In the 

United States Court of Appeals 

For the Seventh Circuit ____________________ 

No. 17-1844 

MARGERY NEWMAN, on behalf of herself and all others similarly situated, 

Plaintiff-Appellant, 

v.

METROPOLITAN LIFE INSURANCE COMPANY, 

Defendant-Appellee. 

____________________ 

Appeal from the United States District Court for the 

Northern District of Illinois, Eastern Division. 

No. 16 C 3530 — Thomas M. Durkin, Judge. 

____________________ 

ARGUED SEPTEMBER 19, 2017 — DECIDED FEBRUARY 6, 2018 

____________________ 

Before WOOD, Chief Judge, and EASTERBROOK and ROVNER,

Circuit Judges. 

WOOD, Chief Judge. At age 56, Margery Newman purchased a long-term care insurance plan from the Metropolitan 

Life Insurance Company (“MetLife”). She opted for one of 

MetLife’s non-standard options for paying her insurance premiums; MetLife called the method she selected “Reduced-Pay 

at 65.” When Newman was 67 years old, she was startled to 
2 No. 17-1844 

discover that MetLife that year more than doubled her insurance premium. MetLife insists that the increase is consistent 

with Newman’s insurance policy, including its Reduced-Payat-65 feature. Newman was unpersuaded and brought this action to vindicate her position. The district court dismissed for 

failure to state a claim. We conclude, however, that Newman 

is entitled to relief on her contract claim and that dismissal of 

the remaining claims was premature. We therefore reverse 

and remand for further proceedings. 

I 

Two documents lie at the heart of this case. The first is MetLife’s “Long-Term Care Facts” brochure, which Newman reviewed before purchasing her insurance plan. The brochure 

describes long-term care generally and catalogs MetLife’s 

non-standard payment options. Newman learned of MetLife’s 

Reduced-Pay option from the brochure. The full description 

reads as follows: 

Reduced-Pay at 65 Option: 

By paying more than the regular premium amount 

you would pay each year up to the Policy Anniversary on or after your 65th birthday, you pay half the 

amount of your pre-age 65 premiums thereafter. 

At the foot of the same page, MetLife instructs the reader that 

the brochure is only a general overview of MetLife’s insurance 

plans, and that the policy governs the terms of the agreement. 

Equipped with this information, Newman purchased a 

long-term care insurance plan from MetLife and selected the 

Reduced-Pay option. Roughly a week later, she received the 

policy—the second critical document. The policy is 29 pages 

long. It includes just one reference to the Reduced-Pay option: 
No. 17-1844 3

In addition, you have selected the following flexible premium payment option: Reduced Pay at 65 

Semi-Annual Premium Amount: 

Before Policy Anniversary at age 65 $3231.93

On or after Policy Anniversary at age 65 $1615.97 

Elsewhere, the policy reserves MetLife’s right to change 

premiums. On the first page, MetLife announces that 

“PREMIUM RATES ARE SUBJECT TO CHANGE.” The 

same paragraph continues with the statement that “[a]ny 

such change in premium rates will apply to all policies in the 

same class as Yours in the state where this policy was issued.” 

In a section titled “Premiums,” MetLife “reserve[s] the right 

to change premium rates on a class basis.” Similar language 

is included in the “5% Automatic Compound Inflation Protection Rider.” The policy defines more than 30 terms, but the 

word “class” is not among them. And the appended “Contingent Benefits Upon Lapse Rider,” which provides coverage 

options in the event of a “Substantial Premium Increase,” includes a table illustrating that that term’s meaning varies with 

the policyholder’s age at the time the policy was issued. The 

table accounts for policyholders who were issued their policy 

at ages up to “90 and over.” Newman had the opportunity to 

review the policy for 30 days and return it for a full refund if 

she was dissatisfied. 

