State Farm Mutual Automobile Insurance Company v. Angelo

CourtDistrict Court, E.D. Michigan
DecidedFebruary 28, 2022
Docket3:19-cv-10669
StatusUnknown

This text of State Farm Mutual Automobile Insurance Company v. Angelo (State Farm Mutual Automobile Insurance Company v. Angelo) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Farm Mutual Automobile Insurance Company v. Angelo, (E.D. Mich. 2022).

Opinion

UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION ______________________________________________________________________

STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY,

Plaintiff,

v. Case No. 19-10669

MICHAEL ANGELO, et al.,

Defendants. ________________________________/

OPINION AND ORDER GRANTING PLAINTIFF’S MOTION TO ENFORCE SETTLEMENT AGREEMENT

Plaintiff State Farm Mutual Automobile Insurance Company brought this action under the Racketeer Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. § 1962(c) and (d), also asserting state law claims of fraud and unjust enrichment. (ECF No. 1, PageID.55-63.) Plaintiff, an automobile insurance company, alleged that Defendant Michael Angelo submitted fraudulent bills for medically unnecessary services and prescriptions rendered to patients involved in automobile accidents. (Id., PageID.2, 4, 54.) After extensive litigation fraught with discovery disputes, the parties entered into a settlement agreement. (ECF No. 118, PageID.6676; ECF No. 126, PageID.7132.) Before the court is Plaintiff’s motion to enforce this settlement agreement. (ECF No. 118.) Plaintiff seeks to enforce provisions that require Defendant to dismiss (“Dismissal Provision”) or release (“Release Provision”) particular categories of claims against Plaintiff. (Id., PageID.6691-97.) Plaintiff contends that Defendant is in breach of these provisions by virtue of his role as a relator in a qui tam action against Plaintiff brought under the False Claims Act (“FCA”). I. BACKGROUND A. Settlement Agreement

Plaintiff brought this action alleging that Defendant Michael Angelo, as the “primary driver of the scheme,” and through several entities that he owns or controls, fraudulently submitted bills and supporting documentation for services purportedly rendered to patients who were involved in automobile accidents and thereby qualified for no-fault benefits under Plaintiff’s policies. (ECF No. 1, PageID.2.) According to Plaintiff, these services were either not performed or were performed regardless of whether they were medically necessary. (Id.) Plaintiff sought compensatory damages as well as a declaratory judgment against Defendant’s entities finding that Plaintiff is “not liable for any pending bills or bills that Defendants have submitted, and caused to be submitted.” (Id., PageID.5, 55-63.)

After litigating the case for approximately two years, the parties ultimately resolved the matter and entered into a settlement agreement on February 19, 2021. (ECF No. 118-2; ECF No. 118, PageID.6680.) Two provisions of their agreement are relevant to the present dispute. First, the agreement’s Dismissal Provision provides: [W]ithin seven (7) days of the date this Confidential Agreement is signed, the Michael Angelo Entities shall take all steps necessary to settle, discontinue with prejudice, and to secure the discontinuance of, any lawsuits, arbitrations, appeals, claims, and other proceedings brought by any Michael Angelo Entity pending against State Farm Mutual and/or any individual insured by State Farm Mutual (“State Farm Mutual Insured”), in any forum, arising from (a) the allegations asserted or that could have been asserted in the Litigation; and/or (b) MVA Related Health Care Services,[1] as hereinafter defined, provided by any Michael Angelo Entity(s) to any State Farm Mutual Insured on or before the Effective Date, and to waive all rights to all remedies and costs relating to such matters, including attorney’s fees.

(ECF No 118-2, PageID.6704-05.) This provision also includes an indemnification clause. (Id.) Second, the Release Provision states: The Michael Angelo Entities hereby release and discharge State Farm Mutual from any and all judgments, claims, demands, losses, liabilities, costs, actions, causes of action, or suits of any kind whatsoever, whether in law or equity, known or unknown, foreseen or unforeseen, that any Michael Angelo Entity has now or may have had against State Farm Mutual, arising from (a) the allegations asserted or that could have been asserted in the Litigation; and/or (b) MVA Related Health Care Services provided by any Michael Angelo Entity(s) to any State Farm Mutual insured on or before the Effective Date. Furthermore, each Michael Angelo Entity agrees not to attempt to collect such bills submitted for benefits under personal injury protection coverage for which charges may remain due from any State Farm Mutual Insureds to whom such goods or services have been provided by Michael Angelo Entity(s).

(Id., PageID.6706-07.) Like the Dismissal Provision, the Release Provision also requires Defendant to indemnify Plaintiff in the event that Defendant fails to comply. (Id.) On March 4, 2021, the court entered a Stipulated Order of Dismissal dismissing Defendant from the action. (ECF No.114, PageID.6173-76.) The order also provided that the court retains jurisdiction to enforce the terms of the settlement agreement. (Id., PageID.6176.)

1 “MVA Related Health Care Services” are defined as those relating to “any good or service related to any accidental bodily injury arising out of the ownership, operation, maintenance, or use of a motor vehicle as a motor vehicle as defined under the Michigan No-Fault Automobile Insurance Act.” (ECF No. 118, PageID.6681.) B. The Qui Tam Action On April 6, 2021, roughly six weeks after the parties entered into the settlement agreement, a qui tam FCA complaint (“Qui Tam Action”) in the Eastern District of Michigan was unsealed; Defendant had filed the action as a relator, naming Plaintiff as

a defendant. (ECF No. 118-3, PageID.6718-79; United States ex rel. Michael Angelo v. State Farm Mut. Auto. Ins. Co., No. 19-12165, ECF No. 1.) The Qui Tam Action, originally filed on July 24, 2019, alleges that Plaintiff “exploited and circumvented the Medicare Secondary Payer Act, and Michigan auto insurance law—the No Fault Act—to avoid paying medical benefits to motor vehicle accident victims it insured, thus causing the government to pick up the expenses without being reimbursed by [State Farm].” (ECF No. 118-3, PageID.6719.) The complaint explains further, “[State Farm] has engaged in an elaborate and sophisticated fraudulent scheme that has caused the government to sustain significant financial loss by paying out sums of money that should have been paid by [State Farm] pertaining to motor vehicle injured victims.”

(ECF No. 118-3, PageID.6719.) The Qui Tam Action also asserts that “[State Farm] . . . knowingly presented, or caused to be presented, false or fraudulent information which causes payment or approval from the United States and/or the State of Michigan.” (Id.) The United States and the State of Michigan declined to intervene in the lawsuit on March 9, 2021. (ECF No. 118-6.) Plaintiff subsequently brought the present motion before the court, contending that, because Defendant filed the Qui Tam Action, Defendant is in breach of the parties’ settlement agreement. (ECF No. 118.) Plaintiff sought, inter alia, an order requiring Defendant Michael Angelo to “immediately cease and desist from taking any further action to prosecute the Quit Tam Lawsuit” and “take all necessary steps to secure dismissal of the Qui Tam Complaint.” (Id., PageID.6668.) Defendant opposed the motion on various grounds. (ECF No. 126.) Defendant explained that it would soon file an amended complaint in the Qui Tam Action which would demonstrate that the action

falls outside of the scope of the Dismissal and Release Provisions and render Plaintiff’s motion moot. (ECF No.

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State Farm Mutual Automobile Insurance Company v. Angelo, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-mutual-automobile-insurance-company-v-angelo-mied-2022.