Roe-Midgett, Paula M v. CC Services, Inc.

CourtCourt of Appeals for the Seventh Circuit
DecidedJanuary 4, 2008
Docket06-3195
StatusPublished

This text of Roe-Midgett, Paula M v. CC Services, Inc. (Roe-Midgett, Paula M v. CC Services, Inc.) 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
Roe-Midgett, Paula M v. CC Services, Inc., (7th Cir. 2008).

Opinion

In the United States Court of Appeals For the Seventh Circuit ____________

No. 06-3195 PAULA M. ROE-MIDGETT, Individually and as Collective Action and Class Action Representative, and PAUL DECKER, Individually and as Collective Action and Class Action Representative, Plaintiffs-Appellants, v.

CC SERVICES, INCORPORATED, Defendant-Appellee. ____________ Appeal from the United States District Court for the Southern District of Illinois. No. 04 C 4051—David R. Herndon, Chief Judge. ____________ ARGUED JANUARY 5, 2007—DECIDED JANUARY 4, 2008 ____________

Before FLAUM, MANION, and SYKES, Circuit Judges. SYKES, Circuit Judge. Plaintiffs Paula Roe-Midgett and Paul Decker sued their employer CC Services, Inc. (“CCS”) for overtime wages under the Fair Labor Stan- dards Act (“FLSA”), 29 U.S.C. § 207(a)(1). CCS contracts with insurance companies to provide claims processing services for auto, home, commercial, and farm policies. Roe-Midgett and Decker were employed as claims ad- justers at different levels of CCS’s claims-processing 2 No. 06-3195

hierarchy. Suing individually and on behalf of four classes of claims adjusters, the plaintiffs contended that CCS improperly classified them as administrative em- ployees exempt from FLSA overtime requirements under 29 U.S.C. § 213(a)(1). Applying the Department of Labor’s so-called “short test” for determining whether employees fall within the FLSA’s administrative exemption, the district court concluded that the primary duties of all four claims- processing positions involved matters (1) “directly re- lated to management policies or general business opera- tions” and (2) “requiring the exercise of discretion and independent judgment.” 29 C.F.R. § 541.214 (2003). Accordingly, the court held the employees were exempt from the overtime pay requirements of the FLSA and granted summary judgment for CCS. On appeal the plaintiffs develop no substantive chal- lenge to the district court’s ruling as it relates to three of the four classes of employees: CCS’s Field Claims Representative II, Field Claims Representative III, and Property Specialist positions. As to these employees, they argue only that material issues of fact preclude sum- mary judgment for CCS. But they failed to identify any real factual dispute specific to these employees. Regarding the final group of employees—those occupying the position of Material Damage Appraiser II—the plain- tiffs contend that the duties of this position do not di- rectly relate to CCS’s management policies or general business operations and do not require the exercise of discretion and independent judgment. We disagree. Material Damage Appraisers provide claims adjust- ment services for CCS’s insurance company clients up to a $12,000 limit of claims settlement authority and repre- sent the “face” of CCS to the countless claimants with whom they interact. They spend much of their time in the No. 06-3195 3

field without direct supervision. They conduct on-site investigations of first- and third-party automobile insur- ance claims; interview claimants, witnesses, and law enforcement personnel; estimate loss; determine whether parts should be repaired or replaced; negotiate with mechanics and body shops and draft final repair estimates; and settle claims up to the limit of their $12,000 settle- ment authority. These duties directly relate to CCS’s business operations and reflect a sufficient degree of discretion and independent judgment to qualify for the FLSA’s administrative exemption. Summary judgment was properly entered for CCS on all four classes of em- ployees.

I. Background CCS is engaged in the business of processing insurance claims for auto, home, commercial, and farm insurers. Headquartered in Bloomington, Illinois, and administered through 37 field offices, CCS’s Claims Division settled roughly $600 million in claims in 2004. The claims-process- ing staff in each field office typically consists of Property Specialists, Field Claims Representatives, and Material Damage Appraisers (“MDA”), as well as other positions not relevant here. MDAs draw an annual salary of $36,952 to $55,427 and primarily handle automobile claims. They do not make coverage or liability determinations, which are typically made by Field Claims Representatives or other claims agents. MDAs are responsible for investigating auto accident damage, making repair or replacement determi- nations, drafting estimates, and settling claims of up to $12,000 where liability has been established and coverage 4 No. 06-3195

approved.1 MDAs spend much of their time in the field without direct supervision. Moreover, because 70% of appraisals assigned to MDAs come from the home office and not the local field office, the field office supervisors do not exert much direct daily control over MDAs. Investigating accident damage entails a physical inspec- tion of the vehicle to ensure the actual damage and its cause correspond to the claimed damage and cause. The cause of the accident often dictates the applicable policy (i.e., comprehensive or collision) and deductible. MDAs may also interview claimants, witnesses, and where relevant, police personnel. If an MDA notes incon- sistencies or otherwise suspects fraud, he relays his observations to a CCS superior in charge of final liabil- ity and coverage determinations. After documenting and investigating vehicle damage on a given claim, the MDA prepares an estimate. The first step in this process is determining if the vehicle is irreparably damaged (a “structural total loss” in industry parlance) or if the cost of repair exceeds the vehicle’s value (an “economic total loss”). The latter calculation is performed by inputting the vehicle’s identification number and damage estimate into a software program that “red flags” potential economic losses. If an MDA suspects a structural total loss, he will relay that sus- picion along with photos of the damage to a claims repre- sentative with final say as to whether the vehicle is a structural total loss. If the vehicle is not a total loss, the MDA must decide which parts to repair and which to replace. For repaired

1 The average MDA payout on auto damage claims is far less than the $12,000 limit. From January to November 2002, for example, the average monthly payout ranged from $1750 to $2400. No. 06-3195 5

parts, the MDA estimates the total labor costs based in part on his estimation of the man hours needed to com- plete the repair. In some instances body shops disagree with the MDA’s projection, and the MDA negotiates for an adjusted hours estimate. MDAs might also adjust a repair estimate to account for “betterment,” a concept intended to reflect the fact that parts that were in good repair cost more to restore to their original preaccident condition than parts already in disrepair at the time of the accident. MDAs also estimate the cost of replacing any parts they deem beyond repair. They input a description of the part into a software program, which then generates an estimate based on labor costs and part price. In estimating the price for the part, the software detects the avail- ability of used parts and automatically factors in that discount. The MDA may override the software and allow for new parts, but only after documenting the reasons for his deviation on a file summary sheet; all other devia- tions from CCS’s adjusting guidelines must similarly be memorialized. “Betterment” adjustments may also affect replacement part estimates. After projecting the repair and replacement costs, MDAs draft a final damage estimate.

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