Quinones v. UnitedHealth Group Incorporated et al

Filing 277

ORDER DENYING PLAINTIFF'S MOTION FOR RECONSIDERATION OF THE COURT'S MARCH 29, 2017 ORDER: (1) GRANTING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT ON COUNTS IV, VI, VII, AND VIII; (2) GRANTING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT O N COUNT X OF PLAINTIFF'S SUPPLEMENTAL COMPLAINT; AND (3) DENYING AS MOOT PLAINTIFF'S MOTION FOR PARTIAL SUMMARY JUDGMENT re 268 Motion for Reconsideration filed by Juan Rios Quinones. Signed by JUDGE LESLIE E. KOBAYASHI on 06/28/2017.(eps, )CERTIFICATE OF SERVICEParticipants registered to receive electronic notifications received this document electronically at the e-mail address listed on the Notice of Electronic Filing (NEF).

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF HAWAII
)
)
Plaintiff,
)
)
vs.
)
)
)
UnitedHealth Group
Incorporated;
)
)
UnitedHealthcare, Inc.;
UnitedHealthcare Insurance
)
)
Co.,
)
)
Defendants.
_____________________________ )
Juan Rios Quinones,

CIVIL NO. 14-00497 LEK-RLP

ORDER DENYING PLAINTIFF’S MOTION FOR RECONSIDERATION OF THE
COURT’S MARCH 29, 2017 ORDER: (1) GRANTING DEFENDANTS’ MOTION
FOR SUMMARY JUDGMENT ON COUNTS IV, VI, VII, AND VIII;
(2) GRANTING DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT ON COUNT X
OF PLAINTIFF’S SUPPLEMENTAL COMPLAINT; AND (3) DENYING AS MOOT
PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT
On April 18, 2017, the Court filed its Amended Order:
(1) Granting Defendants’ Motion for Summary Judgment on Counts
IV, VI, VII, and VIII; (2) Granting Defendants’ Motion for
Summary Judgment on Count X of Plaintiff’s Supplemental
Complaint; and (3) Denying as Moot Plaintiff’s Motion for Partial
Summary Judgment (“4/18/17 Order”).

[Dkt. no. 271.1]

On

April 17, 2017, Plaintiff Juan Rios Quinones (“Plaintiff”) filed
a motion for reconsideration of the 4/18/17 Order (“Motion for
Reconsideration”).2

[Dkt. no. 268.]

Defendants UnitedHealth

1

The 4/18/17 Order is also available at 2017 WL 1395604.

2

While the Motion for Reconsideration responded to the
(continued...)

Group Inc., UnitedHealthcare, Inc., and UnitedHealthcare
Insurance Co. (collectively “Defendants”) filed a memorandum in
opposition on May 1, 2017, and Plaintiff filed a reply on May 15,
2017.3

[Dkt. nos. 273, 274.]

The Court finds this matter

suitable for disposition without a hearing pursuant to Rule
LR7.2(e) of the Local Rules of Practice of the United States
District Court for the District of Hawai`i (“Local Rules”).

The

Motion for Reconsideration is hereby denied because Plaintiff
fails to demonstrate manifest error of law and fails to provide
new evidence that was previously unavailable to him.
STANDARD
A motion for reconsideration
“must accomplish two goals. First, a motion for
reconsideration must demonstrate reasons why the
court should reconsider its prior decision.
Second, a motion for reconsideration must set
forth facts or law of a strongly convincing nature
to induce the court to reverse its prior
decision.” See Davis v. Abercrombie, Civil No.
11-00144 LEK-BMK, 2014 WL 2468348, at *2 (D.
Hawai`i June 2, 2014) (citation and internal
quotation marks omitted). This district court
recognizes three circumstances where it is proper

