O'Brien v. HII Ins. Solutions

CourtDistrict Court, E.D. California
DecidedMarch 19, 2021
Docket2:20-cv-02115
StatusUnknown

This text of O'Brien v. HII Ins. Solutions (O'Brien v. HII Ins. Solutions) is published on Counsel Stack Legal Research, covering District Court, E.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
O'Brien v. HII Ins. Solutions, (E.D. Cal. 2021).

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 11 Jaimi O’Brien and Sean O’Brien, No. 2:20-cv-02115-KJM-AC 12 Plaintiffs, ORDER 13 v. 14 HII Insurance Solutions, et al., 1 > Defendants. 16 17 Plaintiffs Jaimi and Sean O’Brien brought this action in state court against several health 18 | insurers, administrators, agents and brokers.' Defendants removed the action to this court based 19 | onthe parties’ diversity of citizenship. Now plaintiffs move to remand, and each defendant 20 | moves to dismiss. For the reasons below, the court denies the motion to remand and grants the 21 | motions to dismiss.

' The defendants named in the operative First Amended Complaint are (1) HII Insurance Solutions; (2) Health Plan Intermediaries Holdings, LLC (“HPIH”); (3) Benefytt Technologies, Inc., formerly known as Health Insurance Innovations, Inc.; (4) Axis Insurance Company; and (5) ten unnamed Doe defendants. See First Am. Compl. (“FAC”) {J 2-6, ECF No. 1-6. According to HPIH, HII Insurance Solutions is not a business entity, but rather the name under which HPIH does business. See Not. Removal § 6, ECF No. 1. Plaintiffs do not dispute that characterization. The court therefore considers the claims against HPIH and HII Insurance Solutions jointly in this order. Plaintiffs refer to all of the defendants except Axis as the “HII Defendants.” See id. § 13. This order adopts that shorthand.

