MSPA Claim I, LLC v. National Fire Insurance Company of Hartford
Filing
77
ORDER granting 46 Motion to Dismiss. Closing Case. Motions Terminated: 54 Defendant's MOTION for Protective Order Staying Discovery filed by National Fire Insurance Company of Hartford, 46 MOTION to Dismiss for Lack of Jurisdiction 42 Amended Complaint or in the alternative, MOTION for Judgment on the Pleadings filed by National Fire Insurance Company of Hartford, 73 Joint MOTION to Amend/Correct 68 Trial Management Order, /Sched uling Order filed by National Fire Insurance Company of Hartford. Signed by Judge Federico A. Moreno on 9/20/2017. (mmd) NOTICE: If there are sealed documents in this case, they may be unsealed after 1 year or as directed by Court Order, unless they have been designated to be permanently sealed. See Local Rule 5.4 and Administrative Order 2014-69.
UNI
TED STATES DI
STRI COURT FOR THE
CT
SO U TH ERN D I
STRI O F FLOR I A
CT
D
M i miDi son
a
vii
C a e N um be 1 20531- V - O R EN O
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oi
Pl i i f
a ntf ,
NA TI NA L FI I SUM N CE COM PA N Y
O
RE N
OF HARTFORD,
Def nda .
e nt
O R DER G M N TI G M O TI N TO D I I
N
O
SM SS
Thi c s se sfom t M e c r Se
s a e t m r he di a e conda y Pa rAc ' prvae rghtofa ton, w hi h
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o ii ui
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THI CAUSE c me befr t Cour u Defnda ' Moton t Dimis( E.46)
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,
fl on Februarv 6.2017.
ied
TH E CO U RT hm c i e t m oton,t r s
s onsder d he
i he e pons , pertnentportons of t r d,
e
i
i
he ecor
a be ng o he w i e f l a s i t p e i e , i i
nd i t r s uly dvi ed n he r m s s t s
ADJUDGED t tt m oton i GRANTED.I i a s
ha he
i s
t s lo
ADJUDGED t ta1ot rpe ng m o i a e DEN I a moot
ha l he ndi
tons r
ED s
.
1.
Backaround
Pl ntf M SPA Cli 1 LLC i
ai if
a ms ,
nvokes t prva e c e of ac i pr son of t
he i t aus
ton ovii
he
M edia e Se nda y Pa Ac t r ove r i
c r co r yer t o ec r e mbur e e of M e ca e beneis i t s c e.
s m nt
di r
ft n hi as
Pl i if i a t c -e oved as i
antf s wie r m
sgnee of a M e c r Adva a Or ni a i , ca l d Fl i
di a e
nt ge ga z ton le or da
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alhc e us nc.whi h i dia ls ncure
t nr l
m d
,
ufe ed
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r t
c oc ton ai if le s f nda
tonalFie l ur e Co pa pr de
r ns anc m ny ovi d
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ibiiy ns a e or
c nd houl e mbur et c t i ur e by Fl i He t a e Pl
s he oss nc r d
orda alhc r us
,
l Pl ntf alo al gest tNa i lFies tl L.H.sca m agans Soni f $1, on J
nc. ai if s le ha tona r eted
' li
i t c or 500 une
4,201 bu Na i lFie f ie t r mbur eFl i He t r Pl , l .f t ta ount
4, t tona r al d o ei
s orda alhca e us nc or ha m
.
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orda a t a e us I
i nal s i
t l m gans tona r o
Re
cove y Sysems l ,whih,i t n, sg d iscli t Pl i ifM SPA Cl i s1 LLC .
r
t , nc. c n ur as i ne t a m o antf
am ,
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ond
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ant s e t wo ount
i t tona r
is s
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i t i ht
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3 5 ( )3 ( ,
s e ng doubl da ag f Na i
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r s l d a l e o em s orda alhca e us
f r M edi a e be i s i a nce t c r L.H .S m e c l c t . The s cond c
o
c r nett t dva d o ove
'
di a os s
e
ount i f a
s or
de lrtr j
caaoy udgme a t Nai lFie' o i to t r mbure t payme ofc to l
nt s o tona r s blgain o ei s he
nt ondiina
M e ca e be is
di r neft .
