyone else put into evidence the Insurance Trust's charter, by-laws, and any other necessary papers from which it could be determined that the Insurance Trust met the legal requirements of a PRMP as these are set out in the New Hampshire statute granting such entities exemption from insurer status. See N.H.Rev.Stat. Ann. § 5-B:5. Specifically, nothing showed, as the statute requires, that the Insurance Trust (1) is organized under New Hampshire law; (2) is governed by a board of elected or appointed public officials; (3) returns all earnings and surpluses; (4) prepares and files an annual audit; (5) is governed by written by-laws; and (6) prepares an annual actuarial evaluation. See id. Nor was alternative evidence of PRMP status tendered, for example, that some state official qualified to do so had certified that the Insurance Trust was a PRMP. And, contrary to Stratford's present contention, Employers never waived its present objection on this score. Rather, as soon as Stratford raised the argument that the Insurance Trust was a PRMP, hence could not be an insurer, Employers objected that the record did not support a finding of PRMP status. 34 On the other hand, common sense, buoyed by the little we can glean from the record, suggests that the Insurance Trust is probably a PRMP. Employers, indeed, has never claimed that the Insurance Trust is not a PRMP but simply says that Stratford failed to meet its burden of presenting sufficient formal proof for the special master and the district court to find that it is. The special master and the district court may have concluded that the Insurance Trust's status was self-evident and that Stratford, a school district member of the Insurance Trust, would surely know whether the Insurance Trust was a PRMP, and let matters go at that. Still, while Employers' insistence on proof may seem technical, it was Stratford's responsibility to have offered evidence sufficient to establish PRMP status if it wished to assert such status over Employers' objection, as a reason the Endorsement could not be insurance. While the general sense we get from the record is that PRMP status was assumed as never being seriously in doubt, the district court erred in overlooking the absence of formal proof when it confirmed the special master's finding of PRMP status over Employers' specific objection on this score. 4 35 We think, however, that to reverse on the basis of this deficiency would be to elevate form over substance, given the murkiness of the situation after the special master's hearing and the ease with which the deficiency in proof can even now be corrected. We accordingly remand rather than reverse. 36 We vacate the judgment below and remand to the district court with instructions to reopen the record to the extent necessary to determine if the Insurance Trust was at relevant times a New Hampshire PRMP. If the district court finds, on the basis of suitable proof, that the Insurance Trust was a New Hampshire PRMP, the court is instructed to enter judgment for Stratford consistent with this opinion. If, however, adequate evidence that the Insurance Trust is a New Hampshire PRMP is not produced, causing the district court to find that Stratford has not met its burden in this regard, the court will need to reconsider the nature of the Insurance Trust's Endorsement and determine anew whether or not it constitutes 'other insurance' under Stratford's contract with Employers. In such circumstances, it may conduct such future proceedings, and make such further findings and rulings and judgment in the cause, as it deems appropriate. 37 So ordered. Each party to assume its own costs.