Court Opinion

ID: 9952772
Source: CourtListenerOpinion
Date Created: 2024-03-20 18:20:37.13695+00
Date Added: 2024-06-11T14:44:26.968481
License: Public Domain

IN THE SUPERIOR COURT OF THE VIRGIN ISLANDS
                     DIVISION OF ST THOMAS AND ST JOHN
                                         *************

AAC AIR AMBULANCE CARIBBEAN                       ) CASE NO ST 2023 CV 00267
INC D B A/ AEROMD                                 )
                                                  )
                             Plaintiff            ) J URY TRIAL DEMANDED
                                                  )
               vs                                 )
                                                  )
CIGNA HEALTH AND LIFE INSURANCE                   )
COMPANY AXA ASSISTANCE USA INC                    )
AXA GROUP LLC and BEVERLY A JOSEPH                )
GILBERT COMMISSIONG LORI ANDERSON                 )
CLEMMIE MOSSES ST JOHN LORRAINE                   )
MORTON ANDRE DORSEY DR KISHA                      )
CHRISTIAN DEBBIE CHRISTOPHER AND                  )
JOHN ABRAMSON JR COLLECTIVELY in                  )
their Ofﬁcial Capacities as Members of the        )
Government Employees Service Commission           )
Health Insurance Board,                           )
                                                  )
                             Defendants           )

RYAN MEADE ESQUIRE (Ryan Meade Chartered Attorney LLC) St Thomas USVI For the
Plamtsz.

SHEENA CONWAY ASSISTANT ATTORNEY GENERAL (V I Department of Justice) St Thomas
USVI, For Defendants Government Employees Service Commission, Lori Anderson, Andre
Dorsey, Beverly Joseph, and Lorraine Morton

ERICA HILLER ESQUIRE (Kennedys CMK LLP) Miami Florida For Defendant AXA
Assistance USA, Inc

MARIA T HODGE Esquire (Hodge & Hodge), St Thomas USVI, For Defendant Cigna Health
and Life Insurance Company

                                  Cite as 2024 VI Super 14U

                          MEMORANDUM OPINION AND ORDER

1] I   This matter is before the Court on
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        1        Defendants Motion To Dismiss (‘ Motion ’), ﬁled December 22, 2023 on behalf
                of Government Employees Service Commission, Lori Anderson Andre Dorsey,
                Beverly Joseph, and Lorraine Morton';

        2       Plaintiff AAC Air Ambulance Caribbean, Inc d/baa AeroMD’s Response To
                Motion To Dismiss (‘ Response ’), ﬁled January 31, 2024; and

        3       Defendants’ [Government Employees Service Commission] Reply To Plaintiff’s
                Response To Motion To Dismiss ﬁled February 16, 2024

{[2   The Court will grant Defendants Motion and dismiss the Government Employees Service
Commission Health Insurance Board (‘ GESC”) Board Members from the case with prejudice as
the Court lacks subject matter jurisdiction over them

        I       INTRODUCTION

113   On August 8 2023 Plaintiff AAC Air Ambulance Caribbean Inc d/b’a AeroMD
(“AeroMD”) ﬁled a Complaint against Cigna Health and Life Insurance Company (“Cigna"),
AXA Assistance USA Inc ( AXA”), AXA Group LLC (“AXA Group ’), as well as members of
the GESC Board collectively in their ofﬁcial capacities as members of GESC Beverley A Joseph,
Gilbert Commissiong, Lori Anderson, Clemmie Mosses St John, Lorraine Morton, Andre Dorsey,
Dr Kisha Christian, Debbie Christopher, and John Abramson Jr (collectively, “Board Members ’),
asserting thirteen (13) causes of action Count I Breach of Express Contract, asserted against all
Defendants, Count II      Breach of Implied In Fact Contract, asserted against all Defendants, Count
Ill Quantum Memit/Unjust Enrichment, asserted against all Defendants, Count IV Breach of
Contract asserted by AeroMD as Third Party Beneﬁciary of the Cigna Plans, asserted against all
Defendants, Count V        Breach of Fiduciary Duty          Cigna Non ERISA Plans, asserted against
Cigna and AXA, Count V1 Breach of Fiduciary Duty VI Government Plan, asserted against all
Defendants, Count VII  Tortious Interference with Prospective Business Relations, asserted
against Cigna and AXA; Count VIII            Tortious Interference with Existing Contracts     Contract
Between AeroMD and Cigna/GESC, asserted against AXA; Count IX                 Tortious Interference with
Existing Contracts      AeroMD Membership Program Contracts Between AeroMD and Certain
Cigna Plan Enrollees, asserted against Cigna and AXA; Count X Violation of the Virgin Islands
Prompt Pay Statute, 22 V I C § 1725, asserted against all Defendants, Count XI Prima Facie
Tort, asserted against all Defendants; Count XII          Gross Negligence, asserted against Cigna and
AXA; and Count XIII        Declaratory Judgment        Unfair Practices and Frauds Act, asserted against
all Defendants 2

