EDWARD M. CHEN, United States District Judge
Plaintiffs
Currently pending before the Court are two motions to dismiss filed by State Farm and the Verisk Defendants. Docket Nos. 70, 72. On the day before the hearing of Defendants' motions to dismiss, Plaintiffs filed a motion for leave to amend in order to add an additional plaintiff(s) (e.g., the Sheahans' contractor and other similarly-situated contractors). Docket No. 90.
The SAC previously pled thirteen claims for relief. Docket No. 28. The Court dismissed the SAC, permitting leave to amend on a majority of claims.
State Farm sells insurance. See TAC ¶ 75. The Verisk Defendants sell a digital database of home construction information; it offers two software products to State Farm: (1)
According to Plaintiffs, Xactimate "may be used ... to arrive at a valuation within a 10% margin of error for construction estimation." TAC ¶ 81. However, "Xactimate is based on manufactured home data, such as trailers and prefabricated homes, to price houses like a kit of parts"; therefore,
Plaintiffs allege that State Farm held out 360 Value as a tool that can accurately and reliably be used in setting insurance policy value. For example, State Farm's website contains the following representation: "The most appropriate way to estimate the replacement cost of your home is to hire a building contractor or other building professional to produce a detailed replacement cost estimate. Or your State Farm agent can utilize an estimating tool from Xactware Solutions [i.e., a Verisk Defendant] to assist you with an estimate." TAC ¶ 84. However, there is no allegation in the TAC that any of the Plaintiffs viewed this representation. Plaintiffs also assert the "behavior" of State Farm sales agents indicated 360 Value was a "detailed replacement cost estimate performed by a contractor or building professional." Id. ¶ 87. However, Plaintiffs include no details regarding this alleged "behavior."
When a 360 Value estimate is given, a disclaimer is provided (at the bottom of the estimate), which states that it "is a general estimate provided for State Farm customers and should not be considered professional replacement cost survey of the building." TAC ¶ 86; see also id. ¶ 87 (360 Value replacement cost estimate for the Sheahans). State Farm also has a disclaimer in its homeowners insurance policy that states:
Id. ¶ 91.
According to Plaintiffs, their homeowners insurance policies, estimates, and cost of rebuilding were as follows:
Moreover, Plaintiffs submit attachments with the TAC entitled "Specific Allegations" describing their interactions with State Farm agents at the time they signed their homeowners insurance policies:
Plaintiffs bring this suit as a class action against State Farm and the Verisk Defendants, asserting the claims described above.
Federal Rule of Civil Procedure 8(a)(2) requires a complaint to include "a short and plain statement of the claim showing that the pleader is entitled to relief." Fed. R. Civ. P. 8(a)(2). A complaint that fails to meet this standard may be dismissed pursuant to Federal Rule of Civil Procedure 12(b)(6). See Fed. R. Civ. P. 12(b)(6). To overcome a Rule 12(b)(6) motion to dismiss after the Supreme Court's decisions in Ashcroft v. Iqbal, 556 U.S. 662, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009), and Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007), a plaintiff's "factual allegations [in the complaint] `must ... suggest that the claim has at least a plausible chance of success.'" Levitt v. Yelp! Inc., 765 F.3d 1123, 1135 (9th Cir. 2014). The court "accept[s] factual allegations in the complaint as true and construe[s] the pleadings in the light most favorable to the nonmoving party." Manzarek v. St. Paul Fire & Marine Ins. Co., 519 F.3d 1025, 1031 (9th Cir. 2008). But "allegations in a complaint ... may not simply recite the elements of a cause of action [and] must contain sufficient allegations of underlying facts to give fair notice and to enable the opposing party to defend itself effectively." Levitt, 765 F.3d at 1135 (internal quotation marks omitted).
