Articles Posted in Antitrust & Trade Regulation

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Mark Ibsen, Inc., the owner and operator of the Urgent Care Plus medical clinic in Helena, purchased health insurance coverage for its employees from Blue Cross and Blue Shield of Montana (BCBSMT) through a Chamber of Commerce program. Health Care Corporation (Health Care) subsequently acquired BCBSMT’s health insurance business and changed its name to Caring for Montanans, Inc. (Caring). Less than one year later, Ibsen filed a complaint and class action against Caring and Health Care claiming that they had violated the Unfair Trade Practices Act (UTPA). Health Care filed a motion to dismiss and Caring filed a motion for summary judgment. The district court granted the motions, concluding that the legislature did not provide private citizens with the right to bring a cause of action to enforce the UTPA. The Supreme Court affirmed, holding (1) Ibsen may not maintain a private right of action for violation of Mont. Code Ann. 33-18-208 and -212 of the UTPA; and (2) in the alternative, Ibsen’s claims cannot be sustained as common law claims. View "Mark Ibsen, Inc. v. Caring for Montanans, Inc." on Justia Law

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Prior to July 2011, St. Peter’s Hospital’s Medical Staff granted privileges to qualified, non-employee radiologists, including the physicians of Montana Interventional and Diagnostic Radiology Specialists, PLLC (MIDRS), a professional limited liability company whose members are engaged in the practice of radiology. In July 2011, the Hospital closed its radiology department to all non-employee physicians regardless of qualification. MIDRS brought this action against the Hospital, alleging intentional interference with prospective advantage and unfair trade practices. The district court granted the Hospital’s motion for judgment on the pleadings and dismissed the complaint as untimely, concluding that MIDRS filed its complaint outside of the applicable statutes of limitation. The Supreme Court reversed, holding that the accrual of MIDRS’ claims could not be determined from the pleadings alone and that further development of the record was necessary. View "Mont. Interventional & Diagnostic Radiology Specialists, PPLC v. St. Peter’s Hosp." on Justia Law

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During Plaintiff’s marriage dissolution proceedings, Nancy Smith served as guardian ad litem for Plaintiff’s children. After Plaintiff stopped paying bills to Smith, Smith assigned the unpaid bills to Collection Professionals, Inc. (CPI). CPI filed a complaint to collect the debt. Thereafter, Plaintiff filed this action alleging, among other claims, that Collection Professionals, Inc. (CPI) violated the Fair Debt Collection Practices Act (FDCPA) by attempting to collect a false debt. CPI counterclaimed for the amount owed for Smith’s services. The district court entered summary judgment in favor of CPI and Smith. The Supreme Court affirmed, holding that the district court (1) correctly awarded summary judgment to CPI on Plaintiff’s FDCPA claim because the FDCPA did not apply under the circumstances of this case; (2) correctly awarded summary judgment to Smith; and (3) correctly awarded CPI $7,408 in damages plus interest. View "Amour v. Collection Prof’ls, Inc." on Justia Law

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Central United Life Insurance Co. (CULI) purchased Judith Gleason’s cancer benefit insurance policy prior to Gleason’s death from breast cancer. Gleason’s Estate submitted notice of potential claims under the policy to CULI. CULI paid certain claims but denied payment for claims submitted outside the policy limit. The Estate contested the denial of the untimely-filed claims. The district court granted partial summary judgment for the Estate, ruling that CULI owed payment for the untimely-filed claims, provided it was not prejudiced by the late notice. After a trial, the jury found that CULI had violated the Montana Unfair Trade Practices Act (UTPA) but did not award damages and therefore did not consider whether CULI acted with malice. The Supreme Court affirmed in part, reversed in part, and remanded, holding (1) the district court correctly applied the notice-prejudice rule; and (2) when an insurer is found to have violated the UTPA, a jury is not required to find compensatory damages beyond those for breach of the insurance contract before considering malice and punitive damages under the UTPA, and therefore, a new trial must be held on the issue of malice and punitive damages. View "Estate of Gleason v. Cent. United Life Ins. Co." on Justia Law

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After receiving treatment from St. Peter’s Hospital, Plaintiff filed suit alleging that the Hospital violated Montana anti-trust laws and the Montana Constitution by discriminating against her based on her lack of health insurance. After concluding that Plaintiff had standing, the district court awarded summary judgment to the Hospital, determining that uninsured persons are not a protected class under the Montana Constitution. The Supreme Court (1) affirmed the district court’s standing determination; but (2) reversed the court’s entry of summary judgment on the merits, holding that the determinations that the district court made in its summary judgment order did not resolve all of Plaintiff’s claims. Remanded. View "Gazelka v. St. Peter’s Hosp." on Justia Law

