Chandler v. State Farm Mutual Automobile InsuranceChandler v. State Farm Mutual Automobile Insurance
ORDER & MEMORANDUM REGARDING MOTION TO DISMISS
I. INTRODUCTION
This рutative class action presents the Court with the question whether an insurer is permitted to recoup a payout from a third-party tortfeasor’s insurance company before the insured has sued the third-party tortfeasor, and without first making the insured whole. Plaintiff Stuart Chandler purchased from defendant State Farm Mutual Auto Insurance Company an automobile insurance policy that reimburses policyholders for 80% of their out-of-pocket rental сar costs while them automobiles are being repaired following covered accidents. Plaintiff suffered such an accident in March 2007 when his car was rear-ended by the driver of another car. Plaintiff rented a car, which cost him approximately $300, and State Farm reimbursed him 80% of those costs. Then, State Farm, as a partial subrogee of Plaintiff, sought reimbursement from the third-party tortfeasor’s insurer, which questioned the charge and paid State Farm оnly $70. State Farm apparently accepted the $70 payment. Plaintiff then likewise sought reimbursement of his out-of-pocket rental costs from the third-party tortfeasor’s insurer, which refused to pay. Rather than institute a lawsuit against the driver who rear-ended him, Plaintiff demanded that State Farm pay him his out-of-pocket costs from the $70 it had received from the driver’s insurance company because, according to Plaintiff, he is entitled to reimbursement from State Farm under the “made whole” rule, which purportedly bars State Farm from recovering any of its expenses until Plaintiffs rental car expenses are paid in full.
Plaintiff candidly admits that his position could defeat a carrier’s ability to recoup from tortfeasors and their insurers the full amount of its payments to its policyholders, and that it would, in effect and to that extent, require an insurer to pay more than its contractual obligation to the policyholder. Plaintiff claims to find support for his position in a variety of public policy arguments. But in the end, these arguments are not persuasive because Plaintiffs position undermines the most fundamental public policy at play in this and other cases — the principle that the person ultimately responsible for causing the damage should pay for it. In situations like the one presented here, the imposition of an obligation on an insurer to pay the insurеd out of proceeds obtained as reimbursement for its out-of-pocket costs in paying the policyholder’s claim would confer greater rights on the policyholder than provided in the policy and eliminate any incentive on the part of the policyholder to seek reimbursement from the tortfeasor. The policyholder’s carrier would end up short changed, and the tortfeasor would be off the hook even though the tortfeаsor caused the damage in the first place. Although no California case addresses this question, a case from New York provides that a carrier may pursue reimbursement and has no obligation to make the policyholder “whole” out of reimbursement proceeds unless and until the policyholder attempts and fails to recover from the tortfeasor.
Winkelmann v. Ex
*1317
celsior Ins. Co.,
For these reasons, which are discussed in greater detail below, the Court concludes that Plaintiff lacks standing to proceed with his lawsuit, and that Plaintiffs claims are unripe. Defendant’s motion to dismiss is therefore GRANTED, and Plaintiffs claims are DISMISSED WITHOUT PREJUDICE.
II. BACKGROUND
In March 2007, Plaintiff suffered damage to his car when he was rear-ended by the driver of another car. (First Am. Compl. (“FAC”) ¶ 23.) At the time, Plaintiff owned automobile insurance through Defendant. (See FAC, Ex. 1 [Policy].) While his car was being repaired, Plaintiff rented a car and incurred $317.45 in expenses. (FAC ¶ 24.) Pursuant to the terms of Plaintiffs insurance policy, Defendant paid 80% of Plaintiffs rental car expenses, or $253.96, and Plaintiff paid $63.49. (FAC ¶ 24; see FAC, Ex. 1 [Policy at 18-19].) Subsequently, Defendant demanded reimbursement from the third-party insurer of its $253.96 payment. (FAC ¶ 25.) Defendant did not demand reimbursement of the $63.49 paid by Plaintiff. (Id.) The third-party insurer disputed the propriety of the duration of the car rental and the rental rаte, and paid Defendant only $70.00 as payment-in-full for Plaintiffs rental car expenses. (FAC ¶ 26.)
Subsequently, Plaintiff contacted the third-party insurer and requested reimbursement of his $63.49. (FAC ¶ 27.) The third-party insurer rejected Plaintiffs demand for reimbursement of the $63.49, claiming that it had already paid Defendant the full amount of reimbursement owed on the car rental. (Id.) This prompted Plaintiff to seek reimbursement from Defendant of the $63.49. (FAC ¶ 28.) After Defendant also rejected Plaintiffs demand, Plaintiff initiated the рresent putative class action lawsuit against Defendant, asserting claims of (1) violation of California’s Unfair Competition Law, Cal. Bus. & Prof. Code §§ 17200 et seq.; (2) conversion; (3) unjust enrichment; and (4) declaratory relief.
