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  • Case Opinion

MSPA Claims 1, LLC v. Allstate Ins. Co.

MSPA Claims 1, LLC v. Allstate Ins. Co.

United States District Court for the Northern District of Illinois, Eastern Division

September 11, 2019, Decided; September 11, 2019, Filed

No. 17-cv-01340

Opinion

MEMORANDUM OPINION AND ORDER

Plaintiff MSPA Claims 1 LLC has filed this putative class action against Defendant Allstate Insurance Company ("Allstate"), claiming to be the assignee of legal claims held by numerous unidentified Medicare Advantage Organizations ("MAOs"). Plaintiff seeks double recovery under the Medicare Secondary Payer provisions of the Medicare Act, 42 U.S.C. § 1395y(b)(2)-(3) ("MSPA" or "MSPA provisions") for reimbursement of medical expenses that the various MAOs paid on Allstate's behalf. This Court previously dismissed Plaintiff's [*2]  First Amended Complaint for failure to plead facts showing that it is indeed the assignee of the rights at issue. See MAO-MSO Recovery II, LLC v. Allstate Ins. Co., No. 17-cv-01340, 2018 U.S. Dist. LEXIS 55131, 2018 WL 1565583 (N.D. Ill. Mar. 30, 2018). Plaintiff then filed a Second Amended Complaint ("SAC") (Dkt. No. 65). Now before the Court is Defendant's motion to dismiss the SAC, as well as Defendant's motion to dismiss or strike the class allegations contained in the SAC. (Dkt. Nos. 67, 68.) For the reasons explained below, both motions are denied.

BACKGROUND

For the purposes of Defendant's motion to dismiss, the Court accepts as true the well-pleaded facts in the SAC and views them in the light most favorable to Plaintiff. See Firestone Fin. Corp. v. Meyer, 796 F.3d 822, 826-27 (7th Cir. 2015). For present purposes, the Court also assumes familiarity with its March 30, 2018 Memorandum Opinion and Order ("March 30, 2018 Order").

According to Plaintiff, Allstate agreed to serve as the primary insurer for certain enrollees in its no-fault automobile insurance policies. After the enrollees were involved in automobile accidents that caused them to incur expenses for medical treatment, the MAOs paid the enrollees' expenses instead of Allstate. The MAOs thus had the right under the MSPA provisions to institute private [*3]  actions against Allstate for reimbursement and double damages. Plaintiff claims to have obtained the MAOs' rights through a series of assignments and now seeks to enforce those rights against Allstate. Plaintiff also asserts a claim for breach of contract via subrogation of the enrollees' contractual rights, alleging that Allstate breached its no-fault automobile insurance contracts with the enrollees by failing to pay their medical expenses.

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2019 U.S. Dist. LEXIS 155248 *; 2019 WL 4305519

MSPA CLAIMS 1, LLC, Plaintiff, v. ALLSTATE INSURANCE COMPANY, Defendant.

Prior History: MAO-MSO Recovery II, LLC v. Allstate Ins. Co., 2018 U.S. Dist. LEXIS 55131 (N.D. Ill., Mar. 30, 2018)

CORE TERMS

allegations, rights, enrollees, assigned, assignee, assignor, provisions, reimburse, class certification, no-fault, pleaded, entities, contends, insurance policy, medical expenses, medical provider, motion to strike, contractual, argues, conditional payment, class action, administered, fail-safe, expenses