United States v. HawleyUnited States v. Hawley
The United States brought a civil action against Russell T. Hawley, an insurance agent, and his insurance company, Hawley Insurance, Inc. (collectively, “Hawley”), alleging violations of the False Claims Act (“FCA”),
I.
In 1938, Congress enacted the Federal Crop Insurance Act (the “Act”),
The FCIC contracts with approved private insurance companies to offer crop insurance policies to eligible farmers.
The approved private insurance company in this case was North Central Crop Insurance, Inc. (“NCCI”). Russell Haw-ley worked as a private insurance agent for NCCI. Hawley had experience in the crop insurance industry, having previously worked as a crop insurance adjuster for NCCI and another crop insurance company before starting his own crop insurance agency, Hawley Insurance, Inc., in 1994. As NCCI’s agent, Hawley sold Multi-Peril Crop Insurance (“MPCI”) policies to various individuals, receiving commissions from NCCI on those policies. MPCI policies are reinsured by the FCIC and offer coverage for crop losses.
In February 2000, Hawley signed and submitted to NCCI a crop insurance application in the names of brothers Sydney and Stanley Windquist for crops in South Dakota. The Windquists, however, were ineligible to receive FCIC-reinsured coverage, because they had no insurable interest in the crops. The Windquists certified that they had an interest in the crops, and in June 2000, Hawley signed and submitted their acreage reports to NCCI. Subsequently, the Windquists filed claims with NCCI for losses to the insured crops, and NCCI paid the Windquists for those losses. The FCIC ultimately reimbursed NCCI for those payments and for premium subsidies on the Windquist policy, in the amount of $145,540. The government prosecuted the Windquists for federal crop insurance fraud, and the case was resolved when the Windquists admitted that they did not have an insurable interest in the crops and entered into pretrial diversion agreements.
The government learned of Hawley’s actions, and in October 2006, brought a civil action against him in the district court. The complaint alleged that Hawley knowingly caused ineligible farmers to obtain MPCI coverage and to receive payments from NCCI, payments which the FCIC reimbursed. The government sought treble damages and civil penalties under three subsections of the FCA,
The parties filed cross-motions for summary judgment. In April 2008, the district court granted summary judgment in favor of Hawley on the government’s
In June 2008, five days before trial was scheduled to begin, the court
sua sponte
issued an order cancelling trial and granting summary judgment in favor of Hawley on the three remaining claims.
United States v. Hawley,
The government appealed the grant of summary judgment in favor of Hawley on its FCA and fraud claims. On May 20, 2009, after briefing and oral argument in this case, Congress amended the language of
We review the grant of summary judgment
de novo,
viewing the evidence and drawing all reasonable inferences in the light most favorable to the government, the nonmoving party.
Green v. City of St. Louis,
II.
any request or demand ... for money or property which is made to a contractor, grantee, or other recipient if the United States Government provides any portion of the money or property which is requested or demanded, or if the Government will reimburse such contractor, grantee, or other recipient for any portion of the money or property which is requested or demanded.
The government argues that there is a submissible ease on its claim under
Hawley responds that the government is raising a new argument on appeal by identifying the electronic reimbursement demands from NCCI to the FCIC as the “claims” that were presented to the FCIC. Hawley says that the “claims” pleaded and argued by the government in the district court were the claims for payment submitted to NCCI, not the electronic requests for reimbursement from NCCI to the FCIC. Alternatively, Hawley asserts that even if the government preserved a contention that the electronic reimbursement demands were the “claims” presented to the FCIC, it has failed to produce evidence of those electronic demands.
We are satisfied that the government adequately preserved its argument that NCCI’s reimbursement demands were the “claims” presented to the government. There are sufficient references in the government’s complaint and summary judgment papers to assure us that the government is not unfairly switching gears on appeal. The complaint made clear that the FCIC reimbursed NCCI for the payments it paid to the Windquists and Marshall, thus implying that NCCI presented information related to those payments to the FCIC to trigger the reimbursement. The gоvernment argued in its response to Hawley’s motion for summary judgment that Hawley “submitted the false claims to NCCI,” and that NCCI “submitted the claims directly to the Federal Crop Insurance Corporation,” calling this “ ‘presentment’ in its purest form.” In the government’s reply to Hawley’s opposition to the government’s summary judgment motion, the government asserted that it was “undisputed that NCCI submitted [the false documents] for crop losses” to the FCIC for payment. And in that same reply, the
The government has the burden to prove that Hawley presented, or caused to be presented, a false claim to the United States government.