From the outset, Newman paid the elevated premium associated with her “Reduced-Pay” option. When she reached 

age 65, her premium was cut in half. After Newman turned 

67, however, MetLife doubled the premium. MetLife represents that this increase was imposed on a class-wide basis, 

which it said at oral argument means all long-term care policyholders, including Reduced-Pay policyholders over the age 
4 No. 17-1844 

of 65. MetLife defends the increase by noting that Newman 

still pays half the premium of a Reduced-Pay policyholder 

who has not yet reached age 65, and far less than she would if 

she had not purchased the Reduced-Pay option. Nevertheless, 

at age 67, Newman’s semi-annual premium jumped to 

$3,851.80, greater than it has been at any other point during 

the life of the plan. 

Newman filed a four-count complaint on behalf of herself 

and a proposed class. She has alleged that raising her postanniversary premium is a breach of the policy, violates the 

Illinois Consumer Fraud and Deceptive Business Practices 

Act, and renders MetLife’s representations and practices 

fraudulent. The district court granted MetLife’s motion to 

dismiss for failure to state a claim. In its view, the contract 

unambiguously permitted MetLife to raise Newman’s 

premium, even after she reached age 65. This meant also that 

she had no claim for deceptive or unfair business practices or 

common-law fraud, because MetLife did nothing wrong. 

Newman’s appeal from that decision is now before us. 

II 

We consider de novo the district court’s grant of a motion 

to dismiss pursuant to Federal Rule of Civil Procedure 

12(b)(6). Camasta v. Jos. A. Bank Clothiers, Inc., 761 F.3d 732, 736 

(7th Cir. 2014). A complaint survives a motion to dismiss if it 

states a claim that is plausible on its face. Id. The common-law 

and statutory fraud claims must be pleaded with the detail 

required under Rule 9(b)’s heightened standard. Id. The parties agree that Illinois law governs this case. 
No. 17-1844 5

A 

Illinois normally treats insurance policies the same as any 

other contract. Parties are held to the unambiguous terms of 

their agreement. Hobbs v. Hartford Ins. Co. of the Midwest, 

214 Ill. 2d 11, 17 (2005). Ambiguous insurance contracts, however, are construed in favor of the insured. Id. at 30–31. A policy is ambiguous if it is subject to more than one reasonable 

interpretation. Thompson v. Gordon, 241 Ill. 2d 428, 443 (2011). 

Importantly, an insured cannot manufacture ambiguity by 

taking portions of a policy in isolation; the policy (like any 

contract) must be read as a whole. Id. at 441. 

Little in Newman’s policy elucidates the terms of the Reduced-Pay option. It offers one illustration with two numbers: 

Newman’s “before policy anniversary” premium; and her “on 

and after policy anniversary” premium. The first amount is 

twice the second. Newman deduced from this example that 

upon reaching her 65th birthday, her premium would drop to 

half of what it was the day before. MetLife agrees that this is 

what the policy says. The disagreement arises at the next level 

of detail. MetLife takes the position that the only guarantee is 

that from the policy anniversary following Newman’s 65th 

birthday onward, Newman’s premium will be half that of a 

Reduced-Pay policyholder who has not yet reached age 65. 

Newman reads the policy differently. She understands it to fix 

her post-65 premium at half the amount of her pre-65 premium. 

Our independent review of the policy satisfies us that 

Newman has offered one reasonable interpretation of its language. The illustration, which was unexplained, reproduces 

the cost of her personal premiums. It gives no indication 

whether these are the same premiums that all Reduced-Pay 
6 No. 17-1844 

policyholders were paying, and would pay, or if they were 

particular to Newman. A reasonable reader easily could 

think, however, that “on and after” the policy anniversary following age 65, the policy holder (here, Newman) will pay half 

of what she personally was paying prior to that anniversary 

date. Since the person’s 65th birthday converts the pre-anniversary premium into a historical fact, a premium set at half 

that number likewise becomes fixed. In other words, if N is 

set in stone, so too is half of N. 

MetLife responds that even if the portion of the policy referring to the Reduced-Pay option might be understood as we 

just explained, that reading is supportable only if that passage 

is divorced from the rest of the policy—an impermissible step. 

While it is true that the Reduced-Pay excerpt cannot be read 

alone, in this case the remainder of the contract does not win 

the day for MetLife. 

