State ex rel.Third-Party Health Plansand Blue Cross and Blue Shield of Kansas,Inc.vs.Shawn D. Nines

CourtWest Virginia Supreme Court
DecidedNovember 25, 2020
Docket20-0296& 20-0297
StatusSeparate

This text of State ex rel.Third-Party Health Plansand Blue Cross and Blue Shield of Kansas,Inc.vs.Shawn D. Nines (State ex rel.Third-Party Health Plansand Blue Cross and Blue Shield of Kansas,Inc.vs.Shawn D. Nines) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State ex rel.Third-Party Health Plansand Blue Cross and Blue Shield of Kansas,Inc.vs.Shawn D. Nines, (W. Va. 2020).

Opinion

No. 20-0296 – State ex rel. Third-Party Defendant Health Plans, et. al. v. The Honorable Shawn D. Nines, et al. and

No. 20-0297 – State ex rel. Blue Cross & Blue Shield of Kansas, Inc. v. The Honorable Shawn D. Nines FILED November 25, 2020 Hutchison, Justice, dissenting: EDYTHE NASH GAISER, CLERK SUPREME COURT OF APPEALS OF WEST VIRGINIA

I respectfully dissent from the majority’s opinion. I believe that sufficient

allegations were asserted that the foreign third-party-defendant “Blues” had a contractual

arrangement with Highmark of West Virginia (“Highmark”), such that Highmark was

acting as the agent of the Blues in West Virginia. The complaint also sufficiently alleged

that the Blues were conspiring with Highmark in West Virginia in a manner that caused

harm to MedTest in West Virginia. Given that the majority opinion was focused on the

lack of evidence regarding whether the Blues purposely availed themselves of West

Virginia’s jurisdiction through Highmark, they should have sent the case back to the circuit

court and allowed the parties to conduct jurisdictional discovery.

The majority opinion is written to produce the impression that this is little

more than a West Virginia lawsuit between two West Virginia companies over a contract

executed and later breached in West Virginia. That is, Highmark and MedTest entered into

a contract, and MedTest breached the contract by overcharging Highmark to the tune of

$6.4 million. Highmark is just suing to collect the overcharge.

What the majority opinion does not address is the motivation: why was

Highmark suing for the overcharge? The majority opinion paints Highmark as an 1 independent firm; in reality, Highmark is interconnected nationally with the other Blues by

way of the BlueCard program. The record shows that Highmark received a notification

from the Blues that MedTest was charging too much, and it was action from the Blues and

their interconnected BlueCard computer system that compelled Highmark to stop paying

MedTest. Using the BlueCard system, Highmark claims it calculated that MedTest had

billed the Blues – through Highmark – allegedly excessive amounts. So, the records before

this Court show that when Highmark sued, it was only asking for $3,192 for itself; as for

the remaining $6.3 plus million, Highmark was acting as a collection agent for the Blues.

As the majority opinion relates, this case is about specific jurisdiction which

requires weighing three prongs (purposeful availment, arise or relate, and fairness) to see

if “minimum contacts” exist. It tests whether “maintenance of the suit [would] offend

traditional notions of fair play and substantial justice.” Int’l Shoe Co. v. Washington, 326

U.S. 310, 316 (1945). Specific jurisdiction focuses on “the relationship among the

defendant, the forum, and the litigation.” Daimler AG v. Bauman, 571 U.S. 117, 126

(2014).

