US EX REL. BRANCH CONSULTANTS v. Allstate Ins. Co.

560 F.3d 371, 2009 U.S. App. LEXIS 3503, 2009 WL 388947
CourtCourt of Appeals for the Fifth Circuit
DecidedFebruary 18, 2009
Docket07-31191
StatusPublished
Cited by81 cases

This text of 560 F.3d 371 (US EX REL. BRANCH CONSULTANTS v. Allstate Ins. Co.) 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
US EX REL. BRANCH CONSULTANTS v. Allstate Ins. Co., 560 F.3d 371, 2009 U.S. App. LEXIS 3503, 2009 WL 388947 (5th Cir. 2009).

Opinion

560 F.3d 371 (2009)

UNITED STATES of America, ex rel. BRANCH CONSULTANTS, Plaintiff-Appellant,
v.
ALLSTATE INSURANCE COMPANY; State Farm Fire and Casualty Company; Liberty Mutual Fire Insurance Company; Fidelity National Insurance Company; Fidelity National Property and Casualty Insurance Company; American National Property & Casualty Company; Pilot Catastrophe Services, Inc.; Crawford & Company, Allied Claims; NCA Group, Inc.; Simsol Insurance Services, Inc.; Unidentified Parties; American Reliable Insurance Company; Colonial Claims Corp.; Standard Fire Insurance Company, Defendants-Appellees.

No. 07-31191.

United States Court of Appeals, Fifth Circuit.

February 18, 2009.

*372 Allan L. Kanner (argued), Cynthia Green St. Amant, Kanner & Whiteley, LLC, New Orleans, LA, for Plaintiff-Appellant.

Brad D. Brian, Gregory John Weingart, Munger, Tolles & Olson, Los Angeles, CA, Judy Y. Barrasso, Stephen H. Kupperman, Barrassso, Usdin, Kupperman, Freeman & Sarver, New Orleans, LA, Genevieve Cox, Munger, Tolles & Olson, San Francisco, CA, Richard L. Fenton, Steven M. Levy, Sonnenschein, Nath & Rosenthal, Chicago, IL, for Allstate Ins. Co.

Phillip A. Wittmann (argued), Daria Burgess Diaz, Stone, Pigman, Walther & Wittmann, New Orleans, LA, for State Farm Fire & Cas. Co.

Russell Yager, Vinson & Elkins, Dallas, TX, for Liberty Mut. Fire Ins. Co.

*373 Gerald Joseph Nielsen, William Truman Treas, Nielsen Law Firm, Metairie, LA, for Fidelity Nat. Ins. Co. and Fidelity Nat. Prop. & Cas. Ins. Co.

Jay M. Lonero, Christopher Raymond Pennison, Larzelere, Picou, Wells, Simpson, Lonero, Metairie, LA, for Am. Nat. Prop. & Cas. Co.

Robert A. Kutcher, Chopin, Wagar, Richard & Kutcher, Metairie, LA, James H. Crosby, Crosby Saad, LLC, Mobile, AL, Timothy J. Hatch, Gibson, Dunn & Crutcher, LLP, Washington, DC, for Pilot Catastrophe Services, Inc.

Richard B. Eason, II, Raymond Peter Ward, Adams & Reese, New Orleans, LA, for Crawford & Co.

William Glenn Burns, Dominic J. Ovella, Darren A. Patin, Richard T. Simmons, Jr., Hailey, McNamara, Hall, Larmann & Papale, Metairie, LA, for NCA Group, Inc.

Andre Jude Lagarde, McCranie, Sistrunk, Anzelmo, Hardy, Maxwell & McDaniel, Metairie, LA, for Simsol Ins. Services, Inc.

Gordon Paul Serou, Jr., Law Offices of Gordon P. Serou, Jr., New Orleans, LA, for Am. Reliable Ins. Co.

Peter S. Koeppel, Michael Louis Martin, Best Koeppel, New Orleans, LA, for Colonial Claims Corp.

