Justia Civil Procedure Opinion Summaries
Ghazarian v. Magellan Health
Plaintiffs Rafi Ghazarian and Edna Betgovargez had a son, A.G., with autism. A.G. received applied behavior analysis (ABA) therapy for his autism under a health insurance policy (the policy) plaintiffs had with defendant California Physicians’ Service dba Blue Shield of California (Blue Shield). Mental health benefits under this policy are administered by defendants Magellan Health, Inc. and Human Affairs International of California (collectively Magellan). By law, the policy had to provide A.G. with all medically necessary ABA therapy. Before A.G. turned seven years old, defendants Blue Shield and Magellan approved him for 157 hours of medically necessary ABA therapy per month. But shortly after he turned seven, defendants denied plaintiffs’ request for 157 hours of therapy on grounds only 81 hours per month were medically necessary. Plaintiffs requested the Department of Managed Health Care conduct an independent review of the denial. Two of the three independent physician reviewers disagreed with the denial, while the other agreed. As a result, the Department ordered Blue Shield to reverse the denial and authorize the requested care. Plaintiffs then filed this lawsuit against defendants, asserting breach of the implied covenant of good faith and fair dealing against Blue Shield, and claims for intentional interference with contract and violations of Business and Professions Code section 17200 (the UCL) against defendants. Defendants each successfully moved for summary judgment. As to the bad faith claim, the trial court found that since one of the independent physicians agreed with the denial, Blue Shield acted reasonably as a matter of law. As to the intentional interference with contract claim, the court found no contract existed between plaintiffs and A.G.’s treatment provider with which defendants could interfere. Finally, the court found the UCL claim was based on the same allegations as the other claims and thus also failed. After its review, the Court of Appeal concluded summary judgment was improperly granted as to the bad faith and UCL claims. "[I]t is well established that an insurer may be liable for bad faith if it unfairly evaluates a claim. Here, there are factual disputes as to the fairness of defendants’ evaluation. . . .There are questions of fact as to the reasonability of these standards. If defendants used unfair criteria to evaluate plaintiffs’ claim, they did not fairly evaluate it and may be liable for bad faith." Conversely, the Court found summary judgment proper as to the intentional interference with contract claim because plaintiffs failed to show any contract with which defendants interfered. View "Ghazarian v. Magellan Health" on Justia Law
Holley v. Silverado Senior Living Management
Defendants Silverado Senior Living Management, Inc., and Subtenant 350 W. Bay Street, LLC dba Silverado Senior Living – Newport Mesa appealed a trial court's denial of its petition to compel arbitration of the complaint filed by plaintiffs Diane Holley, both individually and as successor in interest to Elizabeth S. Holley, and James Holley. Plaintiffs filed suit against defendants, who operated a senior living facility, for elder abuse and neglect, negligence, and wrongful death, based on defendants’ alleged substandard treatment of Elizabeth. More than eight months after the complaint was filed, defendants moved to arbitrate based on an arbitration agreement Diane had signed upon Elizabeth’s admission. At the time, Diane and James were temporary conservators of Elizabeth’s person. The court denied the motion, finding that at the time Diane signed the document, there was insufficient evidence to demonstrate she had the authority to bind Elizabeth to the arbitration agreement. Defendants argued the court erred in this ruling as a matter of law, and that pursuant to the Probate Code, the agreement to arbitrate was a “health care decision” to which a conservator had the authority to bind a conservatee. Defendants relied on a case from the Third District Court of Appeal, Hutcheson v. Eskaton FountainWood Lodge, 17 Cal.App.5th 937 (2017). After review, the Court of Appeal concluded that Hutcheson and other cases on which defendants relied are distinguishable on the facts and relevant legal principles. "When the Holleys signed the arbitration agreement, they were temporary conservators of Elizabeth’s person, and therefore, they lacked the power to bind Elizabeth to an agreement giving up substantial rights without her consent or a prior adjudication of her lack of capacity. Further, as merely temporary conservators, the Holleys were constrained, as a general matter, from making long-term decisions without prior court approval." Accordingly, the trial court was correct that the arbitration agreement was unenforceable as to Elizabeth. Furthermore, because there was no substantial evidence that the Holleys intended to sign the arbitration agreement on their own behalf, it could not be enforced against their individual claims. The Courttherefore affirmed the trial court’s order denial to compel arbitration. View "Holley v. Silverado Senior Living Management" on Justia Law
Vickers v. Idaho Bd of Veterinary Medicine