State Farm and the Verisk Defendants filed separate motions to dismiss the TAC. State Farm argues that Plaintiffs fail to meet the pleading requirements for all six claims. Docket No. 72 ("State Farm Mot."). The Verisk Defendants join State Farm's motion, but they also argue two additional defenses: (1) the economic-loss rule bars Plaintiffs' state law claims; and (2) the McCarran-Ferguson Act bars Plaintiffs' antitrust claims. Docket No. 70 ("Verisk Mot.").
Plaintiffs' claim for negligent misrepresentation is against State Farm only. The theory of this claim is alleged as follows: State Farm misrepresented that 360 Value and/or Xactimate could provide accurate calculations for determining insurance policy value and replacement cost, respectively. See, e.g., TAC ¶¶ 111-44. The elements of a California negligent misrepresentation
State Farm contends Plaintiffs' misrepresentation claim is subject to the heightened pleading standards of Federal Rule of Civil Procedure 9(b). Plaintiffs do not disagree. Rule 9(b) states that an allegation of "fraud or mistake must state with particularity the circumstances constituting fraud." Fed. R. Civ. P. 9(b). The "circumstances" required by Rule 9(b) are the "who, what, when, where, and how" of the activity. Vess v. Ciba-Geigy Corp. USA, 317 F.3d 1097, 1106 (9th Cir. 2003). In addition, the allegation "must set forth what is false or misleading about a statement, and why it is false." Id.
State Farm argues that under Rule 9(b), the TAC still does not sufficiently allege facts indicating that Plaintiffs received a misrepresentation (i.e., a representation that 360 Value could accurately and reliably determine insurance policy value) and reasonably relied on it. State Farm continues to point out that Plaintiffs have not alleged they ever saw the statement on State Farm's website. Therefore, the website statement cannot be the representation on which Plaintiffs relied. State Farm also contends that, although Plaintiffs indicated the "behavior" of State Farm agents suggests 360 Value "is accurate and can be relied upon to determine policy limits," TAC ¶ 87, Plaintiffs have not pled the alleged behavior with specificity, as required by Rule 9(b).
Plaintiffs argue, however, that they "have alleged with particularity that they communicated with their agents ... and relied upon their agents' representations that policy limits were sufficient to replace the homes." Docket No. 76 ("State Farm Opp.") at 10. Moreover, "Plaintiffs reasonably relied on State Farm's false statements as they continued to renew their policies and believe they had sufficient insurance coverage." Id. But, again, the TAC does not specify what the false statements were, and from whom/to whom they were made. In somewhat of a contradictory manner, Plaintiffs also seem to make an argument that State Farm had a practice of negligent misrepresentation by
Regarding Plaintiffs' Specific Allegations, no affirmative representation about 360 Value's accuracy or that their policies covered the entire rebuild cost is alleged. Accordingly, absent an allegation that Plaintiffs read the statement on State Farm's website or a specific allegation from a State Farm agent that amounts to an affirmative misrepresentation, Plaintiffs' claim must fail because "[a]n `implied' assertion or representation is not enough." Diediker v. Peelle Fin. Corp., 60 Cal.App.4th 288, 298, 70 Cal.Rptr.2d 442 (1997), as modified on denial of reh'g (Jan. 16, 1998)
Plaintiffs attempt to overcome this by citing to J'Aire Corp. v. Gregory, 24 Cal.3d 799, 157 Cal.Rptr. 407, 598 P.2d 60 (1979) for the proposition that, as a party to the contract (e.g., the homeowners insurance policy), State Farm and its agents owed a duty to Plaintiffs to exercise reasonable care—i.e., to take care that Plaintiffs bought sufficient homeowners' insurance. In J'Aire, a restaurant owner sued a general contractor for damages that resulted from the delayed completion of a construction project, which forced the restaurant to shut down. Id. at 802, 157 Cal.Rptr. 407, 598 P.2d 60. But in J'Aire, the legal relationship was not between an insured and an insurer. There, the legal relationship was between the lessee of a commercial property and a contractor who was hired by the lessor to install heating/air-conditioning on the commercial rental property. The lessee's argument was that the contractor owed a duty to them as they were the third-party beneficiary of the contract, so the contractor had an obligation to have the construction "completed within a reasonable time as defined by custom and usage." Id. at 802, 157 Cal.Rptr. 407, 598 P.2d 60. Instead, the contractor delayed the completion of the project, which caused damages to the lessee's business in the form of lost profits. Id. The California Supreme Court held that "a contractor owe[d] a duty of care to the tenant of a building undergoing construction work to prosecute that work in a manner which does not cause undue injury to the tenant's business, where such injury is reasonably foreseeable." Id. at 808, 157 Cal.Rptr. 407, 598 P.2d 60.