Harry A. Rosenberg, Phelps Dunbar, New Orleans, LA, Bryce L. Friedman (argued), Simpson, Thacher & Bartlett, LLP, New York City, Deborah L. Stein, Simpson, Thacher & Bartlett, LLP, Los Angeles, CA, for Standard Fire Ins. Co.

Before BENAVIDES, SOUTHWICK and HAYNES, Circuit Judges.

HAYNES, Circuit Judge:

Relator Branch Consultants appeals the district court's dismissal of its False Claims Act (FCA) complaint under the FCA's first-to-file jurisdictional bar. See 31 U.S.C. § 3730(b)(5) (1994). The district court found the bar applicable because Branch's complaint alleges "the same general conduct and theory" of Katrina-related insurance fraud as the previously-filed FCA action in United States ex rel. Rigsby v. State Farm Insurance Co. (Rigsby),[1] despite the fact that Branch focuses on different details, geographic locations, and other insurer defendants.

We agree with the district court that Branch cannot avoid § 3730(b)(5)'s jurisdictional bar by merely adding details and geographic locations to the material allegations contained in Rigsby. Thus, we affirm the district court's dismissal as to Defendant State Farm Fire and Casualty Company and Allstate Insurance Company —the only Branch Defendants that Rigsby names. But, under the facts of this case, we cannot hold that "suit as to one is suit as to all." Thus, we disagree with the district court that Rigsby's State Farm and Allstate allegations and generic naming of two other insurers, by itself, triggers the first-to-file bar as to Branch's specific allegations against other insurers that Rigsby did not name. Accordingly, we affirm the district court's dismissal as to State Farm and Allstate and reverse the dismissal as to all other Defendants. Because factual findings may be appropriate with respect to the public disclosure ground urged by the remaining Defendants in the alternative, we remand the cause so the district court can consider that ground in the first instance. We also *374 remand so the district court can consider in the first instance the remaining Defendants' argument that Branch's pleading is deficient under FED.R.CIV.P. 9(b).

I. FACTS

Relator Branch brought this action against eight insurance companies and six adjusting firms on behalf of the United States under the qui tam provisions of the FCA.[2] The insurer Defendants are participants in FEMA's Write-Your-Own flood insurance program (the WYO program). This program allows private insurance companies to write and service, in their own names, the federally backed Standard Flood Insurance Policy (SFIP). Participants in the WYO program are responsible for determining the extent of an insured's flood damage, which in turn determines the amount of benefit ultimately paid out by the Federal Treasury. See Wright v. Allstate Ins. Co., 415 F.3d 384, 386 (5th Cir.2005) (noting that payments on SFIP claims are a direct charge on the United States Treasury). While the program has rules applicable to all insurers in the program, the program does not involve coordinated efforts by or joint cooperation among the participating insurers.

To ensure accurate estimates of flood damage, WYO insurers are generally required to comply with certain conditions, such as submitting a proof of loss. Following Hurricane Katrina, however, FEMA was forced to waive certain of these requirements in order to expedite payments to insureds. According to Branch, this created a perverse incentive for WYO insurers to understate losses due to wind (which an insurer would be required to pay under the insured's homeowner's policy) and overstate losses due to flood, thereby shifting the loss from the WYO insurers to the federal government.

A. The Rigsby Complaint

On April 2, 2006, prior to the filing of Branch, Cori and Kerri Rigsby, employees of a company that provides disaster claims management services for several WYO insurers, filed an FCA claim alleging that four insurance companies defrauded the federal government by mischaracterizing wind damage as flood damage in the wake of Hurricane Katrina.[3] Specifically, the Rigsbys alleged that, while adjusting claims for certain WYO insurers, they learned that the insurers "made a corporate decision to misdirect and misallocate claims from those of hurricane coverage to flood claims" payable by the federal government. While the Rigsbys lodged these general allegations of wind/water fraud against four WYO insurers,[4] the only specific instances of fraud alleged in their complaint concerned defendant State Farm.

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
560 F.3d 371, 2009 U.S. App. LEXIS 3503, 2009 WL 388947, Counsel Stack Legal Research, https://law.counselstack.com/opinion/us-ex-rel-branch-consultants-v-allstate-ins-co-ca5-2009.