WARREN W. EGINTON, Senior District Judge.
In this action, plaintiff Lima LS PLC has brought its complaint concerning life insurance policies bought on the secondary market against defendants PHL Variable Insurance Company ("PHL"), Phoenix Life Insurance Company ("PLIC"), The Phoenix Companies, Inc. ("PNX") (collectively, the "Phoenix Defendants"), James Wehr, Philip Polkinghorn, Edward Cassidy, Dona Young and Does 1-20 (collectively, the "Individual Defendants"). Plaintiff alleges the following counts: (1) monopsony
Defendants now move to dismiss this complaint for failure to state plausible claims for relief. For the following reasons, the motion to dismiss will be granted in part and denied in part.
For purposes of ruling on a motion to dismiss, the Court accepts all allegations of the complaint as true.
Plaintiff is a company incorporated in England and Wales with limited liability. Its principal place of business is London.
The Phoenix Companies ("PNX") is the parent company of PHL Variable Insurance Company ("PHL") and Phoenix Life Insurance Company ("PLIC"). PNX's officers and directors overlap with the officers and directors of defendants PHL and PLIC. PLIC issued the life insurance policies owned by plaintiff.
James Wehr is the President and Chief Executive Officer of PNX. Philip Polkinghorn is the Executive Vice President of Business Development of PNX and President of PNX's Life and Annuity Business Segment. Edward Cassidy is the Executive Vice President of Distribution of PNX. Dona Young was the President of PNX from 2000 to April 15, 2009; the Chief Executive Officer and Chairman of the Board of PNX from 2003 to April 15, 2009; and a consultant to PNX until at least April 15, 2010.
The Phoenix Defendants have targeted the market of high net worth individuals, who may want to invest in life insurance with the knowledge that they might sell their policies in the future on the secondary market. The Phoenix Defendants have relied upon the existence of the secondary market for life insurance to drive the primary market for life insurance policies with high death benefits.
Plaintiff is a participant and investor in the secondary market for Phoenix life insurance policies. Plaintiff holds the interest in 197 Phoenix policies (the "Policies") currently in force that were issued between 2003 and 2009. The Phoenix Defendants have collected premiums paid by plaintiff on these policies, although plaintiff has lapsed or surrendered 52 policies. Plaintiff acquired the interest in the policies in December 2010 through its acquisition of five limited liability companies that held interests in the Policies. Plaintiff has resold or attempted to resell Phoenix policies to other investors in the secondary market.
After the stock market crashed in 2008, the Phoenix Defendants sustained massive financial losses and faced difficulty in meeting contractual obligations on billions of dollars in life insurance policies. In response to a weak financial position, the Individual Defendants and other corporate officers orchestrated a plan designed to eliminate the liabilities associated with the life insurance policies. Defendants launched an aggressive campaign to attack and undermine previously-issued policies by refusing to honor or record transfers of ownership. Through such strategy, a policy issued by defendants would become undesirable even to the policyholders, who would be faced with the decision whether to continue paying premiums in light of the uncertainty concerning the future payment of benefits by the Phoenix Defendants. Thus, the uncertainty created by defendants would induce policyholders to lapse or surrender their policies back to the Phoenix Defendants. The Phoenix Defendants would then be able to keep all or most of the premiums without shedding the future liabilities associated with the policies.
Defendants have engaged in tactics to maintain or attain a monopsony for the Phoenix Defendants in light of their unique position to control the value of Phoenix life insurance policies on the secondary market. The Phoenix Defendants have driven the secondary market purchasers out of the market while forcing secondary market sellers to decide whether to continue to pay premiums or sell their policies back for nothing or next to nothing.
The Phoenix Defendants' alleged anticompetitive acts in controlling the secondary market include: (1) refusing to record the transfer of ownership of policies to prevent the secondary market sales of policies to buyers other than the Phoenix Defendants; (2) refusing to tell policyholders whether the policies would be honored; (3) improperly raising cost of insurance ("COI") rates for unauthorized purposes, including targeting policies that were purchased by competitors in the secondary market for policies; (4) raising COI rates on policies that the Phoenix Defendants later contend are void; (5) issuing false and misleading policy illustrations that reflect higher future COI charges to cause policyholders to misprice their policies and/or cause them to make a decision to lapse or surrender their policies; (6) reneging on verifications of coverage; (7) informing policyholders that they cannot rely on the Phoenix Defendants' written statements; (8) improperly denying death benefit claims on the ground that the policies are invalid; (9) delaying and refusing to pay death benefits for pretextual and bad faith reasons; and (10) refusing to return the premiums collected when seeking to rescind or void policies.