Def ntNa i na Fie i movi t dimisa gui t s tl mentn
enda
to l r s
ng o s s r ng he e te
mountof$1500 i
s
,
ls t n t t es d a
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r
ye
t
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f nda t tonal Fi e a g s t
r r ue he
as i e t Pl i if i i i be aus t M e c r A dva a O r ni ton, Fl rda
s gnm nt o a ntf s nvald c e he
di a e
nt ge ga za i
oi
He t r Pl ,I .di no a ove i pro t t flng oft c
alhca e us nc d t ppr
t i r o he ii
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l.
andard
t s vi a m o i t di m i s pl i tf s m us do m o e t n m e el s a e l ga
$
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ton o s s , a n if
t
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oncl i , nse d ai if
'
t s ege om pe is a t l i or hos ncusons
al
f c dim i s loft i c a m s ' Jac n v Be l h Te ec m ., 372F. 1
a e s sa
he r l i .
' kw . lsout l om
3d 250,1 ( t Ci.
263 11h r
2004 . Whe r i o amoton t dimis ac tmus viw t eo anti t lg mos
)
n ulng n
i o s s , our t e he mpli n he iht t
f vo a e t t pli ifa a c t pl ntf s we lpl de f ds astue. Se St Jos ph'
a r bl o he antf nd c ept he ai if
l- ea d a
r
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Hop.I c v Hop. p.fAm.7 F.d9 , 3( lhCi.1 8 ) stne, o v r d e
s , n . . s Cor o , 95 2 48 95 l t r 9 6 .Thi e th we e , o s
n ta py t lg lc n lso s S eAs c o tv I b l l 9 S. .1 7,1 4 ( 0 9 .M o e v r
o p l o e a o cu in . e h rj . q a , 2 Ct 93 9 9 2 0 ) ro e ,
(wl i lg lc n l insc np o ietefa wo k o ac mpan ,h ymus b s p re b
C hl e a o cuso a r vd h rme r f o litt e
g e
t e u po td y
fdua algai . 1 a 1 0. Thos 't cualalegai mus bee
a l le tons' d. t 95
'
e 'la t l tons t nought riearg t
g
o as iht o
r le a ve t s c ai lvelo t a s
ei f bo he pe ul tve e
n he s umpton t ta loft c
i ha l
he ompli ts al ga i ar
a n ' le tons e
tue. BelAt.Cor v
r ' l l p. .Twombl 550 U. 5 5 (
'
y,
S. 44, 45 2007) l s tt co antmus not
. n hor, he mpli
t
m e e y al gea mico
r l le
s nduc , mus de
t but t monsr t t tt pl de i e il d t r le .Se I ,
ta e ha he ea r s ntte o e if e qbal
129 S.Ct a 1950.
.t
1 LeaalAnal s
11.
ysi
The M edi a e A d Pa tC ,a l w s a pr va e i ur ne e pa o r tng a a M e ca e
cr
r
lo
i t ns a c om ny pe a i s
di r
Adva t e O r ni a i t a i s e M edi r benei s pur ua t a eon r c w ih t f de a
n ag
ga z ton o dm ni t r
ca e
tt
s nt o
t a t t he e r l
gove
nune ,Cen e s f M e c r & M e c d Ser c .Huma M e ca PlnsI v.W .
nt
t r or dia e
di ai
vies
na di l a nc.
Heiac I .Co. 83 F. 1
rt e ns , 2 3d 229,1 ( 1h Ci.20l . The lw r r aprmay pln t
235 1 t r 6)
a equies i r a o
ri
embur e M e ca e ii i i de onsr t d t ts h prm a y pl n has orha a r s
s
di r df t s m ta e ha uc i r a
d e ponsbiiy t
i lt o
ma pa ntwihr s c t s ie ors r c '42 U. C.j 1
ke yme t epe t o uch tm
evie.
'
S.
395y( ( ( (i.tgl ohe
b)2)B)i) tln t r
w or , M edi ar m a ob a n r m bur e e f om a pr m a y pl n i i de o t a es t t t
ds
c e y t i ei
s m nt r
i r a f t m nsr t ha he
prma y pl ç sorha a r ponsbiiy't pa f t ie or s r c ' M SP Re ve y
i r an ha
d es i lt o y or he t m
e vi e.
