Guschausky v. American Family Life Assurance Co.

851 F. Supp. 2d 1252, 2012 WL 1072339, 2012 U.S. Dist. LEXIS 46480
CourtDistrict Court, D. Montana
DecidedApril 2, 2012
DocketNo. CV 10-59-H-DWM
StatusPublished

This text of 851 F. Supp. 2d 1252 (Guschausky v. American Family Life Assurance Co.) is published on Counsel Stack Legal Research, covering District Court, D. Montana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Guschausky v. American Family Life Assurance Co., 851 F. Supp. 2d 1252, 2012 WL 1072339, 2012 U.S. Dist. LEXIS 46480 (D. Mont. 2012).

Opinion

ORDER

DONALD W. MOLLOY, District Judge.

The plaintiffs in this class action (“the class”) move for an award of attorney’s fees under Federal Rules of Civil Procedure 23(h)(1) and 54(d)(2) and pursuant to their settlement agreement with the defendants (collectively “AFLAC”). AFLAC opposes the motion in part. The Court must make findings of fact and state its conclusions of law under Rule 23(h)(3) and 52(a). The Court does so here, granting the class’s motion.

Findings of Fact

1. This class action arises from AFLAC’s allegedly wrongful retention of insurance premiums.

2. The case began as a $559.80 premium dispute between Pamela Gushausky, the named plaintiff, and AFLAC but evolved into a potentially multi-million dollar class action.

3. In its complaint, the class alleges that AFLAC wrongfully retained premiums for dependent child coverage, even though a dependent child might never have existed or was otherwise ineligible for dependent child coverage.

4. The class alleges that, under this practice:

[I]f a policyholder never notified [AF-LAC] that he or she was being charged for family coverage but had no eligible dependent children, [AF-[1255]*1255LAC] would continue to collect family coverage premiums, a scenario that [AFLAC] admits, as a general insurance principle, is wrong.

5. Based on its allegations, the class filed a complaint on December 16, 2010, asserting claims for breach of contract, negligence, and unjust enrichment. (Doc. 1.) The complaint also included a request for punitive damages.

6. The parties reached a settlement and the Court prehminarily approved it on December 12, 2011. (Doc. 55.)

7. Under the settlement agreement, AF-LAC will refund the premiums owed to class members that submit a valid claim. In other words, AFLAC has not created a specific or definitive fund to pay the settlement claims. Instead, it will pay those claims as they are made and reviewed.

8. In addition to the provisions related to the refunds, the settlement contains a section governing attorney’s fees. (See Settlement Agreement, doc. 52 at § 8.)

9. AFLAC does not oppose the class’s entitlement to reasonable attorney’s fees and expenses, and both parties stipulate that the Court has “sole[ ] and exclusive[ ]” discretion to determine those amounts:

8.1 Within the time set forth in the Preliminary Approval Order, or as otherwise directed by the Court, Class Counsel may apply to the Court for an award of attorneys’ fees and reimbursement of expenses, which amount shall be determined solely and exclusively by the Court at or after the final fairness hearing. [AFLAC] does not oppose Class Counsel’s entitlement to an award of attorneys’ fees and expenses, but it reserves its right to object to the amount of attorneys’ fees and expenses sought by Class Counsel. Class Counsel’s attorneys’ fees and expenses, if any, as approved and ordered by the Court, shall be paid within fourteen (14) days after Final Approval and shall be paid without reducing or depleting the Settlement Payments to be made to the Class Members and without diminishing any other amount owed by [AF-LAC], if any, under the terms of this Settlement Agreement.
(Settlement Agreement, doc. 52 at § 8.1.) (emphasis added).

10. After the Court preliminarily approved the settlement, the class counsel moved for an award of attorney’s fees. The parties briefed the motion and both filed affidavits in support of their positions: the class counsel asking for an award based on a contingency fee or percentage of the settlement value and AFLAC asking for a much smaller award based on a lodestar calculation.

11. The Court held a hearing on March 21, 2012, to address the motion for attorney’s fees and the parties’ joint motion for final approval of the class action settlement.

12. Over the course of this litigation, the parties’ estimation of the settlement value has converged significantly. Initially, class counsel moved for attorney’s fees in the amount of $5,323,907.25. This calculation was based on a projected settlement value of $21,295,629.00, according to the class. AFLAC placed a much smaller value on the settlement — $4,254,782.00. Later, after actuaries for both parties acknowledged errors in their calculations, the parties stipulated to a number — $6,601,633.00. (Doc. 82.) The class argues that this sum is the minimum settlement value, while AFLAC argues that it is the maximum settlement value.

13. The plaintiffs argue that the $6.6 million sum should be higher for three reasons:

a. The $6.6 million sum incorrectly excludes “Policies where the treatment [1256]*1256date giving rise to the claim is before the policy’s issue date and policies where the treatment date giving rise to the claim is after the policy’s termination date, or after 2/15/2012, if the policy is active[.]” If AFLAC included those policies, the calculated value of the settlement would increase to $6,728,171.00.
b. If the settlement calculation was based on the publicly available data for average premiums, which are more reliable than AFLAC’s data, the settlement value would increase to $9,103,652.
c. The settlement calculation does not include the future and or equitable benefits to the injunctive relief class, which the plaintiffs claim are worth $9,278,148.00 in the next eight years alone and would be much higher if extended out further.

14. AFLAC agrees that it might have to pay out $6.6 million to the settlement beneficiaries. But it claims that this sum is the maximum settlement value because there are several reasons other than age-based denials for why AFLAC might have coded a denial as “dependent not covered” and, thus, why a policy holder might not have a valid settlement claim. AFLAC argues, for instance, that the policy holder might not have paid for dependent coverage.

15. The class argues in response that the reason for denial is irrelevant. Instead, what matters is whether a policy holder paid a premium for Family Coverage without any covered dependents.

16. The class’s actuary assumed that all of the policyholders listed in the stipulated spreadsheet, (doc. 75-3) — the spreadsheet upon which the stipulated sum of $6,601,633.00 is based — are class members. AFLAC, on the other hand, claims that not all of the policyholders in the spreadsheet are necessarily class members and, thus, not all of the policy holders in the spreadsheet are entitled to a refund. Therefore, it argues that the $6.6 million sum is the maximum payout.

17. While apparently claiming that not all of the policy holders listed in the stipulated spreadsheet are class members, AF-LAC has not offered any definitive guidance on how many policy holders in the spreadsheet are class members and how many are not. Instead, AFLAC acknowledges that it might potentially have to pay out $6.6 million to settlement beneficiaries.

18.

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Cite This Page — Counsel Stack

Bluebook (online)
851 F. Supp. 2d 1252, 2012 WL 1072339, 2012 U.S. Dist. LEXIS 46480, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guschausky-v-american-family-life-assurance-co-mtd-2012.