III. DISCUSSION
Defendant seeks to dismiss Plaintiffs suit on a number of procedural grounds, including lack of standing, unripe claims, and failure to state a claim for which relief may be granted. All of Defendant’s arguments, however, boil down to one central legal issue: the “made-whole” rule’s applicability under the present circumstances.
California courts are silent on the issue of the made-whole rule’s applicability to situations in which an insured has not yet sued the third-party tortfeasor, but the insurer has already obtained reimbursement of the policy payout from the third-party tortfeasor’s insurer. Accordingly, to resolve the matter before it, the Court must look to the general principles governing the doctrine of subrogation and the made-whole rule, as well as persuasive authority and public policy considerations.
A. Subrogation and tiib Made-Wiiole Rule
1. General Principles
Subrogation is an equitable doctrine that permits an insurance company to assert the rights and remedies of an insured against a third party tortfeasor.
Allstate Ins. Co. v. Mel Rapton, Inc.,
77
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Cal.App.4th 901,
The made-whole rule is a common law exception to insurers’ right of subrogation.
Allstate Ins.,
2. Application
As noted above, California courts have not squarely addressed the core issue presently before the Court, namely, whether an insurer must make the insured whole before pursuing a subrogation claim against the third-party tortfeasor’s insurer where the insured herself has nоt yet sued the third-party tortfeasor. A case decided by the New York Court of Appeals, however, is directly on point.
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In
Winkelmann v. Excelsior Ins. Co.,
Before reaching the merits of the plaintiffs’ claim against Excelsior, the Winkelmann court explained thаt the plaintiffs’ claim against Excelsior was “premature” because the plaintiffs
may yet recover the balance of their losses in the action against [the third-party tortfeasor]. There is no evidence that [the tortfeasor’s] policy with Colonial has been exhausted or that his personal assets are insufficient to satisfy any additional liability to plaintiffs. Accordingly, Excelsior has not caused its insureds any damages yet. Insofar as plaintiffs allege that Excelsior’s conduct “forced” them to litigate rather than settle their claim against [the third-party tortfeasor], that claim, even if true, does not state a cause of action against Excelsior for impairing plaintiffs’ rights.
Id.
The court then addressed the merits of the plaintiffs’ claim by tackling the main issue in the case: “whether an insurer who has paid its insured the full amount due under a fire policy, but less than the insured’s loss, may proceed against the third-party tоrtfeasor responsible for the loss before the insured has been made whole by the tortfeasor.”
Id.,
The Court finds Winkelmann’s holding and reasoning to be persuasive and adopts the rule enunciated therein in the absence of direct California authority. Moreover, the Court concludes that Winkelmann does not conflict with California case law on subrogation or the relevant public policy considerations underlying the made-whole rule.
The right of subrogation is, in essence, a means of balancing the equities as between the insurer, the insured, and the third-party tortfeasor. An insured who has suffered an injury has a legal right to be made whole; the made-whole rule is the legal doctrine that prevents insurers from interfering with that right. But where the insured has been fully compensated for his injury, subrogation ensures that the insured is not unjustly enriched by. receiving a windfall. Subrogation’s primary purpose, therefore, is to prevent the insured from obtaining double recovery.
See Allstate Ins.,
These public policy considerations do not compel a result contrary to that which the Court reaches today. First, one must keep subrogation claims against insureds separate from subrogation claims against third-party tortfeasors. As between insureds and insurers, California law is clear that an insurer may seek subrogation
from an insured
only if the insured’s
recovery
exceeds that to which he is entitled, i.e., only after the insured has been made whole.
See Sapiano,
Furthermore, the fundamental purpose of the doctrine of subrogation is to hold third-party tortfeasors accountable for the injuries they inflict: “ ‘Subrogation is the insurer’s right to be put in the position of the insured,
in order to recover from third parties who are legally responsible
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to the insured for a loss paid by the insurer.’ ” Plut v. Fireman’s Fund Ins. Co.,
Finally, a rule requiring insurers to make insureds whole before subrogating themselves to insureds’ claims would remove virtually any incentive the insured might have to pursue her claims against the third-party tortfeasors, because the insured could simply take her share from the amount recouped in subrogation by the insurer. Thus, in effect, the insurer would be obligated to compensate the insured in full for the latter’s injuries if the insurer sought to recoup any portion of its payout, even where, as here, the express terms of the insurance policy required something less. Under the present circumstances, Plaintiffs position would ultimately frustrate the parties’ objective intent in entering into the agreement, by requiring Defendant to pay 100% of Plaintiffs rental expenses when Plaintiff plainly agreed that Defendant was obligated to pay only 80% of such expenses.
