Johnson v. Geico Casualty Co.

310 F.R.D. 246, 92 Fed. R. Serv. 3d 1066, 2015 U.S. Dist. LEXIS 128147, 2015 WL 5613155
CourtDistrict Court, D. Delaware
DecidedSeptember 24, 2015
DocketCivil Action No. 06-408-RGA
StatusPublished
Cited by7 cases

This text of 310 F.R.D. 246 (Johnson v. Geico Casualty Co.) is published on Counsel Stack Legal Research, covering District Court, D. Delaware primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Johnson v. Geico Casualty Co., 310 F.R.D. 246, 92 Fed. R. Serv. 3d 1066, 2015 U.S. Dist. LEXIS 128147, 2015 WL 5613155 (D. Del. 2015).

Opinion

MEMORANDUM OPINION

ANDREWS, U.S. DISTRICT JUDGE:

Presently before the Court are Defendants’ Motion to Decertify the Classes (D.I. 700), related briefing (D.I. 701, 704, 708, 715, 717), Plaintiffs’ Motion for Wilmington Pain & Rehabilitation Center and Rehabilitation Associates, P.A. to Intervene and Substitute as Class Representatives (D.I. 726), and related briefing (D.I. 727, 729, 730, 737). The Court heard oral argument on the motion to decertify on May 27, 2015. (D.I. 724).

For the reasons discussed herein, Plaintiffs’ motion to substitute new class representatives is DENIED. Defendants’ motion to decertify the classes is GRANTED.

BACKGROUND

At the center of the complaint is the allegation that Geico uses arbitrary computer-based rules to determine whether to pay personal injury protection (“PIP”) benefits, and that it will not change such determinations once made. Delaware law requires that Geico pay “reasonable and necessary” PIP benefits. 21 Del. C. § 2118(a)(2)(a).

The factual and procedural background leading up to class certification is set forth in the certification opinion, Johnson v. Geico Casualty Co., 673 F.Supp.2d 255, 263-65 (D.Del.2009). At that time, on Plaintiffs’ motion for class certification and over Defendants’ motion to deny certification, the Court certified two classes to pursue counts III (bad faith breach of contract), IV (breach of duty of good faith and fair dealing), and VI (consumer fraud) of the Second Amended Complaint (D.I. 316), under Federal Rule of Civil Procedure 23(b)(3). The classes were certified as follows:

All persons, who, during the period from March 21, 1996 to date of final judgment: (a) submitted first-party medical expense claims to Defendants pursuant to Defendants’ Delaware automobile insurance policy’s PIP coverage; (b) had their claim submitted to Defendants’ computer review system; (c) received or were tendered no payment on the submitted medical expenses for treatment of a passive modality (based on Defendants’ rule declaring that the treatment would “provide no therapeutic benefit during the chronic period” of the diagnosed conditions); and (d) received or were tendered an amount less than the stated policy limits (the “Passive Modality Class”).
All persons, who, during the period from October 7, 1994 to date of the final judgment: (a) submitted first-party medical expense claims to Defendants pursuant to Defendants’ Delaware automobile insurance policy’s PIP coverage; (b) had their claim submitted to Defendants’ computer review system; (c) received or were ten[249]*249dered partial payment but in an amount less than the submitted medical expenses (based on the “80th percentile [cap]”); and (d) received or were tendered an amount less than the stated policy limit[s] (the “Geographic Reduction Class”).

Id. at 266. Defendants filed a petition to appeal the Court’s certification order. See Fed. R. Civ. P. 23(f). The Court of Appeals denied the petition. (D.I. 340).

The classes were certified before any trial plan was filed. Johnson, 673 F.Supp.2d at 267. At the time of certification, it was also “unclear ... whether a determination of damages ... would depend in part on individual class members’ circumstances.” Id. at 270. Plaintiffs represented at that time that computation of damages would not depend on each claimant’s individual circumstances. (D.I. 224 at 73).

Plaintiffs have since proposed a trial plan and made several submissions with respect to damages. (D.I. 432, 531-1, 536, 537). Plaintiffs propose that the measure of damages for these claims is “the amount of the claims Defendants -wrongfully reduced, denied or delayed to class members, monies GEICO retained for its own benefit.” (D.I. 432 at p. 22). Plaintiffs argue that this amount is the difference between what the medical providers billed and what Geico paid. (D.I. 724 at 19-20, 26). Plaintiffs point to the Court’s note at certification that “[t]he relevant injury is the denial, reduction or delay of full PIP benefits without reasonable investigation and justification” to argue that class members need not prove out-of-pocket payments to demonstrate injury. (D.I. 432 at p. 23; see Johnson, 673 F.Supp.2d at 277-78).

Plaintiffs propose presenting expert testimony to prove damages as follows:

Damages evidence will be presented to the jury through a summary prepared from the [Medata and Fair Isaac] extracts ... pursuant to Federal Rule of Evidence 1006. The extracts will show the proof of loss, the amount of the reduction or denial and basis for the reduction or denial. Other evidence of profits and statutory penalties will be presented through direct documents or summaries. There will be no extrapolations or averaging; that is, evidence of damages will be presented for each and every class member.

(D.I. 432 at p. 6). Plaintiffs served Defendants with the expert report of Charles Setz-fand and provided it to the Court in a status report. (D.I. 531). Mr. Setzfand used the electronic medical bill review data to calculate geographic reductions and passive modality reductions based on reason codes, and also calculated statutory penalties on those amounts. (Id.).

In May 2013, Defendants moved for summary judgment as to then-class representative Sharon Anderson’s individual claims. (D.I. 579). On March 26, 2014, the Court granted Defendants’ motion as to consumer fraud and tortious interference with contract. (D.I. 655 at pp. 6-10). On June 16, 2014, the Court granted Defendants’ motion as to breach of contract, bad faith breach of contract, and the breach of good faith and fair dealing. (D.I. 675). On September 12, 2015, the Court granted Defendants’ motion as to the declaratory judgment count. (D.I. 695). All three certified counts are thus currently without a class representative. On June 15, 2015, Plaintiffs moved to substitute Wilmington Pain & Rehabilitation Center and Rehabilitation Associates, P.A. as class representatives. (D.I. 726).

LEGAL STANDARDS

A. Substituting Class Representative

When a named class representative becomes inadequate after the class has been certified, the court may grant leave to substitute new representatives. Goodman v. Lukens Steel Co., 777 F.2d 113, 124-25 (3d Cir.1985); see also 1 McLaughlin on Class Actions § 4:36 (11th ed.) (“[C]ourts have consistently granted plaintiffs leave to substitute new representatives where ... a class has already been certified and the certified representative becomes unavailable (e.g., dies, decides not to pursue the claim, becomes inadequate for another reason, etc.”).

Federal Rule of Civil Procedure 24 provides: “On timely motion, the court may permit anyone to intervene who ... has a claim or defense that shares with the main action a [250]*250common question of law or fact.” Fed. R. Civ. P.

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Bluebook (online)
310 F.R.D. 246, 92 Fed. R. Serv. 3d 1066, 2015 U.S. Dist. LEXIS 128147, 2015 WL 5613155, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-geico-casualty-co-ded-2015.