United Healthcare Services Inc v. Rossel

District Court, N.D. Texas·Decided September 27, 2024·No. 3:21-cv-01547·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF TEXAS DALLAS DIVISION

UNITED HEALTHCARE SERVICES § INC. and UNITEDHEALTHCARE § INSURANCE COMPANY, § § Plaintiffs, § § v. § Civil Action No. 3:21-CV-1547-L-BT § JEREMY ROSSEL; AMIR § MORTAZAVI; CARY ROSSEL; § ARVIN ZEINALI; YAN NAROSOV; § and SEMYON NAROSOV, § § Defendants. §

ORDER

On July 23, 2024, The Findings, Conclusions and Recommendation of the United States Magistrate Judge (“Report”) (Doc. 752) was entered, recommending that the court grant in part Defendants Cary Rossel and Jeremy Rossel’s (the “Rossel Defendants”) Motion for Summary Judgment (Doc. 679) to the extent that Plaintiffs’ claims for fraud by nondisclosure and for alleged violations of the Texas Uniform Fraudulent Transfer Act (“TUFTA”) be dismissed with prejudice; and deny Plaintiffs UnitedHealthcare Services, Inc. and UnitedHealthcare Insurance Company’s Motion for Partial Summary Judgment Against Defendants Amir Mortazavi and Arvin Zeinali (Doc. 681). No objections were filed regarding the magistrate judge’s recommended denial of Plaintiffs’ Motion for Partial Summary Judgment. On August 6, 2024, however, Plaintiffs filed their “Limited Objection” to the Report’s recommendation that Defendants’ Motion for Summary Judgment should be granted to the extent that the court should dismiss Plaintiffs’ fraud by nondisclosure claim. Regarding this claim, the magistrate judge determined that Plaintiffs failed to raise a genuine dispute of material fact regarding their fraud by nondisclosure claim based on the following reasoning: With respect to fraud by nondisclosure, the Rossel Defendants attack each element. Rossel Defs.’ Summ. J. Br. 26-27. Here, even viewing the evidence in the light most favorable to Plaintiffs, Plaintiffs have failed to present evidence sufficient to raise a genuine dispute of material fact as to each element of their fraud by nondisclosure claim.

To establish a claim for fraud by nondisclosure, Plaintiffs must show:

(1) the defendant deliberately failed to disclose material facts; (2) the defendant had a duty to disclose such facts to the plaintiff; (3) the plaintiff was ignorant of the facts and did not have an equal opportunity to discover them; (4) the defendant intended the plaintiff to act or refrain from acting based on the nondisclosure; and (5) the plaintiff relied on the non-disclosure, which resulted in injury.

Bombardier Aerospace Corp. v. SPEP Aircraft Holdings, LLC, 572 S.W.3d 213, 219-20 (Tex. 2019).

“As a general rule, a failure to disclose information does not constitute fraud unless there is a duty to disclose the information. Thus, silence may be equivalent to a false representation only when the particular circumstances impose a duty on the party to speak and he deliberately remains silent.” Bradford v. Vento, 48 S.W.3d 749, 755 (Tex. 2001) (citation omitted). “[T]he existence of a duty to disclose is a question of law that must be decided by the court, not by the jury.” Mercedes-Benz USA, LLC v. Carduco, Inc., 583 S.W.3d 553, 562 (Tex. 2019), reh’g denied (Oct. 18, 2019). A duty to disclose arises in four circumstances:

(1) there was a fiduciary or other special relationship requiring disclosure, (2) the defendant discovered new information that made an earlier representation misleading or untrue, (3) the defendant created a false impression by making a partial disclosure, or (4) the defendant voluntarily disclosed some information and therefore had a duty to disclose the whole truth.

Guevara v. Lackner, 447 S.W.3d 566, 578 (Tex. App.—Corpus Christi–Edinburg 2014, no pet.).