Defendants have allegedly used litigation for an improper anticompetitive purpose by initiating lawsuits without regard to fact or law seeking to void policies. The Phoenix Defendants are now parties in approximately 86 lawsuits.
The Phoenix Defendants' conduct has resulted in a diminished secondary market for their life insurance policies. Any buyers are only willing to purchase policies at severely reduced prices because they do not know whether the terms of the policies will be honored. Plaintiff has suffered and will continue to suffer financial injury because it has been deprived of revenue and profits that it would have made on the policies had the value of such policies not been diminished by defendants' anticompetitive conduct.
The function of a motion to dismiss is "merely to assess the legal feasibility of the complaint, not to assay the weight of the evidence which might be offered in support thereof."
With regard to allegations of fraud or fraudulent conduct, a plaintiff must comply with the higher pleading standard required by Federal Rule of Civil Procedure 9. In order to satisfy Rule 9(b), a complaint must: (1) specify the statements that the plaintiff contends were fraudulent; (2) identify the speaker; (3) state where and when the statements or omissions were made; and (4) explain why the statements or omissions were fraudulent.
Plaintiff has brought its antitrust claims pursuant to the Connecticut Antitrust Act, Connecticut General Statutes §§ 35-24 through 35-45. Specifically, plaintiff has alleged claims for monopsony and attempted monopsony under Section 35-27, which provides that "every contract, combination or conspiracy to monopolize, or attempt to monopolize, or monopolization of any part of trade or commerce is unlawful;" and Section 35-28, which prohibits contracts, concerted action or conspiracy to engage in certain anticompetitive action, including,
Defendants assert that plaintiff's Section 35-28 claims fail because plaintiff cannot establish concerted action; and that plaintiff's Section 35-27 claim fails because (1) the relevant product market cannot be limited to the Phoenix Defendants' brand; (2) Phoenix Defendants have no market power; and (3) plaintiff has not alleged that the Phoenix Defendants engaged in anticompetitive conduct. Generally, Connecticut courts follow federal precedent to interpret the Connecticut Antitrust Act unless the text of the statute or other relevant state law requires a different interpretation.
Section 35-28 has been interpreted to codify federal case law relevant to "per se" antitrust violations, notably Section 1 of the Sherman Antitrust Act, 15 U.S.C. § 1, which prohibits restraints of trade effected by a contract, combination or conspiracy.
Section 35-27 is patterned after Section 2 of the Sherman Act.
The relevant market refers to the relevant product market and the relevant geographic market.
In this instance, the relevant market is the secondary market for life insurance policies issued by the Phoenix Defendants. Defendants argue that plaintiff cannot establish a rational or plausible single-brand market. See Green Country Food Mkt.,
Plaintiff counters that it can establish a single-brand market based on
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Thus, the Court must consider whether plaintiff has sufficiently alleged the
As to the first factor, plaintiff has alleged that purchasers of Phoenix life insurance policies become locked into a Phoenix-specific secondary market due to high switching costs involving a lengthy application process. Plaintiff also alleges that another life insurance company is not likely to insure the same individual with an additional policy and that need for additional policies from another insurer is diminished. As to information costs, plaintiff has alleged that the "lifecycle cost of universal life insurance policies generally, and of Phoenix policies in particular, is not transparent to prospective insureds in the primary market; it is instead difficult to understand and opaque." Plaintiff alleges further that "[c]onsumers who are the primary market purchasers of life insurance have little or no access" to information concerning the basis of the COI rate, which is "essential to the understanding of the true lifecycle cost of a life insurance policy." The complaint maintains that "insurers do not disclose precisely how they have priced their policies, and they write their contracts in a manner that makes them virtually incomprehensible to policyholders." Relevant to the third factor, plaintiff asserts that the Phoenix Defendants changed practices by raising or attempting to raise the COI rates on policyholders who exercised their right to maintain lower accumulated policy values and that the change in practices was not known or foreseeable to policyholders at the time of policy purchase.
