MUNICIPAL HEALTH BENEFIT FUND v. RICKY HENDRIX, INDIVIDUALLY AND ON BEHALF OF ALL ARKANSANS SIMILARLY SITUATED

2020 Ark. 235
Supreme Court of Arkansas·Decided June 11, 2020·No. CV-19-681·Published·Cited by 2 cases

Opinion

Cite as 2020 Ark. 235

SUPREME COURT OF ARKANSAS No. CV-19-681

MUNICIPAL HEALTH BENEFIT FUND Opinion Delivered: June 11, 2020 APPELLANT

V. APPEAL FROM THE POPE COUNTY CIRCUIT COURT [NO.

RICKY HENDRIX, INDIVIDUALLY 58CV-17-499] AND ON BEHALF OF ALL ARKANSANS SIMILARLY SITUATED HONORABLE KEN D. COKER, JR., JUDGE

APPELLEE

AFFIRMED.

JOHN DAN KEMP, Chief Justice Appellant Municipal Health Benefit Fund (“MHBF”) appeals a Pope County Circuit Court order certifying two classes pursuant to Rule 23 of the Arkansas Rules of Civil Procedure. For reversal, MHBF argues that appellee Ricky Hendrix failed to prove the class- certification requirements of commonality, predominance, superiority, typicality, and adequacy and that the circuit court lacked jurisdiction over the class action. We affirm.

I. Facts

MHBF is a trust created by the Arkansas Municipal League under authority of the Interlocal Cooperation Act, Arkansas Code Annotated §§ 25-20-101–108 (Repl. 2014 & Supp. 2017). MHBF provides benefits to employees of its municipal members. The terms of MHBF’s policy booklet apply uniformly to those who receive health-benefit coverage through MHBF, and the policy booklet sets forth the benefits available and MHBF’s rights and obligations concerning payment of those benefits.

Hendrix obtained MHBF health-benefit coverage for his family and himself through his employment as a detective with the Russellville Police Department. On May 20, 2016, Hendrix’s daughter was injured in a car accident, necessitating treatment from multiple medical-care providers. MHBF denied payment for portions of the bills incurred by Hendrix’s daughter based on its interpretation of two exclusionary terms in its policy booklet:

i. [MHBF]’s interpretation of its policy to require an insured to purchase coverage pursuant to [Arkansas Code Annotated] § 23-89-202(1) in conjunction with their automobile insurance coverage or, in the absence of such optional coverage, that the policy entitled the MHBF to coordinate their insurance benefits as if that coverage existed; and

ii. [MHBF]’s position that the medical charges incurred by their insureds can be denied or reduced by the MHBF based on [its] belief that those charges were not “reasonable and customary” under the language (and/or the absence thereof) of the Fund’s policy related to this exclusionary term.

Hendrix appealed both above bases for exclusions to MHBF’s Board of Trustees. An appeal hearing was held on May 5, 2017, and MHBF ultimately denied his appeal of both bases for exclusion in their entirety.

On December 19, 2017, Hendrix filed his amended class-action complaint, alleging that the two exclusionary terms were so subjective, ambiguous, and misleading that they were unenforceable against the classes. He sought a declaration on the enforceability of MHBF’s interpretation of the two exclusionary terms and asserted a failure to pay insurance claims pursuant to Arkansas Code Annotated § 23-79-208 (Repl. 2014) or, alternatively, breach of contract for failure to pay the benefits as agreed.

The circuit court granted Hendrix’s motion to certify two classes to pursue the three causes of action asserted in the amended complaint. The two classes included

Class 1: The auto-insurance class

All individuals and/or entities located and/or domiciled within the State of Arkansas who filed one or more claims with the Arkansas Municipal Health Benefit Fund on and between September 7, 2012 and December 31, 2016 and who had their claim(s)

denied or reduced by the MHBF, in whole or in part, on the stated basis that the Fund was coordinating that claim as if the claimant had the “med-pay” coverage addressed by Ark. Code Ann. [ ] § 23-89-202(1).

