Justia U.S. 6th Circuit Court of Appeals Opinion Summaries

Lesley and Fogg presented the Benistar 419 Plan to the Ouwingas, their accountant, and their attorney, providing a legal opinion that contributions were tax-deductible and that the Ouwingas could take money out tax-free. The Ouwingas made substantial contributions, which were used to purchase John Hancock life insurance policies. In 2003, Lesley and Fogg told the Ouwingas that the IRS had changed the rules; that the Ouwingas would need to contribute additional money; and that, while this might signal closing of the “loophole,” there was no concern about tax benefits already claimed. In 2006, the Ouwingas decided to transfer out of the Plans. John Hancock again advised that there would be no taxable consequences and that the Plan met IRS requirements for tax deductible treatment. The Ouwingas signed a purported liability release. In 2008, the IRS notified the Ouwingas that it was disallowing deductions, deeming the Plan an “abusive tax shelter.” The Ouwingas filed a class action against Benistar Defendants, John Hancock entities, lawyers, Lesley, and Fogg, alleging conspiracy to defraud (RICO, 18 U.S.C. 1962(c), (d)), negligent misrepresentation, fraudulent misrepresentation, unjust enrichment, breach of fiduciary duty, breach of contract, and violations of consumer protection laws. The district court dismissed. The Sixth Circuit reversed, View "Ouwinga v. Benistar 419 Plan Servs., Inc." on Justia Law

Goodyear announced in 2003 that it would restate its earnings for some prior years. The next day, shareholders filed class-action lawsuits against Goodyear and several of its officers and directors. The SEC also commenced an investigation. Eventually, the lawsuits were dismissed and the investigation terminated. Goodyear incurred $30 million of legal and accounting costs and sought recovery from two of its insurers. After several years of litigation, Goodyear released its claim against National Union in exchange for payment of $10 million, but the excess policy with Federal states that coverage attaches only after National Union pays out the full amount of its liability limit, which was $15 million rather than the $10 million that National Union paid. The district court granted summary judgment to Federal. The Sixth Circuit affirmed, rejecting arguments based on Ohio’s “public policy favoring settlements,” and that the settlement did not prejudice Federal in any way. View "Goodyear Tire & Rubber Co. v. Nat'l Union Fire Ins. Co." on Justia Law

In 2000 an “incident” occurred on the ice of a professional hockey game in Switzerland between Miller and McKim. McKim was injured. Swiss courts filed criminal charges against Miller. McKim’s insurer and hockey club filed suit against Miller, and two civil judgments were entered against Miller. Miller left Switzerland before the judgments were finalized and informed his hockey team and its insurer (Winterthur) that he no longer had the financial means to defend the litigation. In 2005, a document was submitted to Miller in Michigan from Winterthur that acknowledged its responsibility for the costs of criminal and civil judgments and proceedings pending in Zurich and previous attorneys’ fees. In 2010, McKim’s team and insurer submitted demands for payment to Miller from the Swiss judgment. Miller, claiming reliance, submitted the demands to Winterthur, which declined to pay the judgments in full. Miller brought suit in Michigan, seeking contractual damages and enforcement of the terms of the 2005 document. The district court granted Winterthur’s motion to dismiss for lack of personal jurisdiction. The Sixth Circuit affirmed. Miller had established a basis for personal jurisdiction under Michigan’s long-arm statute, but the requirements of constitutional due process were not met. View "Miller v. AXA Winterthur Ins. Co." on Justia Law

In a 2009 opinion, the Sixth Circuit held that, in a 1998 collective bargaining agreement, CNH agreed to provide health-care benefits to retirees and their spouses for life, but rejected the suggestion that the scope of this commitment in the context of healthcare benefits, as opposed to pension benefits, meant that CNH could make no changes to the healthcare benefits provided to retirees. The court remanded for a determination of reasonableness with respect to CNH’s proposed changes to its retiree healthcare benefits, under which retirees, previously able to choose any doctor without suffering a financial penalty, would be put into a managed-care plan. The court listed three considerations: Does the modified plan provide benefits “reasonably commensurate” with the old plan? Are the proposed changes “reasonable in light of changes in health care”? And are the benefits “roughly consistent with the kinds of benefits provided to current employees”? On remand, the district court granted CNH summary judgment without reaching the reasonableness question or creating a factual record from which the determination could be made on appeal. The Sixth Circuit again remanded.View "Reese v. CNH America LLC" on Justia Law

Adams worked in coal mines for 17 years, leaving A & E Coal in 1988, after 12 years, because he was having difficulty breathing. He has not worked since. Adams also smoked cigarettes for about 25 years, averaging a pack a day before quitting in 1998 or 1999. Adams filed his first claim for benefits under the Black Lung Benefits Act 30 U.S.C. 901 in 1988. His claim was denied: He did not prove that his pneumoconiosis was caused in part by his coal-mine work, or that his pneumoconiosis totally disabled him. In 2007, Adams filed a second claim. Two pulmonologists agreed that he was completely disabled, but disagreed on what lung diseases Adams had, and on what caused them. An Administrative Law Judge awarded benefits, finding that Adams had pneumoconiosis, that the disease was caused by Adams’s exposure to coal dust during his coal-mine employment, and that he was totally disabled because of the disease. The Benefits Review Board and the Third Circuit affirmed. Although the ALJ was not required to look at the preamble to the regulations to assess the doctors’ credibility, he was entitled to do so. View "A & E Coal Co. v. Adams" on Justia Law

