Carter, et a l . v . North Central Life 05-CV-399-JD 08/17/06 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Gloria Carter and Roy Farr
v. Civil N o . 05-cv-399-JD Opinion N o . 2006 DNH 093 North Central Life Insurance Company
O R D E R
Gloria Carter and Roy Farr filed a putative consumer class
action, alleging that North Central Life Insurance Company
breached its insurance contracts with them and other members of
the putative class by failing to refund the unearned portion of
insurance premiums that had been prepaid as part of their car
financing. Carter and Farr also filed a preliminary motion for
class certification. North Central moves to dismiss the
plaintiffs’ claims and to exclude certain individuals from the
putative class. Carter and Farr oppose North Central’s motions.
I. Motion to Dismiss
North Central contends no breach has occurred, making the
plaintiffs’ claims unripe and depriving them of standing to
proceed. In support of those theories, North Central argues that
it was not obligated to refund the unearned portions of the
plaintiffs’ insurance premiums because the plaintiffs did not
provide notice of their prepayments and because the dispute about
the refunds has not been resolved. North Central also asserts that the claims should be dismissed because the plaintiffs
breached their obligation of good faith and fair dealing by
failing to give North Central notice before filing suit. As a
fallback position, North Central argues that the combined effect
of New Hampshire Revised Statutes Annotated (“RSA”) §§ 361-A:7,
IV-a, 408-A:8, and 402:81 requires notice to the insurer as a
condition precedent to the obligation to refund unearned premiums
to the insured.1 Carter and Farr object to the motion to
dismiss.
In considering a motion to dismiss, pursuant to Federal Rule
of Civil Procedure 12(b)(6), the court accepts the facts alleged
in the complaint as true and draws all reasonable inferences in
favor of the plaintiff. Edes v . Verizon Comms., 417 F.3d 133,
137 (1st Cir. 2005). The court must determine whether the
complaint, construed in the proper light, “alleges facts
sufficient to make out a cognizable claim.” Carroll v . Xerox
Corp., 294 F.3d 2 3 1 , 241 (1st Cir. 2002). “The standard for
granting a motion to dismiss is an exacting one: ‘a complaint
should not be dismissed for failure to state a claim unless it
appears beyond doubt that the plaintiff can prove no set of facts
in support of [her] claim which would entitle [her] to relief.’”
1 North Central introduces the condition precedent argument as follows: “The Court need review this section of North Central’s brief only if it rejects all of North Central’s four previous arguments.” Mem. at 1 7 .
2 McLaughlin v . Boston Harbor Cruise Lines, Inc., 419 F.3d 4 7 , 50
(1st Cir. 2005) (quoting Conley v . Gibson, 355 U.S. 4 1 , 46
(1957)). Because the court “may properly consider the relevant
entirety of a document integral to or explicitly relied upon in
the complaint, even though not attached to the complaint, without
converting the motion into one for summary judgment,” the
insurance documents submitted by the parties will also be
reviewed for purposes of deciding the motion. Clorox C o . P.R. v .
Proctor & Gamble Commercial Co., 228 F.3d 2 4 , 32 (1st Cir. 2000);
see also Carrier v . Am. Bankers Life Assurance Co., 2006 WL
1049721, at *1 (D.N.H. Apr. 2 1 , 2006).
A. Contractual Preconditions
It is undisputed that North Central’s insurance policies at
issue in this case do not expressly require an insured to notify
North Central when prepayment is made and a refund is due. North
Central argues that two provisions in its policies impose
obligations on its insureds that have not been fulfilled by the
plaintiffs here, making the plaintiffs’ breach of contract claim
premature. One provision pertains to payment of interest on
refunds, and the other requires written proof of loss before an
insured may bring suit to recover under the policy. The
plaintiffs contend that neither provision affects their breach of
contract claim.
3 “The interpretation of insurance policy language, like any
contract language, is ultimately an issue of law for the court to
decide.” D’Amour v . Amica Mut. Ins. Co., 891 A.2d 5 3 4 , 536 (N.H.
2005) (internal quotation marks omitted). The court “construe[s]
the language of an insurance policy as would a reasonable person
in the position of the insured based on a more than casual
reading of the policy as a whole.” Id. In interpreting policy
language, the court is bound by its reasonable meaning and is not
free to rewrite policy provisions. Catholic Med. Ctr. v . Exec.
Risk Indem., Inc., 151 N.H. 699, 702 (2005).
