Nieves v. United of Omaha Life Insurance Company

District Court, S.D. California·Decided February 11, 2022·No. 3:21-cv-01415·Unknown

Opinion

MARILYN NIEVES, individually, and on Case No.: 3:21-cv-01415-H-KSC behalf of a class, ORDER DENYING DEFENDANT’S Plaintiffs, MOTION TO DISMISS AND v. DENYING PLAINTIFF’S MOTION TO STRIKE UNITED OF OMAHA LIFE INSURANCE CO., Nebraska corporation; [Doc. Nos. 23, 27-1.] and DOES 1 thru 10, inclusive,

Defendants. On July 6, 2021, Plaintiff Marilyn Nieves (“Plaintiff”) filed her Complaint alleging claims for declaratory relief, breach of contract, bad faith, and unfair competition against Defendant United of Omaha Life Insurance Company (“Defendant” or “United”) and unnamed Does 1 through 10 in the Superior Court of California, San Diego County, on behalf of herself and a putative class of similarly situated individuals. (Doc. No. 1-2.) Defendant removed the action to this Court on August 6, 2021 pursuant to the Class Action Fairness Act, 28 U.S.C. §§ 1332, 1441, and 1453 and federal diversity jurisdiction. (Doc. No. 1.) Defendant filed a motion to dismiss on September 13, 2021. (Doc. No. 14.) Plaintiff then filed her First Amended Complaint (“FAC”) on October 18, 2021. (Doc. No. 22.) Defendant filed a subsequent motion to dismiss on November 5, 2021. (Doc. No. 23.) On January 4, 2022, Plaintiff filed her opposition and a motion to strike several of Defendant’s evidentiary submissions. (Doc. Nos. 27, 27-1.) Defendant filed its reply in support of its motion and an opposition to Plaintiff’s motion to strike on January 18, 2022. (Doc. Nos. 28, 29.) The Court held a hearing on the motion on January 31, 2022. (Doc. No. 32.) Alex M. Tomasevic and Jack B. Winters appeared on behalf of the Plaintiff and Larry Mark Golub and Vivian Ilana Orlando appeared on behalf of the Defendant. For the foregoing reasons, the Court denies Defendant’s motion to dismiss. BACKGROUND1 I. Plaintiff’s Factual Allegations In June of 2016, Plaintiff, a resident of San Diego County, California, purchased a $30,000 whole life policy (the “Policy”) from United that insured the life of her son. (FAC ¶¶ 42, 72.) Plaintiff is the owner and sole beneficiary of the Policy. (Id. ¶ 42.) United is a Nebraska corporation that administers life insurance policies in California, including Plaintiff’s Policy. (Id. ¶ 43.) Plaintiff’s individual claims center on United’s alleged acts related to the Policy. Plaintiff alleges that United repeated the same unlawful acts across thousands of other life insurance policies. (Id. ¶ 2.) The Policy requires a premium payment of $224.40 per year. (Id. ¶ 74.) Plaintiff set up an automatic monthly payment from her bank account to pay the Policy premium. (Id. ¶ 77.) Premiums were paid by this method until February of 2018, when an automatic payment was returned. (Id.) On March 16, 2018, Plaintiff received a notice from United that her payment due on February 6, 2018 was returned. (Id.) Plaintiff subsequently provided a new payment authorization for automatic payments and requested that United deduct the premiums due on April 2, 2018. (Id.) On March 26, 2018, United confirmed receipt of her payment authorization by letter. (Id.) On April 6, 2018, United sent Plaintiff a notice indicating that payment for the February premium had not been received and that as a result, coverage under the Policy 1 The following allegations are taken from Plaintiff’s FAC. had terminated. (Id. ¶ 78.) Plaintiff alleges that no pre-termination notice was sent to any Policy designee or Plaintiff. (Id.) According to Plaintiff, after issuance of the Policy in 2016, she was never advised of her right to designate a second addressee on an annual basis in violation of Cal. Ins. Code § 10113.72(b). (Id. ¶ 75.) Plaintiff contacted United to reinstate her Policy. She was told that “as a condition of seeking reinstatement, she had to pay premiums for the period of time that United had declared her policy void.” (Id. ¶ 79.) On April 16, 2018, United provided Plaintiff with an Application for Reinstatement. (Id. ¶ 81.) Plaintiff alleges that the application requested detailed medical information and the payment of premiums for the uninsured period. (Id.) On May 18, 2018, United received Plaintiff’s reinstatement application. (Id. ¶ 83.) At that time, United purportedly “again violated [Cal. Ins. Code § 10113.72(a)] by failing to provide Plaintiff . . . with a right to designate.” (Id.) On June 8, 2018, United denied reinstatement “based in part on pharmaceutical information we received.” (Id. ¶ 84.) Plaintiff purports that the “pharmaceutical information” indicated that the insured was taking medication to treat his autism—a condition that purportedly existed at the time that the Policy was issued. (Id.) Plaintiff alleges that United used the lapse of insurance coverage as an opportunity to rewrite and renegotiate her Policy. Plaintiff alleges that this practice allows United to remove from its pool of insureds “those individuals who had health issues that were less acute, or that [the insurer] had not fully appreciated, at the time of the original underwriting.” (Id.) Plaintiff alleges that United’s conduct violated the California Insurance Code Sections 10113.71 and 10113.72 (commonly known as “the Statutes”), which regulate the termination of life insurance policies for nonpayment of premiums. (Id. ¶ 1.) Plaintiff alleges that United violated the Statues in several respects by: (i) not offering a right of designation to all “applicants” for various forms of life insurance; (ii) not providing a 60- day grace period; (iii) not mailing accurate 30-day pending lapse notices; (iv) not providing annual notifications to policy owners of their rights to designate; (v) not applying the mandates of the Statutes as an absolute condition for termination of any policy for nonpayment of premium; (vi) treating policy owners directly and indirectly as if they were in default for payment of premiums; (vii) demanding the payment of Unearned Premiums2 on policies that were illegally terminated and repudiated; and (viii) concealing its failure to company with the Statutes. (Id. ¶¶ 65, 99.) According to Plaintiff, when United failed to abide by the Statutes, its termination of her Policy was ineffective. (Id. ¶¶ 9, 53.) Plaintiff states that in May of 2021, United “admitted that it had erred in declaring [Plaintiff’s] policy as having been properly terminated.” (Id. ¶ 92.) But United still required Plaintiff to pay the Unearned Premiums. (Id.) Plaintiff alleges that United has unlawfully charged policy owners “tens of millions of dollars” in Unearned Premiums. (Id. ¶¶ 3, 29.) Plaintiff also alleges that United is withholding “tens of millions of dollars of policy benefits . . . on the patently false assertion that the policies were properly and legally terminated.” (Id. ¶ 29.) On July 23, 2021, after Plaintiff’s suit was originally filed and subsequently removed to this Court, United offered to “unconditionally reinstate the policy and waive any demand for payment of prior premiums.” (Id. ¶¶ 94, 98.) Plaintiff calls United’s offer a “litigation tactic[]” aimed at “eliminat[ing] Plaintiff’s individual and putative Class claims.” (Id. ¶¶ 10, 95.) Plaintiff asserts that the offer does not cure her harm because the Policy is less valuable now than it was prior to reinstatement. (Id. ¶ 59.) Plaintiff accepted the offer under a reservation of rights. In Plaintiff’s correspondence with United, she “specifically advised United not to accept premiums if [United] intended to argue that the claims of [Plaintiff] or

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Nieves v. United of Omaha Life Insurance Company, (S.D. Cal. 2022).

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