MARY ANN VIAL LEMMON, District Judge.
This matter is before the court on motions to dismiss plaintiffs' first amended complaint filed by defendants, National Union Fire Insurance Company of Pittsburgh, PA, American International Group, Inc., Catalyst Health Solutions, Inc., Catamaran Health Solutions, LLC, Alliant Insurance Services, Inc., Alliant Services Houston, Inc. and Virginia Surety Company, Inc.
Plaintiffs, Robert and Maria Watson, filed this putative class action on behalf of themselves and similarly situated Louisiana residents, alleging that defendants are liable to them under theories of unjust enrichment; breach of the duty of good faith and fair dealing; unfair trade practices; conversion; and, civil conspiracy, for their involvement in the sale of a disability and out-of-area emergency insurance policy. Plaintiffs seek to represent a class consisting of: "All individual persons in the State of Louisiana who own, owned and/or purchased disability insurance coverage and/or paid premiums for disability insurance known as HealthExtras with Defendants from 1999 through the date of class certification."
Plaintiffs allege that in 1997, Catamaran, formerly known as Catalyst, and before that known as HealthExtras (collectively, "Catamaran"), developed a disability insurance scheme whereby it sold disability insurance that had a $1,000,000 Accidental Permanent and Total Disability Benefit, and a $2,500 Out of Area Emergency Accident and Sickness Medical Expense Benefit (the "Group Disability Policy"). The policy premium was $9.25 per month for an individual, or $14.50 per month, if the individual added his or her spouse. Catamaran advertised the policy by contracting with credit-card-issuing banks to include a brochure and application in their customers' monthly credit card bills. Consumers who filled out the application and purchased the insurance were designated as "members" of "a fictitious group Trust, which the Defendants own and control, which is called the `AIG Group Insurance Trust, for the Account of HealthExtras'." The participants' insurance premiums were collected as debits on their credit cards.
Plaintiffs allege that Catamaran entered into contracts with various licensed insurance carriers to apply for approval of the Group Disability Policy with each state's insurance department and to underwrite the disability benefits. They claim that the Accidental Permanent and Total Disability Benefit was at first underwritten by Federal Insurance Company, a member of the Chubb Group of Insurance Companies, and after January 1, 2005, National Union. From 2001 to the present, Virginia Surety has underwritten the Out of Area Emergency Accident and Sickness Medical Expense Benefit.
Plaintiffs also allege that because Catamaran "was not a licensed insurance broker in any State, it fraudulently paid for the use of the name, The Sklover Group, Inc., which was a licensed broker and the corporate predecessor to JLT Services Corporation, which is now known as . . . Alliant Services Houston Inc.," and that "the name Alliant Services Houston Inc. has been used by [Catamaran] on correspondence and other documents to create the illusion that [Catamaran] is a valid insurance broker."
In 1999, the Watsons received Catamaran's marketing materials, and purchased the Group Disability Policy with an initial annual premium of $165 that was debited from their credit card. In 2005, the annual premium was increased to $247, and in 2009, it was increased to $319. Plaintiffs allege that the premium increases were illegal because they were enacted without prior approval by the Louisiana Department of Insurance. The Watsons continuously paid the premiums from 1999 until the policies were discontinued on January 1, 2015.
Plaintiffs allege that the insurance program was illegal and defendants purposefully circumvented Louisiana insurance law. According to plaintiffs, Louisiana law requires blanket group disability policies "to be sold only to an employer, or a group which has been otherwise organized and is maintained in good faith for purposes other than that of obtaining insurance." The group "may not be controlled by the insurer and the policy must be issued to a group or association which shall be deemed the policyholder." The group, which has an insurable interest in its members, can "scrutinize the terms of coverage and price of coverage to ensure that its members are receiving a good insurance product for a fair price." Plaintiffs claim that "Catamara, f/k/a Catalyst f/k/a HealthExtras Inc. and its incorporators gained an unfair advantage in the disability insurance market by unilaterally creating their own fictitious `group' and directly marketing an illusory disability policy to individual consumers[.]"
Plaintiffs allege that National Union "either misrepresented to the state insurance regulators that the Group Disability Policy was intended to be issued to a valid group under state law or simply failed to apply for approval of the Group Disability Policy." Plaintiffs claim that neither the insurance policy form, C11695DBG, nor the master policy, SRG 95405189, was approved by the Louisiana Department of Insurance "for sale to any eligible groups in Louisiana."
The defendants filed motions to dismiss arguing that plaintiffs have not stated claims against them under Louisiana law. The defendants all adopt one another's broad arguments.
Rule 12(b)(6) of the Federal Rules of Civil Procedure permits a motion to dismiss a complaint for failure to state a claim upon which relief can be granted. To survive a Rule 12(b)(6) motion to dismiss, enough facts to state a claim for relief that is plausible on its face must be pleaded.
In considering a motion to dismiss for failure to state a claim, the court may consider only the contents of the pleading and the attachments thereto.