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Plaintiff, a Montana corporation, sells workers’ compensation insurance to employers without the use of insurance agencies. Defendant Montana State Fund sells workers’ compensation insurance through in-house and out-of-house agents. The remaining defendants also sell workers’ compensation insurance, including State Fund policies. In 2011, Plaintiff brought this of action against Defendants, alleging violations of the Unfair Trade Practices Act (UTPA) and intentional interference with prospective economic advantage. The district court (1) dismissed Plaintiff’s UTPA claim on the grounds that the UTPA does not create a private right of action by one insurance company against another; and (2) granted Defendants’ motions for summary judgment with respect to interference with prospective economic advantage. The Supreme Court affirmed, holding that Plaintiff’s inability to establish damages was fatal to its intentional interference claim and would be fatal as well to any UTPA-related claim. View "Victory Ins. Co. v. Mont. State Fund" on Justia Law

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Appellant was involved in a car accident with Kent Blough. Appellant's insurer, USAA Casualty Insurance Company, concluded that Appellant was the majority at fault for the accident and refused to honor Appellant's $300,000 UM/UIM coverage. Appellant filed suit against Blough, and in an apparent attempt to prevent Appellant from prevailing, USAA unsuccessfully tried to intervene in the lawsuit. Blough's insurer paid Appellant the limit of Blough's insurance policy. USAA's expert eventually determined that Blough, whom USAA had already paid under Appellant's policy, had been the majority at fault. USAA then tendered to Appellant its $300,000 UM/UIM policy limit. Appellant filed a complaint against USAA for, among other claims, violations of the Montana Unfair Trade Practices Act and emotional distress as a result of the mishandling of her claim. The district court entered summary judgment for USAA. The Supreme Court reversed, holding that the district court (1) erred in determining that Appellant may not pursue a claim based upon USAA's alleged failure to reasonably investigate her claim as required under Mont. Code Ann. 33-13-201(4); and (2) erred when it granted summary judgment in favor of USAA regarding Appellant's claim for damages arising from emotional distress. View " McVey v. USAA Cas. Ins. Co." on Justia Law

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Heath and Vail Freyer, the parents of Alicia Freyer, were all riding in their vehicle, which was insured by State Farm, when the vehicle rolled over, causing Health's death. In Freyer I, the Court held that the subject policy provided coverage for Alicia's claim for derivative damages stemming from Health's death. After remand, State Farm paid the disputed coverage amounts. The Freyers then brought claims against State Farm for the wrongful denial of coverage for Alicia's derivative claims. The district court granted summary judgment to State Farm. The Supreme Court reversed in part and affirmed in part, holding that the district court (1) erred in concluding that State Farm had not breached the insurance contract when it failed to indemnify Vail for Alicia's derivative claims based on State Farm's "reasonable basis in law" defense; (2) properly granted summary judgment to State Farm on the common-law bad faith and breach of the covenant of good faith and fair dealing claims; and (3) did not err in granting summary judgment to State Farm on the Unfair Trade Practices Act claims. View "State Farm Mut. Auto. Ins. Co. v. Freyer" on Justia Law

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This interlocutory appeal arose from the district court's order certifying a class in Plaintiff's class action against Defendant, Allstate Insurance Company. Plaintiff's class action claim arose out of the Supreme Court's remand of his initial non-class third-party claim against Allstate in Jacobsen I. In Jacobsen I, Plaintiff filed a complaint against Allstate for, among other causes of action, violations of the Montana Unfair Trade Practices Act. Plaintiff sought both compensatory and punitive damages. The Supreme Court ultimately remanded the case for a new trial. On remand, Plaintiff filed a motion for class certification, proposing a class definition encompassing all unrepresented individuals who had either third- or first-party claims against Allstate and whose claims were adjusted by Allstate using its Claim Core Process Redesign program. The district court certified the class. The Supreme Court affirmed the class certification but modified the certified class on remand, holding that the district court did not abuse its discretion by certifying the Mont. R. Civ. P. 23(a)(2) class action but that the certification of class-wide punitive damages was inappropriate in the context of a Rule 23(b)(2) class. Remanded. View "Jacobsen v. Allstate Ins. Co." on Justia Law

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Leonard Landa was the sole managing member of a Montana limited liability corporation. Landa carried commercial general liability insurance through Assurance. After a former employee of Landa's filed a complaint alleging that Landa had committed various torts by inducing him to work for Landa under allegedly false pretenses, Landa tendered defense of the former employee's claim to Assurance. Assurance refused to defend Landa, stating that the complaint's allegations were not covered under Landa's policy. Landa filed a complaint seeking declaratory relief establishing that Assurance had a duty to defend and indemnify Landa and alleging violations of Montana's Unfair Trade Practices Act (UTPA), negligence, and other causes of action. The district court granted summary judgment for Assurance, finding that the complaint's allegations were not covered under Landa's policy and that Assurance was not liable under the UTPA because the denial of coverage was grounded on a legal conclusion. The Supreme Court affirmed, holding that Assurance correctly declined to provide a defense where the former employee's complaint did not allege an "occurrence" and, as a result, did not trigger a duty to defend under the policy. View "Landa v. Assurance Co. of Am." on Justia Law