McCracken v. Progressive Direct Ins. Co.
Opinion
The plaintiffs in these consolidated appeals each settled a claim under their automobile-insurance policies with the defendants. But now the plaintiffs maintain that the defendants illegally reduced their settlement offers by taking into account certain benefits they had previously paid the plaintiffs. The district courts dismissed the plaintiffs' putative class-action lawsuits after concluding the plaintiffs each waived their rights to collect further damages from the defendants on their settled claims.
*1168 We reverse in part and remand to the district court with instructions to vacate its judgment in favor of USAA Casualty Insurance Company because it lacked jurisdiction to hear the claims against that defendant. Otherwise, we affirm.
Background
I. Legal Background
These cases involve the interplay between two categories of automobile insurance that insurers must offer under Colorado law: uninsured/underinsured-motorist (UM/UIM) coverage and medical payments (MedPay) coverage.
See
In 2007, the Colorado legislature amended its insurance law to mandate that "the amount of the coverage available" under UM/UIM policies "shall not be reduced by a setoff from any other coverage, including" MedPay.
1
An Act Concerning the Payment of Uninsured Motor Vehicle Insurance as Excess to Other Insurance, § 1,
*1169
But in November 2016, the Colorado Supreme Court issued an opinion that contravened this understanding.
See
Calderon v. Am. Family Mut. Ins. Co.
,
The plaintiff appealed, and the Colorado Court of Appeals held that the setoff was proper under § 10-4-609(1)(c).
II. Factual Background
The plaintiffs in the cases before us each settled a UM/UIM claim after § 10-4-609(1)(c) 's effective date but before the Colorado Supreme Court issued Calderon . The parties thus reached these settlements under the pre- Calderon understanding of § 10-4-609(1)(c).
A. Archuleta's Claim and Settlement
Jerry Archuleta held an insurance policy from the United Services Automobile Association (USAA). The policy included $5,000 in MedPay coverage and $50,000 per person in UM/UIM coverage. Archuleta submitted claims to USAA for MedPay and UM/UIM benefits in November 2012 after an underinsured driver injured him in a collision. USAA paid Archuleta $5,000 to satisfy his MedPay claim. It then paid Archuleta $17,000 in May 2015 to settle his UM/UIM claim.
The parties agree that when USAA calculated this settlement, it took a $5,000 setoff to account for the MedPay benefits it had previously paid Archuleta. In other words, USAA determined that Archuleta incurred $22,000 in injuries and then reduced that amount by the $5,000 it had already paid, arriving at $17,000. Archuleta accepted the $17,000 settlement and signed a form "releas[ing][ ] and forever discharg[ing]" USAA "from any and all claims" he had arising from the November 2012 collision. App. 679.
B. Hecht's Claim and Settlement
Christa Hecht held an auto insurance policy from Progressive Preferred Insurance Company. Hecht's policy included $5,000 in MedPay coverage and $25,000 per person in UM/UIM coverage. Hecht submitted MedPay and UM/UIM claims in August 2013 after an uninsured driver injured her in a collision. Progressive Preferred fulfilled Hecht's MedPay claim and then reached an agreement with her to settle her UM/UIM claim for $21,678. The parties agree that when Progressive Preferred *1170 calculated this settlement, it took a setoff to reflect the MedPay benefits it had previously paid Hecht. 3 Hecht also signed a form acknowledging that the payment was "in full settlement and final discharge of all claims" arising from the August 2013 collision. App. 143.
C. McCracken's Claim and Settlement
Brenda McCracken held an insurance policy from Progressive Direct Insurance Company. McCracken's policy included $10,000 in MedPay coverage and $50,000 in UM/UIM coverage. McCracken submitted claims to Progressive Direct for MedPay and UM/UIM benefits in August 2015 after an uninsured driver injured her in a collision. Progressive Direct fulfilled McCracken's MedPay claims and initially paid her $30,959 for her UM/UIM claim. In September 2016, McCracken and Progressive Direct agreed to settle her final UM/UIM claim for a total of $41,000; Progressive Direct paid McCracken an additional $10,041 to satisfy this settlement.
The parties agree that the settlement incorporates a $5,000 setoff Progressive Direct took to reflect the MedPay benefits it previously paid to McCracken. 4 Upon receiving the final payment from Progressive Direct, McCracken signed a form entitled "Full Release and Trust Agreement" in which she acknowledged receiving $41,000 "in full settlement and final discharge of a disputed claim" arising out of the August 2015 collision. App. 128.
III. Proceedings Below
A. Archuleta v. USAA
Archuleta sued USAA and USAA Casualty in Colorado state court on November 11, 2016-four days after the Colorado Supreme Court decided Calderon . Archuleta alleged that USAA violated § 10-4-609(1)(c) by taking the MedPay setoff into account when it calculated his UM/UIM settlement. He asked the court for damages for breach of contract and a declaratory judgment that averred USAA wrongly denied him UM/UIM benefits. He further purported to represent a class of similarly situated plaintiffs who also settled UM/UIM claims with USAA or USAA Casualty for amounts that took into account setoffs for prior MedPay benefits.