Plaintiffs allege that defendants "sale and collection of premiums" for the insurance at issue "constitutes unfair and deceptive business practices in violation of La. Rev. Stat. 22:1964, et seq.". Specifically, plaintiffs allege that the defendants' conduct constitutes an unfair trade practice because:
Plaintiffs allege that "[d]efendants' omissions . . . were unfair and had the tendency to deceive by . . .:"
Plaintiffs claim that:
Defendants argue that plaintiffs cannot maintain unfair trade practices claims because the Louisiana Unfair Trade Practices Act ("LUTPA"), Louisiana Revised Statutes § 51:1401, et seq., does not apply to actions subject to the jurisdiction of the Louisiana Commissioner of Insurance.
Plaintiffs allege that their unfair trade practices claim arises under La. Rev. Stat. § 22:1964, et seq., not LUTPA. Part IV of Chapter 7 of the Louisiana Insurance Code (Title 22) regulates Unfair Trade Practices in the insurance industry. La. Rev. Stat. § 22:1961, et seq. Section 22:1961 provides that Part IV was enacted "to regulate the trade practices in the business of insurance, . . ., by defining and providing for the determination of all acts, methods, and practices which constitute unfair methods of competition and unfair or deceptive acts and practices in [Louisiana], and to prohibit the same."
Under § 22:1967, only the Louisiana Commissioner of Insurance is empowered to enforce Part IV. Section 22:1967 provides that the:
Plaintiffs allege that the defendants "individually and collectively created a fiduciary relationship" and "entered into a contract with" them by creating the "AIG Insurance Trust, for the Account of HealthExtras," and placing plaintiffs in that group. Plaintiffs claim that the defendants "breached the general duty of good faith and fair dealing . . . and the specified duty of good faith identified in La. Rev. Stat. § 22:1973" by selling "illegal insurance coverage" to plaintiffs. More specifically, plaintiffs allege that "[b]y illegally selling the policy to a group that was not and could not be a legal blanket group, the Defendants have breached their duty of good faith and fair dealing with the Plaintiffs[.]"
"Good faith performance is an implied requirement of every contract under Louisiana law."
The insurance policy is the contract at issue in this case. "A policy of insurance is a contract between the [i]nsured and the [i]nsurer and has the effect of law on the parties."
Further, there is no allegation that either National Union, a division of AIG, or Virginia Surety breached their respective insurance contracts with plaintiffs. Indeed, plaintiffs specify in their complaint that they have not made any claims for covered losses under the insurance policy and exclude from the class all persons who have. Therefore, plaintiffs have not stated a claim for breach of the implied covenant of good faith and fair dealing against National Union, AIG or Virginia Surety, and their motions to dismiss are GRANTED as to breach of the implied covenant of duty of good faith and fair dealing claims, and those claims are DISMISSED.
Plaintiffs contend that defendants are liable for breaching the duty of good faith and fair dealing codified in La. Rev. Stat. § 22:1973, which states that "[a]n insurer, . . ., owes to his insured a duty of good faith and fair dealing[,]" and is "liable for any damages sustained as a result of the breach" of that duty. La. Rev. Stat. § 22:1973(A). The statue enumerates actions that constitute a breach of the duty of good faith and fair dealing if knowingly committed by the insurer.
Plaintiffs allege that all of the defendants were unjustly enriched by plaintiffs' payment of premiums for what plaintiffs allege is "an illegal policy that could never be approved by the Louisiana Department of Insurance or lawfully sold to Louisiana residents" because "Plaintiffs and the Class Members were not members of a legal "blanket group.'" Plaintiffs also allege that Catalyst and Catamaran were unjustly enriched because only $2.24 of the $15.95 monthly premium was paid to National Union, and the remainder did not pay "for anything that would benefit the [plaintiffs]", but rather was retained by Catalyst, Catamaran and HealthExtras "to further the illegal HealthExtras Scheme[.]"
Defendants argue that plaintiffs cannot plead an unjust enrichment claim in the alternative to their breach of the duty of good faith and fair dealing claim. National Union, AIG, Virginia Surety, argue that they were not unjustly enriched because plaintiffs received the insurance coverage they paid for, and that if plaintiffs had made a covered claim during the policy period, the insurers would have been obligated to pay those claims. Also, Alliant Insurance Services and Alliant Services Houston argue that plaintiffs have not alleged that these entities received any of the insurance premium, so they could not have been unjustly enriched.
Louisiana Civil Code article 2298, codifies the Louisiana doctrine of unjust enrichment:
The elements of an unjust enrichment claim are: (1) an enrichment of the defendant; (2) an impoverishment of the plaintiff; (3) a connection between the enrichment and the resulting impoverishment; (4) an absence of justification or cause for the enrichment and impoverishment; and (5) there must be no other remedy at law available to the plaintiff.
Article 2298 specifies that unjust enrichment is "subsidiary in nature," and the "remedy is only applicable to fill a gap in the law where no express remedy is provided."
