OPINION
This case involves the dismissal of the claims of Plaintiffs-Appellants Paul Brown, William Fanaly, Charles Thomas, Gary Riggs, Robert Orlikowski, and Scott Way (collectively referred to as “plaintiffs”) against Defendants-Appellees Cas-sens Transport Company (“Cassens”),
On remand, we REVERSE the district court’s dismissal of plaintiffs’ RICO claims because the WDCA does not preempt their RICO claims and because plaintiffs have sufficiently pleaded a pattern of racketeering activity given that reliance is not an element of a civil RICO fraud claim. We REMAND to the district court for further proceedings consistent with this opinion. The plaintiffs also appeal the district court’s dismissal of their IIED claims for failure to plead outrageous conduct. We AFFIRM the dismissal of the IIED claims because the alleged conduct of these defendants could not be deemed outrageous under Michigan law.
I. BACKGROUND
Plaintiffs are current or former employees of Cassens who have submitted worker’s compensation claims to Cassens based on workplace injuries they have each sustained. On June 22, 2004, plaintiffs filed a complaint raising RICO and IIED claims against the defendants. Plaintiffs alleged that Cassens, which was self-insured for purposes of paying benefits under the WDCA, contracted with Crawford to serve as a claims adjuster for the worker’s compensation claims of Cassens’s employees. They further pleaded that Cassens, Crawford, and Margules, as well as other “cutoff’ doctors, engaged in a pattern of racketeering activity that denied the plaintiffs’ worker’s compensation claims. Specifically, the plaintiffs alleged that Cassens and Crawford deliberately selected and paid unqualified doctors, including Margules, to give fraudulent medical opinions that would support the denial of worker’s compensation benefits, and that defendants ignored other medical evidence in denying them benefits. The plaintiffs claimed that the defendants made fraudulent communications amongst themselves and to the plaintiffs by mail and wire in violation of 18 U.S.C. §§ 1341, 1343, which serve as the predicate acts for their RICO claims.
The district court granted the defendants’ motion to dismiss pursuant to Rule 12(b)(6) on July 15, 2005.
Brown v. Cassens Transp. Co.,
II. STANDARD OF REVIEW
We review de novo a district court’s determination dismissing a suit for failure to state a claim upon which relief can be granted pursuant to Rule 12(b)(6).
Hill v. Blue Cross & Blue Shield,
III. DISMISSAL OF THE CLAIMS OF THOMAS AND RIGGS FOR FAILURE TO STATE A PATTERN
A. General Contours of the RICO Pattern Element and the District Court’s Approach
RICO makes it a crime “for any person employed by or associated with any enterprise engaged in, or the activities of which affect, interstate or foreign commerce, to conduct or participate, directly or indirectly, in the conduct of such enterprise’s affairs through a pattern of racketeering activity or collection of unlawful debt.” 18 U.S.C. § 1962(c). RICO defines “racketeering activity” to include “any act which is indictable under any of the following provisions of title 18, United States Code: ... section 1341 [18 U.S.C. § 1341] (relating to mail fraud), section 1343 [18 U.S.C. § 1343] (relating to wire fraud).” Id. § 1961(1). Plaintiffs claim that defendants engaged in the racketeering activities of mail and wire fraud. 2
RICO states that a “ ‘pattern of racketeering activity’ requires at least two acts of racketeering activity, one of which occurred after [October 15, 1970] and the last of which occurred within ten years (excluding any period of imprisonment) after the commission of a prior act of racketeering activity.” 18 U.S.C. § 1961(5). On this basis, the district court assumed that alleging two acts of racketeering activity was sufficient to state a pattern, and dismissed the claims of Riggs and Thomas because they sufficiently pleaded only one act each of racketeering activity. The plaintiffs appeal this conclusion, claiming that the district court was instead required “to look at the pattern of defendants’ alleged scheme against the group” rather than “the number of predicate acts allegedly committed against each victim.” Appellants Br. at 25-26.
