Gaudet v. Metropolitan Life Insurance Company

CourtDistrict Court, N.D. California
DecidedAugust 25, 2025
Docket5:25-cv-00694
StatusUnknown

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

Bluebook
Gaudet v. Metropolitan Life Insurance Company, (N.D. Cal. 2025).

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 GERMAINE GAUDET, Case No. 25-cv-00694-PCP

8 Plaintiff, ORDER GRANTING MOTION TO 9 v. DISMISS AND MOTION TO STAY

10 METROPOLITAN LIFE INSURANCE Re: Dkt. Nos. 34, 45 COMPANY, 11 Defendant.

12 Plaintiff Germaine Gaudet brings this class action against defendant Metropolitan Life 13 Insurance Company (“MetLife”). Gaudet purchased a MetLife long-term-care insurance policy in 14 2007.1 In 2021, the California Department of Insurance (“CDI”) approved MetLife’s request to 15 raise her premium by 123.8%. After the CDI’s approval of the premium increase, MetLife sent 16 Gaudet a letter informing her about the imminent rate increase and giving her information about 17 her options. 18 Gaudet alleges that MetLife knew of the need to increase premiums as early as 2008. 19 Gaudet brings three California state law claims based on MetLife’s failure to inform her of the rate 20 increase or any of the issues leading to the rate increase until 2021: (1) fraud by omission; (2) 21 violation of California’s Unfair Competition Law (“UCL”), Cal. Bus. & Prof. Code § 17200 et 22 seq., and (3) violation of California Insurance Code § 10234.8. 23 MetLife now moves to dismiss the action pursuant to Federal Rule of Civil Procedure 24 25 1 As Gaudet explains in her opposition, long-term care insurance “covers a variety of services for 26 people who become unable to care for themselves, including assistance in the home, adult daycare, assisted living, and nursing home services.” Sieving v. Cont’l Cas. Co., 535 F. Supp. 3d 762, 767 27 (N.D. Ill. 2021). Because individuals generally purchase long-term care insurance policies in their 1 12(b)(6). For the reasons discussed herein, the Court grants MetLife’s motion with leave to 2 amend. 3 BACKGROUND 4 Gaudet resides in San José, California.2 In November 2006, Gaudet applied for a MetLife 5 long-term care insurance policy.3 Gaudet’s policy became effective on January 19, 2007. Her 6 annual policy premium when purchased was $2,944.45. Gaudet has maintained the policy since 7 that date, and it is still in effect today. Gaudet’s current annual premium is $4,541.48.4 Gaudet’s 8 contract for the policy, which she signed in 2006, includes the following key terms:

9 RENEWABILITY: THIS POLICY IS GUARANTEED 10 RENEWABLE FOR LIFE. PREMIUM RATES ARE SUBJECT TO CHANGE. This means You have the right, subject to the terms 11 of the policy, to continue this policy as long as You pay Your premiums on time. We cannot change any of the terms of this policy 12 without Your consent, except that We may change the premium rates, subject to approval by the California Department of Insurance. Any 13 such change in premium rates will apply to all policies in the same 14 class as Yours in the state where this policy was issued. …

15 The premium is due and payable on the Original Coverage Effective Date of the policy and thereafter in accordance with the Premium 16 Schedule that is in effect for the policy as shown on page 3. The premium must be paid in U.S. currency. 17

18 You may change the premium payment mode with Our approval.

19 The amount of the premium for Your initial coverage is based on Your Original Issue Age, Health Rating and Discounts, as of the 20 Original Coverage Effective Date as shown on page 3.

21 We reserve the right to change premium rates on a class basis. The 22 premium will not increase because You get older or Your health changes. In the event of a premium increase, We will offer You the 23 option to lower Your premium by decreasing Your benefit amounts. 24 2 For the purposes of defendants’ Rule 12(b)(6) motion, the Court assumes the truth of the facts 25 alleged in plaintiffs’ complaint. 26 3 Gaudet purchased a VIP2 policy, which is the subject of this action. The complaint also discusses a VIP1 policy that was phased out in favor of the VIP2 policy in 2004. 27 4 After receiving repeated notices about the premium rate changes, Gaudet elected to reduce her See the Benefit Decreases provision of this policy. Your premiums 1 will change if We change Your benefit amounts as a result of Your 2 request or as a result of an increase as provided under the terms of this policy. 3 … 4 Your premium is not expected to increase as a result of the benefit 5 increases provided by [the 5% Automatic Compound Inflation 6 Protection] Rider. However, We reserve the right adjust premiums on a class basis. 7 8 (emphasis in original). 9 In determining the premiums for its long-term care insurance policies, MetLife relied upon 10 certain assumptions. MetLife learned in 2008 that its actual experience materially and adversely 11 deviated from those assumptions. Rather than seek increases in the premium rates for existing 12 customers like Gaudet, “MetLife decided to replace VIP2 policies’ premium rate schedule with 13 one based on updated/more accurate lapse, morbidity and mortality assumptions.” MetLife 14 introduced its new VIP2 premium rate schedule in all 50 states and the District of Columbia 15 between 2008 and 2010. The schedule only applied to individuals purchasing new VIP2 policies 16 (“VIP2 NEW” policies). Preexisting VIP2 policyholders (“VIP2 OLD” policyholders) like Gaudet 17 were not affected. They were not notified that the rate schedule that their plans were based upon 18 was no longer used for new policies. 19 MetLife thereafter experienced continued pricing issues. In response, it developed an 20 updated rate action plan for existing VIP2 OLD policies like Gaudet’s and sought to implement a 21 58% premium rate increase on all VIP2 OLD policyholders across the country. Between October 22 2012 and July 2014, MetLife filed for the rate increase in each state.5 It filed for a California rate 23 increase with the CDI in 2013, but the CDI denied the requested increase. Between 2012 and 24 2017, MetLife implemented 10% to 88% premium rate increases on VIP2 OLD policyholders in 25 26 5 As the complaint explains, all states except Alaska must approve rate increases to MetLife’s 27 long-term care insurance policies before MetLife can implement them. Upon submission of a rate 1 37 states. Like California, several other states denied MetLife’s premium rate increase request. 2 In 2015, MetLife developed a second revised rate action plan for VIP2 OLD policies 3 pursuant to which it sought to implement an additional 18.98% premium rate increase on all VIP2 4 OLD policyholders across the country (totaling an increase of approximately 88% from the 5 original VIP2 OLD pricing). MetLife again sought approval in nearly all states. In 2019, MetLife 6 requested a 105% premium rate increase for California VIP2 OLD policyholders.6 On or about 7 January 21, 2021, the CDI approved this premium rate increase but increased it to authorize a 8 123.8% increase to be implemented over the next four years. On April 15, 2021, MetLife informed 9 Gaudet that it would be increasing her annual premium by 123.8% over the next four years, with 10 the first increase occurring on January 19, 2022.7 MetLife sent subsequent notices on April 15, 11 2023, April 15, 2024, and April 15, 2025. The notices informed Gaudet of the upcoming 12 implementation of the second, third, and fourth phases of the 123.8% premium rate increase. 13 Those phased increases took effect on January 19, 2023, January 19, 2024, and January 19, 2025. 14 Since 2015, MetLife (which has now imposed premium rate increases on VIP2 OLD 15 policyholders in every state) has created at least three more rate action plans, seeking increases to 16 VIP2 OLD policyholders’ premiums by roughly 16.92% in or around 2019–2020; 31.66% in or 17 around 2021; and 9.88% in or around 2023.

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Gaudet v. Metropolitan Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gaudet-v-metropolitan-life-insurance-company-cand-2025.