2

(...continued)
Court’s order filed on March 29, 2017 (“3/29/17 Order”), [dkt.
no. 266,] in an Entering Order filed on April 19, 2017 (“4/19/17
EO”), the Court construed the Motion for Reconsideration as
relating to the 4/18/17 Order [dkt. no. 272]. The 4/19/17 EO
also noted that the 4/18/17 Order did not make any substantive
changes to the 3/29/17 Order, nor did it alter the Court’s
ultimate rulings on the relevant motions.
3

On May 16, 2017, Plaintiff filed an errata to his reply in
support of the Motion for Reconsideration. [Dkt. no. 275.]
2

to grant reconsideration of an order: “(1) when
there has been an intervening change of
controlling law; (2) new evidence has come to
light; or (3) when necessary to correct a clear
error or prevent manifest injustice.” Tierney v.
Alo, Civ. No. 12-00059 SOM/KSC, 2013 WL 1858585,
at *1 (D. Hawaii May 1, 2013) (citing School
District No. 1J v. ACandS, Inc., 5 F.3d 1255, 1262
(9th Cir. 1993)). “Mere disagreement with a
previous order is an insufficient basis for
reconsideration.” Davis, 2014 WL 2468348, at *3
n.4 (citations and internal quotation marks
omitted).
Riley v. Nat’l Ass’n of Marine Surveyors, Inc., Civil No. 1400135 LEK-RLP, 2014 WL 4794003, at *1 (D. Hawai`i Sept. 25,
2014).
BACKGROUND
On October 24, 2016:

Defendants filed a Motion for

Summary Judgment on Counts IV, VI, VII, and VIII (“Defendants’
Summary Judgment Motion A”); [dkt. no. 210;] Defendants filed a
Motion for Summary Judgment on Count X of Plaintiff’s
Supplemental Complaint (“Defendants’ Summary Judgment Motion B”);
[dkt. no. 214;] and Plaintiff filed a Motion for Partial Summary
Judgment (“Plaintiff’s Summary Judgment Motion”) [dkt. no. 212].
The 4/18/17 Order granted Defendants’ Summary Judgment Motion A
and Defendants’ Summary Judgment Motion B, and denied Plaintiff’s
See 4/18/17 Order, 2017 WL

Summary Judgment Motion as moot.
1395604, at *12.

3

DISCUSSION
The Motion for Reconsideration seeks reconsideration of
the Court’s ruling on Count VI, which alleges the tort of bad
faith.

Plaintiff contends the Court applied the incorrect

standard for a claim of bad faith and newly discovered evidence
creates a genuine issue of material fact.
Motion for Reconsideration at 2.]

[Mem. in Supp. of

The Court will address each of

these arguments in turn.
I.

Manifest Error of Law
As to Plaintiff’s assertion that the Court applied an

incorrect standard of law for Count VI, bad faith, Plaintiff
overlooks that the 4/18/17 Order explained:
Hawai`i courts have recognized that “every
contract contains an implied covenant of good
faith and fair dealing that neither party will do
anything that will deprive the other of the
benefits of the agreement.” Best Place, Inc. v.
Penn Am. Ins. Co., 82 Hawai`i 120, 123-24, 920
P.2d 334, 337-38 (1996) (citations omitted).
“Good faith performance ‘emphasizes faithfulness
to an agreed common purpose and consistency with
the justified expectations of the other party.’”
Hawaii Leasing v. Klein, 5 Haw. App. 450, 456, 698
P.2d 309, 313 (1985) (quoting Restatement (Second)
of Contracts § 205 cmt. a (1981)). This district
court, however, has observed that:
Hawai`i courts have not recognized a
separate tort cause of action for bad faith
or breach of the duty of good faith and fair
dealing based upon any type of contract in
any circumstances. Moreover, in Francis v.
Lee Enterprises, Inc., 89 Hawai`i 234, 971
P.2d 707, 711-12 (1999), the Hawai`i Supreme
Court stressed the importance that claims of
4

