Ameritas Life Ins. Corp. v. Morgan

933 F.2d 1007, 1991 U.S. App. LEXIS 16765, 1991 WL 86260
CourtCourt of Appeals for the Sixth Circuit
DecidedMay 24, 1991
Docket90-6213
StatusUnpublished

This text of 933 F.2d 1007 (Ameritas Life Ins. Corp. v. Morgan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ameritas Life Ins. Corp. v. Morgan, 933 F.2d 1007, 1991 U.S. App. LEXIS 16765, 1991 WL 86260 (6th Cir. 1991).

Opinion

933 F.2d 1007

Unpublished Disposition
NOTICE: Sixth Circuit Rule 24(c) states that citation of unpublished dispositions is disfavored except for establishing res judicata, estoppel, or the law of the case and requires service of copies of cited unpublished dispositions of the Sixth Circuit.
AMERITAS LIFE INSURANCE CORPORATION, Plaintiff-Apellant,
v.
Leroy MORGAN, formerly Commissioner of the Kentucky Dept. of
Insurance; and Matthew Johnson, Director of the
Life and Health Division of the Kentucky
Dept. of Insurance,
Defendants-Appellees.

No. 90-6213.

United States Court of Appeals, Sixth Circuit.

May 24, 1991.

Before KRUPANSKY and MILBURN, Circuit Judges, and CONTIE, Senior Circuit Judge.

PER CURIAM.

Plaintiff-appellant, Ameritas Life Insurance Corp. ("Ameritas" or "plaintiff"), appeals the district court's grant of summary judgment to defendants-appellees, Leroy Morgan, formerly Commissioner of the Kentucky Department of Insurance; and Matthew Johnson, Director of the Life and Health Division of the Kentucky Department of Insurance, on this 42 U.S.C. Sec. 1983 claim. For the following reasons, we affirm.

I.

Ameritas, the plaintiff insurance company, contends that the defendants, regulatory officials with the Kentucky Department of Insurance, unlawfully denied Ameritas the right to sell pharmaceutical policies of insurance in Kentucky. Ameritas is a Nebraska-based insurance company, which attempted in April 1989 to obtain approval from the Kentucky Department of Insurance for its proposed Prescription Drug Expense Benefits group insurance policy. In the proposed insurance form, Ameritas listed 22 exclusions from coverage. Exclusion number 18 stated that the policy would pay "no benefits for expenses incurred because of an injury arising out of, or in the course of, work for wage or profit." In other words, the policy contained a blanket exclusion for claims that arose out of the insured's employment or for-profit activities.

The two defendants in this action were officials of Kentucky's Department of Insurance. Leroy Morgan was Kentucky's Commissioner of Insurance and Matthew Johnson was the department's Director of the Life and Health Division. Defendants maintain that plaintiff's proposed policy of insurance was denied approval because it contained a blanket exclusion for claims that arise out of the insured's employment or for-profit activities, which is deceptive. It is the position of defendants that this exclusion would deceptively affect the risk purported to be assumed in the general coverage of the insurance contract, a violation of K.R.S. Sec. 304.14-130(1)(b). This statute gives the Commissioner of Insurance the authority to disapprove of any form that contains "exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract." Defendants refused to approve plaintiff's proposed exclusion number 18 based on their interpretation of the authority granted to them under this Kentucky statute. The defendants also refused to approve this proposed policy exclusion because they concluded that the policy, as written, violated the Kentucky Consumers' Protection Act.

In response to the intitial rejection of the policy, plaintiff Ameritas modified the wording of the exclusion, adding a prominent disclaimer to the policy indicating that all work-related injuries were excluded. However, defendants still refused to approve the policy, and stated that plaintiff's policy would be approved only if plaintiff deleted the blanket exclusion and limited the exclusion to those situations where the insured was covered by workers' compensation. Plaintiff refused to do so.

Plaintiff then requested an administrative hearing to determine the propriety of the defendants' decision as it was entitled to do under K.R.S. 304.2-310(2)(b). Plaintiff Ameritas contended that the Commissioner's actions were in excess of his authority under Kentucky law, that the Commissioner's actions denied plaintiff due process, and that the Commissioner's decision was arbitrary.

Pursuant to plaintiff's request, a hearing was held on January 24, 1990 before a Hearing Officer appointed by the Commissioner of Insurance. The Hearing Officer subsequently issued recommended Findings of Fact and Conclusions of Law, finding that plaintiff's proposed exclusion did not violate Kentucky law. The Hearing Officer also determined that the Commissioner had no statutory or regulatory authority to issue a per se rule under which a certain class of exceptions to coverage (including exceptions that excluded coverage for work-related injuries) was unallowable under K.R.S. Sec. 304.14-130(1)(b). Nonetheless, the Commissioner of Insurance, defendant Morgan, chose to disregard the Hearing Officer's recommendation and issued his own order, reaffirming his disapproval of the policy. Plaintiff appealed this order to the Franklin Circuit Court pursuant to KRS Sec. 304.2-370, which allows an appeal as of right from an order of the Commissioner. That appeal is pending.

On January 9, 1990, before the hearing with the Hearing Officer had taken place, plaintiff filed suit in the federal district court for the Eastern District of Kentucky under 42 U.S.C. Sec. 1983, alleging that it had suffered a deprivation of substantive due process because of defendants' "wanton and arbitrary" action in declining to approve any insurance form that contained a blanket exclusion barring the payment of benefits resulting from work-related injuries. Plaintiff sued the two defendants in their individual capacities only, seeking compensatory and punitive damages as well as declaratory and injunctive relief.

On August 14, 1990, the district court granted defendants' motion for summary judgment. Plaintiff timely filed this appeal.

II.

We must decide whether the district court erred in deciding that plaintiff failed to state a colorable constitutional claim under section 1983.

Plaintiff argues that his due process rights were violated by the defendants' "flagrant abuse of power" in enforcing an "unwritten rule" that was not authorized under Kentucky law. Plaintiff contends that defendants' actions were not authorized by written Kentucky law and that it has complied with every state statute and written rule or regulation regarding insurance exclusions in force. Plaintiff argues that because it has complied with the law of Kentucky, defendants acted arbitrarily and capriciously in denying them the right to sell insurance there by promulgating an unwritten rule.

The district court treated these allegations as a claim of substantive due process. We disagree with this approach. This claim has two components. The first component requires a determination of state law. In other words, the resolution of this lawsuit demands a determination of whether or not plaintiff's disclaimer is "deceptive" within the meaning of K.R.S. 304.14-130(1)(b), which gives the Commissioner of Insurance the authority to prevent deceptive practices. This is not a federal issue.

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Bluebook (online)
933 F.2d 1007, 1991 U.S. App. LEXIS 16765, 1991 WL 86260, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ameritas-life-ins-corp-v-morgan-ca6-1991.