Domingo v. Prudential Insurance Company of America, The

CourtDistrict Court, N.D. Illinois
DecidedNovember 6, 2020
Docket1:19-cv-02566
StatusUnknown

This text of Domingo v. Prudential Insurance Company of America, The (Domingo v. Prudential Insurance Company of America, The) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Domingo v. Prudential Insurance Company of America, The, (N.D. Ill. 2020).

Opinion

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

CRISPINIANA DOMINGO, ) ) Plaintiff, ) Case No. 19-cv-02566 ) v. ) Hon. Steven C. Seeger ) THE PRUDENTIAL INSURANCE ) COMPANY OF AMERICA, ) ) Defendant. ) ____________________________________)

MEMORANDUM OPINION AND ORDER

Plaintiff Crispiniana Domingo, a nurse at a local hospital, suffered a disability after a coworker falsely accused her of abusing a patient. She was charged and acquitted. She later submitted a disability claim under a policy that her employer had purchased from Defendant Prudential Insurance Company of America. Prudential ultimately rejected the claim, concluding that the disability first emerged after the policy had expired. Domingo filed a complaint in state court, seeking monthly benefits under the policy plus statutory damages and attorneys’ fees. Prudential, in turn, removed the case to federal court on the basis of diversity jurisdiction. The parties are, in fact, diverse, and Prudential alleged that the amount in controversy exceeded $75,000. Prudential pointed to the fact that Domingo was seeking more than $6,000 in monthly benefits alone. Domingo originally agreed that this case satisfied the amount-in-controversy requirement. But months later, Domingo changed her tune. She points to caps that the policy places on recoverable benefits. Based on those caps, Domingo argues that it was legally impossible for her to recover more than $75,000 – measured on the day of removal – even if one includes statutory damages and attorneys’ fees. The caps placed a hard ceiling on the amount of recoverable benefits, and it was a legal certainty that she could not recover more. Domingo filed a motion to remand. The motion is granted. Background In 2000, Plaintiff Crispiniana Domingo began working as a registered nurse at the UIC

Medical Center. See Third Am. Cplt. ¶¶ 1, 30 (Dckt. No. 53).1 Nurses have active, on-the-go jobs. The position of registered nurse is classified as a medium exertion level occupation. Id. at ¶ 30. To do her job, Domingo needed to lift and carry 30 pounds, and perform tasks that required standing, squatting, bending, and crouching. Id. Her life unraveled on May 16, 2016. Id. at ¶ 31. Domingo was arrested at work for allegedly assaulting a patient, based on an accusation made by her secretary. Id. at ¶¶ 31, 33. The complaint alleges that the “University of Illinois” arrested her. Id. at ¶ 31. Maybe Domingo means that she was arrested by campus security. But in any event, her work life was turned upside down, and her health spiraled downward.

The University opened an investigation and instructed Domingo to stay away from the hospital. Id. at ¶¶ 31–32. In the meantime, the University placed her on administrative leave beginning on May 19, 2016. Id. at ¶ 31. She continued to receive pay. Id.

1 The existence of federal jurisdiction depends on the state of affairs when a party invokes it. See 14AA Charles Alan Wright & Arthur R. Miller, Federal Practice and Procedure § 3702.1 (4th ed. 2020). Here, Prudential removed this case on April 16, 2019, and Domingo then filed a series of amended complaints, including a third amended complaint on December 6, 2019. See Third Am. Cplt. (Dckt. No. 53). The Background section of this Opinion relies on facts stated in the third amended complaint because they contain more details, and thus bring the underlying dispute into sharper focus. For example, it contains more information about Domingo’s disability and leave of absence. The additional facts tell a better story and lead to a better understanding of the dispute. Still, the citations to a later-filed amended complaint do not change the fact that federal jurisdiction needed to exist at the time of removal. The question is whether there was jurisdiction on April 16, 2019, when the case arrived in federal court. The police apparently got involved at some point (the complaint does not say when). She spent six nights in the Cook County Jail in July 2016, before the Philippine Nurse Association of Illinois posted bail on her behalf. Id. at ¶ 35. The accusation, arrest, investigation, and incarceration deeply affected Domingo. Id. at ¶¶ 33–34. She experienced “trauma, depression and anxiety, which led to post-traumatic stress

