Government Employees Insurance Co. v. Clear Vision Windshield Repair, L.L.C., 6:16-cv-02077

Background

GEICO companies (Plaintiffs) allege windshield-repair businesses and related entities (Defendants) ran a scheme: obtaining dealership access, convincing insureds to assign benefits, submitting thousands of false windshield-repair claims, and collecting about $310,000.
Insureds with comprehensive coverage may assign payment rights to repair shops; Plaintiffs paid claims without a deductible under Fla. Stat. § 627.7288.
Plaintiffs sued under RICO, FDUTPA, the Florida Civil Remedies for Criminal Practices Act (FCRCPA), common-law fraud, declaratory judgment, and unjust enrichment.
Defendants moved to dismiss for lack of standing (Rule 12(b)(1)), for failure to state a claim and insufficient fraud particularity (Rules 12(b)(6) and 9(b)), and for failure to join indispensable parties (Rule 12(b)(7)).
The court accepted the complaint allegations as true at the motion stage, found the fraud allegations supported by extensive documentary exhibits (over 2,000 sample claim entries), and denied all three motions to dismiss.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Standing (12(b)(1))	Plaintiffs suffered concrete injury by paying $310,000 in fraudulent reimbursements and can sue to recover.	Only insureds (parties to assignments) can challenge how assignments were obtained.	Plaintiffs have standing: injury-in-fact, causation, and redressability shown; motion denied.
Fraud pleading specificity (Rule 9(b))	Complaint + exhibits identify creators of false claims, many representative examples, claim numbers, dates, billed/paid amounts—satisfies 9(b).	Allegations are too generalized; lack particularized identification of each fraudulent act and actor.	Allegations and exhibits meet Rule 9(b) for a multi-act scheme; motion denied.
FDUTPA claimant status	FDUTPA now allows a "person" (not only "consumer"); insurers constitute persons harmed by unfair practices.	FDUTPA protects only "consumers," so insurers cannot bring FDUTPA claims.	Legislature broadened remedy to "person"; Plaintiffs may bring FDUTPA claims; motion denied.
FCRCPA vs. criminal-adjudication insurance-fraud statute	Plaintiffs assert FCRCPA claim requiring no prior criminal adjudication.	Claim should fail absent criminal adjudication under Fla. Stat. § 817.234(5).	FCRCPA is independent and does not require prior criminal conviction; motion denied.
Declaratory judgment / abstention (Brillhart)	Declaratory relief supports ruling that Defendants have no right to pending payments; monetary relief also sought.	Court should abstain because parallel state litigation involving related issues exists.	Court lacks record to determine parallelism and discretionary abstention; defendants failed to establish grounds for dismissal; motion denied.
Unjust enrichment vs. assignments	No contract between Plaintiffs and assignees; assignments transfer payment right only, not duties—unjust enrichment available.	Assignment creates contractual relationship barring unjust enrichment.	Under Florida law assignments do not create privity or duties to insurer; unjust enrichment claim may proceed; motion denied.
Joinder of insureds (12(b)(7))	Insureds were not active in scheme and have not asserted an interest; complete relief possible without them.	Insureds are parties to the assignments and indispensable to adjudication.	Defendants failed to show insureds are indispensable; dismissal for nonjoinder denied.

Key Cases Cited

Alvarez v. Attorney Gen. for Fla., 679 F.3d 1257 (11th Cir. 2012) (complaint allegations accepted as true at motion-to-dismiss stage)
Stalley ex rel. U.S. v. Orlando Reg'l Healthcare Sys., Inc., 524 F.3d 1229 (11th Cir. 2008) (standing is threshold jurisdictional question)
Shotz v. Cates, 256 F.3d 1077 (11th Cir. 2001) (standing elements: injury-in-fact, causation, redressability)
Lujan v. Defenders of Wildlife, 504 U.S. 555 (U.S. 1992) (standing framework)
Ashcroft v. Iqbal, 556 U.S. 662 (U.S. 2009) (pleading standard: plausibility)
Bell Atl. Corp. v. Twombly, 550 U.S. 544 (U.S. 2007) (pleading must be plausible, not merely conceivable)
Brooks v. Blue Cross & Blue Shield of Fla., Inc., 116 F.3d 1364 (11th Cir. 1997) (Rule 9(b) specifics for fraud)
U.S. ex rel. Clausen v. Lab. Corp. of Am., 290 F.3d 1301 (11th Cir. 2002) (RICO/multi-act fraud pleading principles)
Ironworks Local Union 68 v. AstraZeneca Pharm., LP, 634 F.3d 1352 (11th Cir. 2011) (accept well-pleaded facts on motion to dismiss)
State Farm Fire & Cas. Co. v. Silver Star Health & Rehab., 739 F.3d 579 (11th Cir. 2013) (assignments do not create privity between provider and insurer for contract claims)