Plaintiff refutes defendants' assertion that plaintiff cannot establish a plausible single-brand market without an allegation of tying. Plaintiff argues that it need not allege any tying of product sales because this case involves a monopsony. Plaintiff explains that, in a monopsony, the primary market seller (the secondary market monopsonist) seeks to buy products in the secondary market at low costs and cuts off the secondary market seller from other potential buyers; by contrast, in a monopoly, the primary market seller seeks to sell additional products in the secondary market, which can be achieved by tying the primary market purchaser to additional purchases of secondary products from the same seller.
Defendants assert that plaintiff cannot plausibly allege that the Phoenix Defendants held and maintained market share and market power over a sustained period of time as required for an antitrust claim.
Plaintiff has alleged that the Phoenix Defendants retain a 75% share of the secondary market for Phoenix life insurance policies, which should be sufficient to establish market power for antitrust purposes.
Plaintiff counters that the Court should focus upon the "economic reality of the market at issue."
Defendants assert that plaintiff has failed to allege exclusionary conduct or anticompetitive acts. Defendants maintain that the alleged policy correspondence, legal actions, COI rate increases, policy illustrations, and refusals to confirm coverage constitute lawful conduct that may have created uncertainty among the investors.
Exclusionary conduct consists of acts that tend to impair the opportunities of rivals and that do not further competition on the merits or do so in an unnecessarily restrictive way.
Defendants maintain that abundant legal precedent affirms that insurers may challenge policies for lack of an insurable interest even after the two-year contestibility provision has expired.
Plaintiff alleges as exclusionary conduct the Phoenix Defendants' refusals to verify policy validity and payment of benefits on future policy claims. Defendants maintain that there is no legal obligation to do so.
In an unpublished decision, the Central District of California noted: "Phoenix's obligation to pay the death benefits is contingent on the Receiver's continued performance of the insurance contracts by timely paying the premiums. In sum, Phoenix's obligations are not yet due, may never become due if the Receiver decides to stop paying the premiums, and, in event the Policies do mature, Phoenix may decide to pay them."
The District Court of Minnesota considered the plausibility of a fraud claim based on allegations that PHL had represented that a life insurance policy was "in force," "issued" and had "value," although PHL actually considered the policy void and intended to challenge it.
Plaintiff alleges that, in March 2009, the Phoenix Defendants refused to record transfers of ownership in response to requests by several trusts. Defendants maintain that plaintiff should have alleged other instances where the Phoenix Defendants refused to record ownership changes and that plaintiff has failed to allege that defendants have refused to record transfers of ownership relevant to plaintiff's Policies. However, plaintiff has alleged that such bad faith conduct was intended to, and did, substantially depress demand for Phoenix policies in the secondary market. Plaintiff has alleged the requisite facts to establish plausible exclusionary conduct. It need not allege that defendants refused to record transfers of ownership relevant to plaintiff's Policies or cite to other instances of such conduct.
Plaintiff asserts that the Phoenix Defendants have revived policy liens to limit transferability and avoid payment of claims. At paragraph 132, plaintiff alleges: "Phoenix claimed it could not pay the benefits [that had become due when the insureds passed away] unless plaintiff provided Phoenix with a schedule to a purchase agreement to which plaintiff was not a party, which Phoenix said it needed to prove that its own prior conduct in releasing the collateral assignments had, in fact, been correct." At paragraph 134, plaintiff alleges:
Defendants contend that this conduct cannot be considered exclusionary because plaintiff has now been paid in full. However, plaintiff has alleged sufficient facts to establish plausible anticompetitive conduct based on defendant's revival of previously released liens.
Plaintiff has alleged that the Phoenix Defendants issued false policy statements; and that defendants' notices of COI rate increases
Plaintiff has alleged attempted monopsony, which requires allegations that (1) defendants engaged in predatory or anticompetitive conduct; (2) defendants had the intent to monopsonize; and (3) there was a dangerous probability of achieving monopsony power.
Defendants maintain that there is no risk of the alleged monopsony because plaintiff has not alleged a plausible market, market power or exclusionary conduct. For the reasons previously articulated with regard to the claim of monopsony, the Court finds that plaintiff has alleged a plausible attempted monopsony claim.
Plaintiff has based its CUTPA claim upon violation of the Connecticut Unfair Insurance Practices Act ("CUIPA").