disorder and a suicide attempt and repeated suicidal ideation.” Id. at ¶ 33. During her incarceration, Domingo “attempted suicide by trying to hang herself with bed sheets.” Id. at ¶¶ 34–35. She planned to commit suicide after her release. Id. at ¶ 36. After her release in mid-July 2016, Domingo admitted herself for inpatient treatment at another hospital. Id. at ¶ 37. She was sleeping less than 4 hours a night, and sleeping on the floor with feelings of helplessness. Id. She experienced constant crying, and gained 10 pounds in the first month. Id. at ¶ 38. She attributes the physical and mental anguish to the ordeal from the accusation of abuse – she claims that she was disabled since the day of her arrest in May 2016. Id. at ¶¶ 38–40.

During her administrative leave, Domingo began suffering from other serious physical problems, too. She felt significant pain in her neck, shoulders, and back. Id. at ¶ 40. In May 2017, she was diagnosed with neck pain, chronic bilateral shoulder pain, chronic back pain, and cervical radiculopathy (i.e., a “pinched nerve”). Id. at ¶ 41. She received a variety of treatments, including chiropractic care. Id. at ¶ 42. The chiropractic care apparently set her back. In September 2017, Domingo was diagnosed with “Vertebral Artery Dissection with a 2mm dissecting aneurysm,” meaning a tear in one of the four arteries involved in blood flow to the brain. Id. at ¶¶ 43–44. The dissection causes blood to enter the arterial wall and form clots, creating a risk of stroke and causing headaches. Id. at ¶ 44. The likely cause was “chiropractic manipulation, one of the forms of treatment she received for her disabling neck pain.” Id. at ¶ 43. Domingo received more bad news about her health in January 2018. Scans revealed a 3mm aneurysm in the brain. Id. at ¶ 45. Other tests in the spring of 2018 revealed two more aneurysms. Id. at ¶ 52.

In the first quarter of 2018, Domingo went to trial on the abuse charges and was acquitted. Id. at ¶ 46. Video surveillance proved the charges wrong. Id. at ¶¶ 1, 46. According to the complaint, Domingo’s secretary made up the whole thing as revenge for a bad performance review. Id. at ¶ 31. The University fired the secretary and other staff involved in the accusation and arrest. Id. at ¶ 46. After the acquittal, the University told Domingo that it had completed its investigation and allowed her to return to work. Id. But by then, Domingo “was already disabled.” Id. at ¶ 47. She used sick leave from March until September 18, 2018, when it ran out. Id. at ¶ 49. In May 2018, while she was using sick leave, Domingo applied for disability benefits

from two sources. Id. at ¶¶ 47–48. She applied under the State University Retirement System (“SURS”), a state agency that administers retirement, disability, and other benefits for employees in public higher education in Illinois. Id. at ¶ 48. She also applied under a long-term disability insurance policy that the University of Illinois purchased from Prudential, the Defendant. Id. at ¶¶ 6, 48. Domingo was a covered insured under the Prudential policy. Id. at ¶ 25. SURS ultimately approved her claim for benefits, with a disability date of May 16, 2016 (i.e., her last day of work). Id. at ¶¶ 11, 92. SURS awarded her a disability benefit of $6,510.63 per month, representing 50% of her average earnings for the 24 months before she became disabled (that is, half of $13,021.26 per month). Id. at ¶¶ 13, 97–98. But Prudential denied coverage. The policy covered employees who suffer a disability during a “leave of absence” for one year. Id. at ¶ 58.

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