US EX REL. BRANCH CONSULTANTS v. Allstate Ins. Co.US EX REL. BRANCH CONSULTANTS v. Allstate Ins. Co.
UNITED STATES of America, ex rel. BRANCH CONSULTANTS, Plaintiff-Appellant,
v.
ALLSTATE INSURANCE COMPANY; State Farm Fire and Casualty Company; Liberty Mutual Fire Insurance Company; Fidelity National Insurance Company; Fidelity National Property and Casualty Insurance Company; American National Property & Casualty Company; Pilot Catastrophe Services, Inc.; Crawford & Company, Allied Claims; NCA Group, Inc.; Simsol Insurance Services, Inc.; Unidentified Parties; American Reliable Insurance Company; Colonial Claims Corp.; Standard Fire Insurance Company, Defendants-Appellees.
United States Court of Appeals, Fifth Circuit.
*372 Allan L. Kanner (argued), Cynthia Green St. Amant, Kanner & Whiteley, LLC, New Orleans, LA, for Plaintiff-Appellant.
Brad D. Brian, Gregory John Weingart, Munger, Tolles & Olson, Los Angeles, CA, Judy Y. Barrasso, Stephen H. Kupperman, Barrassso, Usdin, Kupperman, Freeman & Sarver, New Orleans, LA, Genevieve Cox, Munger, Tolles & Olson, San Francisco, CA, Richard L. Fenton, Steven M. Levy, Sonnenschein, Nath & Rosenthal, Chicago, IL, for Allstate Ins. Co.
Phillip A. Wittmann (argued), Daria Burgess Diaz, Stone, Pigman, Walther & Wittmann, New Orleans, LA, for State Farm Fire & Cas. Co.
Russell Yager, Vinson & Elkins, Dallas, TX, for Liberty Mut. Fire Ins. Co.
*373 Gerald Joseph Nielsen, William Truman Treas, Nielsen Law Firm, Metairie, LA, for Fidelity Nat. Ins. Co. and Fidelity Nat. Prop. & Cas. Ins. Co.
Jay M. Lonero, Christopher Raymond Pennison, Larzelere, Picou, Wells, Simpson, Lonero, Metairie, LA, for Am. Nat. Prop. & Cas. Co.
Robert A. Kutcher, Chopin, Wagar, Richard & Kutcher, Metairie, LA, James H. Crosby, Crosby Saad, LLC, Mobile, AL, Timothy J. Hatch, Gibson, Dunn & Crutcher, LLP, Washington, DC, for Pilot Catastrophe Services, Inc.
Richard B. Eason, II, Raymond Peter Ward, Adams & Reese, New Orleans, LA, for Crawford & Co.
William Glenn Burns, Dominic J. Ovella, Darren A. Patin, Richard T. Simmons, Jr., Hailey, McNamara, Hall, Larmann & Papale, Metairie, LA, for NCA Group, Inc.
Andre Jude Lagarde, McCranie, Sistrunk, Anzelmo, Hardy, Maxwell & McDaniel, Metairie, LA, for Simsol Ins. Services, Inc.
Gordon Paul Serou, Jr., Law Offices of Gordon P. Serou, Jr., New Orleans, LA, for Am. Reliable Ins. Co.
Peter S. Koeppel, Michael Louis Martin, Best Koeppel, New Orleans, LA, for Colonial Claims Corp.
Harry A. Rosenberg, Phelps Dunbar, New Orleans, LA, Bryce L. Friedman (argued), Simpson, Thacher & Bartlett, LLP, New York City, Deborah L. Stein, Simpson, Thacher & Bartlett, LLP, Los Angeles, CA, for Standard Fire Ins. Co.
Before BENAVIDES, SOUTHWICK and HAYNES, Circuit Judges.
HAYNES, Circuit Judge:
Relator Branch Consultants appeals the district court's dismissal of its False Claims Act (FCA) complaint under the FCA's first-to-file jurisdictional bar. See
We agree with the district court that Branch cannot avoid
I. FACTS
Relator Branch brought this action against eight insurance companies and six adjusting firms on behalf of the United States under the qui tam provisions of the FCA.[2] The insurer Defendants are participants in FEMA's Write-Your-Own flood insurance program (the WYO program). This program allows private insurance companies to write and service, in their own names, the federally backed Standard Flood Insurance Policy (SFIP). Participants in the WYO program are responsible for determining the extent of an insured's flood damage, which in turn determines the amount of benefit ultimately paid out by the Federal Treasury. See Wright v. Allstate Ins. Co.,
To ensure accurate estimates of flood damage, WYO insurers are generally required to comply with certain conditions, such as submitting a proof of loss. Following Hurricane Katrina, however, FEMA was forced to waive certain of these requirements in order to expedite payments to insureds. According to Branch, this created a perverse incentive for WYO insurers to understate losses due to wind (which an insurer would be required to pay under the insured's homeowner's policy) and overstate losses due to flood, thereby shifting the loss from the WYO insurers to the federal government.