The insurers removed Archuleta's lawsuit to federal district court. 5 They then moved for judgment on the pleadings, arguing that Archuleta released his right to collect further damages when he accepted the $17,000 settlement for his UM/UIM claim. Archuleta acknowledged he signed a release but argued that, in the wake of Calderon , the release was unenforceable as *1171 a violation of public policy. The district court enforced the release and ruled for the insurers. Archuleta appeals.
B. McCracken & Hecht v. Progressive
About a week after Archuleta filed his lawsuit, McCracken and Hecht jointly sued Progressive Direct and Progressive Preferred in Colorado state court. Like Archuleta, McCracken and Hecht alleged that the insurers violated § 10-4-609(1)(c) by taking into account MedPay setoffs when calculating their settlements. McCracken and Hecht also sought damages for breach of contract, requested a declaratory judgment that averred the insurers wrongfully withheld UM/UIM benefits from them, and purported to represent a class of plaintiffs with similar claims against Progressive Direct and Progressive Preferred.
The insurers removed McCracken and Hecht's lawsuit to federal district court. 6 McCracken and Hecht moved for partial summary judgment on (1) whether Calderon applied retroactively, (2) whether their releases were unenforceable as a matter of public policy, and (3) whether the district court was required to reform their insurance contracts. The insurers responded with a cross-motion for full summary judgment on the theory that the releases McCracken and Hecht each signed precluded their claims and, alternatively, that Calderon didn't apply retroactively. After hearing arguments, the district court ruled from the bench that the releases were enforceable and granted summary judgment to the insurers.
McCracken and Hecht appealed, and we consolidated their appeal with Archuleta's appeal for the purpose of briefing.
Analysis
I. Archuleta's Standing to Sue USAA Casualty
As a preliminary matter, we sua sponte correct a jurisdictional error in the judgment in Archuleta's case below.
See
City of Colo. Springs v. Climax Molybdenum Co.
,
The district court ruled that Archuleta lacked standing to sue USAA Casualty because his "personal allegations concern only USAA," not USAA Casualty. App. 771. Archuleta doesn't challenge this conclusion on appeal, so we won't revisit it either.
See
Petrella v. Brownback
,
*1172 II. Merits Against the Remaining Defendants
We review both of the orders below de novo.
See
Hall v. Conoco, Inc.
,
A. The Releases
The plaintiffs do not dispute that they each signed a release waiving further claims against the defendants. Nor do they dispute that their present lawsuits fall within the scope of those releases or that, if the releases are enforceable, they bar the plaintiffs' claims. Thus, the purely legal question before us is whether those releases are enforceable under Colorado law.
See
Racher v. Westlake Nursing Home Ltd. P'ship
,
"A release is the relinquishment of a claim to the party against whom such claim was enforceable."
CMCB Enters., Inc. v. Ferguson
,
The plaintiffs argue the releases violate Colorado public policy and are therefore void. "Colorado courts will not enforce a contract that violates public policy."
Rademacher v. Becker
,
The plaintiffs assert that § 10-4-609(1)(c) and
Calderon
signal Colorado's strong public policy for ensuring that UM/UIM policyholders are fully compensated for their claims.
7
Thus, they maintain, their releases are void for violating public policy
*1173
because the releases prevent them from receiving all the UM/UIM benefits they're entitled to-that is, what they would've received without the MedPay setoffs. But after the close of briefing and oral argument in this case, the Colorado Court of Appeals held that the policy interests behind § 10-4-609(1)(c) and
Calderon
do not override the interest in enforcing a release signed pursuant to a negotiated settlement.
See
Arline v. Am. Family Mut. Ins. Co.
, --- P.3d ----,
B. Arline
In
Arline
, the Colorado Court of Appeals resolved an issue that was identical in all relevant respects to the issue before us here: whether a pre-
Calderon
release that took a MedPay setoff into account and that the plaintiff signed pursuant to a UM/UIM settlement was enforceable in light of
Calderon
.
See
The
Arline
court then noted the countervailing policy interests in favor of encouraging the settlement of disputes.
See
Decisions of the Colorado Court of Appeals don't bind us. But we may only disregard them if we're "convinced by other persuasive data" that the Colorado Supreme Court would reach a different result.
Stickley v. State Farm Mut. Auto. Ins. Co.
,
In determining whether the Colorado Supreme Court would reach a different result than the Colorado Court of Appeals reached in
Arline
, one potentially relevant data point is
Calderon
's interpretation of § 10-4-609(1)(c). But although
Calderon
tees up the plaintiffs' argument, it doesn't resolve it. Instead, as the
Arline
court recognized, nothing in § 10-4-609 or
*1174
Calderon
addressed whether parties can agree to a setoff as part of a settlement over a disputed claim.
See
Arline
, --- P.3d at ----,
Thus, when
a court
calculates how much an insurer owes a policyholder in UM/UIM benefits,
that court
cannot take prior MedPay benefits into account.