Four times in the policy MetLife reserves its right to 

change premiums. Three of those instances reserve MetLife’s 

right to do so on “a class basis” or for a “class as Yours.” These 

passages do not resolve the ambiguity, because the word 

“class” is undefined. It might mean age, in which case class 

membership is independent of payment arrangements. But it 

might refer to the payment arrangement, so that everyone in 

the Reduced-Pay group comprises a single class and the effect 

of class membership is defined by the terms of the ReducedPay option. 

Newman believes that it is the latter, and thus that the Reduced-Pay customers have purchased the right not to be 

treated in the same way as ordinary policyholders. The policy’s inclusion of the Reduced-Pay illustration, terse as it may 

be, supports her interpretation. Including language about 
No. 17-1844 7

class-wide changes does not alert her that she is part of a class 

that is broader than her Reduced-Pay group. Absent some 

clarification, Newman had no reason to question her understanding that she had removed herself from the class of typical policyholders—those who had not purchased a frozen 

premium after age 65. Even MetLife’s reservation of the right 

to change premiums for all policies in a “class as Yours” does 

not help matters. Newman knew that her premium, and those 

of others whom she might regard as classmates, might increase before she turned 65. But the only “class” to which she 

thought she belonged was one that exchanged an increased 

(and perhaps variable) premium pre-65 for the right to have a 

stable and lower premium after 65. The baseline for a person 

in this class was the premium she paid pre-65; nothing in the 

policy tipped her off that the baseline was instead whatever 

people of her age were ordinarily charged, no matter how often or when that number changed or what payment arrangement was in place. 

The fourth suggestion that premiums might change appears in the Lapse Rider. Though the rider countenances the 

possibility of a “Substantial Premium Increase,” its illustrative table shows that the definition depends on the policyholder’s age at the time of issuance. The rider accounted for 

policyholders who purchased their long-term care policy at 

ages greater than 65. How, then, could the rider speak to the 

specifics of the Reduced-Pay option, which could be issued 

only to people who had not yet reached their 65th birthday? 

A reasonable person selecting the Reduced-Pay option could 

conclude that the rider was beside the point. 
8 No. 17-1844 

In short, none of the four references in the policy to MetLife’s right to change premiums sufficed to disabuse a reasonable person of the understanding that purchasing the Reduced-Pay option took her out of the class of policyholders 

who were at risk of having their premium increased after their 

post-age-65 anniversary. The policy is thus at least ambiguous, because it can be read reasonably to fix such a person’s 

premium, if she had opted for the Reduced-Pay option. That 

means that Newman prevails on the liability phase of her contract claim. 

B 

Newman separately alleges that MetLife violated the 

Illinois Consumer Fraud and Deceptive Business Practices 

Act (“ICFA”). The ICFA provides a remedy for consumers 

who have been victimized by deceptive or unfair business 

practices. 815 ILCS 505/2; Batson v. Live Nation Entm’t, Inc., 

746 F.3d 827, 830 (7th Cir. 2014). Newman accuses MetLife of 

both. We assess these allegations mindful of the fact that the 

ICFA is a mandate to provide consumers with the greatest 

possible relief. Miller v. William Chevrolet/GEO, Inc., 326 Ill. 

App. 3d 642, 654–55 (2001). 

A deceptive-practice claim under the ICFA has five elements: “(1) the defendant undertook a deceptive act or practice; (2) the defendant intended that the plaintiff rely on the 

deception; (3) the deception occurred in the course of trade 

and commerce; (4) actual damage to the plaintiff occurred; 

and (5) the damage complained of was proximately caused by 

the deception.” Davis v. G.N. Mortg. Corp., 396 F.3d 869, 883 

(7th Cir. 2005). MetLife argues that Newman’s allegations do 

not satisfy the first two elements—deception and intent. 
No. 17-1844 9

An allegedly deceptive act must be viewed “in light of all

the information available to plaintiffs.” Phillips v. DePaul Univ., 

2014 IL App (1st) 122817, ¶ 44 (emphasis in original). We must 

therefore consult both the brochure and the policy. Deception 

does not exist if a consumer has been alerted to the possibility 

of the complained-of result. Davis, 396 F.3d at 884. In MetLife’s 

view, the brochure was not deceptive because it is consistent 

with what happened: after Newman reached age 65, her premium became half that of a policyholder who is not yet 65 

years old. And even if the brochure was misleading, MetLife 

adds, the policy resolved any confusion. 

