Rick Ochoa v. State Farm Life Insurance Comp

CourtCourt of Appeals for the Seventh Circuit
DecidedDecember 13, 2018
Docket18-1336
StatusPublished

This text of Rick Ochoa v. State Farm Life Insurance Comp (Rick Ochoa v. State Farm Life Insurance Comp) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rick Ochoa v. State Farm Life Insurance Comp, (7th Cir. 2018).

Opinion

In the

United States Court of Appeals For the Seventh Circuit ____________________ Nos. 18-1336 & 18-1338 RICK OCHOA and IRENE B. ANDERSON, Plaintiffs-Appellants, v.

STATE FARM LIFE INSURANCE COMPANY and COUNTRY LIFE INSURANCE COMPANY, Defendants-Appellees. ____________________

Appeals from the United States District Court for the Northern District of Illinois, Eastern Division. Nos. 17 C 4274 & 17 C 4270 — Robert W. Gettleman, Judge. ____________________

ARGUED SEPTEMBER 5, 2018 — DECIDED DECEMBER 13, 2018 ____________________

Before KANNE, SYKES, and ST. EVE, Circuit Judges. SYKES, Circuit Judge. 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. 2 Nos. 18-1336 & 18-1338

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 dis- missed 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 partici- pate 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 provi- sion 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 allo- cated to this policy as an annual dividend. Div- idends 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.

1 Ochoa holds five policies from State Farm, some of which contain a slightly different version of the dividend provision. Nos. 18-1336 & 18-1338 3

Ochoa and Anderson concede that their annual divi- dends 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 con- tain 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. 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 (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 (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 “con- 4 Nos. 18-1336 & 18-1338

tain[] 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., 413 N.E.2d 23, 28 (Ill. App. Ct. 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 begin- ning 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 participa- tion; 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”). The plaintiffs contend that “participate” is a term of art that requires a set dividend amount, but they do not articu- late “a fixed and technical meaning in the law” to support their view. Vicencio v. Lincoln–Way Builders, Inc., 789 N.E.2d 290, 301 (Ill. 2003) (quoting Galowich v. Beech Aircraft Corp., Nos. 18-1336 & 18-1338 5

441 N.E.2d 318, 321 (Ill. 1982)). Nor can they. Reading the term “participate” in the insurance context does not alter its meaning in their favor. See Participating Insurance, BLACK’S LAW DICTIONARY (10th ed. 2014) (“A type of insurance that allows a policyholder to receive dividends.”); Participating <~insurance>, WEBSTER’S THIRD NEW INTERNATIONAL DICTIONARY (“entitling the holder to a share in any distribu- tion of surplus by the issuing insurance company”). Perhaps recognizing the weakness of their argument, Ochoa and Anderson ask us to hitch section 224(e) to sec- tion 243 of the Insurance Code, which governs contingency reserves and allows State Farm and Country Life to “accu- mulate and maintain in addition to an amount equal to the net value of its participating policies … a contingency re- serve not exceeding … ten per centum thereof.” 215 ILL. COMP. STAT. 5/243 (2016). The plaintiffs assert that these two provisions, read in pari materia, require insurers to distribute any surplus above the contingency-reserve limit as divi- dends to policyholders. But in Illinois “[i]t is fundamental that before the rule of in pari materia is applied, the statute to be construed must be found to be ambiguous.” People v. 1946 Buick, 537 N.E.2d 748, 750 (Ill. 1989).

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Rick Ochoa v. State Farm Life Insurance Comp, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rick-ochoa-v-state-farm-life-insurance-comp-ca7-2018.