J'Aire is inapposite, because there is no alleged contract between State Farm and the Verisk Defendants to which Plaintiffs can claim to be a third-party beneficiary. As discussed at the last hearing, it appears that State Farm is merely a consumer of the software, and there is no basis to find that the agreement between Verisk Defendants and State Farm was intended to benefit State Farm's insureds. See discussion, infra, at Section III.B.
Absent an affirmative misrepresentation, the general rule is that "an insurance agent does not have a duty to volunteer to an insured that the latter should procure additional or different insurance coverage." Fitzpatrick v. Hayes, 57 Cal.App.4th 916, 927, 67 Cal.Rptr.2d 445 (1997), as modified (Oct. 16, 1997). As discussed in Fitzpatrick, the general rule changes only in the following three scenarios: (1) the agent misrepresents the nature, extent or scope of the coverage being offered or provided; (2) there is a request or inquiry by the insured for a particular type or extent of coverage; and (3) the agent assumes an additional duty by either express agreement or by him- or herself out as having expertise in a given field of insurance being sought by the insured. Id. Plaintiffs attempt to argue that scenario (1) is the case here, but the Specific Allegations do not describe with any specificity the alleged misrepresentations. Instead, they merely indicate that Plaintiffs were acting on their assumptions based on, inter alia, State Farm's reputation in the insurance industry. This does not satisfy scenario (1) of Fitzpatrick. There is no allegation that any of the Plaintiffs requested a certain type of insurance coverage, nor is there an allegation that the State Farm agents held themselves out as having any expertise beyond being insurance agents.
Even if Plaintiffs had demonstrated a misrepresentation that fit into one of the Fitzpatrick exceptions thus imposing a duty upon State Farm, any reliance was
TAC ¶ 91 (emphasis added).
State Farm further points out that disclaimers are required by the California Insurance Code. Section 10101 provides:
Cal. Ins. Code § 10101. Section 10102 in turn provides in relevant part:
Id. § 10102 (emphasis added). In response, Plaintiffs do not specifically address the disclaimers aside from calling them "pattern language disclaimers." State Farm Opp. at 7.
In this regard, the Eighth Circuit's decision in Nelson v. American Family Mutual Insurance Company, 899 F.3d 475 (8th Cir. 2018) is instructive. In Nelson, the Court of Appeals upheld the district court's order granting summary judgment for the insurer, holding that its use of 360 Value to calculate an estimate was not a representation that the policy would cover the entire replacement cost of the insured's home. Thus, summary judgment was appropriate against the plaintiff's negligent misrepresentation claim because "the Policy expressly states that American, Family does not guarantee its replacement cost estimate will be the actual replacement cost in the event of a covered loss and that it is up to the policy holder to select the proper amount of coverage." Id. at 481.