Defendants argue that a "boycott" has been defined within the context of antitrust law as "a concerted refusal to deal" with a disfavored purchaser or seller.
Plaintiff does not address defendants' assertion that no cognizable boycott has been alleged. It counters that the complaint alleges that the Phoenix Defendants have engaged in coercion and intimidation by trying to force policyholders to lapse or surrender their policies.
The Court notes that defendants' cases defining "coercion" and "intimidation" are not specific to the context of CUIPA. Defendants have provided no authority indicating that the Connecticut legislature intended that coercion and intimidation should be afforded such meaning to maintain a CUIPA claim. Accordingly, the Court will not dismiss these claims on the motion to dismiss because the law does not firmly establish that dismissal is proper.
Additionally, plaintiff contends that its allegations against defendants also satisfy the other provisions of CUIPA that prohibit misrepresentations, false advertising, false information and unfair claim settlement practices. Although the complaint does not clearly allege that it asserts such violations of CUIPA, the Court finds that the complaint is susceptible to such interpretation.
Defendants also assert that plaintiff has not alleged damages. For purposes of CUTPA, the extent of the loss need not always be proven with specificity but a party must show that the CUTPA violation produced some loss.
Accordingly, the Court will allow plaintiff to amend the complaint to clarify the violations of CUIPA that it asserts within count three.
Defendants argue that plaintiff's RICO allegations are deficient because (1) plaintiff has not adequately alleged how the Individual Defendants were involved in the racketeering acts; (2) plaintiff has alleged anticipatory breach of contract rather than mail and wire fraud; (3) plaintiff lacks standing because it has not been injured; (4) plaintiff has failed to allege a conspiracy; and (5) the McCarran-Ferguson Act exempts defendants' activities from RICO liability.
Plaintiff alleges that the Individual Defendants are liable under the civil RICO statute, 18 U.S.C. § 1962(c), which provides that it is unlawful for "any person employed by or associated with any enterprise engaged in, or the activities of which affect, interstate or foreign commerce, to conduct or participate, directly or indirectly, in the conduct of such enterprise's affairs through a pattern of racketeering activity...." A RICO claim based on mail and wire fraud must satisfy Federal Rule of Civil Procedure 9(b) by pleading with particularity the circumstances constituting fraud.
A plaintiff must establish that a RICO person directed a RICO enterprise in a pattern of racketeering activity that proximately caused injury to plaintiff's business or property.
Defendants advance that the complaint is deficient because it lacks specific allegations concerning each defendant's participation in the enterprise. Defendants posit that the complaint alleges that defendants collectively "resolved" to prevent the Phoenix Defendants from paying claims on investor-owned policies and "directed" routine correspondence that failed to disclose the intent to void the policies.
Plaintiff counters that the complaint meets the requirement of alleging participation pursuant to Section 1962(c) as set forth by the "operation and management test" of
The complaint alleges,
Although the complaint is highly detailed with regard to the value of defendants' stock shares and marketing of insurance policies to be sold to investors in the secondary market, the complaint lacks specific allegations as to actual acts specific to each of the Individual Defendants. At present, the complaint provides conclusory or even speculative allegations regarding the Individual Defendants' intent, participation and management of the alleged RICO Phoenix enterprise. Plaintiff appears to rely upon the corporate positions of the Individual Defendants to indicate their ability to direct or manage the enterprise. Accordingly, the Court will grant the motion to dismiss on the ground that plaintiff has failed to allege conduct by the Individual Defendants with adequate specificity.
Defendants also argue that plaintiff has failed to establish allegations of a plausible RICO conspiracy pursuant to 18 U.S.C. § 1962(d), which provides that it is "unlawful for any person to conspire to violate any of the provisions of" 18 U.S.C. § 1962(a), (b) or (c). Thus, plaintiff must establish (1) that defendants agreed to facilitate the operation of a RICO enterprise through a pattern of racketeering activity; and (2) that defendants agreed to commit the requisite predicate acts in furtherance of a pattern of racketeering activity in connection with the enterprise.
Defendant asserts that plaintiff's claim for conspiracy also fails because plaintiff has not sufficiently pleaded its RICO claim under Section 1962(c). To the extent that plaintiffs' Section 1962(c) claim is subject to dismissal, the Court will also dismiss the claim of conspiracy.