1. Bona fide dispute.
The refund provisions in the applicable policy certificates
state: “Any refund not paid within 30 days will earn interest at
10 percent beginning on the 31st day, except in a bona fide
dispute, or where the final premium is subject to audit, or other
adjustment of premium.” The applicable group policies state:
“Any refund not paid within 30 days will earn interest at 10% per
annum beginning on the 31st day. In the event the amount is in
bona fide dispute, or where the final premium is subject to audit
or other adjustment, the amount of the refund shall not become
due until the dispute is resolved and the audit or other
adjustment of premium is completed and the final amount of
premium is determined.” North Central asserts that this suit and
4 any suit about a refund constitutes a dispute about the amount of
a refund within the meaning of that provision. Based on that
interpretation, North Central contends that the plaintiffs cannot
bring suit to recover their refunds until the “bona fide dispute”
raised in this action is resolved.
North Central’s interpretation of the “bona fide dispute”
provision does not comport with the standard of what a reasonable
person would conclude the provision means after more than a
casual reading. That provision expressly applies to a dispute
about the amount that is due as a refund. This case does not
involve a dispute, bona fide or otherwise, about the amount of
the refund that is due. The plaintiffs allege that North Central
failed to pay any refund in breach of the policy provision that
promises to make a refund of the unearned part of a prepaid
premium if the insurance is terminated before the final
termination date.
2. Legal action.
The second policy provision North Central invokes states as
follows: “No action at law or in equity shall be brought to
recover on this policy prior to the expiration of 60 days after
written proof of loss has been furnished in accordance with the
requirements of this policy.” North Central interprets that
provision to require its insureds to provide written notice of
5 any claim, including the breach of contract claim alleged here,
before bringing suit. The plaintiffs disagree.
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Carter, et a l . v . North Central Life 05-CV-399-JD 08/17/06 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Gloria Carter and Roy Farr
v. Civil N o . 05-cv-399-JD Opinion N o . 2006 DNH 093 North Central Life Insurance Company
O R D E R
Gloria Carter and Roy Farr filed a putative consumer class
action, alleging that North Central Life Insurance Company
breached its insurance contracts with them and other members of
the putative class by failing to refund the unearned portion of
insurance premiums that had been prepaid as part of their car
financing. Carter and Farr also filed a preliminary motion for
class certification. North Central moves to dismiss the
plaintiffs’ claims and to exclude certain individuals from the
putative class. Carter and Farr oppose North Central’s motions.
I. Motion to Dismiss
North Central contends no breach has occurred, making the
plaintiffs’ claims unripe and depriving them of standing to
proceed. In support of those theories, North Central argues that
it was not obligated to refund the unearned portions of the
plaintiffs’ insurance premiums because the plaintiffs did not
provide notice of their prepayments and because the dispute about
the refunds has not been resolved. North Central also asserts that the claims should be dismissed because the plaintiffs
breached their obligation of good faith and fair dealing by
failing to give North Central notice before filing suit. As a
fallback position, North Central argues that the combined effect
of New Hampshire Revised Statutes Annotated (“RSA”) §§ 361-A:7,
IV-a, 408-A:8, and 402:81 requires notice to the insurer as a
condition precedent to the obligation to refund unearned premiums
to the insured.1 Carter and Farr object to the motion to
dismiss.
In considering a motion to dismiss, pursuant to Federal Rule
of Civil Procedure 12(b)(6), the court accepts the facts alleged
in the complaint as true and draws all reasonable inferences in
favor of the plaintiff. Edes v . Verizon Comms., 417 F.3d 133,
137 (1st Cir. 2005). The court must determine whether the
complaint, construed in the proper light, “alleges facts
sufficient to make out a cognizable claim.” Carroll v . Xerox
Corp., 294 F.3d 2 3 1 , 241 (1st Cir. 2002). “The standard for
granting a motion to dismiss is an exacting one: ‘a complaint
should not be dismissed for failure to state a claim unless it
appears beyond doubt that the plaintiff can prove no set of facts
in support of [her] claim which would entitle [her] to relief.’”
1 North Central introduces the condition precedent argument as follows: “The Court need review this section of North Central’s brief only if it rejects all of North Central’s four previous arguments.” Mem. at 1 7 .
2 McLaughlin v . Boston Harbor Cruise Lines, Inc., 419 F.3d 4 7 , 50
(1st Cir. 2005) (quoting Conley v . Gibson, 355 U.S. 4 1 , 46
(1957)). Because the court “may properly consider the relevant
entirety of a document integral to or explicitly relied upon in
the complaint, even though not attached to the complaint, without
converting the motion into one for summary judgment,” the
insurance documents submitted by the parties will also be
reviewed for purposes of deciding the motion. Clorox C o . P.R. v .
Proctor & Gamble Commercial Co., 228 F.3d 2 4 , 32 (1st Cir. 2000);
see also Carrier v . Am. Bankers Life Assurance Co., 2006 WL
1049721, at *1 (D.N.H. Apr. 2 1 , 2006).