'
co r s LLC .
v. ltt I .Co. 835F. 1 ,1 ( 1h Ci. 6 .
Alsae ns
,
3d 351 355 1 t r 201 )
l a ton t alowi t f r l gover nt t tl s t s eki
n ddii o l ng he ede a
nme o ie ui e
ng r i bur e nt
em s me ,
Congr s as c e t d a prva e rghtofaci n agans a prm a y pl
e s lo r a e
i t i
to
i t
i r
a t tf is t pr de f r
n ha a l o ovi o
prmaypay nt J Atis i t smotont dimisi whehe t t es dnmounta is
i r me . 4. sue n hi
i o s s s t r he hr hol
pple
.
t prva e rght ofa ton by a M e ca e Adva a Or ni a i oronl t cai sbr
o i t i s ci
di r
nt ge ga z ton
y o lm
oughtby
,
t f de algove nm e .
he e r
r nt
A . Th e hol A m ount
zs d
I Alsae,t Elve h Cic te
n lt t he e nt r ui xami d t sr tye oft M e c r Sec a y Paye
ne he tuct
he dia e ond r
r
A c ' prva e c us ofac i . The t xtoft prva e rghtofa ton r ds a f l s
ts i t a e
ton
e
he i t i
c i ea s olow :
The e i es a i hed a prva e c e of a ton f da age .
r s t bls
i t aus
c i or m s
. . n t
i he ca e of a prm ar pl n whi h f is t pr de f
s
i y a
c a l o ovi or
prmar pa nt ( a oprae ri s me ) i
i y yme or ppr it embure nt n
a coda ewihpaag a ( )a ( ( .
c r nc t r r phs l nd 2)A)
4 U. C.j 1 95 ( )3 ( . c g iig te lc o caiy i t e sau e t El vent Cicui
2 S.
3 y b ()A) Re o nzn h a k f lrt n h ttt, he e h r t
hed t t t de
l ha he monsr t r s i lt r quie e i i or aed a a pr r st t
taed e ponsbiiy e r m nt s nc por t
s
e equi ie o
pur ui t prva e c us of a ton. A ls a es835 F 3d a 1
s ng he i t a e
ci
lt t
t 359. TheEl nt Cic thel t s
eve h r ui d hi
.
e t ugh S m onsr t r ponsbiiy' wa note i il i l
ven ho
s
de
taed es i lt ' s
xplcty ncuded a a pr r quiie i t
s
e e st n he
txtoft prvae rghtofa ton a j 1 y( ( ( Rat r t dem onsr t d r ponsbiiy
e
he i t i
ci t 395 b)3)A)
he , he
ta e es i lt
.
p o iini wrte i as p rt s cin j 1 9 y b ( )B) l Alstt ,t pri t rghtofacton
r vso s i n n e aae e to 3 5 ( )2 ( n l a e he va e i
t
i
.
e tbih d i j 1 9 y b ( )A)r frn e p r g a h 2 A) whih,i t n,r er nces par r h
sa ls e n 3 5 ( )3 ( e ee c s a a rp ( , c n ur ef e
ag ap
( ( . Thee oe,t Elvenh Cicui r s ne t de
2)B)
rf r he e t r t ea o d he monsr td r s i lt r uie nt
tae eponsbiiy eq rme
s d be r a i o t prvae rghtofa ton. He e,t quesi goesone sep f t ra t
houl
e d nt he i t i
ci
r he
ton
t urhe nd he
Cour mus de dewhehe t t es da ntf
t t ci
t r he hr hol mou oundi j 1
n 395y( ( s dlke s bera
b)9) houl i wie e d
i o t prva e rghtofac i a a pr r s t .
nt he i t i
ton s e equi ie
The tles d a ountpr son r adsast l :
lr hol m
ovii e
blows
Clus (i ofpaa a ( ( and a rpori rquied
a e i)
rgrph 2)B)
ny e tng e r
b paa rp ( ) s l n t a pl wih r s c t a y
y r ga h 8 hal o p y t e pe t o n
s tlme t j d me t a r , o ohe p y n b a
ete n , u g n , wad r t r a me t y n
a i a e pl ars ng f om labiiy i ur nce .
pplc bl an i i r
i lt ns a
a
nd
fom a l d physca tau a- ed i i nt . .
r
lege
i l r m bas
nc de s
co tt i t al pa e oblga i t a cl m a of not
ns iutng ot
ym nt i ton o
ai nt
mor t n t sngl t e hol a o ca c a e by t
e ha he i e hr s d m unt l ult d
he
S ceayu d rs b aa rp ( f rt ey a ivov d
c rtr n e u p r g a h B) o h e r n le
.
