Brown v. Continental Casualty Company

CourtDistrict Court, N.D. Illinois
DecidedMarch 15, 2022
Docket1:21-cv-02349
StatusUnknown

This text of Brown v. Continental Casualty Company (Brown v. Continental Casualty Company) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brown v. Continental Casualty Company, (N.D. Ill. 2022).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

Damian B. Brown, an individual, and James Mueksch, an individual, on behalf of themselves and all others similarly situated, Case No. 21-cv-2349

Plaintiffs, Judge Mary M. Rowland

v.

Continental Casualty Company,

Defendant.

MEMORANDUM OPINION AND ORDER This case arises from alleged misrepresentations contained in Defendant Continental Casualty Company’s long-term care insurance policy issued to Wells Fargo. Two Wells Fargo employees, Plaintiffs Damian Brown and James Mueksch, obtained coverage under the policy. They claim that the policy stated that Defendant would not raise premiums unless it could do so on a nationwide basis for insureds in a particular age group. In spite of this language, Plaintiffs claim Defendant raised premiums on a State-by-State basis, at different times, by different amounts. Plaintiffs assert that Defendant’s conduct amounts to a breach of contract, fraud, and violations of the California Unfair Competition Law (UCL). Plaintiffs bring a complaint on behalf of a putative class. [1]. Defendant has moved to dismiss Plaintiffs’ class action complaint. [18]. For the reasons explained below, this Court grants in part and denies in part Defendant’s motion. I. Background This Court accepts as true the following allegations from Plaintiffs’ complaint [1]. Crescent Plaza Hotel Owner, L.P. v. Zurich Am. Ins. Co., 20 F.4th 303, 307 (7th

Cir. 2021). A. The Policy Plaintiffs were insured under a group long-term care policy issued and delivered to Wells Fargo & Company. [1] ¶¶ 10, 12. At the times they purchased their policies, Brown resided in California and Mueksch resided in Arizona. Id. Long- term care insurance pays for a variety of services like adult daycare, an assisted living

facility, or skilled nursing home. Id. ¶ 14. According to Plaintiffs, purchasers of long- term care coverage secure a more favorable premium by obtaining coverage at an early age. Id. Defendant issued and delivered group long-term care policy number 9725TQ (the Policy) to Wells Fargo in California; the Policy’s effective date is January 1, 2002. Id. ¶ 18. As an employee of Wells Fargo, Brown purchased a certificate of coverage under the Policy with a coverage effective date of January 1, 2010. Id. ¶ 20.

Muesksch, another Wells Fargo employee, purchased a certificate of coverage under the Policy with a coverage effective date of September 1, 2013. Id. ¶ 21. Defendant underwrote and established the Policy form, premium rates, and actuarial risk pool for Wells Fargo employees nationwide. Id. ¶ 22. Under the heading “PREMIUM,” Plaintiffs’ Policy certificates state: We cannot change the Insured’s premiums because of age or health. We can, however, change the Insured’s premiums based on his or her premium class, but only if We change the premiums for all other Insureds in the same premium class. A change may be made, as provided in the following paragraph, on any Premium Due Date after the end of the Premium Rate Guarantee Period. The Premium Rate Guarantee Period starts on the Participating Employer’s Effective Date. The length of this period is stated in the Schedule of the Master Application.

Id. ¶ 25. B. Premium Increases Originally, Brown’s certificate carried a bi-weekly premium of $3.42, or a quarterly premium of $29.29, and Mueksch’s certificate carried a bi-weekly premium of $24.56, or a quarterly premium of $183.56. Id. ¶ 33. In 2017, Defendant wrote each Plaintiff a letter, stating that his premium would increase by 45.475% in a phased manner, with a 15% increase occurring on May 1, 2017, a 15% increase occurring on May 1, 2018, and a 10% increase occurring on May 1, 2019. Id. ¶ 34. The letter then gave Plaintiff three options to respond to the anticipated premium increase: (1) continue current coverage by paying the new premium; (2) reduce coverage to help “minimize the effect” of the premium increase; or (3) execute a non-forfeiture benefit, discontinuing premium payments and accepting a reduced maximum benefit. Id. ¶ 35. Brown decided to pay the increased premium, keeping his current coverage in place, while Mueksch discontinued his coverage. Id. ¶¶ 36, 37. Plaintiffs claim that in the 2017 letter, Defendant disclosed for the first time that the premium increase is not uniform for everyone in the same age group or premium class. Id. ¶ 38. Specifically, Defendant stated: Since Continental . . . must receive approval or authorization from certain states prior to implementing an increase, it is possible that these states will not approve or authorize the same percentage increase or authorize an increase at the same time. It is also possible some states may deny [Continental]’s request for an increase, or require it be reduced or spread over multiple years. In addition, impacted certificate holders have different premium due dates and have different premium billing mechanisms. Premium increases will be staggered in accordance with the timing of regulatory approvals or authorizations and method of premium payment.

Id. ¶ 38. As a result, Plaintiffs and the putative class members have been subjected to disparate increases in the cost of their premiums depending upon the State that they live in. Id. ¶ 40. Plaintiffs claim that these disparate increases violate the Policy because Defendant has not met its duties to increase premiums “based on [the insured]’s premium class” and “for all other insureds in the same premium class.” Id. ¶¶ 41, 42. As a result, insureds living in different states “bear a disproportionate cost” of coverage, therein subsidizing the premiums of other insureds in contravention of the Policy. Id. ¶ 43. According to Plaintiffs, Defendant knew at the time it issued the Policy that premium increases would and could only be made State-by-State and not for the entire premium class or age group. Id. ¶ 44. C. Plaintiffs’ Claims and Procedural History In their complaint, Plaintiffs bring state-law claims for: (1) breach of contract (first cause of action); (2) breach of the implied covenant of good faith and fair dealing (second cause of action); (3) violation of the California Unfair Competition Law (third cause of action); (4) fraudulent concealment (fourth cause of action); and (5) declaratory and injunctive relief (fifth cause of action). Defendant has moved to dismiss the complaint in its entirety under Federal Rule of Civil Procedure 12(b)(6). [18]. II. Legal Standard

A motion to dismiss tests the sufficiency of a claim, not the merits of the case. Gunn v. Cont’l Cas. Co., 968 F.3d 802, 806 (7th Cir. 2020). To survive a motion to dismiss under Rule 12(b)(6), the claim “must provide enough factual information to state a claim to relief that is plausible on its face and raise a right to relief above the speculative level.” Haywood v. Massage Envy Franchising, LLC, 887 F.3d 329, 333 (7th Cir. 2018) (quoting Camasta v. Jos. A. Bank Clothiers, Inc., 761 F.3d 732, 736

(7th Cir. 2014)); see also Fed. R. Civ. P. 8(a)(2) (requiring a complaint to contain a “short and plain statement of the claim showing that the pleader is entitled to relief”).

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Brown v. Continental Casualty Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brown-v-continental-casualty-company-ilnd-2022.