Dickerson v. Central United Life Insurance

932 F. Supp. 1471, 1996 U.S. Dist. LEXIS 11072, 1996 WL 435607
CourtDistrict Court, M.D. Georgia
DecidedAugust 1, 1996
DocketNo. 5:93-cv-250-2(WDO)
StatusPublished
Cited by2 cases

This text of 932 F. Supp. 1471 (Dickerson v. Central United Life Insurance) is published on Counsel Stack Legal Research, covering District Court, M.D. Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dickerson v. Central United Life Insurance, 932 F. Supp. 1471, 1996 U.S. Dist. LEXIS 11072, 1996 WL 435607 (M.D. Ga. 1996).

Opinion

ORDER

OWENS, District Judge.

Before the court is a motion by defendant Life of America Insurance Company (“Life of America”) to vacate the court’s order of April 17, 1996, which granted plaintiffs’ motion to amend the pre-trial order “so as to change the name of defendant Life of America Insurance Company to Central United [1473]*1473Life Insurance Company, f/k/a Life of America Insurance Company.” [Tab # 86]. After carefully considering the arguments of counsel, the relevant caselaw, and the record as a whole, the court issues the following order.

FACTS

In 1987, plaintiffs dropped their existing health insurance policy with Union Bankers and purchased a policy offering similar benefits from defendant Reserve Life Insurance Company (“Reserve”). Plaintiffs switched to the Reserve policy because of Reserve’s assurances that the policy was “non-eancellable” and “guaranteed renewable for life” as long as premiums were timely paid. Reserve also assured plaintiffs that the premiums owed by plaintiffs under the policy could not be raised unless the premiums for all policies of the same form number (PCM86), class, age class, and state of issuance were raised concurrently.

In 1989, after having marketed the PCM86 policy for three years, Reserve ceased marketing the policy, an act known in the insurance industry as “closing” the block of business. It is widely known throughout the insurance industry, but not to the general public, that closing a block of business, by ensuring that no new insureds will enter the pool covered by the policy, inevitably leads to a decrease in the size of the pool as healthy insureds switch to cheaper policies. This in turn leads to increased premiums, as the risks and costs associated with the pool are shared by fewer and fewer people. As the premiums increase, more healthy insureds flee the policy, leaving only those unhealthy insureds who cannot find insurance elsewhere, and leading to even higher premiums (Depo. of Stanley L. Miller, Exh. 2, at 2).

This vicious circle of higher premiums and a shrinking pool to share the increased costs is known in the insurance industry as a “death spiral,” and is most common in those sectors of the industry that sell policies covering small groups and individuals. In a death spiral situation, eventually the premiums increase to the point where they become unaffordable to the vast majority of policyholders, at which point the insured fails to pay the premium and the policy lapses. Once the pool shrinks to a mere fraction of what it was, the reserves set aside by the insurance company to pay for claims filed by the pool are no longer needed, and can be retained by the company as unallocated cash assets;

At no time during the sale of the policy or afterward were plaintiffs informed that their policy group could be closed, nor were they informed that it had in fact been closed. Even when Mr. Dickerson inquired, at first directly and later through his attorney, as to the cause for the initial 100% premium increase in 1989 (from $1,192.56 to $2,350.32 annually), Reserve did not tell him that the increase was at least in part caused by the block having been closed, but rather told him that the premium increase was due to an unusual number of claims in Georgia that year, and that premium increases in the future would average three to five percent annually [Tab # 59 Exh. A, Exh. 1], Had Reserve informed plaintiffs that the block had been closed, and that this would continue to result in rapidly escalating premiums, plaintiffs would have been able to switch to another insurance company as neither was suffering from major health problems at the time.

Reserve was merged into defendant Midland Life Insurance Company (“Midland”) in 1990. Then, in early 1991, Midland entered into a reinsurance agreement with defendant Life of America whereby Life of America assumed all administrative responsibilities for, and all rights and liabilities under, the policy. Although it had started as a company that sold policies, Life of America was by this time almost exclusively in the business of buying and administering closed blocks of insurance.

As of April 1, 1991, the premium for both plaintiffs to be covered under the policy had risen to $5,322.72 per year. On June 27, 1991, plaintiffs were informed that their premiums would increase from $5,322.72 per year to $23,829.00 per year. Plaintiffs then inquired about alternative coverage arrangements that might be made to reduce the premium amounts on the policy. On August 29,1991, plaintiffs were informed that even if they dropped Mrs. Dickerson from the poli[1474]*1474cy, the premium for coverage for Mr. Dickerson alone would be $75,690.00 per year. Plaintiffs subsequently failed to pay the premium and their coverage under the policy lapsed. After their Reserve/Life of America policy lapsed, plaintiffs attempted to acquire insurance from several other companies, but were turned down due to their health problems, including kidney problems experienced by Mr. Dickerson. As a result of their inability to obtain coverage, plaintiffs personally incurred medical costs in excess of $50,000, and had to forego a necessary kidney operation for Mr. Dickerson that they could not afford themselves. The record shows that had plaintiffs maintained their initial coverage with Union Bankers and never switched to the Reserve/Life of America policy, the premium for full coverage with a minimum deductible for both Mr. and Mrs. Dickerson would today be approximately $6,000 annually-

Plaintiffs filed suit in June 1993 against Life of America, Reserve, and Midland, alleging fraud, misrepresentation, bad faith, failure to honor the insurance contract, violations of insurance regulations, and intentional infliction of emotional distress. One month later, in July 1993, Life of America acquired Central United Life Insurance Company (“Central United”). On December 31, 1993, as part of a reorganization, all of Life of America’s ongoing business was bulk reinsured with Central United, and the companies were consolidated into a single entity operating under the Central United name. Before and after the consolidation, the companies were both majority-owned by Harris Insurance Holdings (Depo. of David W. Harris, at 12-13, 190), and insurance industry reports compiled from official statements to the National Association of Insurance Dealers and questionnaires submitted by the companies themselves listed the companies as having the same address, an identical list of directors, and a nearly identical list of officers [Tab # 89, Exh. B-D], According to Mr. Daniel George, vice-president' of Life of America and of the consolidated entity, the consolidation’s only real effect on the entity known as Life of America was a name-change, and all of Life of America’s business operations continued as they had before the consolidation took place [Tab # 89, Exh. E].

After the first pre-trial conference, but before the pre-trial order had been entered, plaintiffs filed a motion to amend the pretrial order by changing the name of defendant Life of America to “Central United Life Insurance Company, fik/a Life of America Insurance Company.” On April 17, 1996, the court granted Plaintiffs’ motion to amend the pre-trial order, but did not set forth the reasons that guided its decision. It does so now.

DISCUSSION

Pretrial orders are governed by Federal Rule of Civil Procedure 16(e).

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932 F. Supp. 1471, 1996 U.S. Dist. LEXIS 11072, 1996 WL 435607, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dickerson-v-central-united-life-insurance-gamd-1996.