Class 2: The reasonable and customary charges or “UCR” class

All individuals and/or entities located and/or domiciled within the State of Arkansas who filed one or more claims with the Arkansas Municipal Health Benefit Fund on or between September 12, 2012 through the date of entry of this Class Certification Order and who had their claim(s) denied or reduced by the MHBF, in whole or in part, on the stated basis that the charges claimed exceed those that are “reasonable and customary.”

The circuit court ruled that the class members satisfied the requirements of Rule 23, and it made detailed findings on each of the Rule 23 requirements.1 MHBF filed a timely appeal from the circuit court’s order granting class certification.

II. Arguments

MHBF contends that the circuit court’s order granting class certification should be reversed because the classes lacked commonality, predominance, superiority, typicality, and adequacy and because the circuit court lacked jurisdiction over the class action.

Class certification is governed by Arkansas Rule of Civil Procedure 23. ChartOne, Inc.

v. Raglon, 373 Ark. 275, 279, 283 S.W.3d 576, 580 (2008). Circuit courts are given broad

1 Excluded from both classes were (1) any defendant, any entity in which any defendant has a controlling interest or which has a controlling interest in any defendant, and any defendant’s legal representatives, predecessors, successors, and assigns; (2) the judicial officers to whom the case is assigned; and (3) any member of the immediate families of the persons excluded above.

discretion in matters regarding class certification, and we will not reverse a circuit court’s decision to grant or deny class certification absent an abuse of discretion. Id., 283 S.W.3d at 580. When reviewing a class-certification order, we review the evidence contained in the record to determine whether it supports the circuit court’s decision. Id., 283 S.W.3d at 580. Our focus is whether the Rule 23 requirements have been met, and it is totally immaterial whether the petition will succeed on the merits or even if it states a cause of action. Philip Morris Cos., Inc. v. Miner, 2015 Ark. 73, at 3, 462 S.W.3d 313, 316. This court will not delve into the merits of the underlying claims when deciding whether the Rule 23 requirements have been met. Nat’l Cash, Inc. v. Loveless, 361 Ark. 112, 116, 205 S.W.3d 127, 130 (2005). The six requirements for class-action certification, as stated in Rule 23, are (1) numerosity, (2) commonality, (3) typicality, (4) adequacy, (5) predominance, and (6) superiority. Gen. Motors Corp. v. Bryant, 374 Ark. 38, 42, 285 S.W.3d 634, 637 (2008).

A. Rule 23 Requirements

1. Commonality

MHBF argues that the circuit court abused its discretion in finding that the classes met the commonality requirement because any liability involves an individualized inquiry into the reasonableness of charges. It also asserts that because it is a trust, the Uniform Declaratory Judgments Act does not apply; therefore, relief under the declaratory-judgment claim is foreclosed. And because it is neither insurance nor a contract, any relief on the insurance and breach-of-contract claims is unavailable. MHBF contends there cannot be a common question that will resolve its liability as to the claims against it.

Rule 23(a)(2) requires a determination by the circuit court that “there are questions of law or fact common to the class.” Union Pac. R.R. v. Vickers, 2009 Ark. 259, at 8, 308 S.W.3d 573, 578. We have held that

Rule 23(a)(2) does not require that all questions of law or fact raised in the litigation be common. The test or standard for meeting the rule 23(a)(2) prerequisite is . . . [that]

there need be only a single issue common to all members of the class. . . . When the party opposing the class has engaged in some course of conduct that affects a group of persons and gives rise to a cause of action, one or more of the elements of that cause of action will be common to all of the persons affected.

Williamson v. Sanofi Winthrop Pharms., Inc., 347 Ark. 89, 96, 60 S.W.3d 428, 432 (2001) (quotation omitted). Commonality is satisfied when “the defendant’s acts, independent of any action by the class members, establish a common question relating to the entire class.” Id. at 97, 60 S.W.3d at 433.

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MUNICIPAL HEALTH BENEFIT FUND v. RICKY HENDRIX, INDIVIDUALLY AND ON BEHALF OF ALL ARKANSANS SIMILARLY SITUATED, 2020 Ark. 235 (Ark. 2020).

2020 Ark. 235 (MUNICIPAL HEALTH BENEFIT FUND v. RICKY HENDRIX, INDIVIDUALLY AND ON BEHALF OF ALL ARKANSANS SIMILARLY SITUATED) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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