Kirby Vickers filed a grievance letter with Idaho Board of Veterinary Medicine (the Board”) against a veterinarian requesting that they take various disciplinary actions. After an investigation, the Board declined to take any action against the veterinarian. Vickers then filed suit in district court, seeking to compel the Board to hold a hearing. The district court dismissed his suit for lack of subject-matter jurisdiction. On appeal, Vickers argued his letter to the Board initiated a contested action for which he was entitled to judicial review. To this, the Idaho Supreme Court disagreed, finding that a private citizen could not initiate a "contested case" with a grievance letter. Vickers points to the language in caselaw: “[t]he filing of a complaint initiates a contested case,”to argue that any public citizen could file a complaint pursuant to Idaho Rule of Administrative Procedure of the Attorney General (“IDAPA”) 04.11.01.240.02 and begin a contested case. However, the Supreme Court found both the Administrative Procedures Act (APA) and the corresponding IDAPA rules, addressed only agency actions. "Vickers cannot apply these rules to his grievance letter, even if it was referred to as a “complaint” in correspondence from the Board, because it is not an agency action under the APA or IDAPA." The Court affirmed the district court's order dismissed this case for lack of subject-matter jurisdiction. View "Vickers v. Idaho Bd of Veterinary Medicine" on Justia Law
Davis v. Tuma
While living in California, Jefri and Debbie Davis sought to purchase a home in northern Idaho, and hired Charles Tuma and Tuma’s broker, Donald McCanlies, to help them. Tuma and McCanlies both worked for Johnson House Company, which in turn was doing business as Coldwell Banker Resort Realty. Some years after purchasing the property in question, the Davises learned that the road they believed provided access to their home, did not in fact do so. The Davises filed suit against Tuma, McCanlies, and Coldwell Banker Resort Realty (collectively, the Defendants), alleging fraud and constructive fraud. The Defendants moved for summary judgment against the Davises. The Davises responded, filing several declarations, portions of which the Defendants moved to strike. The Davises also sought to amend their complaint to add claims for unlicensed practice of law, surveying, or abstracting; and breach of contract and violation of contractual duties. The district court granted the Defendants’ motions for summary judgment and to strike, but did not specifically identify which statements were being stricken. The district court also denied the Davises’ motion to amend their complaint without explanation of the reasoning behind the decision. The Idaho Supreme Court found genuine issues of material facts to preclude the grant of summary judgment to Defendants. Further, the Court concluded the district court abused its discretion in denying the Davises' motion to amend their complaint. The Court vacated the trial court judgment entered and remanded for further proceedings. View "Davis v. Tuma" on Justia Law
Hinkson v. Stevens
Plaintiff lived in Stowe, Vermont with her husband C.D. and their teenage daughter. Plaintiff and her husband co-founded a business, Transegy, LLC, that provided leadership development and executive coaching. Plaintiff worked from a home office and used her personal cell phone number as the contact number for the business. C.D. previously worked at a company called Inntopia. Defendant lived in Stowe, Vermont as a writer, political strategist and media consultant who had a “reputation as an aggressive operator in his professional pursuits.” He was in a romantic relationship with L.S., who also lived in Stowe and had a teenage son who attended high school in the same class as plaintiff’s daughter. Sometime in 2017, C.D. had a sexual encounter with L.S., who had been exploring potential employment opporunities with Inntopia. Shortly after the incident, L.S. reported to defendant that C.D. sexually assaulted her. L.S. filed a sexual-harassment lawsuit against C.D. and Inntopia, which settled in May 2017. As part of the settlement, L.S. signed a nondisclosure agreement. Plaintiff was unaware of L.S.’s allegations and her husband’s infidelity until the lawsuit settled. Shortly before the settlement, plaintiff began receiving numerous calls from a number with no caller ID. Evidence at trial showed that between April 2017 and March 2018, defendant called her cell phone twenty-six times from a masked number. Defendant also called C.D.’s cell phone repeatedly during this period. In total, he called or texted plaintiff’s and C.D.’s cell phones a total of 151 times. Many of the phone calls took place in the evening, including calls after ten or eleven p.m. Ultimately, plaintiff filed a complaint for Order Against Stalking against defendant. Defendant appealed a final stalking order requiring him to stay 300 feet away from plaintiff. He argued that his conduct of: (1) calling plaintiff’s cell phone repeatedly from a number with no caller ID; (2) sending three shipments of books addressed to her husband to the house she and her husband shared, including primarily books about rape; and (3) watching her in a coffee shop for an unspecified period of time, could not be considered stalking under the civil stalking statute, 12 V.S.A. 5131. Construing the terms of section 5131 narrowly because it mirrored the criminal stalking statute, the Vermont Supreme Court concluded that defendant’s conduct in this case did not rise to the level of stalking, and therefore reversed. View "Hinkson v. Stevens" on Justia Law
Golden v. Worthington
Father, Joe Golden, challenged a family division magistrate’s order requiring him to continue paying child support past his son S.W.’s eighteenth birthday while S.W. was enrolled in a home-study program. Father argued that the magistrate erred in finding that S.W.’s home-study program qualified as high school under the 2002 child-support order and in ordering him to continue paying child support on that basis. Resolving this dispute required review of the evidentiary record, as well as a review of the magistrate’s findings, analysis, and conclusions. The Vermont Supreme Court found father, appearing pro se, did not provide any record of the trial court's proceedings. "Because we lack a sufficient record to review the magistrate’s order, we have no basis on which to disturb it." View "Golden v. Worthington" on Justia Law
Sellers v. Nationwide Mutual Fire Insurance Co.