TMTA obtained a policy, known as the CrimeShield Policy to transfer the risk of employee theft from the TMTA to Hartford. Almost immediately after the parties signed the Policy a TMTA employee began diverting funds into his own accounts from the TMTA Insurance Agency, a limited liability corporation controlled by the TMTA and from which the TMTA receives a significant portion of its income. The Agency is not a named insured under the policy. Hartford took the position that the Agency, not the TMTA, suffered the loss. The Sixth Circuit affirmed the district court, holding that the Agency a party is not directly covered by the policy, and that the policy does not otherwise provide for the TMTA to recover funds that were diverted from the Agency.View "Tooling, Mfg.& Tech. Ass'n v. Hartford Fire Ins. Co." on Justia Law

Policyholders claimed that their insurers incorrectly taxed their premiums as a result of the insurers’ failure to correctly identify the taxing jurisdiction in which the insured risks of each policyholder were located. Kentucky authorizes local governments to tax insurance premiums, Ky. Rev. Stat. Ann. 91A.080, and to charge a “reasonable collection fee. Insurers pass the tax on to the insureds along with the collection fee. Plaintiffs’ claims were narrowed to illegal dealing in premiums, negligence, conversion, and a declaration of rights; they sought refunds and injunctive and declarative relief. After rejecting an argument that it lacked jurisdiction because Kentucky law allowed an administrative remedy, the district court bifurcated class certification discovery from merits-based discovery, then subdivided plaintiffs into 10 subclasses, one for each insurer, and severed the subclasses into separate actions. The district court found the class ascertainable and administratively feasible, the Rule 23(a) prerequisites (numerosity, commonality, typicality and adequacy of representation) met, and the Rule 23(b)(3) requirements (that class litigation is superior and common questions predominate over individuals ones) satisfied. After settlements, only five appeals remained. The Sixth Circuit affirmed. View "Dyas v. State Farm Fire & Cas. Ins." on Justia Law

In 2007, Fifth Third loaned Buford $406,000 in exchange for a mortgage on property that Buford purportedly owned. Fifth Third obtained a title-insurance policy from Direct Title, an issuing agent for Chicago Title. Direct Title was a fraudulent agent; its sole “member” was the actual title owner of the property and conspired with Buford to use that single property as collateral to obtain multiple loans from different lenders. When creditors foreclosed on the property in state court, Fifth Third intervened and asked Chicago Title to defend and compensate. Chicago Title refused to defend or indemnify. Chicago Title sought to avoid summary judgment, indicating that it needed discovery on the questions whether “Fifth Third failed to follow objectively reasonable and prudent underwriting standards” in processing Buford’s loan application and whether Direct Title had authority to issue the title-insurance policy. The district court granted Fifth Third summary judgment. The Sixth Circuit affirmed, noting that “When a party comes to us with nine grounds for reversing the district court, that usually means there are none.”View "Fifth Third Mortg. Co. v. Chicago Title Ins. Co." on Justia Law

In February 2005, hackers used the wireless network at a DSW store for unauthorized access to plaintiffs’ main computer system and downloaded credit card and checking account information for more than 1.4 million customers. Fraudulent transactions followed; plaintiffs were alerted by an affected credit card company and launched an investigation; National Union was notified of the insurance claim and advised plaintiffs that it would investigate. Plaintiffs incurred expenses for customer communications, public relations, customer claims and lawsuits, and attorney fees in connection with investigations by seven state Attorney Generals and the Federal Trade Commission. More than $4 million in losses arose from costs associated with charge backs, card reissuance, account monitoring, and fines imposed by VISA/MasterCard. National Union denied coverage. The district court awarded $6.8 million, finding that plaintiffs suffered a loss “resulting directly from” the “theft of any Insured property by Computer Fraud” and rejected application of the exclusion of “any loss of proprietary information, Trade Secrets, Confidential Processing Methods or other confidential information of any kind.” The court rejected a claim for breach of the duty of good faith and fair dealing. The Sixth Circuit affirmed.View "Retail Ventures, Inc. v. Nat'l Union Fire Ins. Co." on Justia Law

Plaintiffs are retired unionized employees of defendant and were covered by collective bargaining agreements that addressed healthcare benefits. The parties contest whether the CBAs guaranteed employees and their spouses lifetime healthcare benefits after retirement. After retiring, the employees and spouses continued to receive healthcare insurance from defendant. Between ages 62 to 65, defendant paid 80% of the premium costs. When the retirees turned 65, defendant assumed 100% of premium costs. In 2006, defendant informed plaintiffs that the company was instituting a new healthcare plan that would no longer cover 100% of the premiums. Plaintiffs claimed violations of the Labor Management Relations Act, 29 U.S.C. 185, and the Employee Retirement Income Security Act, 29 U.S.C. 1132. The district court ruled in plaintiffs’ favor as to employee coverage, but in favor of defendant as to spouses. The Sixth Circuit reversed in part, in favor of plaintiffs. Although healthcare is a “welfare benefit,” not entitled to the same ERISA protection as pension benefits, employers are free to waive their power to alter welfare benefits. Defendant did so by offering vested healthcare coverage to retired employees and spouses, and by agreeing that CBAs could only be modified with signed, mutual consent of the parties. View "Moore v. Menasha Corp." on Justia Law