{[4     AeroMD seeks damages for unpaid beneﬁts; injunctive and declaratory relief to prevent
Defendants from engaging in actions prohibited by the Cigna plans and law, an order directing
Defendants to pay beneﬁts in accordance with the Cigna plan, an award of lost proﬁts, contractual

' These were the only Defendants served with process as of December 22 2023
  PI sCompl 18 35
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damages, and compensatory damages, an award of exemplary damages; restitution for
reimbursements improperly held by Defendants declaration that Defendants violated the terms of
the Cigna Plans, requiring that Defendants pay AeroMD the beneﬁt amounts, requiring that
Defendants make full payments on all previously denied charges; an award of reasonable
attorney’s fees; an award of costs of suit; an award of pre judgment interest and post judgment
interest; and all other relief to which AeroMD is entitled 3 AeroMD demands a jury trial 4

15     GESC moves to dismiss AeroMD claims pursuant to Virgin Islands Rule of Civil
Procedure 12(b)(l) asserting lack of subject matter jurisdiction 5 GESC argues that AeroMD has
alleged eight (8) claims against GESC that sound in contracts, but neither GESC nor its board
members are patties to any contracts with AeroMD nor do they have the capacity to contract ‘
GESC asserts that to carry out its duties as the Health Insurance Board of Trustees, it makes an
annual recommendation to the Govemor of the Virgin Islands about which health insurance plan
the Government of the Virgin Islands (‘ GVI”) should adopt 7 GESC manages the procurement
process to vet the prospective vendors for the Plan” as well as approves the vendor and the
proposed contract before recommending it to the Governor and submitting it to the Legislature of
the Virgin Islands 8 GESC points out that Cigna is the current vendor and may sub contract to
fulﬁll its services obligation and neither GESC or GVI are parties to those contracts nor do they
vet them 9 GESC avers that the rates in those sub contracts are proprietary in formation and GESC
and the Board Members have no knowledge of those rates '0

116      GESC argues that the enabling statute does not give GESC the right to sue or be sued in its
own name, and GESC is thus not a proper party to this action " GESC argues that it does not have
the authority to contract and once the insurance plan is executed it is administered by the Division
of Personnel not GESC '2 GESC states that since it is not a party to any contract with AeroMD
and Cigna or AXA/AXA Group, Counts I [V VI, X, XI and XIII are frivolous claims against it
and must be dismissed '3

1f7   AeroMD counters that GESC is not a named party to the suit, but rather the individual
Board Members are and “each is sulsyurls in that capacity ”’4 AeroMD cites to V I CODE ANN
tit 3 § 63 1(a) which vests the responsibility for the proper operation of the health insurance plan
with the GESC Board Members '5 AeroMD cites then to § 633(a) which authorizes the GESC

3 Pl 5 Comp! 36 37
4 Pl sCompl 36
5 Defs ’ Mot l
6Defs Mot 2
7 Defs Mot 2
8 Defs Mot 2
° Defs ’ Mot 2
'0 Defs Mot 3
" Defs ’ Mot 5
P Defs ’ Mot 5
'3 Defs ’ Mot 6
'4 P] ’s Resp 2
' Pl sResp 3
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Board “to establish a self funded health insurance plan or to purchase a contract (or contracts) to
provide beneﬁts under a health insurance plan” as well as § 631(b)(4) which authorizes the Board
to adopt rules and regulations related to “contracting with a third party administrator to administer
a self funded health insurance plan ”'6AeroMD states “[u]pon information and belief, the current
Health Insurance plan is a self funded plan and GESC Board Members, delegated some of their
statutory administration obligations to co defendant CIGNA ”'7