RICO’s provision authorizing civil suits, 18 U.S.C. § 1964(c), sheds light on the issue of predicate acts. Section 1964(c) states that “[a]ny person injured in his business or property by reason of a violation of [18 U.S.C. § 1962]” may bring a RICO suit. RICO specifies only that the defendant must have engaged in a “pattern of racketeering activity” to violate 18 U.S.C. § 1962. As long as the defendant engaged in a pattern of racketeering activity, and the plaintiff was injured by this pattern of activity, this suffices to state a claim under 18 U.S.C. § 1964(c); nowhere does the statute require that the injury to each plaintiff must have independently consisted of a pattern of activity by the defendant.
See H.J. Inc. v. Nw. Bell Tel. Co.,
Although the defendants do not appear to take issue with the district court’s holding that two predicate acts constitute a “pattern of racketeering activity,” and thus that a pattern was specifically pleaded by Brown, Fanaly, Way, and Orlikowski, 3 see Appellees Br. at 16 (requesting that the district court’s decision on whether a pattern was established be upheld), we must consider whether the defendants were engaged in a “pattern of racketeering activity” to determine whether the district court erred in dismissing the claims of Riggs and Thomas for failure to state a pattern.
C. Defining a Pattern of Activity Under RICO: Relationship and Continuity
The district court’s assumption that two predicate acts constitute a pattern under 18 U.S.C. § 1961(5) in finding
A relationship among predicate acts is established when they “have the same or similar purposes, results, participants, victims, or methods of commission, or otherwise are interrelated by distinguishing characteristics and are not isolated events.”
Id.
at 240,
“ ‘Continuity’ is both a closed- and open-ended concept, referring either to a closed period of repeated conduct, or to past conduct that by its nature projects into the future with a threat of repetition.”
H.J. Inc.,
D. The Plaintiffs Have Pleaded a Pattern
The plaintiffs have pleaded with sufficient particularity at least thirteen predicate acts, which are comprised of al
First, the predicate acts alleged by the plaintiffs are related. They have the same purpose: to reduce Cassens’s payment obligations towards worker’s compensation benefits by fraudulently denying worker’s compensation benefits to which the employees are lawfully entitled. They have the same result: to deny worker’s compensation benefits to certain Cassens’s employees who are entitled to such benefits under Michigan law. They have the same participants: alleged in the complaint are worker’s compensation officials at Cassens and Crawford, including Tina Litwiller, a claim adjuster for Crawford, and Margules, a doctor who the plaintiffs allege, with regard to some of the predicate acts, fraudulently recommended ineligibility of benefits at the request of Cas-sens and Crawford. They have the same victims: alleged in the complaint are certain Cassens employees who are eligible for worker’s compensation benefits. They have similar methods of commission: fraudulent misapplication of the legal standards set forth in the WDCA in denying worker’s compensation benefits to Cas-sens’s employees by Titwiller, other officials working for defendants, or Margules.
Second, the predicate acts are continuous under either a closed- or open-ended theory. “[P]laintiff[s] may prove [closed] continuity by showing a series of past related predicates occurring over an extended period of time,” generally more than “[a] few months.”
Vild,
As for open-ended continuity, the Supreme Court has explained that an open period of continuity is stated when “the predicates are a regular way of conducting defendant’s ongoing legitimate business.”
H.J. Inc.,
Each of the plaintiffs has also sufficiently pleaded that they were injured by
IV. RELIANCE AS AN ELEMENT OF FRAUD IN A CIVIL RICO CLAIM
A. Reliance Is Not Required for a Civil RICO Fraud Claim
The Supreme Court recently held “that a plaintiff asserting a RICO claim predicated on mail fraud need not show, either as an element of its claim or as a prerequisite to establishing proximate causation, that it relied on the defendant’s alleged misrepresentations.”
Bridge v. Phoenix Bond & Indent. Co.,
— U.S. -,
In addition to rejecting a reliance requirement, the Court in
Bridge
also reaffirmed its position in
Holmes v. Securities Investor Protection Corp.,
After Bridge, plaintiffs need not plead or prove that they relied on defendants’ alleged misrepresentations in order to establish the elements of their civil RICO claim based on mail or wire fraud. Dismissal of plaintiffs claims on this basis cannot be sustained.
