Employers' Innovative Network, LLC v. Bridgeport Benefits, Inc.

District Court, S.D. West Virginia·Decided February 25, 2019·No. 5:18-cv-01082·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA

BECKLEY DIVISION

EMPLOYERS’ INNOVATIVE NETWORK, LLC, et al.,

Plaintiffs,

v. CIVIL ACTION NO. 5:18-cv-01082

BRIDGEPORT BENEFITS, INC., et al.,

Defendants.

MEMORANDUM OPINION AND ORDER

The Court has reviewed Defendants Capitol Administrators Inc. (“Capitol Administrators), Lucent Health Solutions, Inc. (“Lucent”), Mike Tate and Alex Arnet’s (collectively the “Capitol Administrators Defendants’”) Renewed Motion to Set Aside Default (Document 9), Plaintiffs’ Response in Opposition to Renewed Motion to Set Aside Default (Document 10), Defendants Capital Security, Ltd. (Capital Security), Universal Risk Intermediaries, Inc. (Unirisk), and Jeana Nordstrom’s (collectively the “Nordstrom Defendants’) Motion to Set Aside Default (Document 15), and the Plaintiffs’ Response in Opposition to Motion to Set Aside Default (Document 26). The Court has also reviewed the Capitol Administrators Defendants’ Renewed Motion to Extend Time to Answer (Document 8), the Plaintiffs’ Complaint and Petition for Declaratory Judgment (Document1-4), the Amended Defenses and Answer of Capitol Administrators, Inc., Mike Tate, Alex Arnet and Lucent Health Solutions, Inc. and Counterclaim and Cross-claim (Document 5), 1 the Plaintiffs’ Rule 12(f) Motion to Strike Amended Defense and Answers of Capitol Administrators Inc., Mike Tate, Alex Arnet and Lucent Health Solutions, Inc., and Counterclaim and Cross-Claim. (Document 13) and the Motion for Leave of Defendants Capital Security, Ltd., Universal Risk Intermediaries Inc., and Jeana Nordstrom, to File Motion to Dismiss Complaint (Document 16). For the reasons stated herein, the Court finds that both motions to set aside default should be granted, the motion for leave to file the motion to dismiss should be granted, the motion to extend time to answer should be granted, and the motion to strike should be denied. PROCEDURAL HISTORY AND FACTUAL BACKGROUND

A. The Wyoming County Circuit Court Proceedings On April 2, 2018, the Plaintiffs, Employers’ Innovative Network, LLC (EIN) and Jeff Mullins, filed a Complaint and Petition for Declaratory Judgment against the Capitol Administrators Defendants, the Nordstrom Defendants, Bridgeport Benefits, Inc. (“Bridgeport”), Voluntary Benefits Specialists, LLC (“VBS”), Stephen Salinas, Wayne Blasman, and Casey Blasman. The complaint alleges unauthorized practice of insurance, breach of fiduciary duty, slander, negligence, breach of contract, fraud in the inducement, fraud in the performance, and civil conspiracy. The Plaintiffs allege that in 2016, EIN sought an insurance policy to cover its employees. Steven Nordstrom, then President of Capital Security and Unirisk, introduced EIN to

Mr. Salinas, the Director of Benefits at Bridgeport, which is an insurance broker. Mr. Salinas and Wayne Blasman, the President of Bridgeport, offered to broker a policy for EIN with Capital Security, a Bermuda insurance company. The Plaintiffs allege they informed the Defendants that 2 the policy had to be fully insured and that the Defendants represented that it was a fully insured policy. EIN accepted the policy with the belief that it had no financial liability for claims under the plan after the payment of the monthly premiums, because Capital Security would be responsible for paying any claims that could not be paid with EIN’s premiums. In November 2017, EIN switched insurance. Capital Security retained Capitol Administrators as a third-party administrator to administer claims on the policy. The Plaintiffs allege that in early January 2018, Capitol Administrators accidentally sent EIN a report revealing over five million dollars of unpaid claims that Capitol Administrators neither paid nor disclosed to EIN. As a result of the report, EIN contacted Capital Security, which informed EIN that it was not responsible for the unpaid claims because the policy was self-insured, not fully insured. In January 2018, EIN alleges it was made aware that its employees, covered under the policy, were receiving third-party collection notices for medical bills that were submitted to Capitol Administrators but had not been paid.1 Finally,

the complaint alleges that Bridgeport, Capitol Administrators, and Capital Security are not registered with the West Virginia Insurance Commission or licensed to conduct insurance business in the state. The Capitol Administrators Defendants’ answer or responsive pleading was due by May 3, 2018, but on May 3, 2018, counsel for the Capitol Administrators Defendants filed a motion for an extension of time to file an answer, which the Plaintiffs opposed on May 9, 2018.2 On June 7,

1 The Complaint alleges that the Plaintiffs paid Capitol Administrators over four million dollars to ensure payment of the unpaid claims.

2 Counsel for the Capitol Administrator Defendants requested an extension in part because of the passing of his 3 2018, the Wyoming County Circuit Court Clerk entered default against the Capitol Administrators Defendants. On June 8, 2018, the Capital Administrators Defendants filed an answer and requested an extension of time through June 8, 2018. On June 13, 2018, the state court held a hearing to address the entry of default, but the case was removed prior to the issuance of a ruling. B. Federal Court Proceedings On June 27, 2018, the Nordstrom Defendants removed this case pursuant to 28 U.S.C §§ 1332, 1441 and 1446. In the notice of removal, the Nordstrom Defendants alleged that the action may be removed to this Court “because it is a civil action between citizens of different states wherein the amount in controversy exceeds the sum or value of $75,000.00 exclusive of interest and cost.” (Document 1-6, ¶¶ 7-8). On June 29, 2018, the Capitol Administrators Defendants filed an answer as well as a counterclaim and cross-claim to the complaint. On July 3, 2018, the Capitol Administrators Defendants filed a renewed motion to extend time to answer the complaint and a renewed motion to set aside the default entered in state court.3 On July 17, 2018, the

Plaintiffs filed a motion for entry of default against the Nordstrom Defendants as well as a motion to strike the Capitol Administrators Defendants’ answer, counterclaim and cross-claim. On July 18, 2018, the Clerk for this Court entered a default against the Nordstrom Defendants.

mother, and before this matter was removed to this Court, the Capitol Administrators Defendant retained new counsel and the state court issued an Order granting substitute counsel.

3 The Capitol Administrators Defendants’ Renewed Motion to Extend Time to Answer (Document 8) appears to have a typographical error. The Capitol Administrators Defendants state that they filed their answer on June 29, 2018, but only request an extension until June 19, 2018 for the filing to be considered timely. The Court has reviewed the motion as a request to have an extension until June 29, 2018.

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