Gottstein v. National Ass'n for the Self Employed

53 F. Supp. 2d 1212, 1999 U.S. Dist. LEXIS 10030, 1999 WL 447125
CourtDistrict Court, D. Kansas
DecidedJune 18, 1999
DocketCiv.A. 98-2339-KHV, Civ.A. 98-2540-KHV, Civ.A. 98-2541-KHV
StatusPublished
Cited by10 cases

This text of 53 F. Supp. 2d 1212 (Gottstein v. National Ass'n for the Self Employed) is published on Counsel Stack Legal Research, covering District Court, D. Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gottstein v. National Ass'n for the Self Employed, 53 F. Supp. 2d 1212, 1999 U.S. Dist. LEXIS 10030, 1999 WL 447125 (D. Kan. 1999).

Opinion

MEMORANDUM AND ORDER

VRATIL, District Judge.

This matter is before the Court on Defendant PFL’s Motion To Dismiss (Doc. # 17 in Case No. 98-2339), Defendant PFL’s Motion To Dismiss (Doe. # 14 in Case No. 98-2540), and Defendant PFL’s Motion To Dismiss (Doc. # 19 in Case No. 98-2541), all filed February 1, 1999. After carefully considering the parties’ briefs, the Court is prepared to rule. For reasons set forth below, defendant’s motions are sustained and plaintiffs are granted leave to amend their complaints.

Factual Background

On August 3, 1998, Georgeanna and Robert E. Gottstein, Jr. filed their complaint in Case No. 98-2339 (the “Gottstein Complaint”). Nearly four months later, on November 24, 1998, Margaret L. and Kenneth L. Kingston filed their complaint in Case No. 98-2540 (the “Kingston Complaint”). That same day, the Gottsteins and the Kingstons joined forces by filing a class action complaint in Case No. 98-2541 (the “Class Complaint”). On March 15, 1999, the Court consolidated the three actions. See Order (Doc. # 36) filed Mar. 16, 1999 in Case No. 98-2541. The following is a summary of plaintiffs’ allegations in the three complaints.

In 1992, Georgeanna Gottstein completed an application for group health insurance coverage with PFL Life Insurance Company (“PFL”). The National Association for the Self-Employed (“NASE”) had endorsed this policy. Ms. Gottstein paid $277 for the policy premium, $6 for monthly NASE dues and $95 for an administrative fee. PFL denied her application. In December 1992, Ms. Gottstein reapplied through a NASE representative and PFL issued her an individual policy. Ms. Gottstein alleges that UICI and NASE falsely represented (1) the scope of coverage under the policy, (2) that NASE was an independent not-for-profit corporation formed to protect the interests of the self-employed, and (3) that she had to be a *1216 member of NASE before PFL would issue a policy. The Kingstons allege similar misconduct. In addition, they allege that they received a mailer which falsely stated that “NASE, through its negotiating power, had negotiated a favorable policy of health insurance for members of NASE.”

Plaintiffs allege that prospective purchasers of insurance relied on the purported fact that NASE operated at arm’s length from PFL and UICI. Ronald L. Jensen had formed NASE, however, as a not-for-profit association to endorse products and services sold by UICI, which Jensen also formed through its predecessor United Group Association, Inc. (“UGA”). UICI acted as an agent to sell insurance products. NASE endorsed certain insurance products which UICI sold and PFL underwrote. NASE, UICI and the “Insurance Center” that handled PFL policies all operated from the same address. Plaintiffs contend that defendants misled consumers to believe that a large, sophisticated and independent entity represented them to negotiate with various insurance carriers. Plaintiffs allege that PFL issued inadequate insurance policies and that PFL required consumers to purchase unnecessary NASE memberships.

PFL is a named defendant in plaintiffs’ claims for fraud (Count II of the Class Complaint, Count I of the Gottstein Complaint), breach of fiduciary duty (Count III of the Class Complaint), and conspiracy to commit a violation of the Racketeer Influenced and Corrupt Organizations Act (“RICO”) (Count VII of the Class Complaint, Count V of the Gottstein Complaint, Count II of the Kingston Complaint). Pursuant to Fed.R.Civ.P. 12(b)(6), PFL seeks to dismiss plaintiffs’ complaints for failure to state a claim upon which relief may be granted.

Legal Standards

A Rule 12(b)(6) motion should not be granted unless “it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief.” GFF Corp. v. Associated Wholesale Grocers., Inc., 130 F.3d 1381, 1384 (10th Cir.1997) (quoting Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957)). The Court accepts all well-pleaded factual allegations in the complaint as true and draws all reasonable inferences from those facts in favor of plaintiff. See Shaw v. Valdez, 819 F.2d 965, 968 (10th Cir.1987). The issue in reviewing the sufficiency of plaintiffs complaint is not whether plaintiff will prevail, but whether plaintiff is entitled to offer evidence to support his claims. See Scheuer v. Rhodes, 416 U.S. 232, 236, 94 S.Ct. 1683, 40 L.Ed.2d 90 (1974). Although a plaintiff need not precisely state each element of his claims, he must plead minimal factual allegations on those material elements that must be proved. See Hall v. Bellmon, 935 F.2d 1106, 1110 (10th Cir.1991).

Analysis

I. RICO Claims

Plaintiffs claim that UICI and Jensen defrauded them under RICO, 18 U.S.C. §§ 1961-1965, when plaintiffs purchased unnecessary NASE memberships and inadequate health insurance policies. See Class Compl. Count VI (unnecessary NASE dues); Gottstein Compl. Count IV (inadequate policy); Kingston Compl. Count I (inadequate policy). Plaintiffs allege that PFL conspired with UICI and Jensen to further a scheme which told prospective customers that they needed to be members of NASE to purchase individual health insurance policies and that NASE was an independent body which had the power to negotiate favorable health insurance policies with insurance carriers. See Class Compl. Count VII; Gottstein Compl. Count V; Kingston Compl. Count II.

“The object of a RICO conspiracy must be to violate a substantive RICO provision.” United States v. Hampton, 786 F.2d 977, 978 (10th Cir.1986). Plaintiffs must therefore allege a substantive *1217 violation of RICO to maintain their conspiracy claim. A violation of RICO requires conduct of an enterprise through a pattern of racketeering activity. 18 U.S.C. § 1962(c); see Salinas v. United States, 522 U.S. 52, 118 S.Ct. 469, 476, 139 L.Ed.2d 352 (1997); Sedima, S.P.R.L. v. Imrex Co., 473 U.S. 479, 496, 105 S.Ct. 3275, 87 L.Ed.2d 346 (1985).

A. Statute Of Limitations

The statute of limitations for a civil RICO claim is four years from the time the cause of action accrued. See Agency Holding Corp. v. Malley-Duff & Assocs., Inc.,

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Bluebook (online)
53 F. Supp. 2d 1212, 1999 U.S. Dist. LEXIS 10030, 1999 WL 447125, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gottstein-v-national-assn-for-the-self-employed-ksd-1999.