To determine whether plaintiff should be afforded the opportunity to replead, the Court must consider defendants' arguments relevant to lack of predicate acts, lack of injury and standing, and the McCarran-Ferguson Act.
Plaintiff alleges that defendants used the mail and wires to send correspondence that contained mispresentations of fact or fraudulently concealed that defendants secretly intended to deny death claims on life insurance. Plaintiff may not predicate a RICO claim on a hypothetical or anticipatory fraud.
Defendants maintain that plaintiff's claims are unripe and lack the requisite injury. RICO provides a cause of action to "[a]ny person injured in his business or property by reason of" a RICO violation. 18 U.S.C. § 1964(c).
Defendants complain that plaintiff has not yet submitted a death benefit claim, and therefore, it cannot assert that it has sustained damages due to defendants' failure to pay on the claim. Defendants assert that plaintiff cannot seek recovery for payments on claims that it believes will not be honored.
The RICO violation at issue must be proximate cause of the injury to plaintiff's business or property.
In this instance, plaintiff pleaded that it has already lost money due to Policies that have either lapsed or been surrendered, and that defendants have failed to pay or delayed making payments on $33 million in claims. Plaintiff also asserts that defendants' fraudulent scheme has resulted in the devaluation of the Policies. These alleged injuries are all susceptible to a proof because they are not contingent upon events that are yet to occur.
Plaintiff has also alleged that defendants' fraud— including the statements concerning policy validity that failed to disclose the intent to challenge the Policies—has caused plaintiff to purchase the Policies and continue making premium payments. Such injury is premised upon the contingency that plaintiff will not recover the benefits of the Policies. Accordingly, the Court will dismiss any claimed injuries that are hinged upon facts that have yet to be determined.
Defendants argue that plaintiff's claims are incompatible with the McCarran-Ferguson Act.
The McCarran-Ferguson Act provides that "continued regulation and taxation by the several States of the business of insurance is in the public interest," and that "silence on the part of the Congress shall not be construed to impose any barrier to the regulation or taxation of such business by the several States." 15 U.S.C. § 1011. Section 1012(b) provides that federal legislation not specifically relating to the business of insurance cannot be "construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance." The Supreme Court has held that RICO is applicable in the insurance context when it aids or enhances the state regulation and "does not frustrate any declared state policy or disturb the State's administrative regime...."
Defendants argue that application of RICO would disrupt Connecticut insurance law that regulates the content of information transmitted to a policyholder. Defendants point out that Connecticut insurance regulations require the issuance of annual policy statements that specify information including policy values and death benefits and production of an illustration that contains specific information. However, defendants doe not elaborate as to how a federal cause of action seeking remedies for fraud related to the annual statements and illustrations will invalidate, impair and supersede Connecticut's insurance laws.
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Plaintiff alleges fraud and conspiracy against all defendants. Defendants argue that the fraud and conspiracy claims fail for the same reason as the RICO claim. Consistent with the discussion relevant to the RICO claim, plaintiff has not pleaded fraud with particularity with regard to the conduct by the Individual Defendants.
The Court will dismiss the claim of conspiracy with prejudice because the allegations concern conduct of employees acting in the scope of their duties for their employer. The intracorporate conspiracy doctrine bars a finding of conspiracy among employees of a corporation where the wrongful conduct was performed within the scope of official duties where the conduct (1) occurs within the employer's authorized time and space limits; (2) is of the type that the employee is employed to perform; and (3) is motivated, at least in part, by a purpose to serve the employer.
Federal Rule of Civil Procedure 15 provides that leave to amend a pleading "shall be freely given when justice so requires." Generally, courts permit repleading after granting a motion to dismiss.
For the foregoing reasons, the Court GRANTS the motion to dismiss as to the alleged violations of Connecticut General Statutes § 35-28 and the claim of common law conspiracy, which are dismissed with prejudice. The Court GRANTS the motion to dismiss as to the RICO and common law fraud claims, which are dismissed without prejudice. The Court DENIES the motion to dismiss as to the alleged violations of Connecticut General Statutes § 35-27, although the allegations that defendants' litigation constitutes exclusionary conduct are dismissed. The Court also DENIES the motion to dismiss the claim of CUTPA violation.
Within thirty days of this Ruling's filing date, plaintiff should file an amended complaint consistent with this Ruling.