Newman v. Metropolitan Life Insurance Co.

240 F. Supp. 3d 761, 2017 U.S. Dist. LEXIS 33655, 2017 WL 951362
CourtDistrict Court, N.D. Illinois
DecidedMarch 9, 2017
DocketNo. 16 C 3530
StatusPublished

This text of 240 F. Supp. 3d 761 (Newman v. Metropolitan Life Insurance 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
Newman v. Metropolitan Life Insurance Co., 240 F. Supp. 3d 761, 2017 U.S. Dist. LEXIS 33655, 2017 WL 951362 (N.D. Ill. 2017).

Opinion

Memorandum Opinion & Order

Honorable Thomas M. Durkin, United States District Judge

This case arises from a long-term care insurance policy that Plaintiff Margery Newman purchased from Defendant Metropolitan Life Insurance Company. In connection with the policy, Plaintiff purchased a premium-payment option titled the “Reduced-Pay at 65 Option.” As set forth more fully below, the option didn’t function as Ms. Newman anticipated it would. She therefore sues on behalf of herself and others similarly situated for breach of contract, common law fraud and fraudulent concealment, and unfair and deceptive practices under the Illinois Consumer Fraud Act. This Court has jurisdiction under 28 U.S.C. § 1332 as modified by the Class Action Fairness Act. Defendant moves to dismiss the complaint. For the reasons set forth below, Defendant’s motion is granted and the case is dismissed without prejudice.

Standard

A Rule 12(b)(6) motion challenges the sufficiency of the complaint. See, e.g., Hallman v. Fraternal Order of Police of Chi. Lodge No. 7, 570 F.3d 811, 820 (7th Cir. 2009). A complaint must provide “a short and plain statement of the claim showing that the pleader is entitled to relief,” Fed. R. Civ. P. 8(a)(2), sufficient to provide defendant with “fair notice” of the claim and the basis for it. Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). This standard “demands more than an unadorned, the-defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). While “detailed factual allegations” are not required, “labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do.” Twombly, 550 U.S. at 555, 127 S.Ct. 1955. The complaint must “contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Iqbal, 556 U.S. at 678, 129 S.Ct. 1937 (quoting Twombly, 550 U.S. at 570, 127 S.Ct. 1955). “ ‘A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.’” Mann v. Vogel, 707 F.3d 872, 877 (7th Cir. 2013) (quoting Iqbal, 556 U.S. at 678, 129 S.Ct. 1937). In applying this standard, the Court accepts all well-[766]*766pleaded facts as true and draws all reasonable inferences in favor of the non-moving party. Mann, 707 F.3d at 877.

Background

At the age of 56, Plaintiff applied for and purchased MET LIFE Long-Term Care Policy 04856-20065. R. 22 ¶ 15. She did so after reading a 12-page marketing brochure that covers a variety of topics, including likely expenses for common health conditions in people of advanced age, an explanation of what Medicare covers and does not cover, an array of plan benefits, benefit payment options, and optional plan features. R. 22-1 pp. 1-12. It says nothing of policy classes or' the possibility of class-wide premium adjustments.

A page titled “Premium Payment Options” lists “[four] premium payment options which help'you pay off your policy sooner and/or eáse financial obligations down the road, when you might be on a fixed incomé.” Id. at 9. One option offered is the “Reduced Pay at 65 Option,” which allows an insured to “pay[ ] more than the regular premium amount you would pay each year- up to the Policy Anniversary on or after your 65th birthday, [in order to] pay half the amount of your pre-age 65 premiums thereafter.” Id, ¶ 17. In a note at the bottom of the “Premium Payment Options” page, it reads: “This brochure is intended to provide a general overview, and highlight some of the provisions and optional benefits: of MetLife’s Individual Long-Term Care insurance policies. All rights and obligations will be governed by the actual policy language, if and when issued.” R. 22-1 at 9.

Plaintiff opted to purchase a long-term care policy, including the Reduced Pay at 65 Option, based on the. information contained in the brochure. Id. ¶ 16, She received the actual policy shortly thereafter. With respect to the Reduced Pay at 65 Option, the policy says only that “on and after Policy Anniversary at age 65,” premiums will be reduced by half. Id. at 15. Plaintiff alleges that the statement in the brochure and • seemingly consistent language in the policy caused her to reasonably expect that her premiums would be locked-in at a particular amount on the policy anniversary after she turned 65. R. 36 at 1.

Also in the policy, however, in the very first clause on the very first page, there is a bold, all-caps header: “PREMIUM RATES ARE SUBJECT TO CHANGE.” R. 22-1 at 13. The header is followed by a plainly-written provision that reads, in relevant part, “[Defendant] may change the premium rates subject to applicable state Insurance Department approval. Any such change in premium rates will apply to all policies in the same class as yours where the policy was issued.” Id. A similarly-worded provision appears on page 14 of the- policy in a section titled “Premiums,” indicating that Defendant “reserve[s] the right to change premium rates on a class basis,” id. at 30, a phrase which appears again, verbatim, in bold text in the 5% Automatic Compound Inflation Protection Rider (“Inflation Protection Rider”), an optional feature Plaintiff elected to purchase, id. at 37. Another rider, the “Contingent Benefits Upon Lapse Rider” (“Lapse Rider”), sets forth the parties’ rights and obligations in the event of a “substantial premium increase” during the life of the policy. Id.

At the conclusion of the policy, in a list titled “General Provisions,” a clause titled, “The Contract,” reads: “This policy, with any Riders, endorsements and written application attached, make up the entire contract.” Id. at 34. Bolded on the first page pf the policy is the following advisory clause:

30-Day Right to Examine Policy. Please read this policy carefully. It is a legal contract between You and MetLife. If You are not satisfied for [767]*767any reason, You may return this policy to Us or to the sales representative from whom You bought it within thirty (30) days from the date You receive it. If you return it within the thirty (30) day period, this policy will be void...

Id. at 13. Plaintiff did not exercise her right to void the policy. It became effective on September 1,2004. R. 22 ¶ 15.

For eight years, Plaintiff paid larger than regular premiums in anticipation of a 50% reduction in her premium at age 65. R. 22 ¶ 21. In September 2012, the policy anniversary after Plaintiffs 65th birthday, her premium was increased by 18% as part of a class-wide premium adjustment. R. 22-1 at 57. However, because the adjustment became effective once Plaintiff was already 65 years old, she paid only half of the adjusted amount, and did so without objection. Id. ¶23.

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Related

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Cite This Page — Counsel Stack

Bluebook (online)
240 F. Supp. 3d 761, 2017 U.S. Dist. LEXIS 33655, 2017 WL 951362, Counsel Stack Legal Research, https://law.counselstack.com/opinion/newman-v-metropolitan-life-insurance-co-ilnd-2017.