{I8     AeroMD asserts that a cursory reading of the detailed [C]omplaint shows that I) there
were no ‘in network contract [sic] between AeroMD and co defendant CIGNA which would
cover the ‘rates for the products and/or services” as well as that “AeroMD was contracted to
perform lifesaving medivac ﬂight, by Defendants either as principals or agents of each other, on
behalf ofplan enrollees, under the plan which is operated by the GESC Board Members and which
the GESC Board is statutorily authorized to do "8 Lastly, AeroMD cites to § 637 to argue that the
‘ Legislature of the Virgin Islands further saw ﬁt to empower the GESC Board Members with the
authority and responsibility for paying vendors under the plan directly "9 AeroMD avers that
‘ PlaintiffAeroMD has presented valid bills to the GESC Board Members and diligently sought to
collect these overdue amounts from Defendants to no avail ”20

119     GESC replies that AeroMD misstates the law and facts as ‘ Board Members in their ofﬁcial
capacity have no legal administrative duties or responsibilities under the plans ’ and “Board
Members in their ofﬁcial capacity do not and cannot process claims or pay invoices ”7‘ GESC
argues that despite AeroMD’s insistence, GESC and the Board Members are both parties to this
suit ’2 GESC reiterates it was established to advise and recommend to the Governor of the Virgin
Islands which vendors he should select for GVI 3 health insurance plan ’3 GESC states that both
plans it has recommended, the Cigna Plan (for employees and retirees under 65) and its United
Healthcare Plan (for retirees over 65) are fully insured health plans where the insurer assumes the
risk of paying the medical claims and the GVl/Division of Personnel are responsible for
administering the plans 24

110    GESC states that it is a party to the case as ‘ [Board] Members of GESC in their ofﬁcial
capacity are acting as the GESC, and as such, a suit against the Members of GESC in their ofﬁcial
capacity is an action against the GESC ” citing to United State Supreme Court case Kentucky v
Graham ’5 GESC points out that paragraphs 26, 27, and 32 plainly claim the Court has jurisdiction
over GESC, the agency 2" GESC further notes that AeroMD sent summons to the Government

'6 Pl 8 Resp 4
'7 Pl 3 Resp 4
'3 Pl 5 Resp 4
'9 Pl 3 Resp 4
"0 Pl 5 Resp 5
2' Defs Reply 2
  Defs Reply2
3 Defs Reply 2
‘ Defs Reply 2 3
5 473 U S 159 [66 (1985) (citing Brandon v H01! 469 U S 464 471 72 (1985)) Dets Reply 3
° Defs Reply 3 4
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Employees Service Commission Health Insurance Board care of both Governor Albeit Bryan Jr
and Attorney General Ariel M Smith 27 GESC reﬁnes that § 637 requires Board Members in their
ofﬁcial capacity to make payments, as under the fully insured health plans, ‘ the authority to
process and pay the claims for the plan beneﬁts has been contractually outsourced to CIGNA and
United Healthcare 23 Thus, ‘ GESC and Board Members of GESC in their ofﬁcial capacity, have
no capacity, duty, or authority to pay AeroMD for any outstanding invoices generated by those
enrollees it alleges are due to it ”29

{[11     GESC states that additionally, all the tort claims against it, Counts VI and X1, must fail, as
Board Members are GVI employees and AeroMD has not complied with the Virgin Islands Tort
Claims Act (“VITCA”) the pre ﬁling requirements of which are jurisdictional 3° GESC maintains
that AeroMD has not complied with 33 V I C § 3410 which requires ﬁling with the Governor and
the Attorney General a notice of intent 3' GESC avers that “[a]ﬁer a diligent search there is no
evidence that a notice of intent has been served on the Ofﬁce of the Governor or the Attorney
General ofthe U S Virgin Islands ”32 Citing to Virgin Islands caselaw, GESC argues that AeroMD
has not met its burden of showing it complied with this jurisdictional requirement and thus the tort
claims should be dismissed 33

1[12   GESC then argues that Counts related to the Prompt Pay by Insuier statute (22 V I C §
1725) and the Unfair Practices and Fraud Act (22 V I C § 1201) Counts X and XIII respectively
must be dismissed as GESC and its Board Members are not insurers or in the business of insurance,
so the statutes are inapplicable to them 34 Lastly, GESC again argues all the Counts related to
contracts (1 IV) are frivolous since GESC enabling statute does not allow them to be sued or to
sue 3‘

         II       LEGAL STANDARD

                  A Motion To Dismiss        12(b)(1)