B. Plaintiffs Have Sufficiently Pleaded that Their Injuries Were “By Reason of’ the Defendants’ Alleged Fraud
Plaintiffs have sufficiently pleaded that the defendants’ fraud was directly related to and was the proximate cause of their injuries as required by 18 U.S.C. § 1964(c) under
Holmes,
Y. REVERSE PREEMPTION UNDER THE McCARRAN-FERGUSON ACT
The McCarran-Ferguson Act, 15 U.S.C. § 1012(b), provides: “No Act of Congress shall be construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance, ... unless such Act specifically relates to the business of insurance.” “The McCarran-Ferguson Act thus precludes application of a federal statute in face of state law ‘enacted ... for the purpose of regulating the business of insurance,’ if the federal measure does not ‘specifically relat[e] to the business of insurance,’ and would ‘invalidate, impair, or supersede’ the State’s law.”
Humana, Inc. v. Forsyth,
A. The WDCA Was Not Enacted for the Purpose of Regulating the Business of Insurance
The Supreme Court has explained that “ ‘[sjtatutes aimed at protecting or regulating this relationship [between insurer and insured], directly or indirectly, are laws regulating the business of insurance,’ within the meaning of the phrase [used by McCarran-Ferguson].”
United States Dep’t of Treasury v. Fabe,
the focus of McCarran-Ferguson is upon the relationship between the insurance company and its policyholders: “The relationship between insurer and insured, the type of policy which could be issued, its reliability, interpretation, and enforcement — these were the core of the ‘business of insurance.’ Undoubtedly, other activities of insurance companies relate so closely to their status as rehable insurers that they too must be placed in the same class. But whatever the exact scope of the statutory term, it is clear where the focus was — it was on the relationship between the insurance company and the policyholder.”
Id.
(quoting
Nat’l Secs.,
In determining whether particular practices constitute “ ‘the
business of
insurance’ ” under the McCarran-Ferguson Act, three factors are considered: “
first,
whether the practice has the effect of transferring or spreading a policyholder’s risk;
second,
whether the practice is an integral part of the policy relationship between the insurer and the insured; and
third,
whether the practice is limited to entities within the insurance industry.’ ”
Ky. Ass’n of Health Plans, Inc. v. Miller
In assessing whether a state law addresses “the business of insurance” under the McCarran-Ferguson Act, the Supreme Court has made clear that the focus is on “how to characterize
conduct
undertaken by private actors,” rather than “how to characterize
state laws
in regard to what they ‘regulate.’ ”
Ky. Ass’n of Health Plans, Inc.,
In arriving at the conclusion that the WDCA addresses “the business of insurance,” the district court appeared to rely on the benefits-as-insurance theory. This understanding of the WDCA is precarious at best. As stated above, “[t]he focus of McCarran-Ferguson is upon the relationship between the
insurance, company
and
its policyholders.” Fabe,
Insurance is defined as “[a] contract by which one party (the insurer) undertakes to indemnify another party (the insured) against risk of loss, damage, or liability arising from the occurrence of some specified contingency.” Blaok’s Law Diotio-naRY (8th ed.2004). There is no contract in the worker’s compensation scheme. The district court attempts to dismiss the importance of the lack of a contract under the benefits-as-insurance theory by stating that “[t]he WDCA simply deprives the parties of their freedom of contract and, instead, imposes the benefits and burdens of the predetermined bargain upon them.”
Brown,
The WDCA is a public regulation of the employment relationship that is a substitute for the tort system rather than any contractual relationship between employees and employers.
See generally
Richard A. Epstein,
The Historical Origins and Economic Structure of Workers’ Compensation Law,
16 Ga. L. Rev. 775 (1982). In the context of true contractual accident-insurance relationships, the insurer owes no preexisting duty to the insured to compensate the insured for any injury that the insured may sustain. Rather, as with other contractual relationships, the insured provides consideration in exchange for the insurer’s obligation to pay benefits upon the event of an accident. By contrast, in the worker’s compensation context, the employer owed the employee a preexisting duty under common-law tort to compensate the employee for workplace injuries due to the fault of the employer. Mandatory worker’s compensation schemes, including the WDCA, remove the employee’s obligation to prove negligence and causation in exchange for certain benefits in the event of a workplace injury and relinquishing the right to sue (except in cases of intentional torts). However, the employer
Moreover, under the benefits-as-insurance view, the WDCA does not satisfy the
Pireno
factors.