A. Contractual Preconditions
It is undisputed that North Central’s insurance policies at
issue in this case do not expressly require an insured to notify
North Central when prepayment is made and a refund is due. North
Central argues that two provisions in its policies impose
obligations on its insureds that have not been fulfilled by the
plaintiffs here, making the plaintiffs’ breach of contract claim
premature. One provision pertains to payment of interest on
refunds, and the other requires written proof of loss before an
insured may bring suit to recover under the policy. The
plaintiffs contend that neither provision affects their breach of
contract claim.
3 “The interpretation of insurance policy language, like any
contract language, is ultimately an issue of law for the court to
decide.” D’Amour v . Amica Mut. Ins. Co., 891 A.2d 5 3 4 , 536 (N.H.
2005) (internal quotation marks omitted). The court “construe[s]
the language of an insurance policy as would a reasonable person
in the position of the insured based on a more than casual
reading of the policy as a whole.” Id. In interpreting policy
language, the court is bound by its reasonable meaning and is not
free to rewrite policy provisions. Catholic Med. Ctr. v . Exec.
Risk Indem., Inc., 151 N.H. 699, 702 (2005).
1. Bona fide dispute.
The refund provisions in the applicable policy certificates
state: “Any refund not paid within 30 days will earn interest at
10 percent beginning on the 31st day, except in a bona fide
dispute, or where the final premium is subject to audit, or other
adjustment of premium.” The applicable group policies state:
“Any refund not paid within 30 days will earn interest at 10% per
annum beginning on the 31st day. In the event the amount is in
bona fide dispute, or where the final premium is subject to audit
or other adjustment, the amount of the refund shall not become
due until the dispute is resolved and the audit or other
adjustment of premium is completed and the final amount of
premium is determined.” North Central asserts that this suit and
4 any suit about a refund constitutes a dispute about the amount of
a refund within the meaning of that provision. Based on that
interpretation, North Central contends that the plaintiffs cannot
bring suit to recover their refunds until the “bona fide dispute”
raised in this action is resolved.
North Central’s interpretation of the “bona fide dispute”
provision does not comport with the standard of what a reasonable
person would conclude the provision means after more than a
casual reading. That provision expressly applies to a dispute
about the amount that is due as a refund. This case does not
involve a dispute, bona fide or otherwise, about the amount of
the refund that is due. The plaintiffs allege that North Central
failed to pay any refund in breach of the policy provision that
promises to make a refund of the unearned part of a prepaid
premium if the insurance is terminated before the final
termination date.
2. Legal action.
The second policy provision North Central invokes states as
follows: “No action at law or in equity shall be brought to
recover on this policy prior to the expiration of 60 days after
written proof of loss has been furnished in accordance with the
requirements of this policy.” North Central interprets that
provision to require its insureds to provide written notice of
5 any claim, including the breach of contract claim alleged here,
before bringing suit. The plaintiffs disagree.
Written notice is required before an action is brought “to
recover on this policy.” The plaintiffs argue that their suit is
not to recover on the policy, that is to obtain the insurance
benefits provided under the policy, but instead is to recover the
unearned part of their prepaid premiums. The plaintiffs also
point out that they have not suffered a “loss” that is covered by
North Central’s policies.
The policies support the plaintiff’s interpretation of the
“legal action” provision. The policies define “proof of loss” as
follows: “Written proof of loss must be furnished to the Company
at its office in case of claim for loss for which this policy or
any certificates issued hereunder provides any periodic payment
contingent upon continuing loss within 90 days after the
termination of the period for which the Company is liable.”
(Emphasis added.) The “Payment of Claims” provision states:
“Subject to due written proof of loss, all accrued benefits for
loss for which this policy provides periodic payment will be paid
monthly to the Creditor to reduce or extinguish this indebtedness
and any balance remaining unpaid upon the termination of
liability will be paid immediately to the Creditor upon receipt
of due written proof.” (Emphasis added.) Based on those
provisions, read together, the policy unambiguously precludes
6 legal action to recover a benefit provided under the terms of the
policy until sixty days after written proof of a covered loss is
provided to the company. That is not the claim that the
plaintiffs allege here.
Because the applicable policies do not provide preconditions
to the plaintiffs’ breach of contract claim alleged here, the
provisions cited by the defendants do not make the claim unripe
or deprive the plaintiffs of standing to proceed. Similarly,
those provisions do not bar the plaintiffs’ breach of contract
claim in the absence of written notice to North Central.
