Lifeline Limited No. II v. Connecticut General Life Insurance

827 F. Supp. 438, 1993 U.S. Dist. LEXIS 10189, 1993 WL 274230
CourtDistrict Court, E.D. Michigan
DecidedJuly 22, 1993
Docket2:92-cv-74752
StatusPublished
Cited by2 cases

This text of 827 F. Supp. 438 (Lifeline Limited No. II v. Connecticut General Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lifeline Limited No. II v. Connecticut General Life Insurance, 827 F. Supp. 438, 1993 U.S. Dist. LEXIS 10189, 1993 WL 274230 (E.D. Mich. 1993).

Opinion

OPINION AND ORDER

FEIKENS, District Judge.

I. Introduction

A. Procedural History

Plaintiff Lifeline Limited No. II (“Lifeline”) has filed a Second Amended Complaint against defendants Connecticut General Life Insurance Company (“Conn Gen”), Preferred Health Care Corporation (“PHC”), and James Kinville (“Kinville”) 1 alleging one claim of promissory estoppel and one claim of fraudulent misrepresentation. In plaintiffs original Complaint, it alleged one count of restraint of trade in violation of § 1 of the Sherman Act, 15 U.S.C., and two counts of tortious interference with business expectan-ey. In an Opinion and Order dated March 15, 1993, I dismissed plaintiffs antitrust claim for failure to state a claim upon which relief could be granted. See Lifeline Limited No. II v. Connecticut General Life Insurance Co., 821 F.Supp. 1201 (E.D.Mich.1993). In an Opinion and Order dated April 12, 1993, I dismissed plaintiffs claims of tortious interference for failure to state claims upon which relief could be granted. See Lifeline Limited No. II v. Connecticut General Life Insurance Co., 821 F.Supp. 1213 (E.D.Mich.1993). Subsequently, I allowed plaintiff to file a Second Amended Complaint, upon which defendants’ current motion to dismiss is based.

For the reasons set forth below, I DENY defendants’ May 10, 1993, motion to dismiss Second Amended Complaint.

B. Undisputed Facts

Defendant Conn Gen is under contract with non-party General Motors Corporation (“GM”) to perform certain delegated administrative functions on behalf of and as agent for GM as the plan administrator of the GM benefit plan (“plan”). Such a plan is an employee welfare plan as defined in the Employee Retirement Income Security Act of 1974 (“ERISA”), as amended, 29 U.S.C. §§ 1001 et seq. Conn Gen administers the GM substance abuse benefit plan; GM employees and their dependents are beneficiaries under the benefit plan. As an agent for GM, Conn Gen contracts with health care providers who render the substance abuse treatment (“contract providers”).

Defendant PHC is under contract with GM to perform the service of reviewing and assessing proposed contract providers; PHC does not perform the actual contracting with plan providers. PHC recommends to Conn Gen those health care providers with whom Conn Gen should contract. Defendant Kinville is an employee of PHC and is in charge of administering the substance abuse benefits program for GM. Dr. Joseph L. Posch, Jr. (“Posch”) is president and chief executive officer of non-party Doctors Hospital.

*441 Plaintiff Lifeline provides in-patient treatment for persons addicted to cocaine and other chemicals. Lifeline is an Illinois limited partnership with its principal place of business in Illinois. Lifeline subcontracts with health care providers who are contract providers. Doctors Hospital, a contract provider, was the facility through which Lifeline last provided service under the benefit plan. Prior to Doctors Hospital, Lifeline subcontracted to provide substance abuse treatment at non-party Kern Hospital beginning in April 1987, changed to non-party Northwest General Hospital in April 1988, and then transferred to Doctors Hospital after June 1990. Lifeline’s relationship with Doctors Hospital ended in May 1992. After the termination of the Lifeline/Doctors Hospital relationship, Doctors Hospital continued as a contract provider.

Meanwhile, in June 1991, Lifeline contracted with non-party Michigan Health Center (“MHC”) to perform treatment at that facility knowing that MHC was not a contract provider. Even though Lifeline was continuing to provide in-patient substance abuse treatment at Doctors Hospital, it sought to have MHC approved as a contract provider. At the time Lifeline terminated its relationship with Doctors Hospital, it knew that MHC had not been approved as a contract provider. MHC is still not a contract provider.

Defendants do not contract directly with plaintiff Lifeline. Instead, the defendants contract with a contract provider, such as Doctors Hospital. It is the contract provider which contracts with Lifeline. See Lifeline Limited No. II v. Connecticut General Life Insurance Co., 821 F.Supp. 1218 (E.D.Mich.1993).

C. Plaintiffs Allegations

1. Promissory Estoppel

In its Second Amended Complaint, plaintiff alleges the following with regard to its claim of promissory estoppel:

Lifeline alleges that during the spring of 1992, James Butler (“Butler”), an employee of Lifeline, had many conversations with Thomas Sakorafis (“Sakorafis”) of Conn Gen and with Kinville of PHC. Lifeline says that both Sakorafis and Kinville told Butler that if the substance abuse program at Doctors Hospital went out of business, then MHC would be approved as a contract provider. Second Amended Complaint, p. 13.

During a May 20, 1992, telephone conversation between Butler and Kinville, it is alleged Kinville said that PHC controlled approval of the GM substance abuse program administered by Conn Gen and that he was therefore speaking on behalf of both PHC and Conn Gen. Kinville, allegedly, unequivocally promised that if the substance abuse program at Doctors Hospital went out of business, then MHC would be approved as a contract provider and that the Michigan Health Center/Lifeline unit would be authorized to treat beneficiaries of the GM plan. The only contingency allegedly placed on this promise was that Doctors Hospital must no longer be offering its substance abuse program in order for the Lifeline approval at MHC to go forward. Lifeline claims it placed its trust in this commitment. On May 22, 1992, Butler then sent a letter to Kinville confirming the content of the telephone call. In this letter, Butler wrote to Kinville: “[I]f I have left anything out or in any way misstated the situation, please do not hesitate in contacting me.” Exhibit B attached to Second Amended Complaint. Kinville allegedly never contacted Butler to dispute or withdraw his promise of approval for the Lifeline program at MHC. Second Amended Complaint, pp. 14-15.

Plaintiff alleges this promise was material. Approval at the Lifeline program at MHC would result in income of $4,050.00 per day for Lifeline. Second Amended Complaint, p. 15.

Lifeline contends that when it received commitment from the defendants that MHC would be approved as a contract provider once Doctors Hospital’s substance abuse treatment program went out of business, Lifeline began phasing out its program at Doctors Hospital. Doctors Hospital, which was in bankruptcy at the time, sought to reject its contract with Lifeline. Doctors Hospital’s major secured creditor, the Board of Trustees of'the Policemen and Firemen *442 Retirement System of the City of Detroit, objected to the rejection of the Lifeline contract. The debt owed by Doctors Hospital to this secured creditor was so massive that this creditor could have forced Doctors Hospital to keep the Lifeline contract.

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Cite This Page — Counsel Stack

Bluebook (online)
827 F. Supp. 438, 1993 U.S. Dist. LEXIS 10189, 1993 WL 274230, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lifeline-limited-no-ii-v-connecticut-general-life-insurance-mied-1993.