938 F.3d 1170
11th Cir.2019Background
- Suncoast (two chiropractic providers and a medical provider acting as assignees) sued Progressive, alleging Progressive unlawfully limited Florida PIP benefits to $2,500 by relying on negative EMC (emergency medical condition) determinations from non‑treating providers.
- Florida law grants up to $10,000 in PIP benefits when a treating provider determines an EMC; absent such a determination, payments default to the $2,500 cap.
- Suncoast pleaded a declaratory/injunctive count (seeking reprocessing of past claims, a declaration that Progressive’s practice is unlawful, and an injunction) and a breach‑of‑contract damages count for underpaid benefits.
- The district court denied certification of a Rule 23(b)(3) damages subclass (individualized issues would predominate) but certified a Rule 23(b)(2) injunction class; Progressive appealed the (b)(2) certification.
- The Eleventh Circuit reversed: the certified (b)(2) class seeks retrospective relief (reprocessing and payment for past claims), not prospective injunctive relief; accordingly (b)(2) certification was improper and the class was not viable as certified.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Rule 23(b)(2) certification was proper for the injunction/declaratory claim | Suncoast: the class seeks only declaratory and injunctive relief (no classwide damages); a declaration and order to reprocess claims will resolve the common legal issue and require no individualized supervision | Progressive: the class actually seeks retrospective monetary relief (reprocessing past claims), so (b)(2) is an improper vehicle and (b)(3) governs | Court: Reversed. The certified (b)(2) class primarily seeks redress of past harms (damages in substance), so (b)(2) certification was improper; (b)(3) is the appropriate route for damages classes |
| Article III standing for injunctive/declaratory relief (future harm requirement) | Suncoast: members have a continuing injury—Progressive continues to refuse further claims handling—so they have a forward‑looking interest warranting prospective relief | Progressive: alleged injury is retrospective (lost opportunity to have claims fairly processed); absent a real likelihood of future injury, injunctive/declaratory relief is not available | Court: Held that Suncoast’s theory is retrospective (lost opportunity to obtain money for past claims). Because plaintiffs did not allege a substantial likelihood of future harm, injunctive/declaratory relief was unavailable to the certified class |
| Whether the requested declaratory relief "corresponds" to injunctive relief under Rule 23(b)(2) | Suncoast: declaration that Progressive’s practice is unlawful will restore class members to the claim‑handling process and is properly paired with injunctive relief | Progressive: the requested declaration is merely a vehicle to obtain retrospective monetary recovery and does not meaningfully provide prospective relief | Court: The declaratory relief sought does not correspond to injunctive relief because it would serve mainly to facilitate damage recovery; (b)(2) requires relief directed to future harm |
| Adequacy of the class definition (overinclusive/underinclusive) | Suncoast: proposed class covers providers and claimants who were notified of reductions to $2,500 based on non‑treating negative EMC determinations | Progressive: class includes many members who suffered no prospective injury (no harmed providers/claimants) and excludes providers who may face future harm—making the class both over‑ and underinclusive | Court: The class definition confirms retrospective focus and is not suitably crafted for prospective relief; inclusion of uninjured members and exclusion of those with future risk undermines (b)(2) certification |
Key Cases Cited
- Robbins v. Garrison Prop. & Cas. Ins. Co., 809 F.3d 583 (11th Cir. 2015) (interpreting Fla. Stat. § 627.736; absent a positive EMC determination, PIP is capped at $2,500)
- Wal‑Mart Stores, Inc. v. Dukes, 564 U.S. 338 (2011) (Rule 23(b)(2) vs. (b)(3) distinction; limits on certifying monetary claims as (b)(2) injunctive classes)
- Murray v. Auslander, 244 F.3d 807 (11th Cir. 2001) (monetary relief in (b)(2) classes must be incidental to injunctive relief)
- A&M Gerber Chiropractic LLC v. GEICO Gen. Ins. Co., 925 F.3d 1205 (11th Cir. 2019) (standing and future‑injury analysis for provider‑assignee PIP claims)
- Kartman v. State Farm Mut. Auto. Ins. Co., 634 F.3d 883 (7th Cir. 2011) (improper to recast damages claims as (b)(2) injunctive claims to avoid (b)(3) requirements)
- Malowney v. Fed. Collection Deposit Grp., 193 F.3d 1342 (11th Cir. 1999) (declaratory relief requires a substantial likelihood of future injury)