MetLife’s reading of the brochure is far from the only one 

that is possible—indeed, we find it strained. The Reduced-Pay 

option assures that after the anniversary date following the 

policyholder’s 65th birthday, the holder will pay “half the 

amount of your pre-age 65 premiums thereafter” (emphasis 

added). This rationally can be read as an individualized reduction, tied to the consumer’s personal baseline. The brochure never says that Newman’s premium is linked to those 

of general policyholders. And for the reasons already discussed, MetLife’s insistence that the policy clarified matters is 

unpersuasive. 

This case is quite different from one in which the consumer is warned about the undesirable result and simply misconstrues the material offered by the insurance company. See, 

e.g., Toulon v. Continental Casualty Co., 877 F.3d 725 (7th Cir. 

2017). MetLife’s brochure did not warn Newman about the 

possibility of a premium increase after her post-age 65 anniversary date, and as we already have held, her reading of the 

policy is reasonable. 
10 No. 17-1844 

Turning to intent, Newman must show that MetLife intended for her (and those in her position) to rely on the brochure. Cuculich v. Thomson Consumer Elec., Inc., 317 Ill. App. 3d 

709, 716 (2000). Noting the printed caveat that the brochure 

was a general overview, MetLife argues that it did not intend 

that she rely on that document. The actual terms, it stresses, 

were in the policy. It cites Commonwealth Insurance Co. v. Stone 

Container Corp., 351 F.3d 774 (7th Cir. 2003), where we ruled 

that an insurance provider did not intend that consumers rely 

on its policy summary. Id. at 779. The summary included a 

disclaimer that the policy governed the actual terms of the 

agreement. And that policy provided extensive details about 

coverage. Id. at 777–79. MetLife argues that this case is the 

same. But unlike the insurance provider in Commonwealth Insurance, MetLife never described the Reduced-Pay plan anywhere outside the brochure. Newman could have parsed 

every word in the insurance policy and never found information that would have corrected her impression of the Reduced-Pay option. MetLife must have intended for consumers 

to rely on its brochure: it was the only place that described the 

Reduced-Pay option. 

Nothing we have said conflicts with the U.S. Supreme 

Court’s instruction in the analogous context of ERISA plans 

that summary plan descriptions are not part of the ERISA plan 

itself. See CIGNA Corp. v. Amara, 563 U.S. 421, 436 (2011). 

Newman is not relying on the brochure to supply the terms 

of her policy; she relies on it only as evidence of deception and 

the subsequent unfairness of MetLife’s rate increase. In any 

event, there is reason to pause before transposing every detail 

of ERISA to ordinary insurance contracts. In CIGNA Corp., 

CIGNA had sent its employees a newsletter and plan 

summary, as required under ERISA. The summary 
No. 17-1844 11

inaccurately characterized upcoming changes in the pension 

plan. Id. at 426; see also Amara v. CIGNA Corp., 775 F.3d 510, 

515 (2d Cir. 2014). Eleven months later, CIGNA distributed the 

actual plan, which filled in the details. CIGNA Corp., 563 U.S. 

at 426–28. The Supreme Court ruled that only a violation of 

the plan’s terms, as opposed to the summary’s description of 

those terms, could support a lawsuit. Id. at 436–38. 

The Court’s decision was faithful to language in the statute 

that distinguishes between information about the plan from 

the plan itself. 29 U.S.C. § 1022(a); CIGNA Corp., 563 U.S. at 

436. ERISA divides responsibilities for drafting the terms of 

the plan and drafting the plan summary. The plan’s sponsor 

(the employer) is responsible for the plan, while the plan’s administrator (a trustee-like fiduciary) drafts the summary. 