1113     As this Court recently outlined in United Resources Ltd v Virgin Islands Waste
Management Authority‘6

7 Defs Reply 4
3 Defs Reply 4
2" Defs Reply 4
3° Defs Reply 4 5
3' Defs Reply 5
3 Defs Reply 5
3’ Defs Reply 5 (citing ﬁrst Lems v V! Gm tI-losp & Health FaCllltleS Corp 76 V I 145 155 (V 1 Super Ct
2022) then citing Yuxmng Pengv Williams 67 VI 482 484 (VI Super Ct 2017))
“ Defs Reply 5 6
‘5 Defs Reply 6
’6 2024 Vl Super 9U
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           Virgin Islands Rule of Civil Procedure 12(b)(1) allows a party to assert by
           motion the defense that the Court lacks subject matter junsdiction As Rule
           12(b)(1) is a jurisdictional attack, the Court must consider that motion before
           reaching 12(b)(6) motions A Rule 12(b)(1) motion may be treated either as
           facial or factual The difference, as explained by the Virgin Islands District
           Court, is that ‘[o]n a facial attack, a court must accept the allegations in the
           complaint as true” whereas with a factual challenge “the plaintiff‘s allegations
           are not presumed to be true ” With a facial attack, the Court only looks to the
           complaint and any documents referenced in or attached to the complaint in a
           light most favorable to the plaintiff However, when the challenge is factual, the
           Court must evaluate the merits of the jurisdictional claim based on the evidence
           offered by either party and the plaintiff is not afforded a presumption of
           truthfulness 37
                   B Virgin Islands Tort Claims Act        Filing Requirement

1114     Title 33 V I C § 3410 states

           The claim or notice of intention shall be ﬁled in the Ofﬁce of the Governor and
           a copy shall be served upon the Attorney General and a written receipt therefor
           shall be issued with the date of ﬁling indicated thereon The claim shall state the
           time when and the place where such claim arose, the nature of same, and items
           of damage or injuries claimed to have been sustained and the total sum claimed
           The notice of intention to ﬁle a claim shall set forth the same matters except that
           the items of damage or injuries and the sum claimed need not be stated The
           claim and notice of intention to ﬁle a claim shall be veriﬁed

1115     In Richardson v Knud Hansen Memorzal Hospztal,” the Third Circuit held that the Virgin
Islands has sovereign immunity from tort claims and that the Government of the Virgin Islands
may not be sued without its consent” and that ‘ the terms of this consent are jurisdictional, just as
they are under the Federal Tort Claims Act ”39 In Lewzs v Virgin Islands Government Hospztal &
Health Faczltttes Corp ,4” this Court held that “a single conclusory allegation that Plaintiff has
complied with all the pre ﬁling jurisdictional requirements of the VITCA will not sufﬁce 4‘ In
Ywaang Peng v thlzams,42 this Court stated that ‘ [i]t is the plaintiff‘s burden to convince the
court that the court has jurisdiction       Plaintiff simply asserted a single conclusory allegation in

3 [d at 1] 8 (internal citations omitted)
‘8 744 F 2d 1007 (3d Cir 1984)
3" Id at 1010
‘0 2022 VI Super 33
4' 1d at1 11
" 67VI 482 (VI Super Ct 2017)
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her proposed amended complaint that she has ‘complied with all jurisdictional prerequisites of the
[Virgin Isiands] Medical Malpractice Act and the Virgin Islands Tort Claims Act ’ ’43

                C GESC Governing Statutes

116    The statutes g0» eming GESC and its Board Members are found in 3 V I C §§ 631 640a
Relevant portions are highlighted below Section 631 establishes the Board and provides in part

         (a)    The responsibility for the proper operation of the Government health
         insurance plan, which plan shall for purposes of this subchapter also include and
         authorize a life insurance plan, and for making effective the provisions of this
         subchapter is hereby vested in a board of trustees The members of the
         Government Employees Service Commission shall serve ex ofﬁcio as the
         Health Insurance Board of Trustees (hereinafter in this subchapter referred to as
         the Board ’)

         (b) The Board, subject to the provisions of this subchapter, is hereby empowered
         to adopt rules and regulations relating to

         (1) the eligibility of (a) active and (b) retired employees of the Govemment of
         the United States Virgin Islands to participate in the health insurance plan
         authorized by this subchapter

         (2) the terms and conditions of the insurance contract or contracts, as applied to
         (a) active employees and (b) retired employees

