Standard Security Life Insuran v. FCE Benefit Administrators, In

CourtCourt of Appeals for the Seventh Circuit
DecidedJuly 28, 2020
Docket19-2336
StatusPublished

This text of Standard Security Life Insuran v. FCE Benefit Administrators, In (Standard Security Life Insuran v. FCE Benefit Administrators, In) 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
Standard Security Life Insuran v. FCE Benefit Administrators, In, (7th Cir. 2020).

Opinion

In the

United States Court of Appeals For the Seventh Circuit ____________________ No. 19-2336 STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK, et al., Plaintiffs-Appellees,

v.

FCE BENEFIT ADMINISTRATORS, INC., Defendant-Appellant. ____________________

Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No. 19 CV 64 — Ronald A. Guzmán, Judge. ____________________

ARGUED MAY 28, 2020 — DECIDED JULY 28, 2020 ____________________

Before MANION, KANNE, and WOOD, Circuit Judges. WOOD, Circuit Judge. This case had its origins in an Admin- istrative Services Agreement that Standard Security Life In- surance Company of New York and Madison National Life Insurance Company, Inc. (collectively, the “Insurers”) entered into with FCE Benefit Administrators, Inc. (“FCE”). Under that agreement, FCE administered health insurance policies underwritten by the Insurers. After a few years, however, the 2 No. 19-2336

Insurers became dissatisfied with FCE’s performance, and so they invoked the Agreement’s arbitration clause. The arbitration proceeded in two phases. In Phase I, the arbitrators awarded the Insurers damages of more than five million dollars. The Insurers attempted to confirm this award in the Northern District of Illinois, but the district court con- cluded that this effort was premature because the case was not yet ripe for adjudication. This was so because the arbitrators had not yet resolved all matters that had been submitted to them. In Phase II, the arbitrators denied the Insurers’ remain- ing claim and FCE’s counterclaim. After the conclusion of Phase II, the Insurers once again sought confirmation. This time, the district court confirmed the arbitration results in their entirety, meaning both the Phase I and Phase II awards. FCE now appeals from the confirmation of the Phase I award. Finding no reason to set aside the district court’s conclusion, we affirm its judgment. I The parties entered into the initial agreement effective Jan- uary 1, 2011; four years later, they amended it, but they made no changes material to this case. The Agreement assigned to FCE the job of serving as the third-party administrator for pol- icies underwritten by the Insurers. Under Section 18 of the Agreement, the parties promised to settle most disputes “by arbitration in accordance with the rules for commercial arbi- tration of the American Arbitration Association (or a similar organization) in effect at the time such arbitration is initiated … .” (There was an exception, which we discuss below, for indemnity disputes.) No. 19-2336 3

In May 2015, the Insurers, unhappy with FCE’s perfor- mance, terminated the Agreement. Two years later, alleging that FCE had breached many of its obligations under the Agreement, the Insurers filed a formal arbitration demand with FCE. They alleged that FCE had failed to remit premi- ums, had failed to process healthcare claims in a timely and proper manner, and had taken excessive and unearned fees. The Insurers also alleged that FCE caused them to incur reg- ulatory penalties and fines. FCE counterclaimed, asserting that the Insurers wrongfully terminated the Agreement. As required by the Agreement, an arbitral panel consisting of two party-designated arbitrators and an umpire was as- sembled. It scheduled a hearing for September 2018. In July 2018, FCE requested a continuance for discovery purposes, and it sought permission to file an amended counterclaim. The arbitrators issued an interim order on July 27, 2018, deny- ing FCE’s request for a continuance but granting its motion for leave to file an amended counterclaim. The order stated that “[t]he counterclaims will be presented in a second phase of the Hearing which will take place in November/December of this year.” The parties and the arbitrators referred to this bifurcated process as “Phase I” and “Phase II.” The Phase I hearing was held on September 25−29 and Oc- tober 25, 2018. A month later, on November 30, the arbitral panel discussed the evidence at a post-hearing teleconference. Afterwards, the panel asked the parties to submit their pro- posed awards for Phase I. Each side did so, and on December 31, 2018, the panel issued a document entitled “Partial Final Award – Phase I” (the “Phase I Award”), which read in perti- nent part as follows: 4 No. 19-2336

The Panel in the above-captioned arbitration, duly ap- pointed by mutual agreement of the parties, upon con- sideration of all documents, arguments, and evidence submitted by Petitioners [Standard] and [Madison] (collectively “Petitioners”) and Respondent [FCE], and after having held a full hearing of Phase I of this arbi- tration from September 25 through September 29, Oc- tober 25 and November 30, 2018 hereby renders its Par- tial Final Award as follows: 1. Petitioners were within their rights to terminate the amended Agreement for cause. 2. FCE shall pay to Petitioners the principal amounts due with respect to each Category of Damages as set forth in the chart annexed as Exhibit A hereto, together with interest calculated thereon at the rate of 5% per annum, as set forth therein. Such pay- ment shall occur within twenty (20) business days of the date of this Partial Final Award. After such time, interest shall run at 9% per annum. 3. Each party shall bear its own costs, including the costs of its party-appointed arbitrator. The parties shall split equally the costs of the Umpire and the catering expenses associated with the Hearing. 4. The Panel members shall be paid within thirty (30) days of the date hereof. 5. All other claims for relief by the parties are denied. A chart attached as Exhibit A, “Damages Owed to Petition- ers,” provides for an award of $5,348,352.81 to the Insurers. No. 19-2336 5

Three days later, on January 3, 2019, the Insurers filed a motion to confirm the Phase I Award under the Federal Arbi- tration Act, 9 U.S.C. § 9, in the district court for the Northern District of Illinois. FCE responded that the motion was prem- ature because the arbitration had not concluded. Alterna- tively, FCE moved to vacate portions of the Phase I Award under 9 U.S.C. § 10. While the motions were pending in the district court, Phase II of the arbitration proceeded. On January 18, 2019, FCE requested that the arbitrators reconsider the Phase I Award. The panel held the Phase II hearing on February 11−15, 2019, and then denied FCE’s request to reconsider the Phase I Award on February 28. Meanwhile, on March 13 the district court entered an opinion and order dismissing the Insurers’ action without prejudice. The court determined that the matter was not ripe for adjudication because the panel had not finished the arbi- tration. This was actually mistaken: at the time the court en- tered its opinion and order, it was unaware (because the par- ties had not informed it) that two days before, on March 11, the arbitral panel entered this “Final Phase II Award” (the “Phase II Award”): The Panel in the above-captioned arbitration, duly ap- pointed by mutual agreement of the parties, upon con- sideration of all documents, arguments, and evidence submitted by Petitioners [Standard] and [Madison] (collectively “Petitioners”) and Respondent [FCE], and after having held a full hearing of the newly asserted claims in Phase II of this arbitration from February 11 through February 15, 2019, hereby renders its Final Phase II Award as follows: 6 No. 19-2336

1. FCE’s claim for lost profits damages is denied. 2. Petitioners’ claim for reimbursement of excessive administrative fees taken by FCE on limited medi- cal benefits plans in the amount of $477,810.00 is de- nied. 3.

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