Joseph M. Pallozzi, Lori M. Pallozzi v. Allstate Life Ins. Co.Joseph M. Pallozzi, Lori M. Pallozzi v. Allstate Life Ins. Co.
Plaintiffs Joseph M. Pallozzi and Lori R. Pallozzi appeal from the judgment of the United States District Court for the Northern District of New York (Scullin,
J.)
dismissing their complaint against Defendant Allstate Life Insurance Company (“Allstate”) under
Background
A. Relevant statutory provisions.
Title III of the ADA, which generally prohibits discrimination on the basis of disability by so-called “public accommodations,”
see
No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advan *30 tages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation.
Section 501(c) of Title V of the ADA (the “safe harbor” provision) includes the following statement:
INSURANCE
Subchapters I through III of this chapter [i.e., Titles I through III of the ADA] and title IV of this Act shall not be construed to prohibit or restrict—
(1) an insurer, hospital or medical service company, health maintenance organization, or any agent, or entity that administers benefit plans, or similar organizations from underwriting risks, classifying risks, or administering such risks that are based on or not inconsistent with State law....
Id. § 12201(c). The safe harbor provision also states, in its so-called “subterfuge clause”:
Paragraph[ ] (1) ... shall not be used as a subterfuge to evade the purposes of [Titles] I and III of [the Act].
Id.
The McCarran-Ferguson Act, insofar as it bears on the instant dispute, 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.
B. Allegations of the complaint.
The Pallozzis’ are a married couple. Joseph Pallozzi has been diagnosed with major depression and agoraphobia, Lori Pal-lozzi with major depression and borderline personality disorder. Both Pallozzis have received counseling, medication, and inpatient treatment for their conditions in the past.
In October 1996, Plaintiffs applied to Allstate for a joint life insurance policy in the amount of $65,000. Allstate initially issued them a Temporary Insurance Agreement, but soon canceled the agreement based on medical information provided by Plaintiffs’ psychiatrist, and refused to sell them another policy. When Plaintiffs inquired as to why they had been rejected, the carrier gave them a copy of their application and referred them to their psychiatrist for further information. Allstate refused their requests to furnish them with specific reasons for the denial.
In February 1997, Plaintiffs commenced this lawsuit against Allstate in the United States District Court for the Northern District of New York. Their complaint claimed that Allstate refused to sell them life insurance because of their mental disabilities; and that this refusal violated Title III of the ADA and failed to come within the safe harbor of Section 501(c) of the Act because the insurer’s conduct violated various provisions of the New York State Insurance Law, specifically
C. The district court’s ruling.
In May 1997, Allstate moved to dismiss the complaint pursuant to
In March 1998, the district court granted Allstate’s motion to dismiss the complaint.
See Pallozzi,
Plaintiffs appealed.
Discussion
Plaintiffs advance three related arguments: (1) Title III of the ADA does regulate the underwriting practices of insurance companies; (2) its regulation of insurance underwriting is not barred by the McCarran-Ferguson Act because the ADA “specifically relates to the business of insurance”; and (3) the district court imposed unjustified pleading burdens in ruling on the motion under
I. Whether the ADA regulates insurance underwriting practices.
Allstate contends that Title III of the ADA does not reach the underwriting practices of insurance companies. Plaintiffs, marshaling the text of the statute, its legislative history, and interpretive guidelines issued by the U.S. Department of Justice, argue that Title III does regulate insurance underwriting practices. We believe the text of the statute confirms Plaintiffs’ position, making it unnecessary for us to examine their back-up arguments based on legislative history and administrative interpretation.
We start with the fact that Title III specifies an “insurance office” as a “public accommodation.” Section 302(a) bars a “place of public accommodation” from “discriminating] against [an individual] on the basis of disability'in the full and equal enjoyment of [its]
goods
[and]
services.”
This conclusion is reinforced by the safe harbor provision of Section 501(c) of Title V and its subterfuge clause. That provision is labeled “Insurance.”
Allstate argues that Title III defines the term “public accommodation” to include “insurance
officefs],”
not insurance
companies.
We find those arguments unpersuasive. Title Ill’s mandate that the disabled be accorded “full and equal enjoyment of the goods, [and] services ... of any place of public accommodation,”
id.,
suggests to us that the statute was meant to guarantee them more than mere physical access.
Cf. Carparts Distribution Ctr., Inc. v. Automotive Wholesaler’s Ass’n,
We find no merit in Allstate’s contention that, because insurance policies are not used in places of public accommodation, they do not qualify as goods or services “of a place of public accommodation.” The term “of’ generally does not mean “in,” and there is no indication that Congress intended to employ the term in such an unorthodox manner in Section 302(a) of Title III. Furthermore, many of the private entities that Title III defines as “public accommodations” — such as a “bakery, grocery store, clothing store, hardware store, [or] shopping center,”
We therefore hold that Title III does regulate the sale of insurance policies in insurance offices, subject to the limitations of the safe harbor provision in Section 501(c) of Title Y. As we base our holding on the statutory text — which, we find, unambiguously covers insurance underwriting in at least some circumstances — we need not consider Plaintiffs’ arguments that the ADA’s legislative history and the interpretive guidelines issued by the Department of Justice confirm this interpretation. 4
II. Whether the McGarran-Fergusm Act bars application of Title III to insurance underwriting.
Allstate contends that, even if the ADA might be read to cover insurance underwriting, the McCarran-Ferguson Act forbids such an interpretation. That Act mandates in relevant part that no federal statute “shall be construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance ... unless [the statute in question] specifically relates to the business of insurance.”
