Blue Cross and Blue Shield of
New Jersey, Inc., &c. et al.,
Respondents,
v.
Philip Morris USA Incorporated,
et al.,
Appellants,
B.A.T. Industries P.L.C., et al.,
Defendants.
2004 NY Int. 169
Plaintiff Empire Blue Cross and Blue Shield is one of
several Blue Cross plans to commence this action against
defendant tobacco companies alleging that defendants engaged in
deceptive practices designed to mislead the public regarding the
"1. Are claims by a third party payer of health care costs seeking to recover costs of services provided to subscribers as a result of those subscribers being harmed by a defendant's or defendants' violation of N.Y. Gen. Bus. Law § 349 too remote to permit suit under that statute?
"2. If such an action is not too remote to permit suit, is individualized proof of harm to subscribers required when a third party payer of health care costs seeks to recover costs of services provided to subscribers as a result of those
subscribers being harmed by a defendant's or defendants' violation of N.Y. Gen. Bus. Law § 349?"
(344 F3d at 229). We accepted certification (100 2 636 [2003]) and answer the first question in the affirmative, rendering the second question academic.
Under common law, an insurer or other third-party payer
of medical expenditures may not recover derivatively for injuries
suffered by its insured. Rather, the insurer's sole remedy is in
equitable subrogation. "Subrogation is the principle by which an
insurer, having paid losses of its insured, is placed in the
position of its insured so that it may recover from the third
party legally responsible for the loss" ( Winkelmann v Excelsior
Ins. Co., , 85 NY2d 577, 581 [1995] [citations omitted]; see also
Nevertheless, plaintiff argues that, in enacting General Business Law § 349, the Legislature intended to abrogate the common-law rule and permit recovery for derivative injuries. But neither the text of the statute nor the legislative history reflect an intent by the Legislature to authorize insurers to bring their own direct (non-subrogated) actions based upon injuries to their insureds. "It is axiomatic concerning legislative enactments in derogation of common law, and especially those creating liability where none previously existed, that they are deemed to abrogate the common law only to the extent required by the clear import of the statutory language" ( Morris v Snappy Car Rental, Inc., , 84 NY2d 21, 28 [1994] [citations omitted]).
To be sure, the language of the statute permits
recovery by any person injured "by reason of" a deceptive
business practice. But we will not presume an intent to include
In holding that third-party payers cannot recover
derivatively under the General Business Law, we recognize that
section 349 is a broad, remedial statute and that the provision
creating a private right of action employs expansive language.
We are also mindful that the Attorney General asks us not to
adopt a inflexible rule of proximate causation that would limit
the tools and remedies available to protect consumers or
undermine the State's power to redress deceptive consumer
practices. In concluding that derivative actions are barred, we
do not agree with plaintiff that precluding recovery here will
necessarily limit the scope of section 349 to only consumers, in
contravention of the statute's plain language permitting recovery
by any person injured "by reason of" any violation ( see e.g.
Securitron Magnalock Corp. v Schnabolk, 65 F3d 256, 264 [2d Cir
1995], cert denied 516 US 1114 [1996] [allowing a corporation to
use section 349 to halt a competitor's deceptive consumer
practices]; Mem of Attorney General, Bill Jacket, L 1980, ch 346
Plaintiff, in arguing that proximate cause is not required under General Business Law § 349 and that plaintiff should as a result prevail, confuses the concept of indirect injury with causation. An injury is indirect or derivative when the loss arises solely as a result of injuries sustained by another party. Although Empire actually paid the costs incurred by its subscribers, its claims are nonetheless indirect because the losses it experienced arose wholly as a result of smoking related illnesses suffered by those subscribers.
The cases cited by plaintiff are not to the contrary. For example, in Catania v 124 In-To-Go Corp. (287 2 476, 477 [2d Dept 2001], lv dismissed , 97 NY2d 699 [2002]), the plaintiff - - permitted to sue a tavern owner under the Dram Shop Act -- was the party directly injured in an assault by an intoxicated person ( see General Obligations Law § 11-101). But no third party was allowed to sue derivatively to recover moneys expended to treat that injury.
Of course, it is beyond dispute that section 349 (h) permits an actually (non-derivatively) injured party to sue a tortfeasor. We hold simply that what is required is that the party actually injured be the one to bring suit. Empire was not directly injured in this sense.
What plaintiff characterizes as an issue of causation is better viewed as a question of standing. Properly framed, the issue is not whether the deceptive practice is a sufficient cause of the plaintiff's injury, but what types of injuries are cognizable under the statute. Plaintiff's injuries are not. We therefore hold that a third-party payer has no standing to bring an action under General Business Law § 349 because its claims are too remote.[3] In so holding, we do not leave plaintiff without remedy. As an insurer, Empire's traditional common-law remedy to recover excess amounts paid on behalf of an insured, arising from the misconduct of a third party, is an action in equitable subrogation.
We further reject Empire's argument that in view of the
collateral source rule of CPLR 4545 (c), the effect of our
decision is to immunize the tobacco companies from liability.
The rule was enacted in 1984 in order to prevent duplicate
recoveries for, among other things, costs of medical care ( see
1 The United States District Court ordered Empire's claims to be tried first, separate from the claims of the other Blue Cross plans ( see Blue Cross & Blue Shield of New Jersey, Inc. v Philip Morris, Inc., 113 F Supp 2d 345, 353 [ED NY 2000]). Thus, only Empire's claims are at issue for purposes of this appeal.
2 The District Court subsequently awarded plaintiff attorneys fees in the amount of $37,841,054.22 ( see Blue Cross and Blue Shield of New Jersey, Inc. v Philip Morris, Inc., 190 F Supp 2d 407, 429 [ED NY 2002]).
3 We are thus in agreement with A.O. Fox Mem. Hosp. v Am. Tobacco Co., Inc. (302 2 413, 424 [2d Dept 2003]) and Eastern States Health & Welfare Fund v Philip Morris, Inc. (188 Misc 2d 638, 646-647 [Sup Ct, NY County 2000]), which held that the plaintiffs' claims for deceptive trade practices were too remote to allow recovery because they were derivative of the harm to their patients/members. This outcome is also in accord with several other courts that recognize a remoteness bar to recovery under their state consumer protection statutes ( see e.g. Ganim v Smith & Wesson Corp., 780 A2d 98, 133-134 [Conn 2001]; Oregon Laborers-Employers Health & Welfare Trust Fund v Philip Morris, Inc., 185 F3d 957, 968 [9th Cir 1999]; compare Group Health Plan, Inc. v Philip Morris, Inc. 621 NW2d 2, 9-10 [Minn 2001]).