In Re Physician Corp. of America Securities Litigation

50 F. Supp. 2d 1304, 1999 U.S. Dist. LEXIS 7229, 1999 WL 304629
CourtDistrict Court, S.D. Florida
DecidedFebruary 18, 1999
Docket97-3678-Civ.
StatusPublished
Cited by7 cases

This text of 50 F. Supp. 2d 1304 (In Re Physician Corp. of America Securities Litigation) is published on Counsel Stack Legal Research, covering District Court, S.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re Physician Corp. of America Securities Litigation, 50 F. Supp. 2d 1304, 1999 U.S. Dist. LEXIS 7229, 1999 WL 304629 (S.D. Fla. 1999).

Opinion

ORDER DENYING MOTION TO DISMISS

MIDDLEBROOKS, District Judge.

THIS CAUSE comes before the Court on Defendants’ Joint Motion to Dismiss the Consolidated and Amended Complaint (DE# 31). The Court has reviewed the responsive pleadings and the other pertinent portions of the file and heard argument of counsel on this Motion on February 2, 1999. For the reasons set forth below, the Defendants’ Motion to Dismiss is denied.

I Facts

Plaintiffs bring this action against Defendants Physician Corporation of America (PCA) and four individual Defendants, Stanley Kardatzke, Peter Kilissanly, Clifford Donnelly, and Jay Grobowsky for violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, 15 U.S.C.. §§ 78j(b), 78t(a) and Rule 10b-5 promulgated thereunder. 1 Plaintiffs assert this claim as a class action, on behalf of a class of all purchasers of PCA common stock during the period beginning March 31, 1996 through and including March 31, 1997. 2

A Background

For the purposes of this Motion to Dismiss, the Court takes the facts as alleged by Plaintiff in the Amended and Consolidated Complaint. 3 The background facts of the Section 10(b) and Rule 10b-5 claims are as follows. Until its acquisition by Humana, Inc., on September 8, 1997, Defendant PCA was a managed health care company which also provided workers’ compensation coverage to employer *1307 groups. PCA’s wholly owned subsidiary, PCA Solutions, participated in the workers’ compensation market by providing third party administrative services to self-insured employee workers’ compensation funds. PCA also participated in this market by directly underwriting workers’ compensation policies and offering excess of loss reinsurance coverage. Workers’ compensation policies were underwritten by PCA through its wholly owned subsidiary, PCA Property and Casualty Insurance Company, Inc. (“PCA P & C”). ¶ 3.

As a result of changes in the Florida workers’ compensation market, in 1994 and 1995. PCA entered into negotiations with several self-insured funds 4 to structure an agreement in which PCA P & C would assume the assets and liabilities of those funds, in exchange for the employers purchasing workers’ compensation insurance from PCA P & C. In July 1995, PCA commissioned a reinsurance risk management assessment to determine the capital necessary to support workers’ compensation insurance policies that PCA would write for the two self-insured funds that PCA intended to acquire, Florida Business Mutual (“FBM”) and Florida Builders and Employers Mutual Insurance Company (“FBE”) [hereinafter “the Funds”]. The report indicated that approximately $50 million of additional capital would be necessary to support the future business written for employers insured by these funds. ¶ 27. This figure did not include the capital that would be necessary to support claims already incurred by the Funds. As to the prior claims, at the time the parties entered into the 1995 Consent Order discussed below, FBE financial statements for the year ended December 31, 1994, and interim quarterly statements for 1994 showed an $8.9 million surplus. 5 ¶ 31.

PCA P & C met with DOI in order to gain DOI approval for the assumption of FBE’s insurance business; on November 14, 1995, DOI entered a Consent Order (“1995 Consent Order”) establishing the terms on which this arrangement would go forward. The terms included PCA making a $60 million capital infusion to PCA P & C; PCA P & C making a 50% Quota Share Reinsurance Treaty for all Florida primary workers’ compensation coverage written on or after October 1, 1995 for the period October 1, 1995 through December 31, 1995; and PCA P & C renewing all policies of FBM and FBE that would expire on or after December 31, 1995, effective January 1,1996. 1995 Consent Order at 2; ¶ 30. As to FBM, PCA P & C “will assume all liabilities of FBM, via a loss portfolio transfer agreement, in accordance with the terms of the specimen agreement attached to this order as Exhibit 1. The effective date of the assumption is January 1, 1996, for all unpaid losses occurring *1308 through December 31, 1995.” In addition, FBM “will obtain an independent actuarial opinion on loss reserves to be ceded to PCA under the terms of the loss portfolio transfer agreement, that shall be filed on or before April 1, 1996.” 1995 Consent Order at 3-4. As to FBE, PCA P & C “will issue an aggregate stop loss reinsurance policy to FBE, the effective date of which policy is January 1, 1996, and which is attached as Exhibit 3. The attachment point of this reinsurance shall be when all assets of FBE have been liquidated, any and all remaining losses and loss adjustment expenses shall be the responsibility of [PCA P & C].” Furthermore, PCA P & C agreed to renew all policies that expire December 31, 1995 and to assume all policies with expiration dates after January 1, 1996, effective January 1, 1996. 1995 Consent Order at 8-9.

B Summary of Cause of Action

In summary, plaintiffs allege that by March 31, 1996, the start of the class period, defendants knew or recklessly disregarded that the workers’ compensation businesses of the Funds (particularly FBE, a self-insured fund for which PCA P & C was financially responsible), was materially underreserved. PCA acknowledged a'portion of the shortfall in confidential merger negotiations with Sierra Health Services, Inc. (“Sierra”),' and in discussions with DOI. During the class period, however, Defendants did not report these adverse financial developments to the public, but rather issued numerous positive press releases and submitted SEC filings that did not disclose, and attempted to mask, this adverse information and its significance given the substantial liabilities assumed pursuant to the 1995 Consent Order. Specifically, PCA did not disclose to investors the material fact of FBE’s underreserve, but instead issued public statements which misrepresented the financial condition of the workers’ compensation business stating that it was having a positive impact on PCA’s overall financial status; failed to disclose the serious problems PCA P & C was experiencing because of the assumption of the liabilities of materially underreserved funds; and misrepresented that PCA was in the process of turnaround and probable merger with Sierra on terms favorable to PCA. In actuality, PCA’s workers’ compensation business suffered a $284.4 million loss for fiscal year 1996.

As a result of the misrepresentations by Defendants, the price of PCA common stock was artificially inflated during the Class Period, and analysts continued to issue “buy” ratings. On March 31, 1997, the last day of the class period, when the full financial results for 1996 were disclosed, the price of PCA common stock, which had traded as high as $14.75 per share during the class period, closed at $4,625.

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50 F. Supp. 2d 1304, 1999 U.S. Dist. LEXIS 7229, 1999 WL 304629, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-physician-corp-of-america-securities-litigation-flsd-1999.