Blue Cross and Blue Shield v. Butler

630 So. 2d 413, 1993 Ala. LEXIS 1170, 1993 WL 496060
CourtSupreme Court of Alabama
DecidedDecember 3, 1993
Docket1920701
StatusPublished
Cited by7 cases

This text of 630 So. 2d 413 (Blue Cross and Blue Shield v. Butler) is published on Counsel Stack Legal Research, covering Supreme Court of Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blue Cross and Blue Shield v. Butler, 630 So. 2d 413, 1993 Ala. LEXIS 1170, 1993 WL 496060 (Ala. 1993).

Opinion

The defendant, Blue Cross and Blue Shield of Alabama, Inc. ("Blue Cross"), brings this appeal by permission granted pursuant to Rule 5, Ala.R.App.P., from an interlocutory order denying its summary judgment motion. The plaintiff, Betty S. Butler, had originally brought her claim in the district court, but, after appealing to the circuit court, filed a motion for voluntary dismissal of her complaint without prejudice; the circuit court granted that motion. The issue is whether the circuit court's dismissal of that first action without prejudice was effective to allow her to bring the present action, which claims damages in excess of the jurisdictional limits of the district court.

Butler had two front teeth restored with a full coverage porcelain crown by Dr. Kim Peters of Tallassee, Alabama. At the time the dental work was performed, Butler was insured under a group health care and dental plan issued by Blue Cross to the State of Alabama. After performing the dental work, Dr. Peters filed a claim for his charges; Blue Cross denied it on the grounds that the dental work done was not medically necessary and was not covered under the plan.

Butler then filed an action against Blue Cross in the District Court of Elmore County on September 23, 1991, seeking benefits she claimed was due under her Blue Cross group health care and dental plan. Butler brought the action under the terms of the Employee Retirement Income Security Act of 1974 (ERISA). The sixth paragraph of her complaint filed in the district court states the following:

"Plaintiff brings this claim for benefits due and owing pursuant to the terms of the employee retirement income security act of 1974 (E.R.I.S.A.), 29 U.S.C.A. § 1001 et. seq. and 29 U.S.C.A. § 1132."

The ad damnum clause in Butler's complaint stated:

"Wherefore, the premises considered, Plaintiff demands judgment against Defendant in such an amount as to compensate her for all sums presently due and owing to her under the above described policy of insurance, plus costs and interest to date and reasonable attorney's fees."

Blue Cross filed an answer denying that the dental expenses incurred were covered under the insurance policy and denying that Butler was entitled to any benefits under the contract. In paragraph six of its answer, Blue Cross states, "No answer is required of this Defendant for Paragraph 6." No other reference is made in the answer to Butler's ERISA claim or ERISA's applicability to Butler's claim.

The deposition of Dr. Peters was taken on the order of the district judge. The action was tried before the district court on May 6, 1992. The district judge entered a judgment in favor of Butler in the amount of $570, which was the total cost of the dental expenses.

After the entry of judgment, Butler filed a motion with the district court styled "Motion To Alter or Amend Judgment," requesting that the court include a reasonable fee for Butler's attorney. Butler estimated a reasonable attorney fee to be $2,650. She also requested that the costs of the action, in the sum of $159.30, be made part of the judgment. Blue Cross submitted a response to this motion, arguing: "[A]fter the case was tried, the Plaintiff realized that under the 'Government Plan' exception to ERISA, . . . [s]he was not entitled to attorney's fees. Therefore, it would cause this Defendant extreme prejudice to allow the Plaintiff to alter or amend the judgment because of an error that the Plaintiff made in [her] original pleadings." On June 17, 1992, after holding a hearing, the district judge denied the motion to alter or amend the judgment.

On June 29, 1992, Butler appealed to the Circuit Court of Elmore County for a trial de novo. The circuit court docketed this appeal under case number CV-92-222. Butler filed "Plaintiff's First Amendment to Complaint" on July 28, 1992. That amendment added a *Page 415 "Count II," alleging that Blue Cross was liable under the terms of the policy for Butler's dental work, and a "Count III," alleging that Blue Cross had in bad faith breached its contractual duty to deal fairly with Butler. The ad damnum clause demanded judgment against Blue Cross in the amount of $1 million in compensatory and punitive damages.

In open court on August 12, 1992, Blue Cross filed a motion to dismiss this amendment and a memorandum in support of the motion, arguing that Butler had waived the opportunity to amend her complaint because she had not done so in the district court before responsive pleadings were filed. Blue Cross also argued that if the amended complaint were allowed to stand, Butler was limited to collecting damages of $5,000 or less, because that was the jurisdictional limit of the district court. Finally, Blue Cross argued that Rule 13(j), Ala.R.Civ.P., barred the plaintiff from appealing from the district court's judgment and requesting an amount exceeding the district court's jurisdictional limits. On August 12, 1992, counsel for both parties appeared for the hearing on the objection to the appeal. The case action summary sheet contains an August 12, 1992, entry by the circuit judge stating, "Order entered." There is no indication of what this order concerned. It may have been an order denying Blue Cross's objection to the appeal, but, although Butler's brief states that the circuit court denied Blue Cross's objection to her appeal, her brief does not cite a page in the record showing this denial and we cannot find any other indication that the order was denied.

Butler filed a "Motion for Voluntary Dismissal" on September 1, 1992, requesting the court to permit her to voluntarily dismiss her complaint and "refile the Complaint without the restriction imposed by Rule 13(j) of the Alabama Rules of Civil Procedure." Blue Cross filed a response to this motion. On September 21, 1992, the circuit judge held a hearing on the motion for voluntary dismissal and granted the motion, dismissing "the case" without prejudice.

Butler then filed a new complaint in the circuit court on September 23, 1992, alleging bad faith on the part of Blue Cross and requesting $570 in compensatory damages and $1 million in punitive damages, plus interest and costs. This complaint was given case number CV-92-325. Blue Cross filed a motion to dismiss the complaint, with a supporting memorandum brief, on October 16, 1992, arguing that Butler's claims were barred under the doctrine of res judicata. The circuit court held a hearing on this motion; the court, treating the motion as one for summary judgment, denied it. The circuit court entered a subsequent order indicating that the interlocutory order denying summary judgment concerned "a controlling question of law [as to] which there was a substantial ground for difference of opinion, [and] that an immediate appeal from the order would materially advance the ultimate termination of the litigation." We granted permission for that appeal. See Rule 5, Ala.R.App.P.

Blue Cross is correct in arguing that its motion for judgment on the new complaint should have been granted. It was error for the circuit judge to attempt to allow the plaintiff to dismiss her amended complaint without prejudice and then allow her to file a new complaint alleging bad faith on the part of Blue Cross and requesting $1 million in punitive and compensatory damages. The plaintiff stated in her motion to voluntarily dismiss her complaint that she wished to do so to avoid the strictures of Rule 13(j), Ala.R.Civ.P.

Rule 13(j) states the following:

"If the plaintiff appeals a case to the circuit court from a lower court and obtains a trial de novo in the circuit court, the plaintiff shall be

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Cite This Page — Counsel Stack

Bluebook (online)
630 So. 2d 413, 1993 Ala. LEXIS 1170, 1993 WL 496060, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blue-cross-and-blue-shield-v-butler-ala-1993.