4 U.. j 1 9 y b ( )A) Th t rs l a u ts cin rf rn e ca e (i ofp r g a h
2 SC. 3 5 ( )9 ( . e h ehod mo n e to e ee c s lus i
) aa r p
( )B) wh c ,i tr c o sr frn e p rg a () and cl rfes t t any r mburs m ent
2 ( , ih n u n, r s -ee e c s a a rph 9 ,
a ii ha
ei
e
oblgai i ed upon aprmay pln f rpa nt i s jctt paagrph ( 4 U. C.j
i ton mpos
i r a o yme s s ube o r a 9) 2 S.
.
1 9 y b ( )B)i . Une uv c ly sau o y s cin ( )B)r frn e te tr s od a u to
3 5 ( )2 ( (i
)
q io al , ttt r e to 2 ( ee e c s h h e h l mo n f
paa a ()a vi - ra. Folo ng Alsae' rtonae t s C ourtw illkew ie r d t
rgrph 9 nd ceves
lwi
ltt s ai l, hi
l i
s ea he
t es damountr r m e i o t prvat rg ofaci .
hr hol
equie nt nt he i e i ht
ton
Pl i ifr quesst Co ' lmi t t r s d a ntr quie e t c s br
antf e t he ul i t he h e hol mou e r m nt o a es oughtb
t
y
t f de algo nme f r i bur e
he e r
ver nt or em s mentunde 42 U .S. j l y( ( () l s
r
C. 395 2)B)3 . n uppor ofis
t t
poston,M SPA c tsW . H e iag l .Co. 832 F.3 a 1 3 ,o ag et a paa r p ( )B)d e
ii
ie
r t e ns
,
d t 2 7 t r u h t rg a h 2 ( o s
no a y t M e c r Adva a Or ni tons The El ve h Ci c t i Huma ,di not
t ppl o di a e
ntge ga zai .
e nt r ui, n
na d ,
howe ,de i whet rt Govenme ' rg ofa ton i paa aph ( ( wasavalbl t
ver cde
he he
r nts iht ci n rgr 2)B)
ia e o
M e c r Adva a Or ni tons L ,83 F. a 1
di a e
nt ge ga za i . 4. 2 3d t 237,n. (' pa t do no agueand
4$
The ri
es
tr
wed n tc n ie wh t e t eGo r me tsc u eo a to d srb di paa r p ( )B)wa
o o o sd r eh r h ven n ' a s f ci n e c ie n rg a h 2 (
s
i e d t beava lbl t M edia eAdva agcOr niatons' .TheCour,heef e doesnot
nt nde o
ia e o
cr
nt
ga z i . '
)
tt r or,
fnd Pl n if s a gum en pe s s ve t tt t es d a oun onl a i t t g vem m ent s
i
ai tf r
t r ua i ha he hr hol m
t y pples o he o
'
a to ,a notprva eones
c ins nd
i t
.
Thepa te havenotct a c s t tlmist t e hol r quie ntofpaa a ( )
ris
ied ny a e ha i t he hrs d e r me
rgrph 9
t t Go r e ' rg ofaci n a doe nota y i t t prva erghtofa ton. I ed,
o he venm nts i ht
to nd s
ppl t o he i t i
ci
nde
c t ha r c z d t ge a prncpl t t C
ours ve e ogni e he ner l i i e ha s
cong e s cea l i e
r s l ry nt nded t e t be pa iy
her o
rt
bewe MAOs( e c r Adva a Or ni to la ta tona Me c r ' I r Avandi
t en
M diae
ntge ga zains nd rdii l diae ' n e:
a
.