See
The Colorado Supreme Court's decision in
Kral v. American Hardware Mutual Insurance Co.
,
The plaintiff sued for a declaratory judgment that averred the release-trust agreement was void for violating public policy.
*1175
The plaintiffs here argue
Kral
shows that the policy in favor of ensuring full compensation for UM/UIM claims is so strong that parties cannot contract around it, even when settling an existing claim that the parties have had a full and fair opportunity to valuate. We disagree. In distinguishing the facts before it in
Arline
from those before the Colorado Supreme Court in
Kral
, the Colorado Court of Appeals pointed out that the plaintiff in
Arline
-like the plaintiffs in this case and unlike the plaintiff in
Kral
-challenged the method the parties used to calculate their net settlement, not any actual term of the release.
Arline
, --- P.3d at ----,
Moreover, even if the parties here had explicitly agreed to the setoff in the terms of the releases, we're not convinced that
Kral
would render the releases void. As the Colorado Court of Appeals in
Arline
recognized, "
Kral
does not hold that insured parties are required to accept nothing less than full compensation for their losses."
Rather, we read
Kral
as saying that parties to a UM/UIM dispute cannot include a provision in a settlement agreement that necessarily decreases the settlement below the bilaterally agreed upon value of the plaintiff's claim. The parties in
Kral
agreed that the full value of the plaintiff's UM/UIM claim was the full amount of the UM/UIM coverage-$30,000; thus, any amount the plaintiff subsequently reimbursed to the insurer would have reduced the plaintiff's benefits below the full value of the claim.
See
Put differently, the insurer's error in
Kral
was that it bilaterally agreed upon a settlement amount with the plaintiff and then attempted to reduce the plaintiff's benefits below that amount. Here, the insurers unilaterally took the MedPay setoffs into account when calculating their offers, but didn't attempt to further reduce the payments below the value that the plaintiffs accepted.
Kral
doesn't limit what parties can and cannot take into account when assessing the value of their claims.
See
In sum, we're not "convinced by other persuasive data" that the Colorado Supreme Court would disagree with the Colorado Court of Appeals' decision in
Arline
.
Stickley
,
Conclusion
We reverse the judgment in Archuleta v. USAA insofar as it dismissed Archuleta's claims against USAA Casualty with prejudice. As the district court ruled, Archuleta *1176 lacked standing to bring those claims. Accordingly, it did not have jurisdiction to hear them. We therefore remand to the district court with instructions to dismiss those claims without prejudice for lack of jurisdiction. Otherwise, we affirm the remainder of that judgment and affirm the judgment in McCracken & Hecht v. Progressive in its entirety.
A setoff is "[a] debtor's right to reduce the amount of a debt by any sum the creditor owes the debtor." Setoff , Black's Law Dictionary (10th ed. 2014). Thus, in this context, a setoff is an amount by which an insurer reduces a policyholder's claim to account for other benefits for which the policyholder must reimburse the insurer.
One trial court offered the following illustration of this interpretation of § 10-4-609(1)(c) :
For example, if a driver has a liability policy that provides $5,000 in [MedPay] coverage and a separate UM/UIM policy that provides an additional $25,000 in medical coverage, the $25,000 in coverage cannot be reduced by the $5,000 policy. Thus, if the insured sustains $30,000 in medical expenses, the insured is entitled to full payment of the total amount because the insured has $30,000 in coverage ($5,000 + $25,000). Alternatively, if the insured sustains only $10,000 in expenses, she is not entitled to receive $5,000 from the first policy AND $10,000 from the second policy. Such an interpretation would result in an improper double recovery.
Carrion- Kozak , slip op. at 3.
The record doesn't reflect how much Progressive Preferred paid Hecht in MedPay benefits.
The record doesn't reflect how much Progressive Direct paid McCracken in MedPay benefits.
USAA and USAA Casualty asserted the Class Action Fairness Act of 2005 (CAFA) as the basis for the district court's jurisdiction.
See
Progressive Direct and Progressive Preferred asserted in their notice of removal that, by their calculations, they took almost $7 million in MedPay setoffs from more than 1,000 UM/UIM claimants. They further asserted that they were both citizens of Ohio while McCracken was a citizen of Colorado and Hecht was a citizen of New Jersey.
The parties focus much of their briefing on the question of whether Calderon applies retroactively to the plaintiffs' settlements and thus bears on the releases' enforceability at all. But because we ultimately conclude that the releases bar the plaintiffs' claims even taking Calderon into account, we don't consider whether Calderon is retroactively applicable.
Reference
- Full Case Name
- Brenda MCCRACKEN; Christa Hecht, Individually and on Behalf of All Others Similarly Situated, Plaintiffs-Appellants, v. PROGRESSIVE DIRECT INSURANCE COMPANY; Progressive Preferred Insurance Company, Defendants-Appellees. Jerry Archuleta, Individually and on Behalf of All Others Similarly Situated, Plaintiff-Appellant, v. USAA Casualty Insurance Company; United Services Automobile Association, Defendants-Appellees.
- Cited By
- 11 cases
- Status
- Published