Totten,
Calvin Brewer, an official of the United States Department of Agriculture, testified in his deposition about the reimbursement system between private insurance companies and the FCIC. Brewer explained that after the insurance company assesses the loss to the insured crops, the company writes a check to the farmer for a certain amount. The check is tied to a “loss clearing account” in the company’s name. The company then submits data regarding the loss amount to the FCIC through an electronic “data acceptance system.” According to Brewer, once the company submits the data to the system electronically:
they look at a couple [of] minor edits, financial edits they call them, that there is a policy that you’re trying to claim a loss on and that the detail loss records add to the total loss record. If that happens, then ... escrow will pick up— the escrow system will pick up that request the next day and process it and you’ll be — we’ll actually generate a payment and do a[n] [electronic funds transfer] to transfer the money to an escrow account in the [FCIC’s] name.
Brewer testified that at this point, the money is in an escrow account in the FCIC’s name. When the farmer goes to the bank to cash the check he received from the company, the bank transfers the total amount of the check from the FCIC’s escrow account to the company’s loss clearing account to cover the loss amount. At some point after this transfer takes place, the FCIC and the insurance company undergo an annual settlement to determine what percentage, if any, of the loss reimbursed by the FCIC should instead be borne by the company under the terms of the SRA.
In addition to Brewer’s testimony, the SRA mandates that the company submit “accurate and detailed contract data” to the FCIC through the electronic data acceptance system. The SRA also requires that “[a]ll reports submitted for reimbursement must be certified.”
We conclude that this evidence creates a genuine issue of material fact regarding whether Hawley caused NCCI to present claims for reimbursement to the FCIC. There is enough in the record for a factfin-der reasonably to сonclude that the requests for payment originally submitted to NCCI were forwarded in some form to the FCIC.
See Allison Engine,
III.
The government next argues that the district court erred in granting summary judgment in favor of Hawley on its claim under
Several courts have concluded, however, that
The district court ruled that the
The Supreme Court reversed and held that to establish liability under
Applying the reasoning of
Allison Engine,
we conclude that the government made a sufficient showing of intent under
Drawing all justifiable inferences in the government’s favor, we believе a reasonable jury could find that Hawley intended, based on his experience selling federally reinsured crop insurance for NCCI, that NCCI would transmit a farmer’s claim to
Allison Engine
suggests that a defendant should answer under the statute for “the nаtural, ordinary and reasonable consequences of his conduct,”
id.
(internal quotation omitted), and a reasonable fact-finder typically may infer that a person intends the ordinary consequences of his voluntary acts.
See Willis v. State Farm Fire & Cas. Co.,
We next address whether the government offered sufficient proof to survive summary judgment on its
IV.
The government’s final contention is that the district court erred in granting summаry judgment in favor of Hawley on its common-law claim of fraud. Under Iowa law, “[t]he elements of fraud are: (1) a material misrepresentation (2) made knowingly (scienter) (3) with intent to induce the plaintiff to act or refrain from acting (4) upon which the plaintiff justifiably relies (5) with damages.”
Beeck v. Kapalis,
In
Clark v. McDaniel,
[t]he maker of a fraudulent misrepresentation is subject to liability for pecuniary loss to another who acts in justifiable reliance upon it if the misrepresentation, although not made directly to the other, is made to a third person and the maker intends or has reason to expect that its terms will be repeated or its substance communicated to the other, and that it will influence his conduct in the transaction or type of transaction involved.
Id. at 593 (internal quotation omitted). The court elaborated on the “reason to expect” standard, explaining that “[t]he maker of the misrepresentation must have information that would lead a reasonable man to conclude that there is an especial likelihood that it will reach [third] persons and ... influence their conduct.” Id. (internal quotation omitted).
We conclude that the record creates genuine issues of material fact regarding whether Hawley had reason to expect that the representations set forth in false insurance applications and acreage reports that he signed and submitted would reach the FCIC and influence the FCIC’s decision to reimburse NCCI. As noted, Hawley had extensive experienсe as a crop insurance adjuster and private agent selling federally reinsured crop insurance policies in NCCI’s name. Based on that experience, there are fact questions as to whether he knew that NCCI would communicate false representations to the FCIC, because NCCI, when seeking reimbursement, would necessarily represent to the FCIC that the claims arose from persons eligible for crop insurance. Indeed, a basic premise of the SRA between NCCI and the FCIC is that NCCI will insure only eligible individuals, and that the FCIC will reimburse only valid claims. Thus, although the insurance applications and acreage reports were not themselves forwarded to the FCIC, a jury could find that Hawley had reason to expect that the representations included in those documents — namely, that the farmers were eligible for insurance — would be passed on to the FCIC by NCCI. On the same basis, it is reasonable to infer that Hawley had reason to expect that the FCIC would rely on the farmers’ purported eligibility in deciding to reimburse NCCI. Accordingly, summary judgment is not warranted on the government’s common-law fraud claim.
For the foregoing reasons, we reverse the district court’s grant of summary judgment on the gоvernment’s claims under
Notes
. Congress amended
. The parties do dispute whether retroactive application of