Transamerica Life Insurance Company v. Kaufmann

CourtDistrict Court, W.D. Virginia
DecidedSeptember 7, 2023
Docket5:20-cv-00059
StatusUnknown

This text of Transamerica Life Insurance Company v. Kaufmann (Transamerica Life Insurance Company v. Kaufmann) is published on Counsel Stack Legal Research, covering District Court, W.D. Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Transamerica Life Insurance Company v. Kaufmann, (W.D. Va. 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF VIRGINIA HARRISONBURG DIVISION TRANSAMERICA LIFE ) INSURANCE COMPANY, ) ) Case No. 5:20-cv-059 Plaintiff, ) ) By: Michael F. Urbanski v. ) Chief United States District Judge ) BONNIE LOU KAUFMANN, ) STEPHEN J. KAUFMANN, AND ) TAKING CARE OF PEOPLE.ORG, _) ) Defendants. ) MEMORANDUM OPINION This matter comes before the court on plaintiff Transamerica Life Insurance Company’s (“Transamerica”) Motion for Default Judgment. ECF No. 83. For the foregoing reasons, Transametica’s Motion for Default Judgment is GRANTED as to Taking Care of People.org (“TCOP”) on Claims One and Four and DENIED without prejudice as to Bonnie L. Kaufmann (“Bonnie”), Stephen J. Kaufmann (Stephen”), and the remainder of the claims against TCOP. A hearing will be set to determine the amount of damages to be entered pursuant to Federal Rule of Civil Procedure 55. I. Background ‘Transamerica initiated this suit in September 2020, alleging that Bonnie, Stephen, and their organization TCOP defrauded Transamerica out of hundreds of thousands of dollars in long-term care benefits paid under two long-term insurance plans, one benefitting each individual defendant. ECF No. 1, at ff] 1-2.

In 2010, Bonnie submitted a claim for long-term care insurance benefits under her policy with Transamerica, claiming “a variety of subjective ailments” that “caused her to require ‘Substantial Human Assistance’ with her ‘Activities of Daily Living’”’ (ADLs). Id. at 7. Transamerica approved Bannie’s benefit claim and Stephen became her sole caregiver. Id. at {[] 10-11. Stephen created a non-profit organization, TCOP, in which he served as CEO and Director. Id. at J] 11. For much of this alleged scheme, Bonnie was the organization’s only client. Id. The defendants submitted invoices representing that Stephen personally provided seventy hours of assistance to Bonnie per week. At a rate of $293.00 per day, Transamerica paid cash benefits to Bonnie of approximately $107,000.00 per year, totaling to approximately $808,613.95, Id. at 9] 12-13. However, Transamerica alleges that during this time, Bonnie “has ... demonstrated physical abilities entirely inconsistent with her representations to Transamerica that she requires Substantial Human Assistance with her ADLs because, in fact she does not tequite such assistance;’ defendants “knowingly and improperly billed Transamerica for cate that [Stephen] did not provide and [Bonnie] did not receive or pay for;” and Stephen “has remained actively licensed and employed as an attorney during all periods relevant to [Bonnie]’s claim and routinely works at his office, alone, during times he represented to Transamerica that he was cating for [Bonnie].” Id. at {] 14. In 2020, Transamerica claims that defendants began submitting fraudulent claims under Stephen’s long-term care policy, representing that Stephen required and received assistance with his ADLs from a caregiver employed by Taking Care of People.org “on the same dates and times that he billed Transamerica for having purportedly provided such care to [Bonnie].” Id. at | 17.

While the defendants were originally represented by counsel, their counsel was permitted to withdraw on April 19, 2022, after a conflict of interest arose. ECF No. 54. Despite Magistrate Judge Hoppe’s instruction to find new counsel within thirty days, defendants did not do so and TCOP, a corporation, remains pro se. Id. On July 15, 2022, Judge Hoppe found that TCOP had failed to defend against the action and directed the Clerk to enter default under Rule 55(a) of the Federal Rules of Civil Procedure. ECF No. 67, at 3; see also ECF No. 68. II. Jurisdiction and Venue The court has both subject-matter jurisdiction over Transamerica’s claims and personal jurisdiction over the defendants. The court exercises diversity jurisdiction in this matter, pursuant to 28 U.S.C. §1332(a), because parties are respectively citizens of diverse jurisdictions, and the amount in controversy is in excess of $75,000.00. Transamerica is both incorporated in and has its principal place of business in Iowa, and is therefore a citizen of Iowa. Compl., ECF No. 1, at ] 19. Bonnie and Stephen are both Virginia citizens. Id. at {] 20- 21. TCOP is a Virginia citizen because it is organized under Virginia law. Id. at ] 22. Venue is properly laid, pursuant to 28 U.S.C. § 1391(b)(2), because the acts and omissions underlying the Complaint took place in the Western District of Virginia. Il. Legal Standard Federal Rule of Civil Procedure 55 “authorizes the entry of a default judgment when a defendant fails ‘to plead or otherwise defend’ in accordance with the Rules.” United States v. Moradi, 673 F.2d 725, 727 (4th Cir. 1982). The Federal Rules create a two-step process for entry of default judgment. First, the non-defaulting party must move for entry of default under

Rule 55(a). See Fed. R. Civ. P. 55(a). “The Clerk of the Court’s interlocutory entry of default pursuant to Federal Rule of Civil Procedure 55(a) provides notice to the defaulting party prior to the entry of default judgment by the court.” Hummel v. Hall, 868 F. Supp. 2d 543, 547 (W.D. Va. 2012) (citing Carbon Fuel Co. v. USX Corp., 1998 WL 480809, at *2 (4th Cir. Aug. 6, 1998)). Once default has been entered, the non-defaulting party may then move for entry of default judgment under Rule 55(b). Id. “Tf the plaintiffs claim is for a sum certain or a sum that can be made certain by computation, the clerk—on the plaintiffs request, with an affidavit showing the amount due—must enter judgment for that amount and costs against a defendant who has been defaulted for not appearing ....” Fed. R. Civ. P. 55(b)(1). However, □□□□□ citcumstances where the sum is not certain or where there is evidence to suggest that the defendant was incompetent or an infant, Rule 55(b)(2) applies, requiring that default can only be [made] by a court.” Agri-Supply Co., Inc. v. Agrisupply.Com, 457 F. Supp. 2d 660, 662 (E.D. Va. 2006). “Upon the entry of default, the defaulted party is deemed to have admitted all well- pleaded allegations of fact contained in the complaint,” J & J Sports Prods., Inc. v. Romenski, 845 F. Supp. 2d 703, 706 (W.D.N.C. 2012), but not any such “allegations as to damages.” S.E.C. v. Lawbaugh, 359 F. Supp. 2d 418, 422 (D. Md. 2005); Fed. R. Civ. P. 8(b)(6). Therefore, “to determine whether to enter jadgment on a defendant’s default, the court examines whether the well-pleaded allegations in the complaint support the telief sought in the case.” Old Dominion Freight Line, Inc. v. Slabway, LLC, No. 1:22CV164, 2023 WL 2503310, at *1 (M.D.N.C, Mar. 13, 2023) (citing Ryan v. Homecomings Fin, Network, 253 F.3d 778, 780 (4th Cir. 2001). The pleadings must contain a “sufficient basis” for the judgment entered.

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Transamerica Life Insurance Company v. Kaufmann, Counsel Stack Legal Research, https://law.counselstack.com/opinion/transamerica-life-insurance-company-v-kaufmann-vawd-2023.