bad faith be limited to the insurance context
or situations involving special relationships
characterized by elements of fiduciary
responsibility, public interest, and
adhesion. . . .
Sung v. Hamilton, 710 F. Supp. 2d 1036, 1050 (D.
Hawai`i 2010).
2017 WL 1395604, at *8 (emphasis added) (quoting Flynn v.
Marriott Ownership Resorts, Inc., 165 F. Supp. 3d 955, 981-82 (D.
Hawai`i 2016) (some internal quotation marks omitted)).
Plaintiff argues “that the standard for the tort of bad faith, as
set forth in Best Place and its progeny, is applicable to this
case, not the general contractual duty of good faith and fair
dealing that the Court recited.”
Reconsideration at 4.]
the least.

[Mem. in Supp. of Motion for

Plaintiff’s argument is puzzling, to say

The Court not only cited Best Place, but also

specific language explaining the special relationship required to
sustain a claim for the tort of bad faith.

In addition, the

cited portion of the Hawai`i Supreme Court’s decision in Francis
explains the tort of bad faith by extensively citing Best Place.
While Plaintiff may take issue with the fact that,
“[t]he Order contains no subsequent discussion of the elements of
an insurance bad faith claim, or an acknowledgment that
unreasonable delays in benefits . . . is actionable in bad
faith,”

[Reply at 4,] there was no need for the Court to do so

because the Court found that there was not an unreasonable delay
in Plaintiff’s Medicaid benefits and that Defendants acted
5

properly.

See 4/18/17 Order, 2017 WL 1395604, at *8 (“Plaintiff

has not identified any action by Defendants that violated the
relevant statutes or the contract at issue.

Instead, Defendants

have shown that, on two different occasions they received an
application for Medicaid coverage of Plaintiff’s [Personal
Mobility Device (“PMD”)], and on both occasions, they acted
properly.”).4

Accordingly, Plaintiff fails to demonstrate

manifest error of law.
II.

Newly Discovered Evidence
Plaintiff also asserts newly discovered evidence – a

deposition taken on November 17, 2016, which was after the
briefing deadlines on the motions for summary judgment had
expired.

See Mem. in Supp. of Motion for Reconsideration at 4-5;

Motion for Reconsideration, Decl. of Aaron Loeser (“Loeser
Decl.”), Exh. A (excerpts of 11/17/16 Depo. of David. W. Heywood
(“Pltf.’s Heywood Depo.”)).5

First, the hearing on the motions

for summary judgment was held on November 28, 2016, [Minutes,

4

Plaintiff challenges the Court’s consideration of 42
C.F.R. § 433.139(c), asserting, “the Court seemed to hold that a
bad faith claim required an improper denial of coverage, and that
no such denial had occurred in this case.” [Mem. in Supp. of
Motion for Reconsideration at 14.] Plaintiff misstates the
4/18/17 Order. With respect to § 433.139(c), the 4/18/17 Order
does indeed state that there were no denials of Medicaid coverage
in the instant matter, and immediately after that explains why
Plaintiff’s claims of unreasonable delay are unavailing. 2017 WL
1395604, at *8.
5

Mr. Heywood is Defendants’ Health Plan Chief Executive
Officer for Hawai`i. 4/18/17 Order, 2017 WL 1395604, at *3.
6

filed 11/28/16 (dkt. no. 244),] eleven days after Mr. Heywood’s
deposition.

Plaintiff never submitted a request to file a

supplemental concise statement of facts or any kind of
supplemental briefing to account for Mr. Heywood’s deposition and
the exhibits attached thereto.6

Under Fed. R. Civ. P. 56(c)(1),

[a] party asserting that a fact cannot be or is
genuinely disputed must support the assertion by:
(A) citing to particular parts of materials
in the record, including depositions,
documents, electronically stored information,
affidavits or declarations, stipulations
(including those made for purposes of the
motion only), admissions, interrogatory
answers, or other materials; or
(B) showing that the materials cited do not
establish the absence or presence of a
genuine dispute, or that an adverse party
cannot produce admissible evidence to support
the fact.
(Emphasis added.) Plaintiff’s counsel is an attorney licensed to
practice law in Hawai`i, and the Court trusts that he is familiar
with the Federal Rules, as well as the Local Rules.