A. The Rigsby Complaint
On April 2, 2006, prior to the filing of Branch, Cori and Kerri Rigsby, employees of a company that provides disaster claims management services for several WYO insurers, filed an FCA claim alleging that four insurance companies defrauded the federal government by mischaracterizing wind damage as flood damage in the wake of Hurricane Katrina.[3] Specifically, the Rigsbys alleged that, while adjusting claims for certain WYO insurers, they learned that the insurers "made a corporate decision to misdirect and misallocate claims from those of hurricane coverage to flood claims" payable by the federal government. While the Rigsbys lodged these general allegations of wind/water fraud against four WYO insurers,[4] the only specific instances of fraud alleged in their complaint concerned defendant State Farm. The Rigsbys alleged that "State Farm directed its employee adjusters and independent contractor adjusters to show flood damage whenever and wherever there was any amount of water damage, and to adjust the claim as flood insurance rather than hurricane insurance even though the primary mechanism for damage *375 was wind, not flood waters." "[A]djusters were told that if they initially analyzed a claim and found that the insured had less damage under flood coverage than policy limits allowed, the adjuster was told to go back through the claim a second time to ensure that the flood claim `hit limits.'" The Rigsby's complaint alleged two specific instances where State Farm put this fraudulent policy into practice, both dealing with Katrina damage to homes in Mississippi, and also alleged that they provided adjusting services for Allstate.
B. Branch's Complaint
With Rigsby under seal, Branch filed this FCA action on August 2, 2006 and amended its complaint on June 22, 2007.[5] Like Rigsby, Branch alleges that the WYO insurer Defendants "defrauded NFIP by misattributing wind damage and other non-flood losses to the flood policies subsidized or underwritten by the Government rather than correctly attributing such losses to causes that are covered by homeowners policies largely underwritten by themselves." But unlike Rigsby, Branch goes beyond these general allegations of wind/water fraud by detailing fifty-seven specific instances where Defendants allegedly overestimated flood damage on Louisiana properties. Branch contends that it discovered these specific instances of fraud when various insureds hired Branch to re-examine the adjustments conducted by Defendants. During the course of this employment, Branch alleges it discovered:
a. numerous examples of minimal if any flood damage and obvious wind damage, with a WYO adjustment of 100% flood damage,
b. buildings with substantial roof and other damage obviously caused by wind, and a high-water mark only inches off the floor, with all damage nonetheless attributed only to flood, and
c. buildings with a substantial amount of flood damage but even more wind damage adjusted at or near flood policy limits with a relatively small portion of the loss attributed to wind.
For each of the fifty-seven claimed instances of fraud, Branch lists the homeowner's address, his or her insurance company and policy number, the amount of flood damage paid by the federal government, and a dollar amount and explanation of the "true" flood damage to the properties. While Branch, like Rigsby, names State Farm and Allstate, it also names a host of WYO insurers that the Rigsbys did not sue.[6] Branch lodges specific factual allegations against each of the WYO insurers it sued.
C. District Court Proceedings
Defendants filed a motion to dismiss Branch's complaint, arguing that the district court lacked subject matter jurisdiction because (a) Branch's allegations were based on publicly disclosed information, (b) Branch was not an "original source," and (c) Branch failed to file its first amended complaint in camera under seal at least sixty days before service. Defendants also *376 argued that Branch's complaint did not meet the pleading requirements of
The district court granted Defendants' motion to dismiss, ruling only on the issues raised in the supplemental motion. The district court concluded that the FCA's first-to-file bar deprived it of jurisdiction over Branch's complaint because the complaint alleged the "same general conduct and theory of fraud" as Rigsby, regardless of whether Branch alleged different details, different geographic locations, or other participants in the alleged scheme. Branch's claims are now before this Court.