Most important, we emphasize that whether the WDCA addresses any practices related to “the business of insurance” is not the same inquiry as whether the WDCA was
“enacted ... for the purpose of regulating
the business of insurance.” “To equate laws ‘enacted ... for the purpose of regulating the business of insurance’ with the ‘business of insurance’ itself ... would be to read words out of the statute,” which the Supreme Court, and we, “refuse to do.”
Fabe,
The purpose of enacting the WDCA “was to require an employer to compensate a worker for any injury suffered in the course of the worker’s employment, regardless of who was at fault.” Edward Welch,
Worker’s Compensation in Michigan: Law and Practice
§ 1.2 (4th ed.2001);
accord Simkins v. Gen. Motors Corp.,
Our conclusion that worker’s compensation benefits are not insurance and our conclusion that the WDCA was not
“enacted ... for the pwtpose of regulating
the business of insurance,” each independently foreclose the defendants’ argument that the WDCA reverse preempts RICO under the McCarran-Ferguson Act. We additionally note that even in the absence of these conclusions that preclude reverse preemption, the defendants’ insurance-provisions theory would not support their reverse-preemption argument. The insurance-provisions theory views the WDCA as regulating “the business of insurance” because there are a number of provisions in the WDCA regarding the insurance an employer may buy to secure payment for worker’s compensation benefits. Under the insurance-provisions theory, therefore, the employer is the insured and the company providing the insurance is the insurer. There are several provisions of the WDCA that directly relate to the terms of the insurance contract and thus to “the business of insurance.”
See Fabe,
Because worker’s compensation benefits are not a form of insurance and the insurance-policy provisions are a minor element of the WDCA that was not part of the purpose for enacting the law, the WDCA was not “enacted ... for the purpose of regulating the business of insurance,” and thus it does not reverse preempt the plaintiffs’ RICO claims.
B. RICO Would Not Invalidate, Impair, or Supersede the WDCA
Although our conclusion that the WDCA was not “enacted ... for the purpose of regulating the business of insurance,” disposes of the defendants’ reverse-preemption argument, we note that RICO is also saved from reverse preemption by the WDCA under the McCarran-Ferguson Act because RICO would not “invalidate, impair, or supersede” the
The WDCA bars and imposes sanctions on the denial of benefits to which employees are legally entitled, mich. Comp. Laws §§ 418.631, 418.801. A RICO claim here would also act to punish the improper denial of benefits if done as part of a pattern of racketeering activity. “To the extent that the [state] law prohibited practices also prohibited under federal law,” the federal law does not “frustrate a goal of [the state] law.”
Humana,
[i]f weekly compensation benefits or accrued weekly benefits are not paid within 30 days after becoming due and payable, in cases where there is not an ongoing dispute, $50.00 per day shall be added and paid to the worker for each day over 30 days in which the benefits are not paid. Not more than $1,500.00 in total may be added pursuant to this subsection.
Mich. Comp. Laws § 418.801(2). In
Huma-na,
the Supreme Court considered whether “a federal law, which proscribes the same conduct as state law, but provides materially different remedies, ‘impair[s]’ state law under the McCarran-Ferguson Act?”
The Court’s conclusion in
Humana
applies equally here. First,
Humana
treats the impairment consideration as an “as-applied” challenge that looks to whether the federal statute would impair the state statute in a particular application. In
Hu-mana,
the availability of punitive damages under state law greater than the treble damages available under RICO supported the conclusion that RICO did not impair the state law.
VI. INTENTIONAL INFLICTION OF EMOTION DISTRESS
After dismissing the plaintiffs’ RICO claims, the district court proceeded to address their state-law IIED claims, even though a federal court should typically decline to exercise pendent jurisdiction over a plaintiffs state-law claims after dismissing the plaintiffs federal claims.
See
28 U.S.C. § 1367(c)(3);
United Mine Workers of Am. v. Gibbs,
In construing questions of state law, a federal court must apply state law in accordance with the controlling decisions of the highest court of the state.