Any

assertion by Plaintiff’s counsel that Mr. Heywood’s deposition is
newly discovered evidence is, at best, disingenuous.

The

deposition was available to Plaintiff before the hearing on the

6

This is not the first time that Plaintiff’s counsel has
been notified of deficiencies in the record and failed to take
any action to correct them. See, e.g., 4/18/17 Order, 2017 WL
1395604, at *3 n.7 (explaining that Plaintiff submitted an
unsigned declaration, and that he “was notified of this omission
on multiple occasions, including at the hearing on the summary
judgment motions,” but “did not make any effort to correct” it).
7

summary judgment motions, and Plaintiff’s counsel simply chose
not to do anything with it until now.7
Second, Plaintiff argues for the first time in his
Reply that, at the hearing on the motions for summary judgment,
the Court should have allowed Plaintiff to present evidence from
Mr. Heywood’s deposition.

See Reply at 5 (“[T]o the extent that

Plaintiff was required to present newly-discovered evidence at
the hearing herein, it was improper to block Plaintiff from
presenting such evidence at the hearing.”).

Plaintiff’s counsel

referenced Mr. Heywood’s deposition at the hearing by citing an
email from Plaintiff’s doctor, Amendeep Somal, M.D., which the
Court did not consider because it was not part of the record.
[Reply, Decl. of Aaron Loeser, Exh. B (Trans. of 11/28/16 hearing
on motions for summary judgment), at 31.]
raise new arguments in his Reply.

Plaintiff may not

See Local Rule LR7.4 (“Any

argument raised for the first time in the reply shall be
disregarded.”).

Moreover, Plaintiff’s position that the Court

erred by not considering or allowing argument on a document that
was not part of the record as of the hearing, and which Plaintiff
has never sought to make part of the record until the instant

7

As
Heywood’s
documents
(emphasis
Plaintiff
judgment.

Defendants point out, the exhibits attached to Mr.
deposition include bates stamps, “indicating that these
were produced by Plaintiff.” See Mem. in Opp. at 13
omitted). Thus, these documents were also available to
prior to the hearing on the motions for summary
8

motion, is simply incorrect.
Finally, even if the Court were to consider this
evidence, it would not provide grounds for granting the Motion
for Reconsideration.

Plaintiff argues that Mr. Heywood’s

deposition shows that Defendants’ “own policy . . . forbade it
from putting its desire to pursue [third party liability] ahead
of its mandate to meet the needs of its members, and to refrain
from impairing access to its covered services.”

[Mem. in Supp.

of Motion for Reconsideration at 10-11 (footnote and citation
omitted).]

Plaintiff states further that Defendants themselves

“concede[] that it would have been consistent with its policy to
have approved the claim immediately, in June, then coordinated
benefits with Medicare afterwards, as [Defendants] did in
November.”

[Id. at 11.]

While Plaintiff tries to dress it up as

something new, he challenges the same series of events for the
same reasons.

The Court has already explained:

In sum, Defendants considered a request for
coverage of Plaintiff’s PMD on two occasions.
When Defendants received the Second Request, they
stated that they needed additional time – as
permitted by the applicable regulations – and the
Second Request was withdrawn before Defendants had
to make a decision. When Defendants received the
Third Request, they approved it within the
allotted time, but there were delays unrelated to
Defendants’ actions or control. As a result of
the delays, a new assessment had to be completed,
a Fourth Request was submitted, and Plaintiff
received his PMD in early February 2014.
Therefore . . . Defendants did not take any action
that violated the Medicaid statute or regulations,
nor did they ever exceed the time allotted for
9

them to make a decision on Plaintiff’s requests.
4/18/17 Order, 2017 WL 1395604, at *7.8

In addition, Mr.

