Lopez v. Progressive County Mutual Insurance Company

CourtDistrict Court, W.D. Texas
DecidedOctober 2, 2019
Docket5:19-cv-00380
StatusUnknown

This text of Lopez v. Progressive County Mutual Insurance Company (Lopez v. Progressive County Mutual Insurance Company) is published on Counsel Stack Legal Research, covering District Court, W.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lopez v. Progressive County Mutual Insurance Company, (W.D. Tex. 2019).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION

RICHARD LOPEZ, ON BEHALF OF § THEMSELVES AND ALL OTHERS § SIMILARLY SITUATED; AND GLORIA § LOPEZ, ON BEHALF OF THEMSELVES § AND ALL OTHERS SIMILARLY § SITUATED; § § Plaintiffs, § § SA-19-CV-00380-FB vs. § § PROGRESSIVE COUNTY MUTUAL § INSURANCE COMPANY, APRIL § HAGER, § § Defendants. §

REPORT AND RECOMMENDATION OF UNITED STATES MAGISTRATE JUDGE

To the Honorable United States District Judge Fred Biery: This Report and Recommendation concerns Plaintiffs’ Motion to Remand [#18]. All dispositive pretrial matters in this case have been referred to the undersigned for disposition pursuant to Western District of Texas Local Rule CV-72 and Appendix C [#6]. The undersigned has authority to enter this recommendation pursuant to 28 U.S.C. § 636(b)(1)(B). For the reasons set forth below, it is recommended that Plaintiffs’ motion be denied. I. Background Plaintiffs Richard Lopez and Gloria Lopez (collectively, “Plaintiffs”) bring this putative class action against their insurer, Defendant Progressive County Mutual Insurance Company (“Progressive”), and its employee, Defendant April Hager (collectively “Defendants”). This case was originally filed in state court and subsequently removed to this Court by Progressive under the “mass action” provisions of the Class Action Fairness Act of 2005 (“CAFA”). See 28 U.S.C. § 1332(d). Plaintiffs did not originally file this suit as a class action. Their Original Petition against Defendants alleged individual claims for violations of the Texas Deceptive Trade Practices Act and fraud. (Orig. Pet. [#1-3] at 2–20.) Plaintiffs amended their Petition twice prior to removal.

(First Am. Pet. [#1-17] at 2–15; Second Am. Pet. [#1-19] at 2–18.) The First Amended Petition supplemented Plaintiffs’ allegations and added additional claims but did not assert class claims. (First Am. Pet. [#1-17].) It was in Plaintiffs’ Second Amended Petition that Plaintiffs first raised class action allegations seeking recovery on behalf of other individuals. (Second Am. Pet. [#1- 19] at 12–15.) Progressive promptly removed Plaintiffs’ Second Amended Petition under CAFA, and Plaintiffs filed an Amended Complaint [#8], which is the live pleading in this case. By their class action, Plaintiffs, who are insureds of Progressive, seek to recover damages for the allegedly unlawful assertion by Defendants of a right to reimbursement based on a purported subrogation lien under the auto insurance contracts between Progressive and Plaintiffs.

(Am. Compl. [#8] at 1.) Plaintiffs claim that they paid premiums to Progressive to have Medical Payments Coverage included in their policy so that in the event of a motor vehicle collision, the Medical Payments Coverage would pay for medical services received by the insureds. (Id. at 2– 3.) Plaintiffs allege that they were involved in a motor-vehicle collision caused by Corina Hernandez, who was insured by GEICO Choice Insurance Company (“GEICO”), and suffered serious personal injuries. (Id. at 3.) Plaintiffs received medical care in conjunction with their injuries; accrued medical bills for the services rendered; and those bills were paid by Progressive directly to the health-care providers. (Id.) Plaintiffs claim that Progressive subsequently sent standardized letters to Plaintiffs’ counsel and GEICO asserting a right to reimbursement for these payments in the event of any third-party personal-injury recovery or settlement. (Id.) Plaintiffs settled their personal-injury claim with GEICO and Hernandez, and Plaintiffs asked Progressive, through Hager, for a statutory reduction of the claimed subrogation lien such that Progressive would share the costs of attorney’s fees and litigation expenses as required by

Texas law. (Id. at 4.) Hager allegedly declined and reaffirmed Progressive’s claim for full reimbursement of Plaintiffs’ medical expenses. (Id.) Defendants ultimately initiated arbitration proceedings against GEICO to force GEICO to pay the entire amount directly to Progressive. (Id.) GEICO was ordered by the arbitrator to pay, and did pay, the entire $13,406.68 in medical payments to Progressive. (Id. at 6.) Plaintiffs filed this lawsuit because Defendants allegedly refused to reduce the claimed amount to share litigation fees and costs. (Id.) It was only after the parties engaged in discovery that Plaintiffs discovered facts that led them to take the position that they argue in this suit—that Defendants never had any rights to reimbursement in the first instance. (Id.) Plaintiffs also learned through discovery that Defendants have asserted

subrogation liens on over $3,560,510.00 of money paid under Medical Payments Coverage policies in Texas from 2015 through November 2018 and have recovered over $1,085,222.00 from Progressive’s insureds through subrogation liens on personal-injury recoveries. (Id.) Plaintiffs amended their pleadings to add these allegations. By their Amended Complaint, Plaintiffs maintain that Defendants do not have a contractual right of reimbursement to payments made directly to health-care providers, as opposed to payments made directly to Plaintiffs as the insureds. (Id. at 5.) Accordingly, Plaintiffs maintain that Defendants have wrongfully claimed the right to recover money paid to third-party health-care providers and have asserted a subrogation lien to take money that belongs to Plaintiffs. (Id. at 2.) Plaintiffs bring causes of action against Defendants for violations of the Texas Insurance Code, Tex. Ins. Code § 541.051, et seq., the Texas Deceptive Trade Practices Act, Tex. Ins. Code § 541.141(2), and the Texas Civil Practice & Remedies Code § 12.002, and for conversion and theft. (Id. at 7–11.) Plaintiffs bring this lawsuit as a class action and propose the following definition of the Class:

All individuals who had Medical Payments Coverage with their Auto Insurance policy issued by Progressive County Mutual Insurance Company in and subject to the laws of Texas, and against whom Defendants asserted the existence of rights to reimbursement, a subrogation lien, or demands for repayment through a Sub41 letter from their personal injury recoveries of money that was paid to anyone other than the insured individuals from April 3, 2015 to the present.

(Id. at 11.)1

Plaintiffs now move to remand this action to state court, arguing that their case must be remanded under the local-controversy and home-state exceptions to CAFA [#18, #19]. Defendants responded to the motion [#24], and Plaintiffs filed a reply [#26]. Defendants have moved to strike a portion of Plaintiffs’ reply or for leave to file a sur-reply, arguing that Plaintiffs raised an entirely new basis for remand in their reply brief—the discretionary-jurisdiction exception to CAFA [#27].2 Plaintiffs did not respond to Defendants’ motion to strike, and the undersigned will also recommend that the Court grant the motion as unopposed and strike

1 An earlier class definition set forth in Plaintiffs’ Second Amended Petition is relevant to the Court’s analysis of the merits of Plaintiffs’ motion to remand and is discussed infra.

2 “Under CAFA’s discretionary-jurisdiction provision, the citizenship requirement lowers to require that ‘greater than one-third but less than two-thirds of the members of all proposed plaintiff classes in the aggregate . . . are citizens of the State in which the action was originally filed . . . .’” Preston v. Tenet Healthsystem Mem’l Med.

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Lopez v. Progressive County Mutual Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lopez-v-progressive-county-mutual-insurance-company-txwd-2019.