James Heyman v. Lincoln Nat'l Life Ins. Co.

CourtCourt of Appeals for the Sixth Circuit
DecidedJuly 18, 2019
Docket18-5622
StatusUnpublished

This text of James Heyman v. Lincoln Nat'l Life Ins. Co. (James Heyman v. Lincoln Nat'l Life Ins. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
James Heyman v. Lincoln Nat'l Life Ins. Co., (6th Cir. 2019).

Opinion

NOT RECOMMENDED FOR FULL-TEXT PUBLICATION File Name: 19a0370n.06

No. 18-5622

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT FILED JAMES HEYMAN, ) Jul 18, 2019 ) DEBORAH S. HUNT, Clerk Plaintiff-Appellant, ) ) v. ) ON APPEAL FROM THE UNITED ) STATES DISTRICT COURT FOR THE LINCOLN NATIONAL LIFE ) WESTERN DISTRICT OF KENTUCKY INSURANCE COMPANY, ) ) Defendant-Appellee. )

BEFORE: DAUGHTREY, COOK, and GRIFFIN, Circuit Judges.

MARTHA CRAIG DAUGHTREY, Circuit Judge. Plaintiff James Heyman appeals two

orders of the district court, one that denied his motion to remand this matter to the Kentucky state

court from which it was removed and a second that granted judgment on the pleadings to the

defendant, Lincoln National Life Insurance Company. Heyman argues that the district court erred

in concluding that the amount in controversy in the case exceeded $75,000. He thus insists that

the district court did not have subject matter jurisdiction over this lawsuit. He also contends that,

even if the district court properly exercised diversity jurisdiction in this matter, that court

erroneously applied a first-to-file rule to justify granting judgment on the pleadings to Lincoln

National.

We conclude that the district court appropriately determined both that it had jurisdiction

over this matter and that application of the first-to-file rule was proper. However, the district court

abused its discretion, in dismissing Heyman’s lawsuit—even though that dismissal was without No. 18-5622, Heyman v. Lincoln Nat’l Life Ins. Co.

prejudice—rather than holding the matter in abeyance pending resolution of an earlier-filed federal

lawsuit with overlapping parties and issues. We thus affirm the judgment of the district court in

part, reverse the order of dismissal, and remand the matter for such further actions as are

appropriate.

FACTUAL AND PROCEDURAL BACKGROUND

James Heyman formerly was employed by the Louisville-Jefferson County Metropolitan

Government and thus was insured under a group long-term-disability-insurance policy issued by

Lincoln National Life Insurance Company. When Heyman became disabled and unable to work,

Lincoln National began paying benefits to him, beginning on November 9, 2011, in the amount of

$1,222.87 per month. Effective January 1, 2012, the Social Security Administration, having found

Heyman to be disabled according to Social Security standards, also awarded him monthly Social

Security Disability Insurance (SSDI) benefits of $1,977.00.

In August 2013, Lincoln National learned that Heyman had been receiving SSDI benefits—

as well as benefits from the insurance company—for, at that point, 20 months. Pursuant to the

“Other Income Benefits” provisions of Lincoln National’s policy, such Social Security disability

benefits were required to “be offset, in determining the amount of the Insured Employee’s Monthly

Benefit” if “th[o]se amounts . . . result[ed] from the same Disability for which a Monthly Benefit

is payable under [the Lincoln National] Policy.” Because the amount of the monthly SSDI benefits

exceeded the amount of the long-term-disability benefits provided under the Lincoln National

policy, the insurance company asserted that Heyman should not have been receiving the monthly

$1,222.87 payments, but rather only “the minimum benefit amount under the Policy in the amount

of $122.29” for those 20 months. According to a Lincoln National official, “[t]his resulted in a

benefit overpayment made to Mr. Heyman by Lincoln National in the amount of $12,979.38.”

-2- No. 18-5622, Heyman v. Lincoln Nat’l Life Ins. Co.

Upon discovering the overpayments, Lincoln National requested that Heyman reimburse

the insurance company in the amount of those overpayments. When Heyman failed to do so,

Lincoln National, in accordance with expressed policy provisions, began withholding even the

minimum monthly payments of $122.29—beginning in September 2015—in an attempt to recoup

its alleged losses.

In response, Heyman filed suit on December 22, 2015, in Jefferson County (Kentucky)

Circuit Court. In his complaint, he claimed that Lincoln National’s actions in reducing and then

withholding disability benefits constituted: a breach of the company’s contract with Heyman; a

breach of the company’s “duty to act in good faith and fair dealing”; a violation of Kentucky

Revised Statutes § 304.12-230 (Kentucky’s Unfair Claims Settlement Practices Act (UCSPA)); a

violation of Kentucky Revised Statutes § 304.14-375, which “prohibits an insurer from seeking

reimbursement of health insurance overpayments ‘more than two (2) years after the claim was

filed’”; a violation of Kentucky Revised Statutes § 304.12-235, which prohibits delays in payment

of insurance claims; and a violation of Kentucky Revised Statutes § 304.12-010, which prohibits

unfair or deceptive acts or practices by insurance companies. In his prayer for relief, Heyman

sought “all available damages including an amount of money sufficient to satisfy his claims (not

to exceed $75,000) inclusive of pre- and post-judgment interest, attorneys’ fees and costs,

including the cost of any experts, and any other and further relief as the Court deems appropriate.”

Upon receipt of Heyman’s complaint, Lincoln National filed a timely notice of removal to

federal district court. In that filing, Lincoln National noted that Heyman is a citizen and resident

of Kentucky and that the insurance company was organized pursuant to the laws of Indiana and

had its principal place of business in Pennsylvania. Lincoln National further alleged that, despite

Heyman’s efforts to limit his damages to $75,000, the amount in controversy actually far exceeded

-3- No. 18-5622, Heyman v. Lincoln Nat’l Life Ins. Co.

the amount necessary to invoke the district court’s diversity jurisdiction. See 28 U.S.C. § 1332(a).

Specifically, Lincoln National claimed that Heyman’s compensatory damages amounted to

$31,305.40, that damages tied to declaratory and injunctive relief totaled another $303,271.76, and

that Heyman could be entitled to additional punitive damages, attorneys’ fees, and interest.

Disputing the insurer’s calculation of possible damages, Heyman filed a motion to remand

the matter to the Jefferson County court. Lincoln National countered by filing a motion for

judgment on the pleadings, leading Heyman to reemphasize his belief that the district court lacked

jurisdiction over the matter by filing the following stipulation:

I assert in the above cause of action, and any subsequent state court action(s), that I will not seek or accept damages in excess of $75,00.00, inclusive of statutory pre- and post-judgment interest, attorneys’ fees and costs (including the cost of any experts), punitive damages, the fair value of any injunctive relief, and any other and further relief the Court deems appropriate. This stipulation does not limit my ability to seek costs and interest on a judgment as defined in 28 U.S.C. § 1332(a).

In light of that stipulation, the district court ordered Lincoln National either to indicate its

acquiescence to the remand request or to file “a surreply addressing the stipulation.”

Lincoln National chose to file a surreply in opposition to Heyman’s motion for remand. In

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