Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC

CourtSuperior Court of Delaware
DecidedJuly 9, 2024
DocketN24C-01-006 PRW CCLD
StatusPublished

This text of Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC (Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC) is published on Counsel Stack Legal Research, covering Superior Court of Delaware primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC, (Del. Ct. App. 2024).

Opinion

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

) ) PREMIUM CHOICE INSURANCE ) SERVICES, ) Plaintiff, ) v. ) C.A. No. N24C-01-006 PRW CCLD ) INNOVATIVE FINANCIAL GROUP ) HOLDINGS, LLC, and HUMANA, INC., ) Defendants. )

Submitted: July 3, 2024 Decided: July 9, 2024

MEMORANDUM OPINION AND ORDER

Upon Defendants Innovative Financial Group Holdings, LLC, and Humana Inc.’s Motion to Dismiss, GRANTED, in part, DENIED, in part.

Geoffrey G. Grivner, Esquire, Kody M. Sparks, Esquire, BUCHANAN INGERSOLL & ROONEY PC, Wilmington, Delaware; Benjamin N. Gluck, Esquire, Oliver Rocos, Esquire (argued), Barr Benyamin, Esquire, BIRD MARELLA LLP, Los Angeles, California, Attorneys for Plaintiff Premium Choice Insurance Services.

Alexandra M. Cummings, Esquire, Sara Carnahan, Esquire, MORRIS, NICHOLS, ARSHT & TUNNEL LLP, Wilmington, Delaware; Scott C. Solberg, Esquire, Gregory M. Schweizer, Esquire (argued), Caroline P. Malone, Esquire, EIMER STAHL LLP, Chicago, Illinois, Attorneys for Defendants Innovative Financial Group Holdings, LLC, and Humana Inc.

WALLACE, J. This dispute arises from the unilateral and allegedly untimely termination of

the parties’ contractual relationship. The central issue is, essentially, the extent to

which Defendant Innovative Financial Group Holdings, LLC (“IFG”) had the

opportunity for a do-over after submitting a plainly deficient termination notice.

Regardless of the answer to that question, though, Plaintiff Premium Choice

Insurance Services (“Premium”) has viable alternative claims to hold IFG liable.

But no matter IFG’s potential liability, Premium’s claim against IFG’s indirect

parent, Defendant Humana, Inc., is untenable.

IFG and Premium had a contractual agreement comprised of an

interconnected statement of work (the “SOW”) and master services agreement (the

“MSA” and together with the SOW, the “Agreement”). Pursuant to the Agreement,

Premium could sell Medicare Advantage policies that large insurers offered through

IFG—in other words, Premium and IFG are different levels of Medicare middlemen

with IFG working more closely with insurers and Premium more closely with

consumers. Under the Agreement, IFG retained three powers to end the relationship

that are relevant here: (1) IFG could immediately revoke Premium’s authority to

perform services on IFG’s behalf if IFG determined Premium’s performance was

not “satisfactory”; (2) IFG could terminate the Agreement if Premium didn’t remedy

an identified breach within 30 days of receiving notice of the breach; and (3) IFG

could terminate the Agreement for convenience 90 days after providing notice to

-1- Premium.

On November 20, 2023, IFG exercised a fourth option. In an email with the

subject line “Termination of Agreement,” IFG informed Premium that it had “chosen

to move in a new direction and will terminate [its] relationship with Premium

Choice, all agents and downlines effective immediately.” The next day, after

Premium pointed out the Agreement’s termination provisions, IFG sent a new notice

claiming Premium’s performance was unsatisfactory and that Premium had 30 days

to prove that it was fully complying with a nonspecific set of regulatory and

contractual requirements. In that second notice, IFG confirmed it was immediately

revoking Premium’s authority and would terminate the Agreement if Premium did

not demonstrate its compliance within 30 days. Premium sued.

Premium brings alternative claims for breach of contract and breach of the

implied covenant of good faith and fair dealing. The traditional breach-of-contract

claim is premised on the fact that the November 20th email terminated the

Agreement in violation of the Agreement’s terms. The implied covenant claim is

premised on the fact that the November 21st notice was sent in bad faith as a post-

hoc rationalization for the earlier attempt at termination. In the end, those claims

won’t be able to stand together because if the November 20th email effectively

terminated the Agreement, then the November 21st notice had no actual effect.

Though the parties don’t say as much, this case is about the effect of a

-2- repudiation. On November 20, IFG repudiated the Agreement by unequivocally

demonstrating its intent to cease performance. The effect of that act depends on

Premium’s response. Premium could have elected to accept the repudiation, thus

terminating the Agreement, and allowing Premium to sue for total breach; or

Premium could have elected to reject the repudiation and keep the Agreement alive.

Whether Premium can now pursue its breach-of-contract claim or its breach of the

implied covenant claim turns on which option Premium elected. But that factual

issue can’t be resolved at this stage, so the two causes of action survive for now to

proceed as alternatives.

As a separate matter, Premium blames Humana for causing IFG to terminate

the Agreement after Humana acquired IFG, which is the sole pled basis for its

tortious interference claim. But Premium itself acknowledges that IFG breached for

“business reasons,” and Premium doesn’t even hint at an illegitimate motive by

Humana. It is clear, therefore, that the affiliate privilege applies, and Humana cannot

be liable for tortious interference.

Accordingly, the Court GRANTS the Motion as to Count III (tortious

interference) but DENIES the Motion as to Counts I and II (breach of contract and

breach of the implied covenant).

-3- I. BACKGROUND

A. THE PARTIES

Premium is a California corporation with its principal place of business in

California.1 IFG is a North Carolina limited liability company with its principal

place of business in North Carolina.2 And Humana is a Delaware corporation with

its principal place of business in Kentucky.3

B. THE AGREEMENT

Premium is an insurance broker that specializes in Medicare Advantage

policies.4 Due to its comparatively small size, Premium “works with middleman

companies that are agents of national insurance companies,”—like IFG.5

IFG is a licensed agent of insurance companies that offer Medicare Advantage

policies.6 In 2021, IFG and Premium entered a contract through which Premium

would market and sell Medicare Advantage policies offered by IFG’s principals. 7

Premium was paid per policy sold, which amounted to approximately $1 million of

1 D.I. No. 1 (“Compl.”) ¶ 11. 2 Id. ¶ 12. 3 Id. ¶ 13. 4 Id. ¶ 20. 5 Id. ¶¶ 20-21. 6 Id. ¶ 21. 7 Id. ¶ 22.

-4- income per month.8

In August 2022, Humana—one of IFG’s principals—acquired IFG.9 In

October 2023, IFG and Premium re-upped their relationship through the

Agreement.10 The Agreement had an initial one-year term.11 The Agreement

required Premium to abide by all applicable laws, including specific Medicare-

related regulations.12

Three of the Agreement’s provisions are particularly relevant here. First,

MSA Section 14(b) governs termination of the Agreement. MSA Section 14(b)(i)

provides in pertinent part: “[IFG] may terminate this Agreement and/or any SOW

for convenience at any time upon ninety (90) days prior, written notice to [Premium]

provided however that no termination for convenience shall become effective within

a Blackout Period defined as extending from August 1st through January 1st in any

calendar year.” The MSA explains the effect of a termination for convenience

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Cite This Page — Counsel Stack

Bluebook (online)
Premium Choice Insurance Services v. Innovative Financial Group Holdings, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/premium-choice-insurance-services-v-innovative-financial-group-holdings-delsuperct-2024.