§§ 1021(a), 1102; CIGNA Corp., 563 U.S. at 437. Nothing in the 

statute conveys an intent to allow plan administrators indirectly to set the terms of the plan. CIGNA Corp., 563 U.S. at 

437. And the Court recognized that ERISA both requires plan 

summaries and establishes their purpose, which is to describe 

the plan “in a manner calculated to be understood by the average plan participant ... .” § 1022(a); CIGNA Corp., 563 U.S. 

at 437. If plan summaries were binding, plan administrators 

would be forced to write summaries with a level of detail illsuited for their purpose. 

Beyond the statutory distinction, Newman is in a different 

position from that of an ERISA beneficiary. Unlike an ERISA 

beneficiary, Newman is shopping on the open market. MetLife uses its brochure to compete for business. Pre-purchase, 

it is all a potential customer has to rely on. An employer, in 

contrast, is providing and describing an employment benefit. 

MetLife’s situation is thus materially different from that of an 
12 No. 17-1844 

employer offering an ERISA plan. Our decision here thus 

comfortably coexists with CIGNA Corp. 

Returning to the Reduced-Pay policy, we must next consider whether Newman has adequately pleaded that MetLife’s practices were unfair (as opposed to deceptive). Unfairness under the ICFA depends on three factors: “(1) whether 

the practice offends public policy; (2) whether it is immoral, 

unethical, oppressive, or unscrupulous; [or] (3) whether it 

causes substantial injury to consumers.” Robinson v. Toyota 

Motor Credit Corp., 201 Ill. 2d 403, 417–18 (2002). A significant 

showing that any of the three factors is met is enough; so too 

are facts that, to a lesser degree, satisfy all three. Id. at 418. 

Newman has alleged that MetLife engaged in a bait-andswitch strategy, which (if proven) would offend Illinois’s public policy. The State has twice condemned the very practice 

Newman describes. See 215 ILCS 5/149(1) (forbidding insurance companies from misrepresenting the terms of their policies); ILL. ADMIN. CODE tit. 50, § 2012.122(b)(4) (forbidding 

misrepresentation in marketing of long-term care insurance 

policies). MetLife does not dispute the applicability of the 

statute or the administrative code. It simply reiterates its position that there is no violation because the brochure did not 

misrepresent the policy. But we already have shown how both 

the brochure and the policy can be understood in the way 

Newman read them. 

The second factor also supports Newman’s complaint. 

Whether a practice is immoral, unethical, oppressive, or unscrupulous depends on whether it has left the consumer with 

little choice but to submit to it. See Cohen v. Am. Sec. Ins. Co., 

735 F.3d 601, 610 (7th Cir. 2013). MetLife argues that once it 
No. 17-1844 13

raised the premium, Newman had three options: accept reduced benefits, get a new plan, or let the policy lapse and rely 

on the contingent coverage rider she purchased. Each of those 

options fails to recognize the fact that by abandoning her Reduced-Pay plan, Newman would forfeit eight years of sunk 

costs. Every dollar she spent pre-age 65 that exceeded what 

she would have been paying under the normal long-term care 

plan was an investment that could bear fruit only if she stayed 

with the policy. Any of MetLife’s proposed alternatives would 

cost her that entire investment. 

Newman also alleged substantial injury. MetLife induced 

her to pay a premium for eight years at a rate greater than she 

would otherwise have paid. She did so to reap benefits later 

in life. The injury lies in the difference between her elevated 

pre-age-65 premium and the standard premium, as well as 

the elevated premiums she has had to pay (so far) for over two 

years. Newman’s complaint alleges facts that plausibly show 

that MetLife’s policy was both deceptive and unfair. 

