P. ex rel. Dept. of Ins. v. Symons Emergency Specialties CA4/2
Opinion
Filed 11/22/21 P. ex rel. Dept. of Ins. v. Symons Emergency Specialties CA4/2 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT DIVISION TWO
THE PEOPLE ex rel. DEPARTMENT OF INSURANCE et al., E075600
Plaintiffs and Respondents, (Super.Ct.No. CIVDS1607744)
v.
OPINION
SYMONS EMERGENCY SPECIALTIES, INC., et al.,
Defendants and Appellants.
APPEAL from the Superior Court of San Bernardino County. Wilfred J.
Schneider, Jr., Judge. Affirmed.
Garcia Reed & Ramirez and Raul B. Garcia for the Defendants and Appellants.
Kennaday Leavitt and Curtis S. Leavitt for Plaintiffs and Respondents The People ex rel. Sistemas Medicos Nacionaies, S.A. de C.V.
No appearance for Plaintiff and Respondent The People ex rel. Department of Insurance.
This qui tam action was brought by a Mexican health care plan, Sistemas Medicos Nacionales S.A. de C.V. dba SIMNSA Health Plan (SIMNSA), licensed to do business on a limited basis in California. SIMNSA alleged that defendants committed insurance fraud.1 The California Department of Insurance intervened and litigated the case on behalf of the state, although SIMNSA continued to participate as the relator. The case went to trial, and the jury rendered a verdict for defendants.
After the court entered judgment, defendants moved for attorney fees and costs as sanctions against SIMNSA and its counsel. Defendants argue that the trial court erred by denying their sanctions motion. They contend that SIMNSA and counsel engaged in sanctionable conduct by prosecuting this action while SIMNSA lacked a certificate of qualification to transact intrastate business. (Corp. Code, § 2105, subd. (a).) We affirm.
BACKGROUND
In 2000, SIMNSA obtained a license from the California Department of Corporations to operate as a health care service plan in the state. The department issued the license under Health and Safety Code section 1351.2, which provides for the licensure of Mexican prepaid health care plans under certain conditions. Specifically, the license authorizes SIMNSA to sell “employer-sponsored group plan contracts exclusively for the benefit of citizens of Mexico legally employed in California.” (Capitalization and boldface omitted.) Under the license, SIMNSA provides health care services “wholly in Mexico,” except that emergency and urgent care services are available outside of Mexico.
1 Defendants are Symons Emergency Specialties, Inc. (Symons); Symons Ambulance; Jeff T. Grange; and Jeff T. Grange, M.D., Inc.
(Capitalization and boldface omitted.) The license is effective until SIMNSA surrenders it or the state suspends or revokes it.
In 2014, Symons provided emergency services in California to an individual insured by SIMNSA. SIMNSA refused to pay Symons’s claim, so Symons sued SIMNSA. The parties settled that lawsuit.
In May 2016, SIMNSA brought this qui tam action against Symons and the other defendants, alleging that defendants committed insurance fraud. (See Pen. Code, § 550 [criminalizing insurance fraud]; Ins. Code, § 1871.7, subds. (b), (e)(1) [authorizing interested parties to bring a civil action in the name of the state for violations of Pen. Code, § 550]; State ex rel. Aetna Health of California, Inc. v. Pain Management Specialist Medical Group (2020) 58 Cal.App.5th 1064, 1069 (Aetna) [“[A] qui tam action is one brought pursuant to a statute allowing a private person to sue as a private attorney general to recover damages or penalties, all or part of which is paid to the government”].)
The Department of Insurance intervened in July 2017. The amended complaint in intervention alleged that defendants submitted false, fraudulent, or misleading health care insurance claims to SIMNSA and other health care insurers. The department assumed primary responsibility for litigating the case and controlled the overall strategy, but it permitted SIMNSA to participate extensively as the relator. (See Aetna, supra, 58 Cal.App.5th at p. 1070 [the state “retains primacy of a qui tam action” under Insurance Code section 1871.7 and “can dismiss the action, intervene in the action, or permit the
relator to continue”].) The Department of Insurance intended to prosecute the case whether or not SIMNSA participated.
The trial began in February 2020. Early in the trial, defendants orally moved to sever SIMNSA from the case on the ground that SIMNSA had not obtained a certificate of qualification to transact intrastate business in California. (Corp. Code, § 2105, subd. (a) [requiring foreign corporations to obtain a certificate of qualification from the Secretary of State before “transact[ing] intrastate business”]; Corp. Code, § 191, subd. (a) [defining ‘“transact intrastate business”’ and distinguishing intrastate business from interstate and foreign commerce].) Defendants argued that Corporations Code section 2203, subdivision (c), barred SIMNSA from maintaining this action without the certificate of qualification.
SIMNSA’s counsel was unaware that SIMNSA lacked a certificate of qualification until defendants raised the issue at trial. But counsel knew that SIMNSA had a license to sell health care plans in California under Health and Safety Code section 1351.2. Counsel investigated whether SIMNSA was required to have a certificate of qualification and believed that it was not, because the license under Health and Safety Code section 1351.2 qualified it to do business in the state. Counsel argued to the trial court that SIMNSA was not required to have the certificate, but “in an abundance of caution,” SIMNSA sought the certificate of qualification on an expedited basis. SIMNSA obtained the certificate within days, and the trial proceeded without delay.
After the court entered judgment for defendants, they moved for attorney fees and costs in the amount of $355,880.07. They argued that SIMNSA’s knowing maintenance of the action without a certificate of qualification amounted to sanctionable conduct under rule 2.30 of the California Rules of Court and Code of Civil Procedure sections 128.5 and 128.7. (Unlabeled statutory citations refer to the Code of Civil Procedure; unlabeled rule citations refer to the California Rules of Court.) Defendants filed the motion one day after they served it on SIMNSA.
SIMNSA opposed the motion on a number of grounds. In relevant part, it argued:
(1) SIMNSA was engaged in interstate business, not intrastate business, so it was not required to have a certificate of qualification under Corporations Code section 2105; (2) even if SIMNSA were engaged in intrastate business, any defect was cured when it obtained the certificate; (3) defendants failed to comply with the safe harbor provision of section 128.5, and SIMNSA had not engaged in bad faith conduct warranting sanctions under that statute; and (4) defendants failed to identify which court rule SIMNSA had violated, as required by rule 2.30.
The trial court denied the sanctions motion. It ruled that sanctions under sections 128.5 and 128.7 would be improper because defendants did not comply with the safe harbor provisions of those statutes, and defendants could not seek postjudgment sanctions under those statutes for filing the complaint and maintaining the lawsuit. The court also rejected defendants’ request for sanctions under rule 2.30.
STANDARD OF REVIEW
We review a trial court’s ruling on a motion for sanctions for abuse of discretion.
(Primo Hospitality Group, Inc. v. Haney (2019) 37 Cal.App.5th 165, 174 [sanctions motion under § 128.7]; Wallis v. PHL Associates, Inc. (2008) 168 Cal.App.4th 882, 893 [sanctions motion under § 128.5]; Ellerbee v. County of Los Angeles (2010) 187 Cal.App.4th 1206, 1216-1217 [sanctions motion under rule 2.30].)
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