Compton v. Country Mutual Insurance

887 N.E.2d 878, 382 Ill. App. 3d 323, 320 Ill. Dec. 734, 2008 Ill. App. LEXIS 394
Appellate Court of Illinois·Decided April 29, 2008·No. 1-06-2994·Published·Cited by 61 cases

Opinion

JUSTICE HALL

delivered the opinion of the court:

The plaintiff, Ricky Compton, filed an action against the defendant, Country Mutual Insurance Company (Country Mutual), for declaratory judgment, breach of contract and consumer fraud on behalf of himself and similarly situated individuals. In his complaint, the plaintiff maintained that Country Mutual’s practice of placing liens on insurance proceeds due insureds breached its contract of insurance with its insureds and violated the Consumer Fraud and Deceptive Business Practices Act (Consumer Fraud Act) (815 ILCS 505/1 et seq. (West 2004)). The circuit court dismissed the plaintiffs third amended complaint and denied leave to amend. The plaintiff filed a timely notice of appeal.

On appeal, the plaintiff raises the following issues: (1) whether the circuit court erred when it dismissed the third amended complaint; (2) whether the circuit court erred when it refused to vacate the order of dismissal or grant reconsideration of the dismissal order; and (3) whether the circuit court erred when it denied the plaintiff’s motion for leave to file an amended complaint. The pertinent factual allegations are taken from the plaintiffs third amended complaint.

The plaintiff was insured by Country Mutual. After being injured in an automobile accident, the plaintiff filed a claim with the defendant for medical expenses, which Country Mutual paid, “at least in part.” Country Mutual filed a lien with Founders Insurance Company (Founders), the tortfeasor’s insurance company, “to recover, inter alia, payments it made” to the plaintiffs medical providers. The plaintiff settled with the tortfeasor. Pursuant to the settlement, Founders issued a check payable to the plaintiff, the plaintiffs attorney and Country Mutual.

On information and belief, the plaintiff alleged that Founders included Country Mutual on the check because Country Mutual previously provided it with “a notice of lien on payments received by Plaintiff for, inter alia, subrogation for [Country Mutual’s] medical payments on [the plaintiffs] behalf.” The plaintiff further alleged that Country Mutual refused to extinguish the lien, denying the plaintiff access to funds to which he was entitled.

Attached to the third amended complaint were the following exhibits: a copy of the check from Founders, dated August 15, 2004, in the amount of $1,050 and payable to the plaintiff, his attorney and Country Mutual; a copy of a December 18, 2002, letter from Tim Woollen, Country Mutual’s claims specialist, to Founders seeking recovery of $2,391.70 paid out by Country Mutual for property damage related to the plaintiffs accident; and certain provisions of Country Mutual’s insurance policy. The language of the plaintiffs policy with Country Mutual at issue here is as follows:

“9. Our Right to Recover Payment (Subrogation).
a. If we make a payment under this policy, other than Death Benefit, Coverage C-l, and the person to or from whom payment was made has a right to recover damages, we will be subrogated to that right (have that right transferred to us). That person must do whatever is necessary to enable us to exercise our rights and must do nothing after the loss to prejudice our rights.
b. If we make a payment under this policy, other than Death Benefit, Coverage C-l, and the person to or for whom payment was made recovers damages from another, that person must hold the proceeds of the recovery in trust for us and must reimburse us to the extent of our payment.” (Emphasis in original.)

The plaintiff maintained that the above language did not authorize Country Mutual to place liens on the proceeds due the plaintiff and other policyholders because “it is only subrogated to the right to recover medical payments from a person ‘to whom or from whom’ it made the payment.” The plaintiff sought a declaration that Country Mutual’s practice of imposing liens on proceeds due its insureds improperly prevented the insureds from receiving the monies due them. The plaintiff further maintained that Country Mutual’s action breached the contract of insurance because the lien practice was not authorized by the policy. Finally, the plaintiff maintained that Country Mutual’s lien practice violated the Consumer Fraud Act.

Country Mutual filed a motion to dismiss the third amended complaint pursuant to section 2 — 615 of the Code of Civil Procedure (the Code) (735 ILCS 5/2 — 615 (West 2004)). Country Mutual maintained that it exercised its right to reimbursement as provided for by section 9(b) of the policy, not subrogation under section 9(a) of the policy as argued by the plaintiff. Therefore, Country Mutual asserted that the plaintiff failed to state a cause of action for breach of contract or consumer fraud.

In his response to the motion to dismiss, the plaintiff argued that section 9(b) did not authorize reimbursement via the lien procedure utilized by Country Mutual. Under the section 9(b) reimbursement, if the insured recovered damages, the proceeds must be held in trust and repaid to the insurer to the extent of the insurer’s payment. The plaintiff reasoned that he could not recover the damages because Country Mutual’s lien “tied up” the proceeds and prevented him from holding them in trust.

On August 21, 2006, the circuit court dismissed the third amended complaint with prejudice. On September 28, 2006, the plaintiff filed a combined motion to vacate, or, in the alternative, to reconsider the dismissal order and for leave to file an amended complaint. On October 4, 2006, the circuit court denied the combined motion. This timely appeal followed.

ANALYSIS

I. Section 2 — 615 Dismissal

A. Standard of Review

The granting of a motion to dismiss pursuant to section 2 — 615 of the Code is reviewed under the de novo standard of review. Carroll v. Faust, 311 Ill. App. 3d 679, 725 N.E.2d 764 (2000).

B. Applicable Principles

A section 2 — 615 motion to dismiss attacks the legal sufficiency of the complaint based upon defects appearing on the face of the complaint. Guinn v. Hoskins Chevrolet, 361 Ill. App. 3d 575, 586, 836 N.E.2d 681 (2005). “When reviewing the sufficiency of a complaint, the court must accept as true all well-pleaded facts and all reasonable inferences that can be drawn from those facts.” Guinn, 361 Ill. App. 3d at 586. Legal and factual conclusions, unsupported by allegations of fact, may be disregarded. Guinn, 361 Ill. App. 3d at 586. “It is the court’s duty to determine, considering the allegations of the complaint in the light most favorable to the plaintiffs, whether the allegations are sufficient to state a cause of action upon which relief may be granted.” Guinn, 361 Ill. App. 3d at 586.

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Compton v. Country Mutual Insurance, 887 N.E.2d 878, 382 Ill. App. 3d 323, 320 Ill. Dec. 734, 2008 Ill. App. LEXIS 394 (Ill. Ct. App. 2008).

887 N.E.2d 878 (Compton v. Country Mutual Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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