1 I. BACKGROUND 2 On some unspecified date in 2017, plaintiffs purchased health insurance from “an 3 unlicensed agent/broker named Julio [who] was working for the HII Defendants.” First Am. 4 Compl. (“FAC”) ¶ 16; ECF No. 1-6. Julio did not have a license to sell insurance in California, 5 but plaintiffs did not know this. Id. They claim that during the sales process, defendants—that is, 6 all of the many entities described in footnote 1 above—“made specific representations to 7 plaintiffs about the nature and scope of coverage that they would receive.” Id. They also allege 8 Julio told them that “co-pays would be $10 for regular doctors and $30 for specialists; that 90% 9 of all doctors in the nation were in network; that all out-of-network care was covered at 50%, that 10 all hospital care was covered at 70%.” Id. ¶ 61. Plaintiffs “accept[ed] the offer and paid the 11 premium.” Id. ¶ 16. 12 After plaintiffs purchased the policy, Jaimi O’Brien required medical care. Id. ¶ 16. The 13 complaint does not allege how much this care cost, but in later filings, plaintiffs claim the amount 14 of their charges was about $58,000. See Mot. Remand at 2, 7, ECF No. 10-1. Plaintiffs allege 15 that when they submitted an insurance claim to defendants for these charges, they learned the 16 insurance policy did not cover any of the medical bills. FAC ¶ 16. Plaintiffs also claim the HII 17 Defendants and Axis did “not follow claims handling standards” and “refuse[d] to investigate and 18 refuse[d] to look for coverage for [plaintiffs’] claims.” Id. ¶ 61. They allege they “communicated 19 with a woman named Erica” after these “coverage problems arose,” but they do not say what they 20 or Erica said and did. See id. ¶ 61. 21 In June 2019, plaintiffs filed this lawsuit in state court. Compl., Notice of Removal Ex. 1, 22 ECF No. 1-1. They sought payment of their insurance benefits and interest on those benefits, and 23 prayed for attorneys’ fees, interest and punitive damages, but did not allege the amount of their 24 damages. Id. ¶¶ 26, 35, 44, 48, 55, 56, 65. The operative amended complaint, which also does 25 not allege an amount of damages, makes eight claims: 1) breach of contract against all 26 defendants; 2) breach of the implied covenant of good faith and fair dealing against Axis only; 27 3) reformation and breach of reformed contract against Axis only; 4) breach of the implied 28 covenant of good faith and fair dealing (reformed policy) against Axis only; 5) negligence against 1 all defendants; 6) fraud in the concealment against all defendants; 7) negligent misrepresentation 2 against all defendants; and 8) fraudulent and unfair business practices under California’s Unfair 3 Competition Law (“UCL”) against all defendants. See generally FAC. 4 A little more than a year after the case was filed, plaintiffs’ counsel did not appear at a 5 hearing in state court, and that state court issued an order to show cause for failure to appear and 6 failure to prosecute. Order to Show Cause, Notice of Removal Ex. 3, ECF No. 1-3. A few days 7 later, plaintiffs served HPIH. Not. Removal ¶ 9, ECF No. 1. They did not serve Benefytt for 8 several more months. See Cheng Decl. ¶ 3, ECF No. 24-2. 9 A few months after HPIH appeared, it served interrogatories on the plaintiffs, which, 10 among other things, asked them to state the amount of their damages. Id. ¶ 5. After an extension, 11 plaintiffs served their answers, which included a response by Jaimi O’Brien estimating that her 12 “hospital bills” were “approximately $58,000,” that she paid “other health provider bills” of $730, 13 and that she lost income of between $16,000 and $18,500. See Notice of Removal ¶ 11; 14 J. O’Brien Interrog. Resps. at 4, 8, Notice of Removal Ex. 10, ECF No. 1-10. Defendants 15 removed the case to this court ten days later, asserting diversity jurisdiction. Notice of Removal 16 ¶ 1. Four motions are now fully briefed before the court, as follows: 17  Plaintiffs’ motion to remand, see Remand, ECF No. 10; Opp’n to Remand, ECF 18 No. 24; Reply Remand, ECF No. 34. 19  HPIH’s motion to dismiss, see HPIH MTD, ECF No. 7; Opp’n to HPIH, ECF 20 No. 12; HPIH Reply, ECF No. 31; 21  Axis’ motion to dismiss, Axis MTD, ECF No. 13, Opp’n to Axis, ECF No. 26; 22 Axis Reply, ECF No. 33; and 23  Benefytt’s motion to dismiss, Benefytt MTD, ECF No. 15; Opp’n to Benefytt, 24 ECF No. 27; Benefytt Reply, ECF No 32. 25 The court held a videoconference hearing on February 19, 2021. Demian Oksenendler appeared 26 for plaintiffs; Mitchell Popham, lead counsel on the motion for remand, and Jamie Mei Cheng, 27 lead counsel on the motion to dismiss, appeared for HPIH and Benefytt. Adya Baker, with Jacob 28 Sommer observing, appeared for Axis. 1 II. MOTION TO REMAND 2 A. Legal Standard 3 A defendant may remove a matter to federal court if the district court would have original 4 jurisdiction. 28 U.S.C. § 1441(a); Caterpillar, Inc. v. Williams, 482 U.S. 386, 392 (1987). When, 5 as here, the asserted source of a district court’s original jurisdiction is diversity of citizenship, the 6 parties must be completely diverse, and the amount in controversy must exceed $75,000. See 7 28 U.S.C. § 1332. 8 Removal may occur within two thirty-day periods. 28 U.S.C. § 1446(b); Kuxhausen v. 9 BMW Fin. Servs. NA LLC, 707 F.3d 1136, 1139 (2013). “The first thirty-day removal period is 10 triggered ‘if the case stated by the initial pleading is removable on its face.’ The second thirty- 11 day removal period is triggered if the initial pleading does not indicate that the case is removable, 12 and the defendant receives ‘a copy of an amended pleading, motion, order or other paper’ from 13 which removability may first be ascertained.” Carvalho LLC v. Equifax Info. Servs., LLC, 14 629 F.3d 876, 885 (9th Cir. 2010) (quoting 28 U.S.C. § 1446(b) and Harris v. Bankers Life & 15 Cas.

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Bluebook (online)
O'Brien v. HII Ins. Solutions, Counsel Stack Legal Research, https://law.counselstack.com/opinion/obrien-v-hii-ins-solutions-caed-2021.