Taqueria El Primo LLC v. Farmers Group, Inc.

District Court, D. Minnesota·Decided September 13, 2023·No. 0:19-cv-03071·Unknown

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA TAQUERIA EL PRIMO LLC, VICTOR MANUEL DELGADO JIMENEZ, MITCHELLE Civil No. 19-3071 (JRT/ECW) CHAVEZ SOLIS, BENJAMIN TARNOWSKI,

EL CHINELO PRODUCE, INC., and

VIRGINIA SANCHEZ-GOMEZ, individually

and on behalf of all others similarly

situated,

MEMORANDUM OPINION AND ORDER Plaintiffs, ON CROSS MOTIONS FOR SUMMARY JUDGMENT AND MOTIONS TO EXCLUDE v.

ILLINOIS FARMERS INSURANCE COMPANY; FARMERS INSURANCE EXCHANGE; FARMERS GROUP, INC.; TRUCK INSURANCE EXCHANGE; FARMERS INSURANCE COMPANY, INC.; and MID- CENTURY INSURANCE COMPANY,

Defendants.

Anne T. Regan and Nathan D. Prosser, HELLMUTH & JOHNSON PLLC, 8050 West Seventy-Eighth Street, Edina, MN 55439; David W. Asp, Derek C. Waller, Jennifer Jacobs, Kristen G. Marttila, and Stephen Matthew Owen, LOCKRIDGE GRINDAL NAUEN PLLP, 100 Washington Avenue South, Suite 2200, Minneapolis, MN 55401; Paul J. Phelps, SAWICKI & PHELPS, 5758 Blackshire Path, Inver Grove Heights, MN 55076, for plaintiffs.

Emily C. Atmore, John Katuska, and Marc A. Al, STOEL RIVES LLP, 33 South Sixth Street, Suite 4200, Minneapolis, MN 55402; Timothy W. Snider, STOEL RIVES LLP, 760 Southwest Ninth Avenue, Suite 3000, Portland, OR 97205, for defendants. Plaintiffs represent a Damages Class and an Injunctive Class who brought claims against Defendants Illinois Farmers Insurance (“Illinois Farmers”); Farmers Group, Inc.

(“FGI”); Trucker Insurance Exchange (“TIE”); Farmers Insurance Company, Inc. (“FICI”); Farmers Insurance Exchange (“FIE”); and Mid-Century Insurance Company (“Mid- Century”) (collectively “Farmers”) under the Minnesota Consumer Fraud Act (“MCFA”), the Minnesota Uniform Deceptive Trade Practices Act (“MDTPA”), and for breach of

contract. Plaintiffs allege that Farmers entered into billing limitation agreements with healthcare providers that violate the Minnesota No-Fault Automobile Insurance Act (the “No-Fault Act” or “the Act”). At the conclusion of discovery, Defendants moved to

exclude the expert testimony of Allan I. Schwartz, Dr. Akshay R. Rao, and Michael Rothman. Plaintiffs moved to exclude the expert testimony of Bruce Strombom and of Nancy Watkins. The parties also cross moved for summary judgment. As for Defendants’ motions to exclude, the Court will deny the motion to exclude

Schwartz’s testimony because it finds that Schwartz’s methodology is reliable and helpful to the jury, but the jury must nevertheless consider and conclude whether there are any damages in this case. The Court will deny the motion to exclude Dr. Rao because he properly relies on his expert qualifications and expertise and because mere challenges to

his conclusions are not grounds for exclusion. The Court will deny the motion to exclude Rothman’s testimony because he properly relies on his own background and expertise. As for Plaintiffs’ motions to exclude, the Court will deny the motion to exclude Strombom because it finds that he is the proper author of his report. The Court will also deny the motion to exclude Watkins because disagreements over the inputs used in an otherwise

reliable model are not grounds for exclusion. The Court concludes that the billing limitation agreements entered into by Farmers violate the No-Fault Act as prohibited preestablished limitations and because they have the effect of managed care, which is also prohibited by the No-Fault Act.

