Liberty Mutual Insurance v. Tribco Construction Co.

185 F.R.D. 533, 1999 U.S. Dist. LEXIS 3632, 1999 WL 166999
CourtDistrict Court, N.D. Illinois
DecidedMarch 22, 1999
DocketNo. 94 C 1366
StatusPublished
Cited by4 cases

This text of 185 F.R.D. 533 (Liberty Mutual Insurance v. Tribco Construction Co.) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Liberty Mutual Insurance v. Tribco Construction Co., 185 F.R.D. 533, 1999 U.S. Dist. LEXIS 3632, 1999 WL 166999 (N.D. Ill. 1999).

Opinion

MEMORANDUM OPINION AND ORDER

NORDBERG, District Judge.

This case involves the issue of plaintiffs duties under its retrospectively-rated worker’s compensation and general liability insurance policies issued to defendants. Plaintiff Liberty Mutual Insurance Company (“Liberty”) filed this lawsuit to collect outstanding and unpaid insurance premiums allegedly due under those policies. Defendants have filed a second amended counterclaim alleging that Liberty breached its duties under those policies by failing to properly and thoroughly investigate claims made against the defendants. As part of their counterclaim, defendants filed a motion seeking to certify a class consisting of Illinois companies which purchased similar retrospectively-rated insurance policies from Liberty. Defendants allege that Liberty engaged in standardized claims handling practices which violated the standard terms of the retrospectively-rated [535]*535policies issued to putative class members.1 For the reasons set forth below, this court denies the motion for class certification.

BACKGROUND

Liberty is a Massachusetts corporation. Defendants and counter-plaintiffs Tribco Construction Company, McColl Construction Company, and Tribeo/Riteway Joint Venture are construction companies or entities located in Illinois. For the sake of convenience, the three defendants will be referred to collectively as “Tribco.”

This case concerns certain worker’s compensation and general liability insurance policies which Liberty issued to Tribco and which were in effect from approximately 1989 to 1991. By virtue of the fact that these were worker’s compensation and general liability policies, they provided that Liberty, as insurer, would handle and process the various worker’s compensation or other claims filed against Tribco. Liberty would handle such claims by investigating, settling, and/or litigating them. These particular policies also were “retrospectively-rated” policies. To understand this case, it is necessary to understand how such a'policy works.

As explained by the parties, a retrospectively-rated policy differs from a standard insurance policy. The premiums owed by the insured under a retrospectively-rated policy are not a set amount. Instead, they are periodically adjusted based on the amount of money paid in claims in the previous year and the amount of expenses relating to those claims. Because future premiums are determined based on past loss experience, the premiums are thus “retrospectively-rated.” Premiums are adjusted based on a specific formula. Although the formula is more complex, its basic effect is that the insured ends up paying for most of the settlement amounts and related expenses up to certain pre-set maximum amounts.2 The key point for purposes of this litigation is that the insurer makes the various decisions on how to investigate and litigate the claims and whether to settle them and for how much but the insured company actually pays for the settlements and expenses through higher future premiums. Thus, the role of the insurer is sometimes described as one similar to that of a claims processor or a third-party administrator.

In 1994, Liberty filed this lawsuit alleging that Tribco owed approximately $700,000 in unpaid premiums under the various retrospectively-rated policies.3 After taking discovery, Tribco eventually filed a second amended counterclaim (the “Counterclaim”) along with a motion for class certification. Tribco alleged that Liberty failed to properly and thoroughly investigate and litigate the various worker’s compensation and general liability claims made against Tribco. As a result, according to Tribco, Liberty paid out too much to settle claims or settled claims which were questionable or doubtful. Tribco states that the nature of the retrospectively-rated policy encouraged Liberty to spend little time investigating claims because Liberty ultimately would be able to recoup the amounts paid in settlements by imposing higher premiums on Tribco.

The Counterclaims contains five state law counts.4 Count I alleges a violation of the [536]*536Illinois Consumer Fraud and Deceptive Business Practices Act, 815 ILCS 505/1 et seq. Count II seeks an accounting of the premiums due under the policies. Count III seeks a declaratory judgment of the parties’ rights under the policies and whether Liberty satisfied its obligations under those policies. Count IV alleges breach of contract. Count V is a claim for negligence. Tribeo seeks to recover the “unreasonable and excessive” retrospective premiums, which it states are “in excess of $1.8 million.” (K 54.) Tribeo also alleges that “its reputation in the community” has been harmed. (Id.)

The focus of the Counterclaim is that Liberty breached its duties under the written insurance contracts by not investigating thoroughly the various claims against Tribeo. Tribeo alleges that Liberty orally represented that it would take various measures to ensure that it paid out only on legally valid claims. The Counterclaim also contains detailed allegations as to various oral representations allegedly made in December 1989 to Tribco’s president by a Liberty sales representative named Mary Foy Doherty. Specifically, the Counterclaim alleges that Doherty met with Tribco’s president, Robert McCol-lam, in December of 1989 and “told” McCol-lam that Liberty would provide various services in connection with Tribco’s policy. (WI 15-22.) Among other things, Doherty allegedly told McCollam that Liberty would institute “safeguards” to ensure that Tribeo would be charged the lowest possible premiums under the retrospectively-rated policies (1115); that Liberty would assign a “loss control representative” to “analyze Tribco’s operations, identify loss sources and recommend corrective actions to be implemented by Tribeo” (1116); that Liberty’s claims adjusters would audit claimants’ medical and pharmaceutical bills, analyze doctor payments, analyze medical charges, and provide a hospital control program to limit claimants’ hospital stays to the time needed to treat injuries properly at the lowest possible expense to Tribeo (K17); that Liberty would investigate all of Tribco’s claims and pay to claimants only those benefits required of Tribeo under the applicable laws (K 18); and that Liberty “would set accurate loss reserves” (II21).

In addition to Doherty’s alleged oral misrepresentations, Tribeo alleges that Liberty owed a duty of good faith, fair dealing and reasonableness based solely on the fact that the policy was a retrospectively-rated policy. In sum, the Counterclaim alleges that the duties breached were written, oral, and implied-in-law under the duty of good faith. The Counterclaim lists 25 specific types of acts or omissions that constitute improper claims handling procedures and thus were alleged breaches of duty. (K 50.)

Tribeo also seeks to certify a class consisting of insureds whose address is in Illinois and who obtained worker’s compensation or general liability insurance policies with Liberty which were retrospectively-rated. (II56.) The basis for proceeding as a class action is that Liberty’s claims adjusters allegedly engaged in “standardized” claims handling procedures and practices.

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Cite This Page — Counsel Stack

Bluebook (online)
185 F.R.D. 533, 1999 U.S. Dist. LEXIS 3632, 1999 WL 166999, Counsel Stack Legal Research, https://law.counselstack.com/opinion/liberty-mutual-insurance-v-tribco-construction-co-ilnd-1999.