Rick Ochoa v. State Farm Life Insurance Comp

910 F.3d 992
Court of Appeals for the Seventh Circuit·Decided December 13, 2018·No. 18-1336 & 18-1338·Published·Cited by 16 cases

Opinion

Sykes, Circuit Judge.

*993 Rick Ochoa and Irene Anderson hold participating life-insurance policies from State Farm Life Insurance Company and Country Life Insurance Company respectively. The policies guarantee policyholders annual dividends from their insurers' surpluses, but the insurers decide the dividend amounts.

Dissatisfied with their dividends, Ochoa and Anderson filed nearly identical class-action complaints claiming that the dividend provisions in their policies violate the Illinois Insurance Code. In a single decision, the district court dismissed the complaints. We consolidated the appeals and now affirm. Illinois requires only that life-insurance policies of this type contain a provision for policyholders to participate in their insurers' surpluses. The policies at issue here contain such a provision.

I. Background

The dividend provisions in the State Farm and Country Life policies do not materially differ. The State Farm provision reads: "We may apportion and pay dividends each year. Any such dividends will be paid at the end of the policy year if all premiums due have been paid." 1 Similarly, the Country Life provision states:

This is a participating policy, which means it may share in any dividends We pay to policy Owners. Each year We determine how much money may be paid to Our policy Owners as divisible surplus. We then determine how much of that divisible surplus should be allocated to this policy as an annual dividend. Dividends may be allocated to this policy only while it is in full force or continued as paid-up life insurance. If the policy is Extended Term Insurance, no dividends will be paid.

Ochoa and Anderson concede that their annual dividends satisfied the terms of their respective policies. But they contend that their policies do not contain a standard dividend provision mandated by the Illinois Insurance Code. Asserting claims for breach of contract, they sued the insurers in the Northern District of Illinois invoking class-action jurisdiction. See 28 U.S.C. § 1332 (d). Because the suits were functionally equivalent, the cases were assigned to the same judge.

The insurers moved to dismiss for failure to state a claim. See FED. R. CIV. P. 12(b)(6). The judge resolved the motions in a single decision, holding that the policies in question contain the standard provision required by Illinois law. The judge accordingly entered judgment for the insurers, and Ochoa and Anderson appealed. Because the appeals are materially identical, we consolidated the cases.

*994 II. Analysis

We review a Rule 12(b)(6) dismissal de novo. Avila v. CitiMortgage, Inc. , 801 F.3d 777 , 786 (7th Cir. 2015). To survive a motion to dismiss, the plaintiffs' complaints must state a plausible claim to relief. Bell Atl. Corp. v. Twombly , 550 U.S. 544 , 570, 127 S.Ct. 1955 , 167 L.Ed.2d 929 (2007). "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." Ashcroft v. Iqbal , 556 U.S. 662 , 678, 129 S.Ct. 1937 , 173 L.Ed.2d 868 (2009).

While styled as claims for breach of contract, the claims actually rest on an interpretation of section 224 of the Illinois Insurance Code, which describes the standard provisions that all life-insurance policies issued in Illinois must "contain[ ] in substance." 215 ILL. COMP. STAT. 5/224 (2016). The standard provisions required by statute "form a part of" a life-insurance policy and control when they conflict with the actual policy provisions. DC Elecs., Inc. v. Emp'rs Modern Life Co. , 90 Ill.App.3d 342 , 45 Ill.Dec. 690 , 413 N.E.2d 23 , 28 (1980).

At issue here is section 224(e), the standard provision governing dividends, which requires "that the policy shall participate annually in the surplus of the company beginning not later than the end of the third policy year." 215 ILL. COMP. STAT. 5/224(e). The question for us is whether a policy that indisputably provides for annual dividends but allows insurers discretion to set dividend amounts complies with this provision.

Ochoa and Anderson insist that the answer is "no." Their argument recasts section 224(e) as requiring " full annual participation" in the insurers' surpluses. But section 224(e) doesn't require "full" participation. It requires only that policyholders "participate" in the company's surplus. The ordinary meaning of "participate" at the time of the section's enactment in 1907 did not speak to the extent of participation; nor has the meaning changed since then. See Participate , WEBSTER'S NEW INTERNATIONAL DICTIONARY (1st ed. 1907) ("to receive a part of"); Participate , OXFORD ENGLISH DICTIONARY (1st ed. 1909) ("to take or have a part or share of or in"); Particpate , WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY (1981) ("to have a part or share in something").

Free access — add to your briefcase to read the full text and ask questions with AI

Rick Ochoa v. State Farm Life Insurance Comp, 910 F.3d 992 (7th Cir. 2018).

910 F.3d 992 (Rick Ochoa v. State Farm Life Insurance Comp) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Hopman v. State Farm Mutual Automobile Insurance Co.
2024 IL App (2d) 230423-U (Appellate Court of Illinois, 2024)
Bradley Hotel Corp. v. Aspen Speciality Insurance Com
19 F.4th 1002 (Seventh Circuit, 2021)
Matthew Flynn v. Karen Donnelly
Seventh Circuit, 2019
John Vergara v. City of Chicago
939 F.3d 882 (Seventh Circuit, 2019)
United States ex rel. Morgan v. Champion Fitness, Inc.
368 F. Supp. 3d 1198 (C.D. Illinois, 2019)