Security Plans, Inc. v. Cuna Mutual Insurance Society

769 F.3d 807, 2014 U.S. App. LEXIS 19884, 2014 WL 5293421
CourtCourt of Appeals for the Second Circuit
DecidedOctober 17, 2014
DocketDocket No. 13-384
StatusPublished
Cited by81 cases

This text of 769 F.3d 807 (Security Plans, Inc. v. Cuna Mutual Insurance Society) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Security Plans, Inc. v. Cuna Mutual Insurance Society, 769 F.3d 807, 2014 U.S. App. LEXIS 19884, 2014 WL 5293421 (2d Cir. 2014).

Opinion

SACK, Circuit Judge:

This appeal from a judgment of the United States District Court for the Western District of New York (David G. Larimer, Judge) concerns the scope and effect of the implied covenant of good faith and fair dealing that, as a matter of law, accompanies contracts concluded under New [810]*810York law. Security Plans, a credit insurer, sold its business to CUNA Mutual in' exchange for an upfront sum and a performance-based payment, which would be calculated using three years of returns on Security Plans’ former business. After the requisite time period, CUNA Mutual determined that Security Plans was not entitled to any performance-based payment. Security Plans argues that CUNA Mutual committed a company-wide error in managing its insurance policies, which substantially reduced the payment calculation. CUNA Mutual’s failure to control for this error, Security Plans argues, constituted an arbitrary and irrational exercise of contractually conferred discretion, violating the implied covenant of good faith and fair dealing.

Under New York law, all contracts that confer discretion include an implied promise that neither party will “act arbitrarily or irrationally” in exercising that discretion. Dalton v. Educ. Testing Serv., 87 N.Y.2d 384, 389, 639 N.Y.S.2d 977, 663 N.E.2d 289, 291 (1995). The district court acknowledged this principle. But the court rejected the plaintiffs implied covenant claim, concluding that the record at the summary judgment stage reflected no evidence that CUNA Mutual acted in bad faith or with wrongful intent. We conclude that, on the facts of this case, a question of fact remains as to whether the defendant acted arbitrarily in calculating the earnout amount. We therefore vacate the portion of the district court’s decision concerning the implied covenant and remand for further proceedings. For the reasons set forth below, we affirm the portion of the district court’s judgment that granted summary judgment to the defendant on a separate breach of contract claim.

BACKGROUND

Security Plans, Inc., formerly known as Creditor Services, Inc., is a corporation based in Mendon, New York, which until 2002 specialized in the sale of credit-related insurance products, primarily to credit unions. Security Plans’ primary products were credit life and credit disability insurance, which promise to pay the outstanding balance on a loan in the event the borrower dies or becomes disabled. In 2002, Security Plans agreed to sell substantially all of its assets to CUNA Mutual Insurance Society, a company incorporated in Iowa, with its principal office in Madison, Wisconsin. The parties set in motion a plan to transfer Security Plans’ insurance clients (its “book of business”) to CUNA Mutual. The merger was completed on January 2, 2003.

The Merger Agreement and Earnout Formula

An Asset Purchase Agreement, dated May 31, 2002, set forth the terms of this merger. CUNA Mutual agreed to pay $3 million immediately plus an additional performance-based payment to be made three years after the merger was concluded for Security Plans’ property and book of business. The deferred-payment component of this compensation package is commonly referred to as an “earnout.”1 Under this contract, the maximum possible earnout was $2.2 million.

[811]*811CUNA Mutual also executed three-year employment agreements with each of the three Security Plans shareholders, in which the shareholders agreed to assist in transitioning the book of business. Each former Security Plans client would have to decide individually whether to accept CUNA Mutual as its new insurer, and the earnout was therefore designed to encourage the shareholders to convert as many clients as possible.

The basic formula for calculating the earnout is not in dispute. The performance of Security Plans’ book of business would be calculated annually for three years after closing, and then another three years of performance would be projected based on the data from the third year. Two variables would largely determine the size of the earnout: a weighted average of total written premiums brought in by the acquired business, and a weighted average of the business’s combined loss ratios.2 These two amounts would be used to calculate a preliminary total earnout, which would then be reduced by service fees and other reimbursements paid to credit unions. This reduced figure would represent the final payment.

The Asset Purchase Agreement also provided:

[Security Plans] acknowledges that [CUNA Mutual] is under no obligation to operate its business after Closing in a manner focused on maximizing the Earn-Out ... and may operate the business in accordance with its best business judgment.

Asset Purchase Agreement ¶ 2.9(e).

This dispute concerns two factors that affected the calculation of the earnout. First, Security Plans contends, CUNA Mutual used incorrect figures to calculate loss ratios for these accounts, thereby leading to a lower earnout than that to which Security Plans was entitled. Second, Security Plans argues, CUNA Mutual imposed an excessive deduction relating to service fees paid to credit unions.

Loss Ratios and the Claim Reserves Issue

Insurers are required by accounting rules and by statute to carry claim reserves, which are kept in anticipation of future liabilities. Claim reserves are, for accounting purposes, considered to be a component of incurred claims. Increases in incurred claims ordinarily will, all other things being equal, increase a company’s loss ratio. Higher loss ratios would reduce Security Plans’ earnout.

The parties agree that the loss ratios recorded for Security Plans’ book of business for 2003 through 2005 — the relevant reporting period for the earnout — were “atypically high.” Def.’s Statement of Facts Pursuant to Local R. 56.1, ¶ 30; accord Pl.’s Resp. Pursuant to Loe. R. 56.1(B), ¶ 30. Their unusually high loss ratios were largely attributable to the fact that, during the same period, CUNA Mutual was carrying abnormally high claim reserves on all of its business, including the Security Plans policies. CUNA Mutual began to release claim reserves in 2006 to compensate for the problem, but it did not correct the reserves concerning Security Plans’ book of business in time to affect the earnout.

The reason for the magnitude of the claim reserves is not entirely clear. [812]*812CUNA Mutual has asserted that, although the reserve levels were later revised downward, their size during the 2003 to 2005 time period resulted from “the exercise of business judgment by CUNA Mutual’s actuaries.” Def.’s Statement of Facts Pursuant to Loc. R. 56.1, ¶ 81. The plaintiff disputes that, characterizing the reserve levels as a systemic, company-wide error, which CUNA Mutual sought to correct in 2006 by releasing what ultimately amounted to millions of dollars in excess reserves. In other words, the plaintiff suggests that rather than deliberately keeping high claim reserves as a strategic or actuarial decision, CUNA Mutual failed to correct aberrations that distorted the performance data until 2006.

The record contains some evidence supporting the plaintiffs position.

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Bluebook (online)
769 F.3d 807, 2014 U.S. App. LEXIS 19884, 2014 WL 5293421, Counsel Stack Legal Research, https://law.counselstack.com/opinion/security-plans-inc-v-cuna-mutual-insurance-society-ca2-2014.