Here, Plaintiffs argue that Nelson is distinguishable because State Farm "expressly represented to Plaintiffs that its tools are the same quality as estimates performed by California licensed professionals,
In sum, the disclaimers would render any reliance on the alleged misrepresentation by State Farm unreasonable. Accordingly, because Plaintiffs have not sufficiently pled misrepresentation or reliance, their claim for negligent misrepresentation must fail. State Farm's motion to dismiss this claim is
In Plaintiffs' second claim for relief, they allege that both State Farm and the Verisk Defendants were negligent because they owed them a duty. Given these allegations, the negligence claim appears to be duplicative of the claim for negligent misrepresentation. See Roberts v. Assurance Co. of Am., 163 Cal.App.4th 1398, 1403-04, 78 Cal.Rptr.3d 361 (2008) (arguing that an insurance company has no duty to determine whether an insured has sufficient coverage for his or her needs). To the extent that Plaintiffs attempt to argue that "[o]nce insurance companies began setting policy limits using big data, they took on the responsibility to achieve an accurate replacement coverage estimate[,]" State Farm Opp. at 14, they do not cite authority for this proposition.
Oddly, Plaintiffs allege negligence against the Verisk Defendants, too, despite not pleading a negligent-misrepresentation claim against them. In support of their negligence claim, Plaintiffs allege that
All Plaintiffs' negligence allegations against the Verisk Defendants are one stepped removed—i.e., they rely on alleged representations that the Verisk Defendants made to State Farm, which then require the inference that State Farm made those identical representations to Plaintiffs. There is no factual allegation supporting this conduit theory of reiterated misrepresentation. According to Plaintiffs, the Verisk Defendants "represented that its software could accurately calculate the replacement costs for each home, knowing that Plaintiffs, or State Farm policy holders similarly situated, would consider and rely upon such representations for the purpose of calculating rebuilding costs." TAC ¶ 163. It is unclear what, if any, representations about 360 Value the Verisk Defendants conveyed to State Farm or whether it was conveyed for the purpose of reaching Plaintiffs. No further factual allegations pertain to the Verisk Defendants on this claim for relief, and Plaintiffs' opposition explicitly states that "[d]iscovery is needed to understand the extent of the relationship and communications between [State Farm and the Verisk Defendants]." Docket No. 75 ("Verisk Opp."), at 14. Plaintiffs fail to satisfy Rule 9(b) pleading requirements.
Plaintiffs also cite to J'Aire to support its negligence claim against the Verisk Defendants by analogizing the subcontractor relationship, arguing that they were a third-party beneficiary of any contract between State Farm and the Verisk Defendants and, thus, owed a duty. See Verisk Opp. at 14. This analogy is not persuasive. If anything, State Farm was simply a direct consumer of the 360 Value software; as noted above, there are no alleged facts providing a basis to apply the third party beneficiary doctrine. Indeed, Plaintiffs conceded —and, here, still concede—that 360 Value and Xactimate can yield accurate results if properly used. There is nothing inherent in these products that would inevitably injure State Farm's customers.
As such, the Court
In the third claim for relief, Plaintiffs allege a violation of California Business & Professions Code § 17200 against both State Farm and the Verisk Defendants. Plaintiffs, again, invoke all three prongs of § 17200—e.g., fraudulent, unlawful, and unfair conduct. Defendants argue that Plaintiffs' claim cannot survive because it was mostly dismissed with prejudice. This Court previously ruled as follows:
Dismissing Order at 21 (emphasis added).
Plaintiffs have not alleged enough under Rule 9(b) to establish a claim for fraudulent misrepresentation. As to the Verisk Defendants, Plaintiffs have not alleged that the Verisk Defendants made any misrepresentations, and there are insufficient allegations to support a conspiracy to defraud. Therefore, Plaintiffs' fraudulent-conduct claim under Section 17200 is
The Court previously dismissed this prong with prejudice. But Plaintiffs nonetheless argue that Defendants' conduct was unlawful because they "failed to meet the requirement of Insurance Code § 10103 and Contractor's license § 7208[,]" which, according to Plaintiffs, "may be considered unlawful." State Farm Opp. at 17. They argue that pursuant to Section 7028, "Contractors, including subcontractors, specialty contractors, and persons engaged in the business of home improvement... must be licensed before submitting
The Court previously ruled that this prong is only viable against State Farm. The TAC argues that "Defendants' method of calculating the initial policy limits replacement cost of Plaintiffs' homes materially failed to consider several of these components and features of Plaintiffs' insured structures." TAC ¶ 184. Specifically, Plaintiffs argue that the 360 Value estimate failed to include: (1) costs for architect's plans; (2) roofing material and type of roof; and (3) whether the structure is located on a slope; (4) nonstandard wall heights; and (5) size and type of attached garage. Id. ¶ 185 (citing 10 California Code of Regulations § 2695.183).
