Joseph M. Pallozzi, Lori M. Pallozzi v. Allstate Life Ins. Co.

198 F.3d 28
Court of Appeals for the Second Circuit·Decided January 13, 2000·No. 1997·Published·Cited by 56 cases

Opinion

LEVAL, Circuit Judge:

Plaintiffs Joseph M. Pallozzi and Lori R. Pallozzi appeal from the judgment of the United States District Court for the Northern District of New York (Scullin, J.) dismissing their complaint against Defendant Allstate Life Insurance Company (“Allstate”) under Fed.R.Civ.P. 12(b)(6). See Pallozzi v. Allstate Life Ins. Co., 998 F.Supp. 204, 208 (N.D.N.Y.1998). The complaint alleged in main that Allstate discriminated against Plaintiffs on the basis of their mental disabilities by refusing to issue them a joint life insurance policy, thereby violating Title III of the Americans with Disabilities Act (the “Act” or “ADA”), 42 U.S.C. §§ 12181-12189. Because the complaint failed to allege that Allstate’s refusal to insure Plaintiffs was without actuarial justification, the district court dismissed the action. See 998 F.Supp. at 207-08. We disagree with the court’s reasoning and disposition, and therefore vacate the judgment.

Background

A. Relevant statutory provisions.

Title III of the ADA, which generally prohibits discrimination on the basis of disability by so-called “public accommodations,” see 42 U.S.C. §§ 12181-12189, provides in Section 302(a) that

No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advan *30 tages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation.

Id. § 12182(a). Title III includes a long list of private facilities that qualify as “public accommodations” so long as their operations “affect commerce,” including an “insurance office, professional office of a health care provider, hospital, or other service establishment.” Id. § 12181(7)(F).

Section 501(c) of Title V of the ADA (the “safe harbor” provision) includes the following statement:

INSURANCE
Subchapters I through III of this chapter [i.e., Titles I through III of the ADA] and title IV of this Act shall not be construed to prohibit or restrict—
(1) an insurer, hospital or medical service company, health maintenance organization, or any agent, or entity that administers benefit plans, or similar organizations from underwriting risks, classifying risks, or administering such risks that are based on or not inconsistent with State law....

Id. § 12201(c). The safe harbor provision also states, in its so-called “subterfuge clause”:

Paragraph[ ] (1) ... shall not be used as a subterfuge to evade the purposes of [Titles] I and III of [the Act].

Id.

The McCarran-Ferguson Act, insofar as it bears on the instant dispute, provides:

No Act of Congress shall be construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance ... unless such Act specifically relates to the business of insurance.

15 U.S.C. § 1012(b).

B. Allegations of the complaint.

The Pallozzis’ are a married couple. Joseph Pallozzi has been diagnosed with major depression and agoraphobia, Lori Pal-lozzi with major depression and borderline personality disorder. Both Pallozzis have received counseling, medication, and inpatient treatment for their conditions in the past.

In October 1996, Plaintiffs applied to Allstate for a joint life insurance policy in the amount of $65,000. Allstate initially issued them a Temporary Insurance Agreement, but soon canceled the agreement based on medical information provided by Plaintiffs’ psychiatrist, and refused to sell them another policy. When Plaintiffs inquired as to why they had been rejected, the carrier gave them a copy of their application and referred them to their psychiatrist for further information. Allstate refused their requests to furnish them with specific reasons for the denial.

In February 1997, Plaintiffs commenced this lawsuit against Allstate in the United States District Court for the Northern District of New York. Their complaint claimed that Allstate refused to sell them life insurance because of their mental disabilities; and that this refusal violated Title III of the ADA and failed to come within the safe harbor of Section 501(c) of the Act because the insurer’s conduct violated various provisions of the New York State Insurance Law, specifically N.Y. Ins. Law §§ 2606, 2608, and 4224. It further asserted that Allstate’s actions constituted a “subterfuge to evade the purposes of Title III of the ADA.” The complaint sought a declaratory judgment that Allstate violated Plaintiffs’ rights under Title III and New York law, and an order directing Allstate to sell Plaintiffs a life insurance policy “at a price which is based on sound actuarial principles, or actual or reasonably anticipated experience.”

C. The district court’s ruling.

In May 1997, Allstate moved to dismiss the complaint pursuant to Fed.R.Civ.P. 12(b)(6) for failure to state a claim upon which relief may be granted. The carrier did not dispute that Plaintiffs’ mental ailments are recognized “disabilities” under *31 the ADA, and conceded that it had refused to issue Plaintiffs a life insurance policy because of their medical history. It contended, however, that Title III of the ADA does not regulate the underwriting practices of insurance companies.

In March 1998, the district court granted Allstate’s motion to dismiss the complaint. See Pallozzi, 998 F.Supp. at 208. After reviewing the statutory text and legislative history, the court questioned whether Title III of the ADA was intended to reach the underwriting practices of insurance companies. See id. at 207. Nonetheless, the court ruled that “While Title III ... does not ordinarily apply to the underwriting practices of insurance companies, an individual may not be denied insurance coverage based on a disability unless such denial is based upon sound risk classification.” Id. Turning to the allegations in the complaint, the court found that Plaintiffs “have not alleged facts from which the Court can draw a favorable inference that the[ir] denial might not have been based on sound actuarial principles.” Id. The court also found that Plaintiffs “have failed to provide factual support for their contention that the Defendant used the ‘safe harbor’ provision [of Section 501(c) of the ADA] as a subterfuge.”

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Joseph M. Pallozzi, Lori M. Pallozzi v. Allstate Life Ins. Co., 198 F.3d 28 (2d Cir. 2000).

198 F.3d 28 (Joseph M. Pallozzi, Lori M. Pallozzi v. Allstate Life Ins. Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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