Meridian Mut. Ins. Co. v. Kelliman,
It has not been enough that the defendant has acted with an intent which is tortious or even criminal, or that he has intended to inflict emotional distress, or even that his conduct has been characterized by “malice”, or a degree of aggravation which would entitle the plaintiff to punitive damages for another tort. Liability has been found only where the conduct has been so outrageous in character, and so extreme in degree, as to go beyond all possible bounds of decency, and to be regarded as atrocious, and utterly intolerable in a civilized community. Generally, the case is one in which the recitation of the facts to an average member of the community would arouse his resentment against the actor, and lead him to exclaim, “Outrageous!”
Id. at 908-09 (internal quotation marks omitted).
In applying this standard, the Michigan Supreme Court held that a no-fault insurer’s “failure ... to facilitate the filing of a replacement services claim, a delay of at most six months in responding to the claim as filed, and the denial of benefits owed” was insufficient to meet the standard for outrageous conduct. Id. at 911. In arriving at this conclusion, the court noted that “[t]here is no indication that [the insurer] set out to harass these plaintiffs, nor does the evidence disclose a course of conduct that may fairly be characterized as so outrageous in character ... as to go beyond all possible bounds of decency....” Id. (internal quotation marks omitted).
We affirm the district court’s dismissal of the plaintiffs’ IIED claims because, like the defendant’s conduct in
Roberts,
the plaintiffs’ allegations of defendants’ fraudulent denial of worker’s compensation benefits are not “so outrageous in character ... as to go beyond all possible bounds of decency.”
Id.
Decisions of the Michigan Court of Appeals confirm this conclusion. That court has explained that the “wrongful, bad faith termination of benefits, by itself, is not sufficiently outrageous to support a claim for intentional infliction of emotional distress.”
Atkinson v. Farley,
VII. CONCLUSION
We REVERSE the dismissal of plaintiffs’ RICO claims because their RICO
Notes
. The plaintiffs filed a motion for leave to file an amended complaint, but they did not appeal the district court's denial of this motion in their Notice of Appeal. Therefore, that decision is not before us. Fed. R.App. P. 3(a)(1).
. Plaintiffs also pleaded that defendants engaged in witness tampering in violation of 18 U.S.C. § 1512, which, also constitutes a predicate act of racketeering under RICO, see 18 U.S.C. § 1961(1)(B). The district court dismissed the witness-tampering claims, and plaintiffs do not press these claims on appeal.
. The district court’s treatment of Orlikow-ski’s claim is confused. The district court noted that Orlikowski "fails to specify the means of the communication” with regard to one of the two predicate acts he alleges,
Brown,
. Federal Rule of Civil Procedure 9(b)’s requirement that "[i]n alleging fraud or mistake, a party must state with particularity the circumstances constituting fraud or mistake” has been applied to allegations of fraud made in support of a RICO claim.
See, e.g., Blount Fin. Servs., Inc. v. Walter E. Heller & Co.,
The plaintiffs contend that under Rule 11(b)(3) and
Rotella v. Wood,
. The parties agree that RICO does not "specifically relate[] to the business of insurance.” 15 U.S.C. § 1012(b).
. The plaintiffs err by asserting that " ‘a state law regulates insurance if a common sense meaning of the language of the statute indicates that it is specifically directed toward [the insurance] industry,' ” Appellants Br. at 50 (quoting
Med. Mut. of Ohio v. deSoto,
. In the district court, Cassens argued that § 301 of the Labor Management Relations Act ("LMRA”), 29 U.S.C. § 141, preempted plaintiffs' IIED claims. The district court did not address this argument because it dismissed the IIED claims under Rule 12(b)(6). The district court likely should have addressed the preemption question first because in cases of LMRA preemption, the court must “recharac-terize” the state cause of action as a federal claim and analyze the claim under federal law. 14B Charles A. Wright, Arthur R. Miller, & Edward H. Cooper, Federal Practice and Procedure § 3722.1 (3d ed.1998). However, the defendants do not raise LMRA preemption on appeal, and thus we simply review the district court’s decision to dismiss for failure to state a claim.