State Farm argues that based on the Specific Allegations submitted with the TAC, only the Sheahans allege that State Farm created their estimate using 360 Value (the remaining plaintiffs' estimates predate the use of 360 Value). After comparing the 360 Value report for the Sheahans in October 2009 to their contractor's rebuild estimate, the large disparity is, according to State Farm, based on the Sheahans' desire to rebuild a "more luxurious home."
In any event, the core problem with Plaintiffs' Section 17200 claim is that the requested relief identified by Plaintiffs for Defendants' alleged failure to consider all components of cost was already found by the Court to be inappropriate.
The Court previously dismissed with prejudice Plaintiffs' request for an order requiring State Farm to adjust Plaintiffs' claims without respect to the policy limits of their homeowners insurance policies. Dismissing Order at 10. The Court also dismissed with prejudice Plaintiffs' request for an order compelling State Farm to provide Truth in Insurance disclosures during future policy issuances because the request invades areas that are more appropriate for the California legislature and is largely unnecessary and/or moot by California Insurance Code section 10101 et seq. See Cal. Ins. Code § 10101 (providing that "no policy of residential property insurance may be first issued or.... initially renewed in this state by any insurer unless the named insured is provided a copy of the California Residential Property Insurance disclosure statement as contained in Section 10102").
Accordingly, the Court
The fourth, fifth, and sixth claims for relief are antitrust claims brought pursuant to state and federal law—the Cartwright Act and the Sherman Act, respectively. Plaintiffs continue to label the three claims as "cartel" and "conspiracy" in their hub-and-spoke conspiracy theory. Defendants offer various arguments against this antitrust conspiracy. State Farm argues that Plaintiffs (1) suffered no antitrust injury and (2) fail to state a claim for a vertical conspiracy, hub-and-spoke conspiracy, and Cartwright Act claim. The Verisk Defendants join State Farm's arguments and also argue that the McCarran-Ferguson Act bars Plaintiffs' Sherman Act claims. Verisk Mot. at 17. As discussed below, Plaintiffs claims are problematic because, inter alia, they still have not identified an antitrust injury.
As pled in the TAC, Plaintiffs' antitrust theory is as follows: State Farm deliberately sells inadequate homeowners insurance (i.e., not enough to cover "true" replacement cost) so that it can offer a product cheaper than that offered by the
The Court previously found that Plaintiffs failed to allege any antitrust injury. "Antitrust injury is `injury of the type the antitrust laws were intended to prevent and that flows from that which makes the [antitrust] defendants' acts unlawful.'" Chip-Mender, Inc. v. Sherwin-Williams Co., No. C 05-3465 PJH, 2006 WL 13058, at *5, 2006 U.S. Dist. LEXIS 2176, at *14 (N.D. Cal. Jan. 3, 2006). Defendants argue that there is no injury recognized by the antitrust laws because "Plaintiffs do not contend they paid a supra-competitive price or received coverage lower in quality than they otherwise would have obtained for the same price absent an antitrust violation." State Farm Mot. at 19.
In response, Plaintiffs allege that "[t]he harm is artificially lowered prices for consumers, with significantly decreased insurance coverage quality. The harm to the competing insurance companies is the inability to offer policies for comparatively low rates because the goalposts were moved to underinsure the property at the time that the policy value was offered to Plaintiffs." TAC ¶ 215. The result, according to Plaintiffs, is that other insurers cannot compete with State Farm's cheap pricing that are a product of "diminished coverage quality." Id.
