United Healthcare Corp. v. American Trade Insurance

88 F.3d 563
CourtCourt of Appeals for the Eighth Circuit
DecidedJuly 2, 1996
Docket94-3380, 94-3496
StatusPublished
Cited by1 cases

This text of 88 F.3d 563 (United Healthcare Corp. v. American Trade Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United Healthcare Corp. v. American Trade Insurance, 88 F.3d 563 (8th Cir. 1996).

Opinion

BEAM, Circuit Judge.

Edmund Benton (Benton) appeals from the district court’s entry of judgment on a jury verdict awarding United Healthcare Corporation (UHC) damages for Benton’s violation of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. § 1962(c) (RICO). Benton argues that UHC was not a real party in interest to the litigation, and that the district court erred in denying his motion for judgment as a matter of law. Benton also challenges several of the district court’s evidentiary rulings and its refusal to submit Benton’s proposed special verdict form to the jury. UHC, in turn, cross appeals the district court’s denial of its petition for attorney’s fees and costs. We affirm the judgment on the verdict, but reverse and remand for a determination of costs and attorney’s fees.

I. BACKGROUND

In the 1980s, Congress responded to a perceived crisis in certain insurance markets by passing the Liability Risk Retention Act, 15 U.S.C. §§ 3901-06 (Act). The Act loosened previous restrictions on the ability of nontraditional insurers to provide liability insurance through “risk retention groups” and “purchase groups.” 1 Under the Act and its subsequent amendments, risk retention groups and purchase groups are exempt from state laws prohibiting their operation or regulating their membership. 15 U.S.C. §§ 3902 & 3903.

UHC is the parent company of United Healthcare Management Corporation (United Healthcare Management), a management company which owns and manages a number of Health Maintenance Organizations (HMOs) across the United States. 2 According to its management agreements, United Healthcare Management is responsible for obtaining liability insurance coverage for these HMOs. In 1987, United Healthcare Management sought this coverage from Healing Arts National Association (HANA), a purchase group formed to take advantage of the exemptions provided by the Act. Over the next two years, UHC, through its subsidiary, paid nearly $300,000 in premiums to the HANA program to obtain insurance coverage on behalf of the HMOs it owned or managed.

During the period at issue in this case, HANA insureds were to be covered by master insurance policies provided by either Diversified Insurers Corporation (Diversified) or Victoria Insurance Company (Victoria). After purchasing insurance through HANA for two years, however, UHC discovered that the insurance premiums it had paid had never in fact reached these insurance companies and that the policies purporting to provide insurance coverage were worthless. UHC instigated this lawsuit, naming over 40 individuals and entities as defendants. Originally, UHC focused its litigation efforts on the recovery of costs associated with defending lawsuits brought against one of its HMOs, Physician’s Health Plan of Arizona, which was to be insured through the HANA program. By the time of trial, however, UHC had abandoned this course of action'and elected, instead, to seek reimbursement of. insurance premiums. Most of the defendants either defaulted or settled with UHC, leaving only defendant Benton and one of Benton’s corporations, BFT Management, in the litigation at the time of trial.

At trial, UHC traced the premiums it paid to HANA through various entities, including several owned by Benton. The premiums were initially sent to IMACO, an insurance brokerage company. That company would deduct its commission and forward the remaining premium to Robis International, a *568 re-insurance intermediary. Robis would subtract its commission and wire the premium balance to Comtell, a defendant corporation which began its association with HANA in 1986. Benton was Comtell’s vice president and a signator on Comtell’s bank accounts. Benton also owned approximately twenty-five percent of Comtell through one of his corporations.

Comtell provided “administrative services” to HANA, and thus was responsible for securing insurance coverage for the HANA members, forwarding premiums to the participating insurers, and issuing insurance certificates. By 1987, however, two other companies, SUMI, Inc. and Purchase Group Management (PGM), were established to assume some of Comtell’s responsibilities. Both of these companies were owned and controlled by Benton. With the establishment of these entities, Comtell was no longer responsible for forwarding premiums to the insurance companies. Instead, Comtell transmitted the premiums it received to PGM to forward on to the insurers.

Despite this arrangement, the evidence demonstrated that neither Victoria nor Diversified received premiums from either Comtell or PGM. Financial records and bank statements showed that after the premiums reached Comtell and PGM, approximately $600,000 went into brokerage accounts controlled by Benton, several hundred thousand dollars worth of cheeks were made out to “cash” and individual defendants, including Benton, and over one million dollars of premium monies disappeared and remain untraceable.

■ After UHC completed its case, Benton and BFT Management moved for judgment as a matter of law. The court granted the motion as to all counts except UHC’s RICO claims, brought under 18 U.S.C. § 1962(a) — (d). Benton and BFT Management then presented their defense, claiming that Benton was merely a computer consultant to Comtell and challenging UHC’s basic premise that, because none of the premiums reached Victoria and Diversified, UHC’s HMOs were never, in fact, insured. After presentation, of their defense, Benton and BFT Management renewed their requests for judgment as a matter of law. The district court granted BFT’s motion and dismissed it from the case, and granted Benton’s motion as to all of UHC’s claims except its claim under 18 U.S.C. § 1962(c). The court allowed this claim to go to the jury, and the jury returned a verdict for UHC in the amount of $188,426.80. The court trebled the damage award as required by 18 U.S.C. § 1964(c) and entered judgment in the amount of $565,280.40.

After trial, the district court considered Benton’s renewed motion for judgment as a matter of law and UHC’s petition for attorney’s fees and costs. The district court denied Benton’s motion and UHC’s request for fees and costs, and both parties appeal.

On appeal, Benton contends that UHC was not a proper party to bring this lawsuit. Benton further argues that judgment as a matter of law should have been granted because UHC failed to establish the elements required to prove a RICO violation under 18 U.S.C. § 1962(c).

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Bluebook (online)
88 F.3d 563, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-healthcare-corp-v-american-trade-insurance-ca8-1996.