Heywood’s deposition supports Defendants’ actions.

See, e.g.,

Pltf.’s Heywood Depo. at 253 (“[M]y review of the documents,
looking at the documents is, there was an attempt to submit a
prior authorization request that could be covered by Medicare.
And we are required by the state of Hawaii and by the contract
. . . to pursue that.”); Mem. in Opp., Decl. of Diane Winter
Brookins, Exh. D (excerpts of 11/17/16 Depo. of David W. Heywood)
at 274-75 (“We have an obligation under the Medicaid contract to
coordinate benefits . . . and ensure that the primary payer
covers their benefits first.”).
Plaintiff’s argument that “newly discovered evidence”
proves the urgency of his requests for benefits is equally
unavailing.

Plaintiff states that “there is direct evidence to

support that Plaintiff’s need for the replacement PMD was
urgent,” and that Defendants were “required under [their]
contract to consider this [as] an expedited request.”
Supp. of Motion for Reconsideration at 12-13.]

[Mem. in

To support his

position, Plaintiff cites an email from Dr. Somal, expressing her

8

While this section of the 4/18/17 Order directly discusses
Count IV, the Court used the same reasoning in ruling on
Count VI. See 4/18/17 Order, 2017 WL 1395604, at *8 (“Defendants
have shown that, on two different occasions, they received an
application for Medicaid coverage of Plaintiff’s PMD, and on both
occasions, they acted properly.”).
10

concern about the delay in Plaintiff’s PMD.

[Loeser Decl.,

Exh. A-2 (5/22/13 email from Dr. Somal to Defendants’ Medicaid
field service coordinator assigned to Plaintiff).]

However, as

the 4/18/17 Order explained, Dr. Somal did not write, nor could
she have written, the request for Plaintiff’s PMD.
1395604, at *7.

2017 WL

Further, the language of Dr. Somal’s email does

not evince a request for expedited consideration of Plaintiff’s
PMD, and, at his deposition, Mr. Heywood explained that
Defendants’ employees did not have any duty to ask Dr. Somal
about the urgency of the request.9

See Pltf.’s Heywood Depo. at

272.
In short, Plaintiff does not provide new evidence that
was previously unavailable, and, even if the Court were to
consider the evidence that Plaintiff does submit with his Motion
for Reconsideration, it does not provide any reason for the Court
to reconsider the 4/18/17 Order.

The Court has great compassion

for Plaintiff and his frustration is understandable.

However,

the Court may not bend the law to provide relief where none is
warranted.

The Motion for Reconsideration is therefore denied.

9

In his Reply, Plaintiff repeats a number of arguments that
he made previously and which the Court considered in the 4/18/17
Order. See Reply at 8. They do not state proper grounds for
reconsideration, and the Court does not need to address them
here.
11

CONCLUSION
On the basis of the foregoing, Plaintiff Juan Rios
Quinones’s Motion for Reconsideration, filed on April 17, 2017,
is HEREBY DENIED.

The Court DIRECTS the Clerk’s Office to enter

final judgment and close this case immediately.
IT IS SO ORDERED.
DATED AT HONOLULU, HAWAII, June 28, 2017.

/s/ Leslie E. Kobayashi
Leslie E. Kobayashi
United States District Judge

JUAN RIOS QUINONES VS. UNITEDHEALTH GROUP INCORPORATED, ET AL;
CIVIL 14-00497 LEK-RLP; ORDER DENYING PLAINTIFF’S MOTION FOR
RECONSIDERATION OF THE COURT’S MARCH 29,2017 ORDER: (1) GRANTING
DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT ON COUNTS IV, VI, VII,
AND VIII; (2) GRANTING DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT ON
COUNT X OF PLAINTIFF’S SUPPLEMENTAL COMPLAINT; AND (3) DENYING AS
MOOT PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT

12