It is unclear what competition or trade State Farm and the Verisk Defendants are alleged to have suppressed, especially if all the other insurance companies are also part of this alleged agreement. If Plaintiffs are alleging that the agreement is
If Plaintiffs are alleging that all insurance companies are using the Verisk Defendants' software, thus causing insureds like Plaintiffs unavoidable injury in the marketplace. Plaintiffs failed to adequately allege such conspiracy. Plaintiffs describe the conspiracy as a hub-and-spoke cartel. TAC ¶ 21; see also Howard Hess Dental Labs. Inc. v. Dentsply Int'l, Inc., 602 F.3d 237, 255 (3d Cir. 2010) (explaining that a hub-and-spoke conspiracy "involves a hub, generally the dominant purchaser or supplier in the relevant market, and the spokes, made up of the distributors involved in the conspiracy. The
For this hub-and-spoke theory, Plaintiffs rely heavily on United States v. Apple Inc. During a bench trial in Apple, however, the district court made a finding that electronic-book publishers conspired with each other and Apple to "eliminate retail price competition in order to raise e-book prices, and that Apple played a central role in facilitating and executing that conspiracy." Apple Inc., 952 F. Supp. 2d at 647. However, Plaintiffs fail to allege specific facts establishing any agreement among insurance companies to use 360 Value in the same way as State Farm—selling policies which purposefully undervalues the property insured in order to reduce premiums. And if all insurers were reducing policy values and hence premium rates, then none are receiving a competitive advantage over other insurers. And, if anything, an industrywide practice of selling cheap insurance would seem to diminish overall profits. Plaintiffs' theory is thus counterintuitive from an antitrust perspective. Plaintiffs failed to state a plausible antitrust claim under Twombly.
Furthermore, Plaintiffs continue to fail to allege antitrust injury. Whereas in Apple, the consumers of e-books suffered an antirust injury in the form of overpriced goods, here Plaintiffs have not overpaid for goods resulting from monopoly power or unreasonable restraint of trade; they allegedly are paying less for an inadequate product.
Plaintiffs seek to argue (and further amend in their complaint) to assert anti-competition or trade restraint aimed at the construction industry; they assert that Sheahan's contractor is available to testify that he lost over $10-20 million in business due to these undervalued policies. Id. ¶ 219. But neither of the Plaintiffs here are contractors. State Farm or the Verisk Defendants are not in competition with the construction industry. Again, Plaintiffs fail to allege antitrust injury to themselves.
Recognizing their failure to overcome the deficiencies identified by this Court when it dismissed similar claims in the SAC, Plaintiffs belatedly seek to amend the complaint (yet again) to add a new Plaintiff—a contractor. But Plaintiffs have had ample opportunity to allege viable antitrust claim. The Court will not allow a fourth amended complaint. Chodos v. W. Publ'g Co., 292 F.3d 992, 1003 (9th Cir. 2002) (discretion to deny leave to amend is particularly broad where plaintiff has had prior opportunities to amend). The Court therefore
Additionally, Plaintiffs' request for leave to file an amended complaint (Docket No. 90) to add the Sheahans' contractor as a plaintiff is
On December 9, 2019 (over a month after the briefing on these motions to dismiss were completed) Plaintiffs filed a request for judicial notice, asking the Court to take judicial notice of the chronology of legislation and case law following Fitzpatrick v. Hayes, 57 Cal.App.4th 916, 67 Cal.Rptr.2d 445 (1997). Docket No. 82 ("RJN"). State Farm objects to the RJN as, among other things, untimely because it was not filed with Plaintiffs' opposition.
This Court
This order disposes of Docket Nos. 70, 72, and 90. The Clerk is instructed to enter Judgment and close the case.
Nelson, 899 F.3d at 478 (emphasis in original).