Childs v. UNIFIED LIFE INSURANCE COMPANY

781 F. Supp. 2d 1240, 2011 U.S. Dist. LEXIS 27871, 2011 WL 1045533
CourtDistrict Court, N.D. Oklahoma
DecidedMarch 17, 2011
Docket4:10-cr-00023
StatusPublished
Cited by11 cases

This text of 781 F. Supp. 2d 1240 (Childs v. UNIFIED LIFE INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court, N.D. Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Childs v. UNIFIED LIFE INSURANCE COMPANY, 781 F. Supp. 2d 1240, 2011 U.S. Dist. LEXIS 27871, 2011 WL 1045533 (N.D. Okla. 2011).

Opinion

OPINION AND ORDER

TERENCE C. KERN, District Judge.

Before the Court are Defendant Unified Life Insurance Company’s (“Unified”) Motion to Dismiss (Doc. 11) (“Motion to Dismiss”) and Plaintiffs Opposed Motion for Leave to File an Amended Complaint (Doc. 62) (“Motion for Leave”).

1. Background

The following facts are alleged in Plaintiffs Class Action Complaint (“Complaint”). 1 Plaintiff is the daughter of Ethel Levina Kirk (“Kirk”), who resided in Broken Arrow Nursing Home before she died on May 30, 2009. During her stay at the nursing home, Kirk was eligible for and received Medicaid assistance from the State of Oklahoma. Accordingly, Plaintiff alleges that Kirk, “an elderly lady in need of dentures,” was “entitled to receive denture-related services as provided by Medicaid, at no charge to her personal funds.” (Compl. ¶ 25.) However, on an unknown date, but before May 1, 2007, Kirk applied for and purchased a dental insurance policy (“Dental Plan”) from Unified, presumably to cover denture-related expenses. Kirk was invoiced for the Dental Plan on a monthly basis. Acting on behalf of Kirk, Plaintiff would pay the Dental Plan premium out of Kirk’s checking account. The Dental Plan was not purchased by Broken Arrow Nursing Home on Kirk’s behalf. Nor were the Dental Plan premiums paid by Broken Arrow Nursing Home out of its daily rate for routine services.

Plaintiff, as Special Administrator of Kirk’s estate and on behalf of all others similarly situated, 2 now brings this class *1243 action suit against Unified, claiming the Dental Plan is contrary to Oklahoma law and therefore void. 3 Specifically, Plaintiff maintains that the Dental Plan violates Okla. Admin. Code § 317:30-5-133.1 (“Section 317:30-5-133.1”) because: (1) “the Dental Plan is not purchased by Oklahoma nursing facilities to benefit their individual Medicaid residents,” but is instead marketed and sold directly to Medicaid residents or their representatives, (Compl. ¶ 21); (2) “Dental Plan premiums are not collected ... from any nursing facility’s ‘daily rate for routine services’ [but are] instead [collected from Medicare (sic) residents’ personal funds” or by money held in trust for the benefit of the residents, (id. ¶ 22); and (3) the Dental Plan “contains numerous per-proeedure benefit caps and co-payments relating to both participating and non-participating dentists,” (id. ¶ 23). Plaintiff also alleges that the denture-related services offered by the Dental Plan were “virtually identical to the denture-related ‘routine-services’ ” already provided by Medicaid at no charge to nursing facility residents. (Id. ¶ 19.)

In conjunction with these allegations, Plaintiff asserts three causes of action against Unified. First, Plaintiff brings a claim for “unjust enrichment/restitution,” claiming that the Dental Plan constitutes an illegal contract, and Unified has therefore wrongfully retained the monthly premiums paid by Kirk and the Proposed Class. (Id. ¶¶ 38^14.) Second, Plaintiff alleges that Unified, by accepting and not returning the illegally obtained premiums, has committed a claim for conversion. (See id. ¶ 46.) Finally, Plaintiff brings a claim under the Oklahoma Consumer Protection Act (“OCPA”), maintaining that Unified engaged in an “unfair trade practice” by “selling to [Kirk] and members of the Class the Dental insurance contract, which is illegal and thus ‘offends established public policy.’ ” (Id. ¶ 51.)

Unified has moved to dismiss the Complaint, claiming that it fails to state a claim upon which relief can be granted under Federal Rule of Civil Procedure 12(b)(6) (“Rule 12(b)(6)”). 4 Specifically, Unified argues that Plaintiffs Complaint should be dismissed because: (1) Plaintiffs claims are based on the Oklahoma Health Care Authority’s (“OHCA”) regulations, which do not provide a private cause of action; (2) Plaintiff received the counterperformance specified by the Dental Plan, prohibiting a claim for unjust enrichment; (3) Plaintiffs claim for conversion seeks to recover money rather than tangible personal property; and (4) Plaintiffs action is exempt from the OCPA. Plaintiff objects to Unified’s Motion to Dismiss and further seeks leave to file an Amended Complaint in order to: (1) add MobileCare 2U, LLC (“MobileCare”) as a defendant; 5 (2) elimi *1244 nate all references in the Complaint to Sterling; and (3) adjust the nature of the conversion claim, “making it [i]n the nature of a ‘Thing in Action,’ ” (Mot. for Leave 2-3). In objecting to Plaintiffs Motion for Leave, Unified rests on the arguments advanced in its Motion to Dismiss, maintaining that the proposed amendments to the Complaint are futile because the First Amended Complaint does not remedy the deficiencies identified in the Motion to Dismiss.

II. Motion to Dismiss

In considering a motion to dismiss under Rule 12(b)(6), a court must determine whether the plaintiff has stated a claim upon which relief may be granted. The inquiry is “whether the complaint contains ‘enough facts to state a claim to relief that is plausible on its face.’ ” Ridge at Red Hawk, LLC v. Schneider, 493 F.3d 1174, 1177 (10th Cir.2007) (quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007)). In order to survive a Rule 12(b)(6) motion to dismiss, a plaintiff must “ ‘nudge [ ] [his] claims across the line from conceivable to plausible.’” Schneider, 493 F.3d at 1177 (quoting Twombly, 550 U.S. at 570, 127 S.Ct. 1955). Thus, “the mere metaphysical possibility that some plaintiff could prove some set of facts in support of the pleaded claims is insufficient; the complaint must give the court reason to believe that this plaintiff has a reasonable likelihood of mustering factual support for these claims.” Schneider, 493 F.3d at 1177.

The Tenth Circuit has interpreted “plausibility,” the term used by the Supreme Court in Twombly, to “refer to the scope of the allegations in a complaint” rather than to mean “likely to be true.” Robbins v. Okla. ex rel. Okla. Dep’t of Human Servs., 519 F.3d 1242, 1247 (10th Cir.2008). Thus, “if [allegations] are so general that they encompass a wide swath of conduct, much of it innocent, then the plaintiffs have not nudged their claims across the line from conceivable to plausible.” Id. (internal quotations omitted). “The allegations must be enough that, if assumed to be true, the plaintiff plausibly (not just speculatively) has a claim for relief.” Id.

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781 F. Supp. 2d 1240, 2011 U.S. Dist. LEXIS 27871, 2011 WL 1045533, Counsel Stack Legal Research, https://law.counselstack.com/opinion/childs-v-unified-life-insurance-company-oknd-2011.