         (3) the purchase of such insurance contract or contracts and the administration
         of the health insurance plan and

         (4) contracting with a third party administrator to administer a self funded health
         insurance plan

         (c) The Board shall create an advisory committee of seven (7) members, which
         shall meet at least twice each year to advise and assist the Board in carrying out
         its functions and responsibilities under this subchapter and to review from time
         to time the health insurance plan 44

117    Section 637 which deals with payment of beneﬁts states in full

'3 1d at 484 (citing Tyson v Samuel Case No SX 2014 CV 00105 2017 V I LEXIS 79 at *3 (Super Ct May 24
2017))
4‘ 3 V I C 9‘ 63]
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         Any beneﬁts payable under the plan may be made either directly to the attending
         physicians, hospitals, medical groups, or others furnishing the services upon
         which a claim is based, or to the covered employee, upon presentation of valid
         bills for such services, subject to such provisions to facilitate payment as may
         be made by the Board 45

1118    Section 638 which deals with contributions states in part

         (c) Notwithstanding any other law to the contrary, the Division of Personnel may
         make straight payments of the Health Insurance premiums under subsection (a)
         to the Government of the Virgin Islands Health Insurance provider 46

1119   Lastly, § 640a, which governs a “Health Insurance Special Projects Fund,” states in part

         (a) Notwithstanding any other law, the Board may establish and maintain a
         separate operating bank account to be known as the “Health Insurance Special
         Projects Fund ’ (“the Fund ) The Board shall provide for the administration of
         the Fund and shall promulgate rules and regulations governing expenditures
         from the Fund, consistent with the provisions of this section

         (e) The Chairperson of the Board, or his designee or designees shall be
         empowered to expend money from the Fund

         (f) Monies in the fund shall be expended for expenses, including operating costs
         and expenses of the Board not otherwise provided for by the operating budget
         of the Division of Personnel, or other costs and expenses associated with the
         administration of the group insurance program as may be considered necessary
         and as duly authorized by the Board 47

               D Contract

1120   The Virgin Islands Supreme Court in Phillip v Marsh Monsanto43 adopted the following
elements for breach of contract claims “(1) an agreement; (2) a duty created by that agreement,
(3) a breach of that duty; and (4) damages ‘9

               E   Insurer Prompt Pay Statute

1[21   The Prompt Pay Statute ’ for insurers is located in 22 V l C § 1725 and states in ﬁJll

”'5 3 V I C § 637
46 3 V I C §638(c)
4 3VlC §640a(a) 3VIC §640a(e) 3 VIC §640a(f)
‘8 66 V I 612 (V I 2017)
“Id at 621 (citing BIOllll/aldl DUMOIIg Capital Inc 63 VI 788 798 (VI 2015))
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       (a) Any insurer pioviding health insurance coverage shall be required to process
           and pay any uncontested claim, within thirty (30) calendar days from the date of
          receiving the claim

       (b) If there is a contested claim, the insurer shall, within the same thirty (30) day
           calendar period notify the health care provider of its decision not to reimburse
          that amount, which notice shall provide a clear and concise statement to the
          health care provider of all the reasons for the insurer’s decision

       (c) Any insurance payment which is not made within the thirty day period shall
           accrue interest at the rate of 10% or the prevailing prime rate applicable on the
           date of payment, pursuant to Title 1 1, section 951 of this Code, or whichever is
           greater, from the date the services were provided to the date of payment

       (d) The health care provider shall be entitled to receive payment from the patient for
          any services rendered which are not reimbursable by the insurer within sixty
          days after service is rendered

       (e) The Commissioner of Insurance may review any contested claim to determine
           whether (I) the services are covered under a health insurance plan, (2) the fees
          are reasonable for the services, and any other matter necessary to determine how
          the claim should be handled ‘0

                 F   Unfair Practices and Frauds Act

1122     The Unfair Practices and Frauds Act is contained in 22 V I C § 1201 which states in full

       (a) No person engaged in the business of insurance shall engage in unfair methods
           of competition or in unfair or deceptive acts or practices in the conduct of such
           business as such methods acts or practices are deﬁned pursuant to subsection
           (b) of this section

       (b) In addition to such unfair methods and unfair or deceptive acts or practices as
           are expressly deﬁned and prohibited by this title, the Commissioner may from
           time to time by regulations promulgated only after a hearing thereon, deﬁne
          other methods of competition and other acts and practices in the conduct of such
          business reasonably found by him to be unfair or deceptive

