Harris v. Pacificare Life & Health Ins. Co.

514 F. Supp. 2d 1280, 2007 U.S. Dist. LEXIS 73383, 2007 WL 2846477
CourtDistrict Court, M.D. Alabama
DecidedSeptember 28, 2007
DocketCiv. Act. 2:06cv956-ID
StatusPublished
Cited by14 cases

This text of 514 F. Supp. 2d 1280 (Harris v. Pacificare Life & Health Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, M.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harris v. Pacificare Life & Health Ins. Co., 514 F. Supp. 2d 1280, 2007 U.S. Dist. LEXIS 73383, 2007 WL 2846477 (M.D. Ala. 2007).

Opinion

MEMORANDUM OPINION AND ORDER

IRA DE MENT, Senior District Judge.

I. INTRODUCTION

Before the court is a motion to remand, which is accompanied by a memorandum of law, filed by Plaintiffs Romie Harris, Jr., Amy Harris, Ruby Francis Fowler, *1284 Mary Lois Green, James Thomas, Lula Thomas and Janie Buford (“Plaintiffs”). (Doc. Nos. 7-8.) The motion includes a request for an award of costs and attorney’s fees. (Id.) Defendant Pacificare Life and Health Insurance Company (“Pacifi-care”), the removing defendant, opposes Plaintiffs’ motion. (See Doe: Nos. 12-13.) Plaintiffs originally filed their complaint in the Circuit Court of Bullock County, Alabama, accusing Pacificare and its agents of fraud and other state common-law violations in connection with the purchase of one of Pacificare’s Medicare insurance policies. Although the complaint does not refer to any federal law, Pacificare removed this case to the United States District Court for the Middle District of Alabama pursuant to 28 U.S.C. §§ 1331 and 1441(b), arguing that this case arises under the Medicare Act, 42 U.S.C. §§ 1395w-21 — w28, as amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (“MMA”), by virtue of the MMA’s preemption clause, codified at 42 U.S.C. § 1395w-26(b)(3). Plaintiffs challenge Pacificare’s jurisdictional ground and move to remand this lawsuit back to state court. Plaintiffs argue that removal was proeedurally defective and that their state common-law claims are not completely preempted. After careful consideration of the arguments of counsel, the relevant law and the record as a whole, the court finds that Plaintiffs’ motion to remand is due to be granted, but that Plaintiffs’ request for costs and attorney’s fees is due to be denied.

II. STANDARD OF REVIEW

Pacificare, as the party removing this action to federal court, has the burden of establishing federal jurisdiction. See Leonard v. Enterprise Rent a Car, 279 F.3d 967, 972 (11th Cir.2002); Diaz v. Sheppard, 85 F.3d 1502, 1505 (11th Cir.1996). Federal district courts are “ ‘empowered to hear only those cases within the judicial power of the United States as defined by Article III of the Constitution,’ and which have been entrusted to them by a jurisdictional grant authorized by Congress.” Univ. of South Alabama v. The American Tobacco Co., 168 F.3d 405, 409 (11th Cir.1999) (quoting Taylor v. Appleton, 30 F.3d 1365 (11th Cir.1994)). Accordingly, the federal removal statutes must be “construed narrowly,” and, generally speaking, all doubts about removal must be resolved in favor of remand. Allen v. Christenberry, 327 F.3d 1290, 1293 (11th Cir.2003).

III. BACKGROUND

Seven Plaintiffs, adult citizens of Bullock County, Alabama, filed this lawsuit on September 21, 2006, in the Circuit Court of Bullock County, Alabama. 1 (Compl. ¶¶ 1-5 (Doc. No. 1-3).) The complaint alleges the following facts.

At various times during 2006, Plaintiffs enrolled in a Medicare Advantage plan offered by Pacificare. Pacificare’s plan is called the Secure Horizons Direct, which is a “Private Fee for Service Health Plan.” (Id. ¶ 13.) The individual Defendants are “agents” of Pacificare who sold Plaintiffs the plans at issue. (Id. ¶¶ 7-9.) Plaintiffs allege that Defendants “acted in concert” to contact “all Medicare recipients” in Bullock County, Alabama, including Plaintiffs. (I d. ¶ 14.) As part of their concerted efforts, Defendants misrepresented that Plaintiffs “were required to enroll in Secure Horizons Direct under the federal government’s new prescription drug program,” (id. ¶ 15), and misrepresented that Defendants, in actuality, were “dis-enrolling Plaintiffs from their Medicare coverage *1285 and enrolling them” in .Secure Horizons Direct’s private Medicare Advantage plan. (Id. ¶ 16.) Consequently, Plaintiffs contend that their “benefits and healthcare coverage through Medicare was drastically reduced” and that, in most cases, medical care previously provided to Plaintiffs was “summarily denied by Pacificare,” causing Plaintiffs to suffer physical injury and mental distress and to incur large medical bills. (Id. ¶¶ 17-19.)

Plaintiffs’ complaint alleges state common-law causes of action against Pacificare and the individual Defendants. In Count 1, a fraud claim, Plaintiff^ contend that Defendants “misrepresented themselves as signing up people for the government’s new prescription drug program.” (Id. ¶¶ 22-26.) In Count II — an unjust enrichment claim predicated upon averments that Defendants “fraudulently diverted Plaintiffs’ Medicare premiums” to Pacifi-care’s Medicare Advantage plan — Plaintiffs seek “disgorgement of all premiums paid by Plaintiffs and a permanent injunction against Defendants barring them from contacting others in Bullock County.” (Id. ¶¶ 28-29.) Counts III, IV and V set forth claims under Alabama law for negligent infliction of emotional distress, wantonness, and outrage based upon averments that Defendants “lie[d]” about the terms and conditions of Pacificare’s Medicare Advantage plan “to exploit the old and infirm for profit” and compromised Plaintiffs’ healthcare needs. (Id. ¶¶ 30-41.) Compensatory and punitive damages are sought. (Id. at 3-5.)

IV. DISCUSSION

Because this lawsuit began in, state court, the court’s jurisdiction depends on the propriety of removal. Pacificare predicates federal-question removal jurisdiction on the doctrine of complete preemption. Pacificare relies on 42 U.S.C. § 1395w-26(b)(3) as the statutory vehicle through which complete preemption of Plaintiffs’ state common-law claims is accomplished. 2 (See. Pacificare Not. of Removal ¶¶3, 5-(Doc. No. 1-1)); (Pacificare Resp. to Pis. Mot. Remand at 4 (¶ 2.5) (Doc. No. 12)); 28 U.S.C. §§ 1331,1441(b).

Plaintiffs’ arguments opposing removal and urging remand are twofold. First, Plaintiffs assert that removal was proee-durally defective because Pacificare failed to join Defendant Robert Bell (“Bell”) in the removal action. - (Pis. Mot. ¶ 4 (Doc. No.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
514 F. Supp. 2d 1280, 2007 U.S. Dist. LEXIS 73383, 2007 WL 2846477, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harris-v-pacificare-life-health-ins-co-almd-2007.