Plaintiff contends that Defendant’s position in this case opens the door to an anomaly whereby the made-whole rule will not apply where an insured has not yet sued the third-party tortfeasor, but will apply to an insured who sues the tortfeasor and settlеs for $1.00. Plaintiff also argues that Defendant’s position would permit insurers to grab the “lower-hanging fruit,” leaving the insured to have to reach higher for a smaller recovery. As explained above,
Winkelmann
addressed and dismissed Plaintiffs latter argument, which is essentially a reformulation of the
Winkelmann
plaintiffs’ “unequal bargaining position” argument. With respect to Plaintiffs anomaly argument, the Court is not convinced that an insured could circumvent the rule espoused by the Court today so eаsily. First, as a practical matter, it is highly unlikely that an insured would settle its claim against a third-party tortfeasor — the source of the insured’s injury — for $1.00 just so it could then be made whole by her own insurer, especially where there is a chance that the insured might be made whole by the third-party tortfeasor. Moreover, at least in cases in which the insurer is representing both the insurer and insured, it is unlikely that the insurer’s attorney would settle a claim for $1.00 where it was clear that the рurpose of so settling would be to preclude the insurer from subrogating to the insured’s claims before the latter was made whole.
See Unigard Ins. Group v. O’Flaherty & Belgum,,
*1322 B. Defendant’s Motion to Dismiss Under Rule 12(b)(1)
With the foregoing analysis in mind, the Court now directly addresses the merits of Defendant’s motion to dismiss. On a motion to dismiss for lack of standing, a district court must accept as true all material allegations in the complaint, and must construe the complaint in the nonmovant’s favor.
Bernhardt v. County of Los Angeles,
As noted above, Defendant moves to dismiss Plaintiffs lawsuit under Rule 12(b)(1) of the Federal Rules of Civil Procedure on the ground that Plaintiff lacks standing, and that his claims are unripe. The Article III case or controversy requirement limits federal courts’ subject matter jurisdiction by requiring, inter alia, that plaintiffs have standing and that claims be “ripe” for adjudication.
Allen v. Wright,
“[T]he irreducible constitutional minimum of standing contains three elements,” all of which the party invoking federal jurisdiction bears the burden of establishing.
Lujan v. Defenders of Wildlife,
In the present case, Plaintiff lacks standing because he has not alleged, and indeed, cannot allege at this juncture, sufficient facts to establish that his injury is fairly traceable to Defendant’s conduct. The challenged conduct underlying Plaintiffs lawsuit consists of Defendant’s act of obtaining partial reimbursement of the $253.96 it paid Plaintiff from the third-party tortfeasor’s insurer without first making Plaintiff whole. To have standing to sue under the made-whole rule, Plaintiff must show that he was foreclosed from recovering from the tortfeasor because of Defendant’s act of seeking and obtaining reimbursement of the rental car expenses.
See Winkelmann,
For essentially the same reasons, Plaintiffs claims are unripe. “[T]he question of ripeness turns on the fitness of the issues for judicial decision and the hardship to the рarties of withholding court consideration.”
Pac. Gas & Elec. Co. v. State Energy Res. Conservation & Dev. Comm’n,
Here, Plaintiffs lawsuit is unripe because Plaintiff has not sufficiently established that he cannot recover the $63.49 from the third-party tortfeasor. Unless and until Plaintiff sues the third-party tortfeasor and is unable to rеcover the amount he claims he is owed, Plaintiff cannot claim that Defendant has prevented him from recovering that amount. Thus, at this stage, Plaintiffs claims involve future events that are too uncertain and speculative to permit Plaintiff to proceed with his lawsuit.
IV. CONCLUSION
For the foregoing reasons, the Court concludes that Plaintiff lacks standing and that his claims are unripe. Accordingly, Defendant’s Rule 12(b)(1) motion to dismiss is GRANTED, and Plaintiffs claims are DISMISSED WITHOUT PREJUDICE. 1
IT IS SO ORDERED.
Notes
. Because the Court concludes that Plaintiff lacks standing to pursue his claims, it does not address Defendant's motion to dismiss for failure to stale a claim.