       (c) No such regulation shall be made effective prior to the expiration of 30 days
           aﬁer the date of the order on hearing by which it is promulgated

5022 VIC § 1725
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       (d) If the Commissioner has cause to believe that any person is violating any such
           regulation he shall order such person to cease and desist thereﬁ‘om The
           Commissioner shall deliver such order to such person direct or mail it to the
               person by registered mail with return receipt requested If the person fails to
               comply therewith before expiration of ten days after the cease and desist order
               has been received by him, he shall forfeit to the people of this territory a sum
               not to exceed $250 for each violation committed thereafter, such penalty to be
               recovered by an action prosecuted by the Commissioner

          111        LEGAL ANALYSIS

                     A GESC is not a proper party to this suit

{[23      Taking the allegations in the Complaint as true and in a light most favorable to Plaintiff,
AeroMD cannot maintain an action against GESC Although AeroMD contends it is suing the
Board Members and not GESC, it is well settled that suing government ofﬁcials in their ofﬁcial
capacity is not a suit against the individual, but the entity they represent As the United States
Supreme Court put it “As long as the government entity receives notice and an opportunity to
respond, an ofﬁcial capacity suit is, in all respects other than name, to be treated as a suit against
the entity           [t is not a suit against the ofﬁcial personally, for the real party in interest is the
entity ”5‘

1i24   Sovereign immunity is “[a] govemment’s immunity from being sued in its own courts
without its consent ”5’ “The Revised Organic Act grants sovereign immunity to the Government
of the Virgin Islands for tort claims ”53 When establishing an instrumentality, entity, semi
autonomous corporation, or other division of the CV], the Virgin Islands Legislature outlines in
the enabling statutes the rights and powers of said division For example, the Virgin Islands Waste
Management Authority 3 (‘ VIWMA”) enabling statute 29 V I C § 496, states that among other
rights and powers it shall have the right to sue and be sued in its corporate name ’54 As this Court
stated in United States Virgm Islands Economic Development Authorzty v h(ypohte,55 “Courts in
the Virgin Islands have found the power to sue and be sued’ instructive, regarding the waiver of
sovereign immunity for government entities ”56

$25       In Hypolzte, this Count found that the Economic Development Authority could be sued as,
like with VIWMA, the enabling statute gave the agency the power to sue or be sued 57 Similarly,

5' Kentucky 1 Graham 473 U S 159 166 (1985)
5’Soi erelgn Immunity BLACK 5 LAW DICTIONARY (1 1th ed 2019)
5’ Yuttang Peng 1 Williams 67 V 1 482 485 n 2 (VI Super (.t 2017)
5‘ 29 V I C § 496(d)
55 Case No ST 2016 CV 00268 2019 V1 LEXIS 10 (V1 Super Ct Jan 28 2019) (unpublished)
5" Id at 1! 7
57 Id at1l 9
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in United Resources Ltd v Virgin Islands Waste Management Authority,58 this Court dismissed
some charges against GVI, as the proper party with regard to those claims was VIWMA since it
had been granted the right to sue or be sued, partially severing it from the government with regards
to tort or contract liability 59 Conversely, in Government Employees Retirement System of the
Virgin Islands v Juan F Lats Hospital & Medical Center,60 the Court dismissed the hospital from
the case because the Virgin Islands Legislature had not granted it the authority to sue or be sued 6'

1126     In the present case, nowhere in GESC s enabling statute, or elsewhere in the subchapter, is
there a right for GESC to sue or be sued Nor is there any sort of indication that the Legislature
intended GESC to have this authority Additionally, there is no indication, either in the enabling
statute or elsewhere, that GESC has any sort of autonomous legal existence or is anyway separate
from GVl Given that it is well established that suing government agents in their ofﬁcial capacity
constitutes a suit against the respective government division those agents represent, and that GESC
has no identity separate from the government or the capability to sue or be sued, then the Court
has no subject matter jurisdiction over GESC and its respective Board Members Therefore, the
individual Board Members must be dismissed ﬁ'om the case

