True v. Robles

571 F.3d 412, 2009 U.S. App. LEXIS 12679, 2009 WL 1608882
CourtCourt of Appeals for the Fifth Circuit
DecidedJune 10, 2009
Docket08-50782
StatusPublished
Cited by120 cases

This text of 571 F.3d 412 (True v. Robles) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
True v. Robles, 571 F.3d 412, 2009 U.S. App. LEXIS 12679, 2009 WL 1608882 (5th Cir. 2009).

Opinion

BENAVIDES, Circuit Judge:

This putative class-action suit raises a novel question concerning the fundamental legal structure of a peculiar entity known as a reciprocal insurance exchange, which is essentially an insurance company cooperatively owned by those it insures, known as “members” or “subscribers.” Specifically, we must inquire into the nature of the legal relationship between the board of directors of the United Services Automobile Association (“USAA”), a large reciprocal insurance exchange, and its subscribers, and determine what legal duties are created by that relationship. James True, a USAA subscriber, alleges that the USAA board of directors breached fiduciary and contractual duties owed to individual members by retaining billions of dollars in unallocated surplus funds, and not allocating those funds to the USAA savings accounts of individual subscribers. True contends that the unallocated surplus vastly exceeds the amount required by applicable state regulations or needed to ensure USAA’s financial stability.

The district court, applying Texas law, dismissed the suit, holding that: (1) the board did not owe a fiduciary duty to USAA’s individual members, but rather only to the entity itself, and therefore that individual members could not pursue claims for breach of fiduciary duty or constructive fraud against the board; (2) True’s subscriber agreement with USAA was not a contract between True and the board, and thus could not serve as the basis for a breach of contract claim; and *414 (3) Trae had failed to allege facts sufficient to avoid the application of the business judgment rale to the board’s decision. True contends that the district court erred with respect to each of these holdings.

For the reasons discussed in greater detail below, we hold that there is no fiduciary or contractual relationship between individual subscribers and the USAA board of directors, and therefore that True has failed to state a claim for relief. Because we hold that True has failed to allege that the board violated any legal obligation owed to individual subscribers, we do not reach the question of whether the board’s decision to retain billions of dollars in unallocated surplus funds, rather than allocate those funds to the USAA savings accounts of individual subscribers, should be accorded business judgment deference. Accordingly, we AFFIRM the judgment of the district court.

I. Background

A. Reciprocal Insurance Exchanges

1. In General

The parties refer to USAA as a “reciprocal interinsurance exchange,” but such an association is also referred to as a “reciprocal insurer,” a “reciprocal insurance exchange,” an “interinsurance exchange,” an “interindemnity exchange,” or a “reciprocal.” The most commonly used name appears to be “reciprocal insurance exchange.” A reciprocal insurance exchange is essentially an insurance company cooperatively owned by those it insures. See Kiepfer v. Better, 944 F.2d 1213, 1216 (5th Cir.1991); Wilson v. Marshall, 218 S.W.2d 345, 346 (Tex.Civ.App.1949). Through such an entity, members “undertake to indemnify each other against certain kinds of losses by means of a mutual exchange of insurance contracts, usually through the medium of a common attorney-in-fact appointed for that purpose by each of the underwriters.... ” 43 Am. Jur.2d Insurance § 81 (2008). Thus, in its pure form, a reciprocal insurance exchange is a web of contractual relationships between subscribers who agree to insure one another, consummated through a common agent with power of attorney. See Dennis F. Reinmuth, The Regulation Of Reciprocal Insurance Exchanges 11 (1967) (“[Cjonceptually a reciprocal consists of a series of private contracts among the members or subscribers, each agreeing to insure one another, the exchange of insurance being consummated through the common agent of the members, the attorney-in-fact, and by means of the subscriber’s agreement of power of attorney.”).

2. A Brief History

When reciprocal insurance exchanges were first established in the late nineteenth century, subscribers had several, not joint, liability on all of the exchange’s liabilities. See Lee v. Interinsurance Exch. of the Auto. Club of S. Cal., 50 Cal.App.4th 694, 702-03, 57 Cal.Rptr.2d 798 (1996) (citing Delos v. Farmers Ins. Group, 93 Cal.App.3d 642, 652, 155 Cal.Rptr. 843 (1979); 2 Couch on Insurance 2d § 18.11, at 613 (1984); Reinmuth, supra, at 10-20). The exchange had no capital, and funds for the payment of losses were collected from subscribers after losses occurred. Id. at 703, 57 Cal.Rptr.2d 798 (citing Mitchell v. Pac.Greyhound Lines, 33 Cal.App.2d 53, 59-60, 91 P.2d 176 (1939); Couch, supra, §§ 18:11, at 614-15; Reinmuth, supra, at 2).

To avoid delays, exchanges began collecting advance annual deposits, which were kept in a separate account for each subscriber, with the subscriber’s pro rata share of losses and expenses being deducted as needed. If a subscriber’s account had a positive balance at the end of the year, that amount became part of a sub *415 scriber’s “savings” or “surplus,” and was either distributed to subscribers or held until the subscriber withdrew from the exchange. If the balance was negative, the subscriber could be assessed for a specified maximum amount beyond their deposit. Id. at 703, 57 Cal.Rptr.2d 798 (citing Couch, supra, §§ 18:26-18:30, at 633-641; Reinmuth, supra, at 2, 30-31).

The original concept of reciprocal insurance contemplated the allocation of all surplus to the accounts of individual subscribers, but over time it became customary for reciprocals to accumulate unallocated surplus, which was held perpetually in anticipation of catastrophic losses and not subject to withdrawal by departing subscribers. However, the use of such separate surplus accounts is merely an internal bookkeeping device; all assets are held in a common fund, and there is no physical segregation of assets to individuals. Reinmuth, supra, at 31. As a result of the accumulation of surplus assets, many reciprocals, including USAA, began issuing nonassessable policies, under which subscribers had no contingent liability for claims, expenses, or losses of the exchange. See Lee, 50 Cal.App.4th at 703-04, 57 Cal.Rptr.2d 798 (citing Reinmuth, supra, at 2, 18, 30-37, 186-87). True holds such a nonassessable policy from USAA.

3. Under Texas Law

The Texas Insurance Code specifically authorizes the establishment of reciprocal insurance exchanges and establishes rules relating to their operation. See Tex. Ins. Code Ann. §

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Bluebook (online)
571 F.3d 412, 2009 U.S. App. LEXIS 12679, 2009 WL 1608882, Counsel Stack Legal Research, https://law.counselstack.com/opinion/true-v-robles-ca5-2009.