Justia Class Action Opinion Summaries

Steve Sangwin, a State employee, was a qualified subscriber and beneficiary of the State of Montana Employee Benefits Plan (Plan), which was administered by Blue Cross and Blue Shield of Montana (BCBS). Steve's daughter, McKinley, was also a beneficiary under the Plan. This case arose after BCBS denied a preauthorization request for a medical procedure for McKinley on the grounds that the procedure was "experimental for research." Steve and his wife (collectively, the Sangwins) initiated this action by filing an amended complaint setting forth five counts, including a request for certification of a class action. The Sangwins defined class members as other beneficiaries of the Plan who had their employee benefits denied by the State based on the experimental exclusion for research in the past eight years. The district court granted the Sangwins' motion for class certification. The State appealed. The Supreme Court (1) affirmed the district court's order defining the class; but (2) reversed and remanded with respect to the question certified for class treatment, holding that the district court abused its discretion in specifying for class treatment the question of whether the State breached its contract of insurance with the plaintiffs.View "Sangwin v. State" on Justia Law

This interlocutory appeal arose from the district court's order certifying a class in Plaintiff's class action against Defendant, Allstate Insurance Company. Plaintiff's class action claim arose out of the Supreme Court's remand of his initial non-class third-party claim against Allstate in Jacobsen I. In Jacobsen I, Plaintiff filed a complaint against Allstate for, among other causes of action, violations of the Montana Unfair Trade Practices Act. Plaintiff sought both compensatory and punitive damages. The Supreme Court ultimately remanded the case for a new trial. On remand, Plaintiff filed a motion for class certification, proposing a class definition encompassing all unrepresented individuals who had either third- or first-party claims against Allstate and whose claims were adjusted by Allstate using its Claim Core Process Redesign program. The district court certified the class. The Supreme Court affirmed the class certification but modified the certified class on remand, holding that the district court did not abuse its discretion by certifying the Mont. R. Civ. P. 23(a)(2) class action but that the certification of class-wide punitive damages was inappropriate in the context of a Rule 23(b)(2) class. Remanded. View "Jacobsen v. Allstate Ins. Co." on Justia Law

Plaintiffs filed a putative class action lawsuit against Black Hills Federal Credit Union and CUNA Mutual Insurance Society for changing their credit disability insurance policy. The complaint alleged that Defendants wrongfully switched the credit disability insurance policies of 4,461 borrowers. Plaintiffs filed a motion for class certification, but the trial court denied the motion, finding that Plaintiffs did not meet the adequacy requirement or the predominance and superiority requirements of the class certification statutes. The Supreme Court reversed, holding that the trial court erred in its application of the class certification statutes to the facts in this case. Remanded for certification of the class.View "Thurman v. CUNA Mut. Ins. Soc'y" on Justia Law

A class of Plaintiffs brought suit against Insured, a hotel proprietor, alleging that Insured violated the Telephone Consumer Protection Act (TCPA). The class and Insured subsequently reached a settlement. The class then filed a garnishment action against Insurer. Insurer sought a declaratory judgment that its policy with Insured did not provide coverage because the policy did not cover damages awarded related to the TCPA. The trial found (1) Insurer owed Insured a duty to defend in the class actions because the class's claims were covered under the policy; and (2) Insurer had a duty to indemnify Insured for the full settlement plus interest. The Supreme Court affirmed, holding (1) the trial court correctly determined that Insurer wrongly refused to defend Insured under its policy coverage; (2) Insurer was not entitled to a reassessment of the reasonableness of the settlement; and (3) policy limits did not bar Insurer's indemnification of the settlement.View "Columbia Cas. Co. v. HIAR Holding, LLC" on Justia Law

Plaintiff, who carried health insurance through New West Health Services (New West), was injured in an automobile accident resulting in medical expenses totaling approximately $120,000. The tortfeasor's insurer paid approximately $100,000 of Plaintiff's medical bills. Plaintiff later filed a complaint against New West alleging individual and class claims, asserting that New West failed to pay approximately $100,000 of her medical expenses because the third party liability carrier had paid the majority of the bills. The district court certified the class complaint. The Supreme Court affirmed, holding that the district court did not abuse its discretion by adopting the class definition proposed by Plaintiff and denying New West's motion to modify the class definition.View "Rolan v. New West Health Servs." on Justia Law