                 B The claims would fail nonetheless against GESC

1127   Assuming arguendo that GESC and its Board Members may be sued, the claims must still
be dismissed AeroMD has failed to comply with the jurisdictional pre ﬁling requirements of
VITCA, and thus the Court lacks jurisdiction over the tort claims asserted against GESC The
Prompt Pay and Unfair Practices and Frauds statute based claims must fail as GESC is not an
insurer nor does it have the ability to pay under third party contracts The only basis for GESC to
presently be able to guide payments is in 3 V l C § 640a, which involves only the Chairman of
the Board or his designee and is in reference to a Health Insurance Special PrOJects Fund, which
is not nor is it alleged to be, at issue in this case ‘2 Otherwise, the statutes governing GESC permit
it to engage a third party to handle health insurance payments and disbursements as well as
authorize the Division of Personnel not GESC, to handle payments 63 Finally, the contract claims
would fail as GESC is not party to any contract with AeroMD nor does it have any agreements
with AeroMD Therefore, even if the Court did have proper subject matter jurisdiction over GESC,
AeroMD 3 claims would still be dismissed as to GESC 3 Board Members

        IV       CONCLUSION

128   On August 8, 2023, AeroMD ﬁled a Complaint against, Intel aha, the nine (9) Board
Members that compromise GESC alleging thirteen ( I 3) Counts sounding in torts, contracts equity,
and statutory violations of the Prompt Pay and Unfair Practices and Frauds Acts GESC is a

58 2024 VI Super 9U
5" See Id at 1H 4 22 (dismissing claims against GVI as VIWMA was the proper legal party to the contract)
6° Case No SK 2016 CV 00346 2016 VI LEXIS 128 (V I Super Ct Aug 29 2016) (unpublished)
6|1d at *4 10
‘ 3 V I C §§ 640(3) 640(e}
°3 3 V I C §§ 631 637 638(c)
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government entity created to advise the Governor and the Legislature and assist them in selecting
and or craﬁing a health insurance plan for the beneﬁt of government employees In creating GESC,
the Legislature did not grant it to the right to sue or be sued or otherwise partition or sever it from
CW as an autonomous or semi autonomous agency, instrumentality, corporation, or other such
division

1129     While AeroMD claims it is suing the Board Members individually, it is well settled that
suing a government agent in their ofﬁcial capacity is genuinely a suit against the division or agency
they serve As the Legislature has not severed GESC from the GVI writ large, the Court lacks
subject mattet jurisdiction over it in particular Even if the Court were to have subject matter
jurisdiction, AeroMD’s claims against GESC would still fail as AeroMD has not complied with
the pre ﬁling requirements of VITCA, AeroMD is not in privity of contract with GESC, GESC is
not an insurer, and GESC does not have the ability to pay under the third party contracts
Therefore, the nine (9) Board Members shall be dismissed from this case with prejudice

1130     Accordingly it is hereby

        ORDERED that Beverley A Joseph, Gilbert Commissiong, Lori Anderson, Clemmie
Mosses St John, Lorraine Morton, Andre Dorsey, Dr Kisha Christian, Debbie Christopher,
and John Abramson Jr are hereby DISMISSED from the case WITH PREJUDICE and it is
further

        ORDERED that the Government Employees Service Commission Health Insurance
Board is hereby DISMISSED from the case WITH PREJUDICE and it is further

       ORDERED that a copy of this Memorandum Opinion and Order shall be directed to
counsel of record

DATED March ﬂ 2024                          W 7 i 3                      27 61M LAO
                                                          DENISE M        RANCOlS
                                               Judge of the Superior Court of the Virgin Islands

ATTEST

TAMARA CHARLES
Clerk of the Court

       LATOYA LAMACHO
W      Court Clerk Supervisor :5 1 / ? [ZDZL/
          IN THE SUPERIOR COURT OF THE VIRGIN ISLANDS
                     District of St. Thomas/St. John

AAC-Air Ambulance Caribbean, Inc., d./b/a      Case Number: ST-2023-CV-00267
Aeromd,                                        Action: Breach of Contract
                   Plaintiff
v.

Cigna Health and Life Insurance Company et
al,
                       Defendant.

                                 NOTICE of ENTRY
                                       of
                                      Order
 To: Ryan C. Meade, Esq.                          Sheena Conway, Esq.
                                                  Eric Andrew Hiller, Esq.
                                                  Maria T. Hodge, Esq.

                          Please take notice that on March 20, 2024
          a(n)                  Memorandum Opinion and Order
                    dated        March 19, 2024         was/were entered
                           by the Clerk in the above-titled matter.

Dated:   March 20, 2024                                             Tamara Charles
                                                                   Clerk of the Court
                                                    By:

                                                                   Elizabeth A. David
                                                                   Chief Deputy Clerk