Newman v. Metropolitan Life Ins. Co.

Dist. Ct. erred in dismissing for failure to state cause of action plaintiff’s breach of contract action alleging that defendant-insurance company wrongfully increased her premiums on long-term care policy when she turned 65, after plaintiff had previously signed up for “reduced-pay at 65” option that allowed her to pay half of “amount of your pre-age 65 premiums thereafter.” Plaintiff alleged sufficient allegations to support judgment in her favor, where instant policy was at least ambiguous about whether policy fixed her premium after she turned 65, and where plaintiff could reasonably have understood that purchasing reduced-pay option took her outside of class of policyholders who were at risk of having their premiums increased after their post-age 65 anniversary. Moreover, plaintiff stated viable cause of action under Ill, Consumer Fraud and Deceptive Business Practices Act, where: (1) language in defendant’s long-term care brochure and policy did not necessarily support defendant’s act of linking plaintiff’s post-age-65 premium to premiums paid by its general policyholders; (2) defendant intended for customers to rely on language in its brochure that arguably misled them with respect to defendant’s treatment for post-age-65 premiums under reduced pay option; and (3) plaintiff alleged that defendant engaged in bait and switch strategy when marketing reduced-pay at 65 option.