In Feeney II, the Massachusetts Supreme Court affirmed the ruling of the superior court invalidating a class action waiver in the parties' arbitration agreement, holding that the Federal Arbitration Act (FAA) does not foreclose a court from invalidating an arbitration agreement that includes a class action waiver if it effectively denies the plaintiffs a remedy. The U.S. Supreme Court subsequently issued an opinion in American Express Co. v. Italian Colors Restaurant (Amex) holding that a class action waiver in an arbitration agreement is enforceable under the FAA even if a plaintiff proves that the class waiver effectively precludes the plaintiff from vindicating his federal statutory rights. The Massachusetts Supreme Court subsequently concluded that following Amex, the Court's analysis in Feeney II no longer comported with the U.S. Supreme Court's interpretation of the FAA, holding instead that a class waiver may not be invalidated on the grounds that it effectively denies the plaintiffs a remedy. Remanded.View "Feeney v. Dell Inc. " on Justia Law

Several insureds filed a class action against the predecessor of Washington National Insurance Corporation concerning insurance policies that provide for reimbursement of certain home health care expenses. The district court granted summary judgment for the insureds, concluding that various provisions in the policy, including a certificate schedule, demonstrated an ambiguity concerning whether an automatic increase applied only to the daily benefit or also applied to the lifetime maximum benefit amount and the per occurrence maximum benefit amount. Because there was ambiguity in the policy, the court of appeal certified questions of law to the Florida Supreme Court, which held (1) because the policy was ambiguous, it must be construed against the insurer and in favor of coverage without consideration of extrinsic evidence; and (2) when so construed, the policy's automatic benefit increase applies to the daily benefit, the lifetime maximum benefit, and the per occurrence maximum benefit.View "Washington Nat'l Ins. Corp. v. Ruderman" on Justia Law

This suit was filed as a putative class action on behalf of Texas royalty owners alleging that Phillips Petroleum Company underpaid oil and gas royalties. The trial court certified three subclasses of royalty owners. The court of appeals reversed. The Supreme Court affirmed as to two of the subclasses but reversed as to the third subclass, which alleged breach of a uniform express royalty provision contained in gas royalty agreements that amended the class members' leases. On remand, Respondent, class representative of the remaining subclass, amended her petition to add a claim for breach of the implied covenant to market. Phillips unsuccessfully filed various motions contending that there was no class claim for breach of the implied covenant to market. The court of appeals dismissed Phillips' interlocutory appeal for lack of jurisdiction and denied Phillips' petition for writ of mandamus. The Supreme Court reversed, holding (1) the court of appeals erred in dismissing the interlocutory appeal for lack of jurisdiction; and (2) the trial court abused its discretion in allowing the addition of a class claim for breach of the implied covenant to market without requiring Respondent to file an amended motion for class certification or holding a certification hearing.View "Phillips Petroleum Co. v. Yarbrough" on Justia Law

Plaintiffs filed a class action complaint against a check advance company, asserting claims based on numerous Florida statutes. Plaintiffs later amended the complaint to add Tiffany Kelly as an additional plaintiff and named class member. Because Kelly had signed the version of Defendant's arbitration agreement that contained a class action waiver, this case focused on her contracts with Defendant. The trial court eventually denied Defendant's motion to compel arbitration, ruling that the class action waiver was unenforceable because it was void as against public policy. The court of appeal affirmed, finding that no other reasonable avenue for relief would be available if it enforced the class action waiver. After the court of appeal decided this case, the U.S. Supreme Court issued its decision in AT&T Mobility, LLC v. Concepcion. Applying the rationale of Concepcion to the facts set forth in this case, the Supreme Court quashed the court of appeal's decision, holding that the Federal Arbitration Act preempted invalidating the class action waiver in this case on the basis of the waiver being void as against public policy.View "McKenzie Check Advance of Fla., LLC v. Betts" on Justia Law

Plaintiff was injured in an automobile accident and received medical treatment at Benefis Health System, Inc. Plaintiff had healthcare coverage as a TRICARE beneficiary and also had medical payments coverage through his insurance carrier, Kemper. Plaintiff's medical treatment costs totaled $2,073. Benefis accepted $662 from TRICARE as payment in full satisfaction of the bill pursuant to a preferred provider agreement (PPA) between Blue Cross Blue Shield and Benefis. Benefis subsequently received $1,866 from Kemper, upon which Benefis reimbursed TRICARE's payment in full. Plaintiff filed an individual and class action complaint, claiming that he was entitled to the additional $1,204 that Benefis received from Kemper over and above the TRICARE reimbursement rate. Plaintiff filed a motion for judgment on the pleadings, asking the district court to find Benefis breached its contract with TRICARE and that Benefis was liable for Plaintiff's damages. The district court converted the motion into a motion for summary judgment and granted summary judgment to Plaintiff. The Supreme Court reversed the grant of summary judgment, holding (1) Plaintiff was not entitled to pocket the difference between the TRICARE reimbursement rate and the amount Benefis accepted from Kemper; and (2) Plaintiff failed to establish any damages that resulted from the alleged breach. View "Conway v. Benefis Health Sys., Inc." on Justia Law