B. Implied Covenant of Good Faith and Fair Dealing
North Central contends that the court should read a notice
requirement into its policies as part of the insureds’ implied
obligation of good faith and fair dealing. That request would
stretch contract interpretation far beyond its permissible scope
in this case. The implied covenant of good faith and fair
dealing in the performance of a contract imposes limits on “a
promise subject to such a degree of discretion that its practical
benefit could seemingly be withheld.” Centronics Corp. v .
Genicom Corp., 132 N.H. 133, 144 (1989). That is not the
situation presented here. Further, contrary to North Central’s
request, the court is not free rewrite the policies to add a
notice requirement that North Central chose not to include.
Catholic Med. Ctr., 151 N.H. at 702.
7 C. Statutory Notice Requirements As a last resort, North Central argues that the combined effect of three New Hampshire statutes relieves it of any obligation to pay a refund unless or until it received some notice that the plaintiffs had prepaid their loans. The effect of the first two statutes, RSA 361-A:7 and 408-A:8, was thoroughly discussed in the court’s decision in Carrier v . Am. Bankers Life Assurance Co., 2006 WL 1049721 (D.N.H. Apr. 2 1 , 2006), and will not be repeated here. North Central’s efforts to change that outcome for purposes of this case are not persuasive.2
North Central also contends that a third statute, RSA
402:81, I , when added to the other two, relieves it of any refund
obligation absent notice of prepayment. RSA 402:81, I , however,
pertains to refunds due upon cancellation of insurance policies
by either the insurer or the insured. In this case, the
insurance policies terminated automatically upon prepayment of
the loans. Because the policies were not cancelled by either
party, RSA 402:81 has no bearing on the claim alleged here.
2 In particular, North Central appears to misunderstand RSA 361-A:7 and that part of the Carrier decision which interprets the statutory scheme.
8 II. Motion to Exclude Certain Individuals from Purported Class
The plaintiffs filed a preliminary motion to certify a class
shortly after they filed their initial complaint in this case.
They asked, however, that the court “take the question of class
certification under advisement pending preliminary discovery and
briefing.” The motion was intended only to prevent any issue of
mootness should North Central offer judgment to individual
plaintiffs before a class was certified. The defendants have
filed no response to the motion. Therefore, a class has not been
certified in this case, and no substantive motion to certify a
class is pending.
Nevertheless, North Central moves to exclude from “the
purposed nationwide class” any individuals who “signed
arbitration agreements with third parties (such as lenders,
finance companies, and motor vehicle dealerships) in connection
with the motor vehicle loans at issue.” Motion at 2 . North
Central asserts in its motion: “some of those [third-party]
arbitration agreements encompass the claim asserted in the
Complaint on behalf of those class members against North Central;
as a non-signatory, North Central may rely on arbitration
agreements signed by class members in order to compel arbitration
of the covered claims.” Id.
The plaintiffs oppose the motion. They point out that the
class they proposed in the amended complaint already excludes any
9 individuals who signed North Central insurance policies with
arbitration clauses. The plaintiffs contend that North Central’s
effort to incorporate arbitration clauses from third-party
agreements into its policies should be denied based on the
integration clause in North Central’s policies, because the
policies did not include such restrictions as required under New
Hampshire insurance law, because efforts to restrict the class at
this precertification stage are premature, because North Central
provided no evidence to support its theory, and because North
Central cannot enforce a third-party arbitration clause. In
response, North Central filed a reply raising a complex choice of
law question.
North Central’s motion is premature. At this stage, there
is no substantive motion for class certification before the
court. As a non-signatory to the alleged third-party arbitration
agreements, North Central would have to show that any such
agreements require arbitration of the breach of contract claim
the plaintiffs allege here. North Central has not made that
showing. The choice of law question may or may not need to be
addressed and, if s o , will need further briefing. Therefore, the
motion is denied without prejudice to raise the same issues at an
appropriate time.
10 Conclusion
For the foregoing reasons, the defendant’s motion to dismiss
(document n o . 23) is denied. The defendant’s motion to exclude
(document n o . 25) is denied without prejudice. The plaintiff’s
motions to file a surreply to the motion to exclude (document n o .
40) and motion to strike the defendant’s response (document n o .
42) are terminated. The plaintiffs’ preliminary motion to
certify the class (document n o . 3 ) is terminated pursuant to the
provision in the parties’ discovery plan for filing a class
certification motion.
SO ORDERED.
___>eph eph A. DiClerico, Jr. _ United States District Judge
August 1 7 , 2006 cc: Lee E . Bains, Jr., Esquire James E . Butler, Jr., Esquire Thomas J. Butler, Esquire Christopher Cole, Esquire Kate S . Cook, Esquire Lorrie L . Hargrove, Esquire Robert R. Lucic, Esquire Michael D. Mulvaney, Esquire Edward K. O’Brien, Esquire Joel O . Wooten, Jr., Esquire