1. Purposeful availment: The defendant must “purposefully avail[] itself

of the privilege of conducting activities within the forum State,” such that the defendant

has “clear notice that it is subject to suit there.” World-Wide Volkswagen v. Woodson, 444

U.S. 286, 297 (1980). This is the primary issue challenged by the Blues. The purposeful

availment element considers how defendants have structured their affairs and where they

reasonably anticipate being sued. “The purposeful availment requirement of specific

2 personal jurisdiction ensures that a defendant will not be haled into a jurisdiction as a result

of isolated, fortuitous, or random acts.” Syl. pt. 9, State ex rel. Ford Motor Co. v. McGraw,

237 W. Va. 573, 788 S.E.2d 319 (2016).

2. Arise or Relate: The controversy must “arise out of or relate to”

defendant’s activities in the forum; there must be “an affiliation between the forum and the

underlying controversy[.]” Bristol-Myers Squibb Co. v. Superior Court of California, 137

S. Ct. 1773, 1780 (2017).

3. Fairness: The exercise of jurisdiction must be “reasonable” and

comport with “fair play and substantial justice.” Asahi Metal Indus. Co. v. Superior Court

of California, Solano Cty., 480 U.S. 102, 113 (1987).

The central question in this case is the first element, purposeful availment. I

believe it was established in MedTest’s complaint.

First, this record establishes the Blues purposely conducted activities in West

Virginia under the “agency theory of jurisdiction.” Under this theory, the acts of an agent

acting within the scope of its agency, and the resulting contacts therefrom, are imputable

to the principal for determining specific personal jurisdiction of the principal. In effect,

the principal may purposefully avail itself of a foreign forum through its agent’s actions.

The United States Supreme Court acknowledged that an agency relationship may create

sufficient in-state jurisdictional contacts:

3 Agency relationships, we have recognized, may be relevant to the existence of specific jurisdiction. “[T]he corporate personality,” International Shoe Co. v. Washington, 326 U.S. 310 (1945), observed, “is a fiction, although a fiction intended to be acted upon as though it were a fact.” Id., at 316. See generally 1 W. Fletcher, Cyclopedia of the Law of Corporations § 30, p. 30 (Supp. 2012–2013) (“A corporation is a distinct legal entity that can act only through its agents.”). As such, a corporation can purposefully avail itself of a forum by directing its agents or distributors to take action there. See, e.g., Asahi, 480 U.S. at 112 (opinion of O’Connor, J.) (defendant’s act of “marketing [a] product through a distributor who has agreed to serve as the sales agent in the forum State” may amount to purposeful availment); International Shoe, 326 U.S., at 318, 66 S.Ct. 154 (“the commission of some single or occasional acts of the corporate agent in a state” may sometimes “be deemed sufficient to render the corporation liable to suit” on related claims). See also Brief for Petitioner 24 (acknowledging that “an agency relationship may be sufficient in some circumstances to give rise to specific jurisdiction”). . . .

Daimler AG v. Bauman, 571 U.S. at 135 n.13.

The agency theory of jurisdiction is simply stated: “For purposes of personal

jurisdiction, the actions of an agent may be attributed to the principal.” Daynard v. Ness,

Motley, 290 F.3d 42, 55-56 (1st Cir. 2002). Numerous federal courts have adopted this

theory. See, e.g., Sher v. Johnson, 911 F.2d 1357, 1362 (9th Cir. 1990) (“For purposes of

personal jurisdiction, the actions of an agent are attributable to the principal.”); E.I. duPont

de Nemours & Co. v. Rhodia Fiber, 197 F.R.D. 112, 122 (D. Del. 2000) (“Delaware law

allows a court to find jurisdiction over a parent corporation for the acts of its subsidiary

through either an alter ego theory or the agency theory.”); Wessels, Arnold & Henderson

v. Nat’l Med. Waste, Inc., 65 F.3d 1427, 1433 (8th Cir.

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Related

International Shoe Co. v. Washington
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MacKey v. Compass Marketing, Inc.
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Daimler AG v. Bauman
134 S. Ct. 746 (Supreme Court, 2014)
SER Ford Motor Co. v. Hon. Warren R. McGraw, Judge
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Charles Schwab Corp. v. Bank of America Corp.
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Yoost v. Caspari
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Sher v. Johnson
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State ex rel.Third-Party Health Plansand Blue Cross and Blue Shield of Kansas,Inc.vs.Shawn D. Nines, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-relthird-party-health-plansand-blue-cross-and-blue-shield-of-wva-2020.