Nationwide appealed both the district court's order denying Nationwide's motion in limine and the final judgment entered in favor of plaintiff, as assignee of Gary Gardner & Gary Gardner Builders, Inc. At issue is the preclusive effect of a judgment entered by a federal court exercising diversity jurisdiction on a nonparty to an earlier federal action. The Eleventh Circuit held that when determining the preclusive effect of an earlier judgment rendered by a federal court exercising diversity jurisdiction, federal common law adopts the rules of issue preclusion applied by the State in which the rendering court sits. In this case, the court held that the district court was required to apply Alabama's rules of issue preclusion. Instead, the district court applied a federal rule of issue preclusion and that federal rule is not substantively similar to Alabama's rule on nonparty issue preclusion. Therefore, the court reversed the district court's order denying Nationwide's motion in limine, vacated the final judgment in favor of plaintiff, and remanded for further proceedings. View "Sellers v. Nationwide Mutual Fire Insurance Co." on Justia Law
Frank v. Target Corp.
Named plaintiffs filed a putative class action in Illinois, alleging that defendants made false claims about dietary supplements. The parties negotiated a settlement. Over the objection of class member Frank, the district court approved it. The Seventh Circuit reversed. In 2015, the parties submitted “the Pearson II settlement.” Three class members objected to the Pearson II settlement. Nunez had filed his own putative class action against the defendants in California. After the Seventh Circuit vacated the first Pearson settlement, Nunez wanted to represent a Pearson subclass. The Pearson parties refused to include Nunez’s counsel in their negotiations. Nunez objected to the Pearson II settlement. The district court approved it. All three objectors appealed, then dismissed their appeals. Frank moved for disgorgement of any payments made to objectors in exchange for those dismissals. Discovery showed that the objectors had received side payments in exchange for dismissing their appeals. The district court denied disgorgement. The Seventh Circuit reversed. The district court had the equitable power to order the settling objectors to disgorge for the benefit of the class the proceeds of their private settlements. “Falsely flying the class’s colors, these three objectors extracted $130,000 in what economists would call rents from the litigation process simply by showing up and objecting" to the settlement.” Settling an objection that asserts the class’s rights in return for a private payment to the objector is inequitable and disgorgement is the most appropriate remedy. Those objectors are, in essence, “not paid for anything they owned.” View "Frank v. Target Corp." on Justia Law
Taylor Construction Company, Inc. v. Superior Mat Company, Inc.
Michael Montgomery, an employee of Taylor Construction working as a truck dispatcher, called Superior Mat Company, Inc. to rent mats for Taylor Construction’s use. From June 9, 2017, to June 27, 2017, Taylor employees drove to Superior’s location in Covington County, Mississippi, and picked up several hundred mats. Taylor Construction trucks returned the mats to Covington County on July 17, 2017. Superior alleged the mats came back in varying degrees of dirtiness or, in some cases, damaged beyond repair. Taylor Construction paid Superior for the mats until Superior additionally billed Taylor Construction for the mats it alleged Taylor Construction did not return. Taylor Construction later stopped payment on all invoices from Superior. Superior filed suit against Taylor Construction at the Covington County Circuit Court, alleging breach of contract, open account, quantum meruit, and bad-faith breach of contract. Taylor Construction filed its answer along with a motion to transfer venue under Rule 82(d). After hearing arguments, the circuit court denied Taylor Construction’s motion. Taylor Construction appealed, but finding the record demonstrated credible evidence that substantial events or acts occurred in Covington County, the Mississippi Supreme Court affirmed. View "Taylor Construction Company, Inc. v. Superior Mat Company, Inc." on Justia Law
Southern Farm Bureau Life Ins. Co. v. Thomas
Former Southern Farm Bureau Life Insurance Company employees Regina Thomas and Pam Pilgrim filed suit against the company claiming they were wrongfully discharged. While recognizing Mississippi is an at-will-employment state, the former employees alleged Southern Farm Bureau’s employee handbook altered their at-will status. They insisted the handbook conferred certain substantive and procedural rights, including the right not to be discriminated against based on gender and age, which they suggest they were denied. But upon review, the Mississippi Supreme Court found the employee handbook expressly disclaimed the formation of any employment contract. "So under Mississippi law, Thomas and Pilgrim remained at-will employees. This meant they could be fired for good reason, bad reason, or no reason at all, except for reasons independently declared legally impermissible." Rather than having exhausted their administrative remedies, as was required when bringing a gender-discrimination claim, they asked the Supreme Court to create an exception to an already existing exception to the at-will doctrine, which would have allowed them to avoid the express procedural requirements for federal discrimination claims. But the Mississippi Supreme Court has recognized that creating exceptions to the at-will doctrine was a legislative concern, not a judicial task. "Because Congress has already created a discrimination-based exception to the at-will doctrine—which Thomas and Pilgrim failed to pursue - we reject their request." View "Southern Farm Bureau Life Ins. Co. v. Thomas" on Justia Law