The Court also concludes that the Damages Class’s MCFA claims are actionable because Farmers omitted a material fact and because the Court finds that the nature of the billing limitations and their confidentiality constitute special circumstances giving rise

to a legal or equitable duty to disclose them under Minnesota law. However, the Court will deny partial summary judgment to Plaintiffs because issues of fact remain as to whether Plaintiffs can prove a causal nexus between any damages that may exist and the billing limitations.

Because the Court finds the billing limitations violate state law, the Court will grant summary judgment to the Injunctive Class and enjoin Farmers from entering or enforcing these and similar agreements with providers. However, the Court grants summary judgment to Farmers on the breach of contract claims because Plaintiffs failed to prove

that explicit terms in their policies guaranteed them their choice of provider and because certifying compliance with state law does not incorporate all aspects of said statute into a contract. Finally, the Court denies Farmers’ request to dismiss all claims against FGI, because issues of fact remain as to their involvement in the policies challenged by Plaintiffs.

However, the Court will dismiss all claims against FICI because Plaintiffs failed to produce any evidence that FICI issued any policies to Class Members or anyone in Minnesota.

BACKGROUND I. FACTUAL BACKGROUND Defendants consist of many divisions of Farmers that are involved in the auto insurance business. Defendants TIE, FIE, Illinois Farmers, and Mid-Century all underwrite

personal and commercial automobile policies in Minnesota. (See Decl. Margaret S. Giles (“Giles Decl.”) ¶¶ 7–10, Feb. 11, 2022, Docket No. 371.) FGI provides various common services to the other Defendants including legal and underwriting services, billing,

advertising, drafting policy language and forms, internal investigations and discipline, and regulatory filings. (1st Decl. of David W. Asp (“1st Asp Decl.”), Ex. 2 at 64:17–69:7, Mar. 20, 2021, Docket No. 129-1.) Collectively, Farmers has issued hundreds of thousands of policies worth more than $1 billion in total premiums paid over the relevant time period.

(1st Asp Decl., Ex. 20, at 5, Mar. 30, 2021, Docket No. 129-18.) Farmers sells insurance policies in Minnesota that purport to conform with the Minnesota No-Fault Automobile Insurance Act. (See e.g., 1st Decl. of Kristen G. Marttila (“1st Marttila Decl.”), Ex. 23, at 19, Feb. 16, 2023, Docket No. 550-18.) The No-Fault Act

“is a comprehensive and highly-detailed statutory scheme that governs the compensation of persons injured in automobile accidents.” Stout v. AMCO Ins. Co., 645 N.W.2d 108, 112 (Minn. 2002). The Act states that its purpose is in part:

to relieve the severe economic distress of uncompensated victims of automobile accidents within this state by requiring automobile insurers to offer [insurance] . . . which will provide prompt payment of specified basic economic loss benefits to victims of automobile accidents without regard to whose fault caused the accident. Minn. Stat. § 65B.42(1). It is undisputed that beginning in 2012, Farmers entered into confidential settlements with certain providers under which the providers agreed not to bill Farmers for any treatment provided to someone insured by Farmers.1 (1st Marttila Decl., Ex. 22, at 3–7, Feb. 16, 2023, Docket No. 551-15.) Some of these agreements restricted billing not only by named individuals and practices, but also by any individuals associated with the named practices. (See e.g., 1st Marttila Decl., Ex. 17, ¶ 3, at 4, Feb. 16, 2023, Docket No. 550-14.) It is also undisputed that Farmers did not disclose the agreements and their billing

limitations to consumers, the Minnesota Department of Commerce, or to its own insurance agents. (1st Marttila Decl., Ex. 22, at 3–6, Feb. 16, 2023, Docket No. 551-15.)

1 For consistency with prior opinions, the court refers to these agreements as “billing limitations.” Purchasers of insurance products from Farmers were thus unaware that certain providers were not permitted to bill Farmers if a policyholder sought care from the provider.

The number of providers subject to these agreements varied over time.

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