Plaintiffs have not alleged a claim for unjust enrichment against National Union, AIG or Virginia Surety. There was a justification for the enrichment because the insurers would have been obligated to pay any covered claims that plaintiffs made during the policy period if plaintiffs had made such claims. In 2004, HealthExtras sent plaintiffs information regarding their insurance policy which explained the coverages provided by National Union, a division of AIG, and Virginia Surety. Further, plaintiffs potentially had another remedy available at law, because, if the plaintiffs had made a claim for a covered event and the insurers failed to pay it, plaintiffs would have had a breach of contract action against the insurers. As a result, National Union's, AIG's and Virginia Surety's motions to dismiss are GRANTED as to plaintiffs' unjust enrichment claims, and those claims are DISMISSED.
Plaintiffs have not alleged an unjust enrichment claim against Alliant Insurance Services or Alliant Services Houston because they did not allege any enrichment to either entity. Plaintiffs allege that the insurers received a small portion of the premium and the rest was retained by Catalyst, Catamaran and HealthExtras. There is no allegation of any enrichment to Alliant Insurance Services' or Alliant Services Houston. Therefore, Alliant Insurance Services' and Alliant Services Houston's motions to dismiss are GRANTED as to plaintiffs' unjust enrichment claims, and those claims are DISMISSED.
Plaintiffs have stated unjust enrichment claims against Catalyst and Catamaran. Plaintiffs allege that these defendants, along with HealthExtras, were enriched by receiving 80% of the insurance premiums and that plaintiffs were impoverished by this without justification because that payment provided no benefit to plaintiffs. Further, plaintiffs have no other remedy at law available to redress this harm. Plaintiffs did not have a contract with these defendants, nor do they have a remedy under tort law of conversion. Therefore, Catalyst's and Catamaran's motion to dismiss is DENIED as to plaintiffs' unjust enrichment claims.
Plaintiffs allege that the defendants committed the tort of conversion when they "unilaterally increased [the insurance] premiums without notice or regulatory approval and debited the credit card or bank accounts of the Plaintiffs and the putative Class Members for the increased amount." Defendants argue that plaintiffs cannot state a claim for conversion regarding the increased insurance premiums because they implicitly authorized the increased amount by failing to object to the increases and continuing to pay the increased premiums for years.
"Conversion is defined as an act in derogation of the plaintiff's possessory rights or any wrongful exercise or assumption of authority over another's goods, depriving him of the possession, permanently, or for an indefinite time."
In this case, plaintiffs implicitly gave defendants their permission to collect the increased insurance premiums by failing to object when the premiums were increased in 2005 and 2009, and by continuing to pay the increased premiums for years without questioning them. Plaintiffs were informed of the increased insurance premiums on their credit card statements or bank statements, and they did not question these increases in either 2005 or 2009 when they occurred. Instead, plaintiffs continued to pay the premiums, thereby ratifying the increases. Thus, plaintiffs are estopped from bringing conversion claims against the defendants. Defendants' motions to dismiss are GRANTED as to plaintiffs' conversion claims, and those claims are DISMISSED.
Defendants argue that plaintiffs failed to properly plead a claim for civil conspiracy because they did not allege any facts demonstrating an agreement between the defendants to inflict any wrong, and the existence of a business relationship among the defendants is insufficient. Defendants also argue that plaintiffs did not assert any overt acts taken by any defendants in furtherance of the conspiracy. Further, defendants argue that civil conspiracy requires a valid underlying tort claim, which plaintiffs have not alleged. Plaintiffs cite allegations in the complaint which they argue demonstrate that conspiracy is adequately alleged.
"Conspiracy by itself is not an actionable claim under Louisiana law," and must be based on an underlying tort.
Plaintiffs base their civil conspiracy claim on the underlying torts of unfair trade practice violations and conversion. This court has determined that plaintiffs' have no cause of action for unfair trade practice and conversion. Therefore, plaintiffs cannot sustain a claim for civil conspiracy based on unfair trade practice violations and conversion. Defendants' motions to dismiss are GRANTED as to plaintiffs' civil conspiracy claims, and those claims are DISMISSED.
VA Surety seeks payment of under 28 U.S.C. § 1927 of excess costs, expenses and fees incurred in preparing its motion to dismiss plaintiffs' first amended complaint. It argues that plaintiffs' national counsel filed the defective original complaint knowing that the defendants would raise the same arguments they have made in companion cases around the country, and then filed the first amended complaint after defendants filed motions to dismiss the original complaint, which necessitate the filing of motions to dismiss the first amended complaint. VA Surety argues that plaintiffs' national counsel is purposely prolonging the litigation and driving up the defendants' costs.
Title 28, United States Code, Section 1927, provides:
Because § 1927 is penal in nature, it is strictly construed.
No evidence has been presented that plaintiffs' counsel in this case was acting vexatiously, recklessly, in bad faith, or with an improper motive when they filed the first amended complaint in this case. Therefore, Virginia Surety's motion for sanctions under § 1927 is DENIED.