American United Life Insurance v. Martinez

480 F.3d 1043, 2007 U.S. App. LEXIS 5274, 2007 WL 677729
CourtCourt of Appeals for the Eleventh Circuit
DecidedMarch 7, 2007
Docket05-14920
StatusPublished
Cited by316 cases

This text of 480 F.3d 1043 (American United Life Insurance v. Martinez) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American United Life Insurance v. Martinez, 480 F.3d 1043, 2007 U.S. App. LEXIS 5274, 2007 WL 677729 (11th Cir. 2007).

Opinion

FAY, Circuit Judge:

The appellants, seventeen insurers that filed an ancillary tort suit in a Securities and Exchange Commission (“SEC”) action against a group of viatical settlement companies, challenge the dismissal of their amended complaint. A viatical contract is an agreement to purchase life insurance benefits from a viator, a policyholder who is terminally ill or of advanced age. The original policyholder sells the rights to his policy for a fraction of what the policy would pay upon his death, realizing an immediate return on an otherwise illiquid asset. The insurers alleged that the ap-pellees, three viatical settlement companies and their court-appointed receiver, knowingly purchased and/or serviced life insurance policies from a number of individuals who submitted fraudulent insurance applications. Although the viatical settlement companies (“receivership entities”) had acquired the rights to 1700 of the insurers’ policies before they entered receivership, the insurers’ complaint focused on just five policies. The insurers asserted twenty-five claims, ranging from common law conspiracy, aiding and abetting fraud, violations of the federal Racketeer Influenced and Corrupt Organizations (“RICO”) Act, and violations of the Florida Viatical Settlement Act (“FVSA”) and of a Pennsylvania insurance fraud statute. The receiver moved to dismiss all of the claims except one, which alleged a violation of Pennsylvania insurance law. The district court granted the motion, but dismissed the complaint in its entirety, giving the insurers leave to file a Second Amended Ancillary Complaint by a certain deadline. The insurers allowed the deadline to pass without amending the complaint further, and filed this appeal. For the reasons stated below, we affirm the dismissal of the entire amended complaint, including the stia sponte dismissal of the claim concerning Pennsylvania insurance law.

BACKGROUND

The district court dismissed the insurers’ complaint for being short on the facts, namely, those required to plead fraud under Rule 9(b) of the Federal Rules of Civil Procedure, but we preface this discussion by noting several important facts. The insurers’ complaint hinges on a series of statements that four HIV-positive individuals made when they applied for life insurance in the mid 1980’s-early 1990’s. The individuals all made the same allegedly fraudulent statement on their insurance applications; they said that they had never been diagnosed or treated for AIDS or any other blood or immune system disorder. The insurers do not allege that these particular individuals — Wendell Mullins, Jack Johnson, Gerald Metoyer, and William Bu-chner — share any association with each other, apart from the fact they ultimately sold their policies to the receivership entities. The insurers have not named these individuals or their estates as additional defendants in this suit. Nor have they joined the investors who ultimately purchased interests in these separate viaticáis as parties.

Significantly, none of these individuals resided in Florida, a fact that bars the insurers’ claims under the FVSA, which only regulates viatical transactions with instate viators. 1 Moreover, each of these *1048 individuals obtained their insurance policies from different companies at various times over a ten-year period and, in at least two cases, well before the receivership entities came into existence. 2 One fact that links these separate policies, however, is that they all contain “incontestability” clauses. These clauses grant the insurers a two-year window of opportunity in which to contest a policy. Thereafter, the incontestability clauses prohibit insurers from cancelling or voiding the policy for any reason other than non-payment of premiums.

Accordingly, we note at the outset that the FVSA does not govern the viaticáis at issue here. They are regulated, if at all, by statutes in the states where the viators reside(d). We also note that incontestability clauses may apply here to bar the insurers’ from pursuing their fraud-based claims (request for declaratory judgment, aiding and abetting fraud, conspiracy to commit fraud, and even RICO claims). Given the amount of time that elapsed between issuance of the policies and their conversion into viaticáis, which amounts to at least six years in two instances, statutes of limitations may also apply to bar the insurers from pursuing common law fraud and conspiracy claims. Statutes of limitations may also apply to bar the insurers’ statutory claims under the Pennsylvania law, and may provide alternative grounds for dismissing the insurers’ FVSA claims.

Additionally, only four of the seventeen insurers who joined as plaintiffs in the ancillary action against the receivership entities allege that the receiver played a part in underwriting the challenged policies: Valley Forge Life Insurance Company (“VFL”), Reassure American Life Insurance Company (“Reassure”), American United Life Insurance Company (“AUL”), and Jefferson Pilot Financial Insurance Company (“Jefferson Pilot”). The remaining insurers have not asserted particularized claims against the receivership entities or the receiver.

The impetus behind this complaint occurred on May 3, 2004, when the SEC requested a temporary restraining order (“TRO”) against Mutual Benefits Corporation (“MBC”), Viatical Benefits, LLC (“VBLLC”) and Viatical Services, Inc. (“VSI”). The SEC asked the court to appoint a receiver to administer the companies’ assets while it pursued enforcement proceedings against them for violating federal securities laws. The court *1049 issued a TRO on May 4, 2004, which prohibited the three companies from engaging in new business and appointed a receiver, Roberto Martinez, Esquire, to oversee their existing viatical accounts, which included at least 1700 of the insurers’ policies.

The SEC alleged that the receivership entities had defrauded investors by misrepresenting the amount of escrow that would be needed to cover future premium payments on the policies, by using erroneous life expectancy profiles in solicitations to investors, and by paying premiums on some policies out of the escrow accounts of others. By this point, MBC, which began purchasing viaticáis in 1994, owned interests in over 9,000 separate life insurance policies, and could claim assets, in the form of future death benefits, totalling $1.067 billion.

As news of the SEC action broke, the insurers realized that a large number of their policies might have ended up in the portfolio of viaticáis under receivership. The insurers filed an Ancillary Complaint in the SEC action on August 31, 2004, asserting that a substantial proportion of their policies, perhaps as much as 40%, had been procured through fraud. They based this estimate on a finding in a 2000 Florida grand jury report that noted 40%-50% of the viaticáis brokered by Florida companies had been procured through fraud.

The insurers asserted seven causes of action, five of which were predicated on allegations of fraud.

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Bluebook (online)
480 F.3d 1043, 2007 U.S. App. LEXIS 5274, 2007 WL 677729, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-united-life-insurance-v-martinez-ca11-2007.