M kt Sal Pr ctce & Pr . Li b. Lii , 685 F. 353, 364 n. 1 ( Ci.201 . Thi
g. es a i s
ods a
tc.
3d
8 3d r 2)
s
prncpl i alo r l c e i t r ultonspr ul t d unde M ediar , wh c saeçth MA
i i e s s efe t d n he eg a i
om ga e
r
c e ih tt d l e
g
g e caeAdva age Or niai wile riet smerghst r overfom aprmaypln,
M di r
nt ) ga z ton l xecs he a i t o ec
r
i r a
e tt, ri dv d a t t h S ceaye ecs su d rt eM S g e ia eSe o d r Pa e Acq
n i o n iiu lha t e e rtr x r ie n e h
y
P M d c r c n ay y r t
rgultons'42C. R.j422.084
e ai .' F.
1 9,
Eve i t Cour we e t a e wih Pl ntf t tt sa ut i a bi
n f he
t r o gr e t ai if ha he tt e s m guousa t wheher
so
t
t t es d r quieme i e
he hr hol e r nt s mbedde i t prva e rght of ac i , a e mi ton oft
d n he i t i
ton n xa na i
he
l iltve hit y doesno s
eg sai
sor
t how t tCongr s i e d t dr w ditnc i n be we M e ca e
ha
e s nt nde o a
si to t en di r
a M e ca e Ad nt ge Or ni to
nd
di r
va a
ga zai ns
.
Pli if a gue Co r s i l d t t e hol
a ntf r s ng e s ncude he hr s d
a oun onl t a s e t Gover e doe notr c
m
t y o s ur he
nm nt s
e overl st n t c tt ptr ue a c a m . The
es ha he os o l s
li
pr e wih t Pli ifs a gume i t t t cos-a ngs r tonae apples e ly t
oblm
t he antf
r
nt s ha he
ts vi
ai l
i qual o
M cdi a e A d nt e O r ni a i , whih a e f
cr
va ag
ga z tons
c r unded outoft s m e tus f
he a
r t unds t ts ppor
ha u
t
t a tona M e ca e. Se 42 U .S. j 1 w- t M or ve,i Pli if wer c r t a
r dii l di r
e
C. 395 23().
eo r f antf
e orec,
M e c r bene i a y r evi be ft fom a M e c r Advantge Or zai woul be
dia e
fcir ec i ng ne is r
di a e
a
gani ton
d
r quie t r i bur e t or ni a i r ga dls oft s tlm e a ount w he ea a M e c r
e r d o em s he ga z ton e z e s he e te nt m
r s
di a e
,
b nei i r r c vi be is fom ta tona M e ca e woul noti t a
e tc a y e ei ng neft r r dii l di r
d
f he mountwasbe ow t
l he
t es d. Se 42 C. R.j411. g)(ttng t gove nme ha arghtofaci a ns a
hr hol
e
F.
24( sai he
r nt s i
ton gai t ny
e iy,i l ng abe iir t tha r c ve aprmar pa nt. Surl Congrs di no
ntt ncudi
nefcay, ha s e ei d i y yme )
ey,
es d t
i e dipa a e te t e bewe n be fca i ofM e ca e and t e ofM e c r Adva ag
ntnd s r t r am nt t e ne i ires
di r
hos
dia e
nt e
O r zatons.
gani i
6
undiput d t t a t tme of t s tlm e i t s c e,t t es d a oun
s e ha t he i
he ete nt n hi as he hr hol m t
rfrnce i paagrph ( oft M e c r Se
eee d n r a 9) he diae conday Pa r Ac wa stat$2,
r ye t s e
000. l i
ts
undiput d t tNa i Fie' s tlm e f $l500 was ls t n $2, a t t es d t
s e ha tonal r s ete nt or ,
e s ha
000 nd he hr hol o
brng a c us ofaci i notme . The Pli if t r f e,doe notsa e a cogni bl cli
i
a e
ton s
t
a ntf , he e or
s
tt
za e am
unde t M edi r Se onda y Pa rA c .
r he
ca e c
r ye t
Pli tf' s co co
a n ifs e nd unt unde t Decar t y J
r he
l aor udgme Ac doe not co e an
nt t
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