C 

Finally, Newman asserts that MetLife’s representations 

about the Reduced-Pay option in its brochure and policy constitute common-law fraudulent misrepresentation and fraudulent concealment. The elements of misrepresentation largely 

overlap with a deceptive-practices claim under the ICFA. The 

plaintiff must allege: 

(1) a false statement of material fact; (2) known or 

believed to be false by the person making it; (3) an 

intent to induce the plaintiff to act; (4) action by the 

plaintiff in justifiable reliance on the truth of the 
14 No. 17-1844 

statement; and (5) damage to the plaintiff resulting 

from such reliance. 

Doe v. Dilling, 228 Ill. 2d 324, 342–43 ( 2008). Our discussion of 

the ICFA claims subsumes the first, third, and fifth elements, 

and so we need say no more about them. The second element 

is not seriously at issue. In Illinois, a defendant knowingly 

misrepresents a fact if it makes a statement “with a reckless 

disregard for its truth or falsity.” Gerill Corp. v. Jack L. Hargrove 

Builders, Inc., 128 Ill. 2d 179, 193 (1989); see also Wigod v. Wells 

Fargo Bank, N.A., 673 F.3d 547, 569 (7th Cir. 2012) (finding the 

elements of fraudulent misrepresentation satisfied because a 

bank offered, but refused to honor, a permanent mortgage 

modification). MetLife portrayed its policy as one that offered 

a fixed premium after age 65. Newman has alleged that it did 

so in bad faith, intending not to honor that representation. She 

also asserts that MetLife disseminated information about the 

Reduced-Pay option with at least reckless disregard for the 

truth. 

Newman had to provide enough in her complaint to make 

a plausible case for reasonable reliance. Davis, 396 F.3d at 882. 

Reliance is not justifiable if a consumer has reason and opportunity to question the truth of the alleged misrepresentation. 

Id. For example, reliance on a loan agent’s account of the terms 

of a loan agreement is unjustified when the consumer also has 

documentation of the terms of the loan and those documents 

conflict with the oral statement. Id. at 882–83. But it is reasonable to rely on a misrepresentation if nothing impugns its veracity. See Miller, 326 Ill. App. 3d at 651–52. Newman’s reliance on the brochure was reasonable—it was the only information available to her before she made her purchase. When 
No. 17-1844 15

she received the policy, she looked at that too. The 30-day refund provision gave her an opportunity to review the terms 

of the policy and clarify any resulting confusion. But she 

found nothing in the policy to undermine her understanding 

of it. Indeed, she had no reason to doubt her interpretation 

until the company raised her premium roughly a decade later. 

Finally, Newman’s complaint alleges fraudulent concealment. For this claim, Newman must adequately plead that 

MetLife concealed material information while under a duty to 

disclose. Connick v. Suzuki Motor Co., 174 Ill. 2d 482, 500 (1996). 

Such a duty may arise when a defendant makes a statement 

“that it passes off as the whole truth while omitting material 

facts that render the statement a misleading ‘half-truth.’” 

Crichton v. Golden Rule Ins. Co., 576 F.3d 392, 397–98 (7th Cir. 

2009). In Crichton, the insured did not meet this standard because the communications from the insurance provider never 

purported to explain all the underwriting factors that might 

affect premiums. Id. at 398. Newman’s fraudulent concealment claim, in contrast, stands on the policy and the brochure. 

Together, she contends, they were the “whole truth.” The brochure told Newman that her rate would be fixed. Though it 

also instructed policyholders to look to the policy, the policy 

did not reveal how MetLife intended to treat Reduced-Pay 

policyholders. Newman thus alleges that she reasonably believed that her post-anniversary rate was fixed. That was 

enough, under the pleading rules that prevail in federal court. 

III 

Newman asserts that MetLife lured her into a policy by 

promising a trade of short-term expense for long-term stability. She took the deal and spent nine years investing in a plan, 

only to have MetLife pull the rug out from under her. Neither 
16 No. 17-1844 

MetLife’s brochure nor the terms of the policy forecast this 

possibility. These allegations were enough to entitle her to 

prevail on the liability phase of her contract claim, and they 

are enough to permit her to go forward on her other theories. 

We therefore REVERSE the district court’s grant of MetLife’s 

motion to dismiss and REMAND for further proceedings.