In
Barnett Bank v. Nelson,
Neither the McCarran-Ferguson Act’s language, nor its purpose, requires the Federal Statute to relate predominantly to insurance. To the contrary, specific detailed references to the insurance industry in proposed legislation normally will achieve the McCarran-Ferguson Act’s objectives, for they will call the proposed legislation to the attention of interested parties, and thereby normally guarantee, should the proposal become law,that Congress will have focused upon its insurance-related effects.
Id.
at 41-42,
Applying the analytic framework of
Barnett Bank
to this case leads us to conclude that the ADA does “specifically relate to the business of insurance,” and therefore falls outside the scope of McCarran-Fer-guson’s prohibition. As for step one, the ADA clearly “relates” to the insurance business, insofar as Title III defines an “insurance office” as a “public accommodation,”
Third, we find that the ADA does regulate the “business of insurance,” in that it affects “matters ... at the core of the' McCarran-Ferguson Act’s concern,” such as “the relation of insured to insurer and the spreading of risk.”
Barnett Bank,
Finally, turning to
Barnett
Bank’s fourth step, consideration of the ADA in light of McCarran-Ferguson’s purposes also supports our conclusion. The ADA’s specific references to insurance in Title III and Section 501(c) suggest that any intrusion by the statute on state insurance regulation is not
“inadvertent.” Barnett Bank,
Indeed, we believe the safe harbor provision of Section 501(c) was written by Congress with McCarran-Ferguson in mind, precisely to communicate that message. With the benefit of minimal decoding, we understand Congress to be saying:
(1) Because of the general preference expressed in McCarran-Ferguson’s default rule that insurance matters be regulated by State authority, rather than by us, we require a plaintiff seeking to prove a claim arising from underwriting decisions to show that the practice complained of is proscribed not only by this statute but also by State law.
(2) If, on the other hand, the insurer uses State law as a subterfuge to evade the purposes of this Act, that also will support a claim.
(3) We set forth this separate provision (under the caption “Insurance”) to make clear that our statute “specifically relates to the business of insurance” and therefore must be interpreted, notwithstanding McCarran-Ferguson, to regulate insurance practices.
Finally we note that the Seventh Circuit in
Mutual of Omaha
also found McCarran-Ferguson satisfied with respect to the type of discriminatory practice at issue in this case. Athough ruling on a different issue, the court expressed the view that Title III forbids an insurer’s discriminatory refusal to sell its policies to a disabled person, and that this interpretation of the ADA would not be barred by McCarran-Ferguson.
5
See Mutual of Omaha,
III. Whether the district court erred in the pleading requirements it imposed.
The district court interpreted the ADA to provide that “an individual may not be
*36
denied insurance coverage based on a disability unless such denial is based upon sound risk classification.”
Pallozzi,
The safe harbor provision directs that Titles I through III of the ADA shall not be construed to regulate insurance underwriting practices unless these practices are inconsistent with state law or the safe harbor itself is used as a “subterfuge” to evade the purposes of Titles I and III of the Act.
See
In
Public Employees Retirement System v. Betts,
to observe the terms of ... any bona fide employee benefit plan such as a retirement, pension, or insurance plan, which is not a subterfuge to evade the purposes of this chapter, except that no such employee benefit plan shall excuse the failure to hire any individual, and no such ... employee benefit plan shall require or permit the involuntary retirement of any individual ... because of the age of such individual.
We next consider whether Plaintiffs’ complaint met this obligation. We find it did. The complaint clearly alleged that Allstate’s conduct violated various provisions of New York State law. This allegation, coupled with the further allegation that Allstate’s conduct violated Title III, sufficed to state an actionable claim under the ADA. There was no basis for requiring Plaintiffs to .plead in addition that the challenged conduct lacked actuarial justification.
6
The court’s judgment dis
*37
missing Plaintiffs’ complaint under
Conclusion
The judgment of the district court is Vacated, and the case Remanded to the district court for further proceedings consistent with this opinion.
Notes
. Plaintiffs also argue that Title III prohibits underwriters from denying coverage by reason of disability except on the basis of "sound actuarial principles.” We need not reach that contention and express no views on it.
. We understand this somewhat awkward language to mean that the Act shall not be construed to prohibit or restrict insurers from underwriting risks, classifying risks, or administering risks in a manner that is not inconsistent with State law.
.
Parker v. Metropolitan Life Ins. Co.,
.
See, e.g., In re Olga Coal Co.,
. On a different question, whether Title III prohibits a health insurer from imposing a cap on benefits for treatment of AIDS, the court ruled that it did not, and that in any event McCarran-Ferguson would bar such an interpretation.
See Mutual of Omaha,
. The provisions of New York law that Plaintiffs alleged were violated by Allstate do not require a plaintiff to plead absence of actuarial justification in order to state a claim.
See