Dodd v. John Hancock Mutual Life Insurance

688 F. Supp. 564, 1988 U.S. Dist. LEXIS 5563, 1988 WL 61754
CourtDistrict Court, E.D. California
DecidedJune 14, 1988
DocketCiv. S-87-644 LKK
StatusPublished
Cited by36 cases

This text of 688 F. Supp. 564 (Dodd v. John Hancock Mutual Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dodd v. John Hancock Mutual Life Insurance, 688 F. Supp. 564, 1988 U.S. Dist. LEXIS 5563, 1988 WL 61754 (E.D. Cal. 1988).

Opinion

ORDER

KARLTON, Chief Judge.

James C. Dodd and his wife are the sole owners of all of the stock of James C. Dodd & Associates, Inc., a California corporation. That corporation enrolled in a group health plan issued by defendant John Hancock Mutual Life Insurance Company (“John Hancock”) to the Trustees of the California Council of the American Institute of Architects. Plaintiff's wife suffered a stroke which he alleges requires her to have 24-hour nursing care. When the defendant insurance company declined to pay for the care, plaintiff brought suit in Sacramento Superior Court, alleging violation of various state statutory and common law rights. Defendants removed the action to this court on the grounds that plaintiff’s state law claims were completely preempted by the Employee Retirement Income Security Act ("ERISA”), 29 U.S.C. §§ 1001, et seq., and that the action was therefore removable under the authority of Metropolitan Life Insurance Company v. Taylor, 481 U.S. 58, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987), and Pilot Life Insurance Company v. Dedeaux, 481 U.S. 41, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987).

Defendants subsequently filed a motion for summary judgment on the grounds that plaintiff’s claims under the California Insurance Code and for extracontractual damages are preempted by ERISA. Plaintiff opposed the motion, asserting that Dodd & Associates, plaintiff’s purported employer, did not have an ERISA employee welfare benefit plan at any relevant time and/or that even if such a plan existed, the plaintiff was not a participant in that plan. In light of plaintiff’s argument, the court continued defendants’ motion and ordered plaintiff to bring on a motion to remand.

I

STANDARDS

It is well-settled that defendants, as the parties removing an action to federal court, have the burden of establishing removal jurisdiction. Salveson v. Western States’ Bankcard Ass’n, 731 F.2d 1423, 1426 (9th Cir.1984). Because the “removal statutes are strictly construed against removal,” Lib hart v. Santa Monica Dairy Co., 592 F.2d 1062, 1064 (9th Cir.1979), *566 generally speaking, doubts about removal must be resolved in favor of remand. National Audubon Society v. Dept. of Water & Power of the City of Los Angeles, 496 F.Supp. 499, 507 (E.D.Cal.1980). In the instant case, however, there is no dispute about the historical facts, and the only question is whether, under those facts, ERISA governs the relationship between plaintiff and defendant, a pure question of law.

II

MOTION TO REMAND

In Metropolitan Life Insurance Co. v. Taylor, 481 U.S. -, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987), the Supreme Court held that the preemptive force of ERISA is so extraordinary that it “converts an ordinary state common law complaint into one stating a federal claim for purposes of the well-pleaded complaint rule.” Id. 481 U.S. at -, 107 S.Ct. at 1547, 95 L.Ed.2d at 64. Thus, whether this action was properly removed depends on whether plaintiff's state law claims are completely preempted by ERISA, which, in turn, depends on whether those claims come “within the scope of [the] civil enforcement provisions of § 502(a)” of ERISA, id. 481 U.S. at -, 107 S.Ct. at 1548, 95 L.Ed.2d at 65; if they are not within the ambit of the federal statute, the matter must be remanded to state court where plaintiff will be free to pursue his state remedies.

Section 502(a) of ERISA, 29 U.S.C. § 1132(a), provides in relevant part that a participant or beneficiary may bring a civil action “to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B). To decide the motion to remand, then, two questions must be resolved: (1) was the John Hancock insurance policy at issue purchased by James C. Dodd and Associates, Inc. pursuant to an employee benefit plan governed by ERISA and, (2) if so, was James C. Dodd a participant in that plan within the meaning of ERISA? 1

A. Was There An Employee Welfare Benefit Plan Within the Meaning of ERISA?

The statute defines an employee welfare benefit plan, in relevant part, as:

[A]ny plan, fund, or program which was heretofore or is hereafter established or maintained by an employer or by an employee organization, or by both, to the extent that such plan, fund, or program was established or is maintained for the purpose of providing for its participants or their beneficiaries, through the purchase of insurance or otherwise, (A) medical, surgical, or hospital care or benefits, or benefits in the event of sickness, accident disability, death or unemployment....

29 U.S.C. § 1002(1). In Donovan v. Dillingham, 688 F.2d 1367 (11th Cir.1982) (en banc), the court examined the prerequisites for finding the existence of an “employee welfare benefit plan” under this provision. 2

By definition, then, a welfare plan requires (1) a “plan, fund or program” (2) established or maintained (3) by an employer or by an employee organization, or by both, (4) for the purpose of providing medical, surgical, hospital care, sickness, accident, disability, death, unemployment or vacation benefits, apprenticeship or other training programs, day care centers, scholarship funds, prepaid legal services or severance benefits (5) to participants or their beneficiaries.

*567 Donovan, 688 F.2d at 1371. The court thought that the third, fourth and fifth prerequisites were “either self-explanatory or defined by statute.” Id. It concluded that:

The gist of ERISA’s definitions of employer, employee organization, participant, and beneficiary is that a plan, fund, or program falls within the ambit of ERISA only if the plan, fund, or program covers ERISA participants because of their employee status in an employment relationship, and an employer or employee organization is the person that establishes or maintains the plan, fund, or program.

Donovan, 688 F.2d at 1371. As I discuss in section II-B, infra, the demarcation between employer and employee is not discerned without some difficulty in the instant case.

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Bluebook (online)
688 F. Supp. 564, 1988 U.S. Dist. LEXIS 5563, 1988 WL 61754, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dodd-v-john-hancock-mutual-life-insurance-caed-1988.