II. DISCUSSION
Branch contends that the district court's construction of
When addressing a dismissal for lack of subject matter jurisdiction, we review application of law de novo and disputed factual findings for clear error. Krim v. pcOrder.com,
A. FCA Background
We have discussed the procedural underpinnings of the FCA's qui tam provisions on prior occasions and thus do not repeat them here. See Riley v. St. Luke's Episcopal Hosp.,
The history of the FCA's qui tam provisions demonstrates repeated attempts by Congress to balance two competing policy goals. On the one hand, the provisions seek to encourage whistleblowers with genuinely valuable information to act as private attorneys general in bringing suits for the common good. Id. On the other hand, the provisions seek to discourage opportunistic plaintiffs from filing parasitic lawsuits that merely feed off previous disclosures of fraud. Id. To promote the latter goal, Congress has placed a number of jurisdictional limits on the FCA's qui tam provisions, including
B. The FCA's First-to-File Bar
Although LaCorte focused primarily on the text of
In Walburn v. Lockheed Martin Corp.,
We agree with these circuits that the applicability of
1. Details and Geographic Locations
We agree with the district court that a relator cannot avoid
Under this framework, the district court properly dismissed Branch's allegations against State Farm. Rigsby specifically alleged that State Farm, in its capacity as a WYO insurer, reallocated claims on two Mississippi properties from wind damage to flood damage in a pernicious attempt to shift its costs to the federal fisc. Branch brought identical allegations against State Farm, except it also alleged facts concerning ten properties in neighboring Louisiana. Because Branch cannot avoid the preclusive effect of Rigsby by focusing on additional instances of fraud occurring in other geographic locations,
*379 2. Allstate
For this same reason, we affirm the dismissal of Allstate, named in the Rigsby complaint. We recognize that only skeletal allegations are raised against Allstate in that case. We express no opinion on the as-yet-unpresented question of whether a dismissal for lack of any factual basis or on
3. Unnamed Defendants
The district court also dismissed Branch's allegations against a host of Defendants not named in Rigsby, presumably on the theory that Rigsby's broad allegations preempted the entire field of Katrina-related WYO fraud. No circuit has directly addressed the issue of whether allegations in a first-filed action can bar related allegations against wholly unrelated defendants brought in a subsequent action. The closest cases are those holding that allegations of fraud against a corporation may bar subsequent allegations of fraud against the corporation's subsidiaries. In Hampton, for example, the District of Columbia Court of Appeals held that
Several circuits have also addressed the issue of unnamed wrongdoers in the context of the FCA's public disclosure bar,
If we were to apply these decisions by analogy to the first-to-file situation, they suggest that there might be situations in which the allegations in a first-filed complaint pertain to such a narrow or readily-identifiable group of potential wrongdoers that
Further, unlike the additional defendants named in Hampton and Grynberg, the additional defendants named in this case are not corporate affiliates or subsidiaries of the Rigsby defendants. Neither Rigsby nor Branch alleges that Katrina-involved WYO insurers conspired or acted in concert to defraud the government. They are not part of a small group of carefully-monitored federal contractors, or working together on a particular site. Rather, the class of wrongdoers that may have committed Katrina-related wind/water fraud are independent entities operating wholly separately, related only by their mutual participation in the government's WYO program. Under these circumstances, forcing the government to expend its limited time and resources wading through the records of ninety-one WYO insurers in an attempt to identify specific instances of fraud would completely undermine the enforcement component of the FCA's qui tam provisions.
That is not to say that the first-filed bar can never bar a suit against an unnamed alleged fraud-feasor who is not a corporate relative of the named fraud-feasor. As stated above, "once the government knows the essential facts of the fraudulent scheme, it has enough information to discover related fraud." LaCorte,
Accordingly, we conclude that the district court erred in dismissing under the first-to-file rule the Branch Defendants that Rigsby failed to name.
*381 C. Public Disclosure Bar
The insurer Defendants argue that this Court should affirm the dismissal of Branch's claims on the alternative ground of the FCA's public disclosure bar. As discussed above, the public disclosure bar is based upon the notion that a qui tam suit does not benefit the Government if the information about the fraud is already publicly known, unless the plaintiff is an original source. See United States ex rel. Reagan v. E. Tex. Med. Ctr. Reg'l Healthcare Sys.,
III. CONCLUSION
We AFFIRM the district court's dismissal of Branch's claims against State Farm and Allstate. We REVERSE the dismissal of Branch's claims against all other Defendants based upon the ground of the first-to-file bar. Rather than address Defendants' alternative grounds for affirmance, we REMAND the cause so the district court can consider those arguments in the first instance. See Breaux v. Dilsaver,
NOTES
Notes
[1] No. 1:06-CV-433 (S.D.Miss. Apr. 26, 2006).
[2] The Appellees in this appeal are Allstate, State Farm, Liberty Mutual Fire Insurance Company, Fidelity National Insurance Company, Fidelity National Property and Casualty Insurance Company, American National Property & Casualty Insurance Company, Pilot Catastrophe Services Inc., Crawford & Company, Allied Claims, NCA Group Inc., Simsol Insurance Services Inc., American Reliable Insurance Company, Colonial Claims Corp., and Standard Fire Insurance Company (collectively Defendants).
[3] The Rigsby complaint is currently pending in the Southern District of Mississippi.
[4] The insurer defendants in Rigsby are State Farm, Allstate, Nationwide Insurance Company, and USAA Insurance Company.
[5] Our focus is on the allegations in Branch's first amended complaint because "when a plaintiff files a complaint in federal court and then voluntarily amends the complaint, courts look to the amended complaint to determine jurisdiction." Rockwell Int'l Corp. v. United States,
[6] The additional Branch insurer Defendants are Liberty Mutual, Fidelity National Insurance Company, Fidelity National Property & Casualty Company, American National Property & Casualty, American Reliable, and St. Paul Travelers.
[7] "When a person brings an action under this subsection, no person other than the Government may intervene or bring a related action based on the facts underlying the pending action."
[8] A court lacks jurisdiction "over an action under this section based upon the public disclosure of allegations ... unless ... the person bringing the action is an original source of the information."
[9] Nothing in Lujan indicates that the Ninth Circuit meant the phrase "same material elements of fraud" to be construed differently than LaCorte's phrase "all the essential facts" of the fraud, especially since the Ninth Circuit found LaCorte's "reasoning persuasive" as to the proper test under
[10] Branch further contends that the district court erred in failing to analyze Rigsby for
[11] Indeed, private WYO insurance companies are independently responsible for issuing flood coverage and for adjusting, settling, paying, and defending all claims arising from such coverage.