Barnhill Contracting Co. v. Oxendine

105 F. Supp. 3d 542, 2015 U.S. Dist. LEXIS 62213, 2015 WL 2227848
CourtDistrict Court, E.D. North Carolina
DecidedMay 12, 2015
DocketNo. 7:14-CV-211-FL
StatusPublished
Cited by4 cases

This text of 105 F. Supp. 3d 542 (Barnhill Contracting Co. v. Oxendine) is published on Counsel Stack Legal Research, covering District Court, E.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Barnhill Contracting Co. v. Oxendine, 105 F. Supp. 3d 542, 2015 U.S. Dist. LEXIS 62213, 2015 WL 2227848 (E.D.N.C. 2015).

Opinion

ORDER

LOUISE W. FLANAGAN, District Judge.

This matter is before the court on the motion to dismiss for failure to state a claim by defendants Roy Bain and Bain & Rodzik PC (the “Bain defendants”) (DE 7). Plaintiff responded in opposition, and the Bain defendants replied. The court stayed further case scheduling activities pending resolution of the motion. In this posture, the issues raised are ripe for ruling. For the following reasons, the Bain defendants’ motion to dismiss will be granted in part and denied in part, and the court will lift the stay.

BACKGROUND

Plaintiff, as plan sponsor, administrator, and fiduciary of the Barnhill Contracting Company Employee Health Plan (the “Plan”), brought suit on September 29, 2014, against defendant Paula Oxen-dine (“Oxendine”), a participant in the Plan and recipient of medical benefits under the Plan; defendants Storm Builders, Inc. and Davie Lynn Smith (the “Storm defendants”), who settled claims for an automobile accident involving defendant Oxendine; and the Bain defendants,' an attorney and a law firm that obtained the settlement on behalf of defendant Oxen-dine.

Plaintiff seeks declaratory and injunc-tive relief under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et seq., 29 U.S.C. §§ 1132(a), (e), (f), and (g), as well as compensatory damages based on state common law claims. As pertinent here, plaintiff brings the following claims against the Bain defendants:

1. Declaratory relief, seeking declaration as to plaintiffs reimbursement, subro-gation, and recovery rights under the [545]*545Plan to funds expended by plaintiff and paid, recovered, or to be recovered by the Bain defendants (First Cause of Action); ■

2. Intentional / negligent interference with contract (Sixth Cause of Action);

3. Conversion (Seventh Cause of Action).

The Bain defendants moved to dismiss all claims against them for failure to state a claim on October 21, 2014, and the motion was fully briefed. On February 27, 2015 the court stayed further scheduling activities until disposition of the pending motion to dismiss. On March 17, 2015, on plaintiffs motion, the court entered default judgment against • defendant Oxendine. On March 27, 2015, the court awarded attorney’s fees against defendant Oxen-dine, and the court entered separate judgment on attorney’s fees on April 6, 2015.

STATEMENT OF FACTS

The facts alleged in the complaint, as pertinent to the Bain defendants’ motion to dismiss, may be summarized as follows.

Defendant Oxendine was a participant in the Plan, either directly or through a family member. Defendant Oxendine was injured in a motor vehicle accident on February 16, 2012, when a vehicle in which she was á passenger collided with a vehicle driven by defendant Davie Lynn Smith. Pursuant to the terms of the Plan, the Plan paid significant medical expenses on behalf of defendant Oxendine as a result of said motor vehicle accident. The sums expended by the Plan on behalf of defendant Oxendine are specifically identifiable amounts itemized by defendant Oxendine’s health care providers from the date of said motor vehicle accident to and including the present date, which sums total no less than $69,117.31 (“Specifically Identified Funds”).

Defendant Oxendine contended that the Storm defendants were responsible for the injuries and damages she sustained in the motor vehicle accident, including the medical expenses incurred by defendant Oxen-dine. Defendant Oxendine retained the Bain defendants as counsel to pursue recovery from the Storm defendants and their liability insurance -carrier for damages Oxendine sustained as a result of -the accident.

The Plan enjoys rights of subrogation and reimbursement as set forth in relevant provisions of the Plan’s Summary Plan Description, which provides, in relevant part:

Immediately upon paying or providing any benefit under the PLAN, the PLAN shall be subrogated to the rights of recovery a MEMBER ' has against any party potentially responsible for making any payment to a MEMBER due to a MEMBER’S injuries, illness or condition, to the full extent of benefits provided or to be provided by the PLAN. In addition, if a MEMBER receives any payment from any potentially responsible party as á result of an injury, illness or condition, the PLAN has the right to recovery from, and be reimbursed by, the MEMBER for all amounts the PLAN has,paid and will pay as a result of that injury or illness, up to and including the full amount the MEMBER receives from all potentially responsible parties. The MEMBER agrees that if -the MEMBER receives any payment from any potentially responsible party as a result of an injury or illness, the MEMBER will serve as a constructive trustee over the funds for the benefit of the PLAN. Failure to hold such finds in trust will be deemed a breach of the MEMBER’S fiduciary duty to the PLAN.

(Compl. ¶ 12, Ex. A).

On multiple occasions, plaintiff has provided actual and/or constructive notice to the Bain defendants that it had claims for [546]*546reimbursement and/or subrogation arising from the payment of medical benefits pursuant to the Plan. The notices informed the Bain defendants that they may be required to satisfy the Plan’s claim with any monetary recovery that defendant Ox-endine received from or on behalf of the. Storm defendants as a result of her claims.

Without the Plan’s knowledge or consent, defendant Oxendine, through and with the assistance of her counsel, the Bain defendants, settled her claims against the Storm defendants and their liability insurance carrier arising out of the February 16, 2012, automobile accident for the sum of $284,594.00. The Bain defendants refused, and continue to refuse, to acknowledge the existence of plaintiffs claims for reimbursement and subrogation pursuant to the Plan or otherwise.

Defendant Oxendine and the Bain defendants have made a recovery of funds as a result of a settlement, a portion of which rightfully belongs to plaintiff under the terms of the Plan. Such monies rightfully belonging to Plaintiff are in the possession and/or control of defendants, including the Bain defendants. The Specifically Identified Funds were paid by or on behalf of the Storm defendants to defendant Oxen-dine and/or the Bain defendants without recompense to plaintiff as required by the Plan and despite notice to defendant Oxen-dine and the Bain defendants of the Plan’s rights with respect to such funds. '

DISCUSSION

A. Standard of Review

A motion to dismiss under Rule 12(b)(6) tests the legal sufficiency of the complaint but "does not resolve contests surrounding the facts, the merits of a claim, or the applicability of defenses.” Republican Party v. Martin, 980 F.2d 943, 952 (4th Cir.1992). A complaint states a claim under 12(b)(6) if it contains “sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) (quoting Bell Atl. Corp. v. Twombly,

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Bluebook (online)
105 F. Supp. 3d 542, 2015 U.S. Dist. LEXIS 62213, 2015 WL 2227848, Counsel Stack Legal Research, https://law.counselstack.com/opinion/barnhill-contracting-co-v-oxendine-nced-2015.