In their response brief, Plaintiffs argue that the Rossel Defendants “failed to disclose that the claims they caused to be submitted to UHC were the result of lab and pharmacy-based kickback schemes they administered, which were designed to pay physicians in exchange for their referral of lab specimens and ordering pharmacy prescriptions.” Pls.’ Summ. J. Resp. Br. 39. Plaintiffs assert that Defendants had a duty to disclose these facts but fail to cite to any evidence in support of this position. Even assuming the existence of a duty to disclose, in their response, Plaintiffs also fail to cite to evidence showing that Defendants “knew that plaintiff was ignorant of or did not have the opportunity to discover” the material facts allegedly not disclosed. See Dorsey v. Portfolio Equities, Inc., 540 F.3d 333, 341 (5th Cir. 2008). Other than mentioning this element in conclusory fashion, Plaintiffs do not address it in their response brief. See Pls.’ Summ. J. Resp. Br. 38- 39. Plaintiffs rely on the pre-severance memorandum opinion regarding a motion to dismiss on the pleadings to bolster their fraud by nondisclosure claim. See Pls.’ Summ. J. Resp. Br. 39. But motions to dismiss and motions for summary judgment “are governed by different legal standards[;]” Lexxus Int’l, Inc. v. Loghry, 512 F. Supp. 2d 647, 649 (N.D. Tex. 2007) (Lindsay, J.), the former relying entirely on the face of the complaint and the latter weighing the evidence. See Doe v. Univ. of N. Texas Health Sci. Ctr., 2023 WL 5200666, at *2 (N.D. Tex. Aug. 14, 2023) (O’Connor, J.) (“[A] Rule 12(b)(6) . . . motion only entails an examination of the sufficiency of the pleadings. In contrast, a summary-judgment motion typically is based on the pleadings as well as any affidavits, depositions, and other forms of evidence relevant to the merits of the challenged claim or defense that are available at the time the motion is made.”) (citation omitted).

For these reasons, Plaintiffs have failed to raise a genuine dispute of material fact with respect to each element of their fraud by nondisclosure claim and, therefore, the District Judge should grant the Rossel Defendants’ no-evidence motion for summary judgment on this claim.

Report 49-52. Plaintiffs object to the magistrate judge’s determination that they failed to raise a genuine dispute of material fact regarding the second element (legal duty to disclose) and the third element (Plaintiffs’ ignorance of the fact of nondisclosure), as well as the related determination that “even assuming the existence of a duty to disclose, . . . Plaintiffs also fail to cite to evidence showing that Defendants ‘knew that plaintiff was ignorant of or did not have the opportunity to discover’ the material facts allegedly not disclosed.” Obj. 3 (quoting Report 51) (quoting Dorsey v. Portfolio Equities, Inc., 540 F.3d 333, 341 (5th Cir. 2008)). Plaintiffs assert that there is sufficient circumstantial evidence to infer actual knowledge of ignorance. Regarding the duty to disclose element, Plaintiffs acknowledge the distinction between the legal standards applicable to motions to dismiss and motions for summary judgment. They, nevertheless, contend that consideration of United States District Judge Ada Brown’s prior order denying a motion to dismiss this claim is sufficient to establish, as a matter of law, the existence

of a legal duty to disclose: [T]he Recommendation . . . notes that whether there is a duty to disclose is a legal question.

Free access — add to your briefcase to read the full text and ask questions with AI

United Healthcare Services Inc v. Rossel, (N.D. Tex. 2024).

United Healthcare Services Inc v. Rossel (United Healthcare Services Inc v. Rossel) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Malacara v. Garber
353 F.3d 393 (Fifth Circuit, 2003)
Dorsey v. Portfolio Equities, Inc.
540 F.3d 333 (Fifth Circuit, 2008)
Lexxus International, Inc. v. Loghry
512 F. Supp. 2d 647 (N.D. Texas, 2007)
Bradford v. Vento
48 S.W.3d 749 (Texas Supreme Court, 2001)
Jorge Guevara, M.D. v. Mark Lackner and Robert E. Lackner
447 S.W.3d 566 (Court of Appeals of Texas, 2014)
Michael Wease v. Ocwen Loan Servicing, L.L.C., et
915 F.3d 987 (Fifth Circuit, 2019)
Bombardier Aerospace Corp. v. Spep Aircraft Holdings, LLC
572 S.W.3d 213 (Texas Supreme Court, 2019)