Kesselman v. THE RAWLINGS CO., LLC

668 F. Supp. 2d 604, 2009 U.S. Dist. LEXIS 126264, 2009 WL 3805587
CourtDistrict Court, S.D. New York
DecidedNovember 13, 2009
Docket08 Civ. 7417(BSJ)
StatusPublished
Cited by17 cases

This text of 668 F. Supp. 2d 604 (Kesselman v. THE RAWLINGS CO., LLC) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kesselman v. THE RAWLINGS CO., LLC, 668 F. Supp. 2d 604, 2009 U.S. Dist. LEXIS 126264, 2009 WL 3805587 (S.D.N.Y. 2009).

Opinion

Order

BARBARA S. JONES, District Judge.

In this action, Plaintiffs have brought a putative class action complaint against numerous Defendants 1 alleging violations of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (“ERISA”) and the Fair Debt Collection Practices Act, 15 U.S.C. § 1692, et seq. (“FDCPA”). The lawsuit concerns a puta *606 tive class of plaintiffs who (1) “were involved in motor vehicle accidents in the State of New York,” (2) “had a portion of their medical bills paid by their respective private health insurance companies,” (3) subsequently “recovered a settlement or judgment” for “pain and suffering” from the other driver and/or that driver’s insurance company, and (4) “were subjected to claims for reimbursement by the Defendants.” (Am. Compl. ¶ 98.) Plaintiffs have named as Defendants the Plaintiffs’ health insurance carriers that paid them medical bills, the subrogation agents collecting on behalf of these insurance carriers, and a few of the Plaintiffs’ employers who acted as health plan administrators. This opinion addresses ten motions to dismiss by fourteen Defendants, many of whom raise the same arguments. Accordingly, to avoid an unduly duplicative and lengthy opinion, the movants’ legal arguments will be grouped together by claim.

The Plaintiffs assert four “Counts” for relief. In Counts One, Two, and Three, Plaintiffs assert that Defendants’ communications and assertions of reimbursement rights violated provisions of ERISA, specifically § 502(a)(1)(B) and § 502(c)(7). In Count Four, Plaintiffs assert these same acts by certain Defendants, the subrogation agents, violated the Fair Debt Collection Practices Act (“FDCPA”). Plaintiffs have voluntarily dismissed Count Three pertaining to violations of ERISA § 502(c)(7). For the reasons set forth below, Defendants’ Motions to Dismiss all the remaining claims are GRANTED.

BACKGROUND 2

The Plaintiffs plead many common factual allegations. Each of the eight Plaintiffs 3 alleges that he or she was a New York State resident at the time that he or she sustained personal injuries from unrelated automobile accidents, all occurring in New York. (Am. Compl. ¶ 48.) All the Plaintiffs allege that they had their resulting medical bills paid by one or more of the moving Defendants pursuant to the terms of a health benefit plan. (Am. Compl. ¶¶ 51, 55, 61, 67, 73, 79, 85, 90.) All of the Plaintiffs’ plans, except Kesselman’s and Prescott’s, were ERISA plans. (Am. Compl. ¶ 25.) 4

At the time of his or her accident, each Plaintiff was covered by a “No-Fault” insurance policy with a minimum coverage of $50,000 for economic losses. (Am. Compl. ¶ 49.) Each Plaintiff “had a personal injury claim presented” by Michael Goldberg (“Goldberg”) — who is also their attorney in this action — against person(s) allegedly responsible for his or her injuries which resulted in a recovery for “non-economic” loss. (Am Compl. ¶ 50.) Each Plaintiffs plan contained a provision entitling the plan to reimbursement from the Plaintiffs third-party recovery. (Am. Compl. ¶ 52 (Kesselman), ¶ 56 (Aiello), ¶ 62 (Chait), ¶ 68 (Haskell), ¶ 74 (Trínchese), ¶ 80(Ram), ¶ 86 (Prescott) and ¶ 90 (Jean-Pierre).) Each Plaintiff alleges that one or more of the Defendants notified him or her, or Goldberg, of their rights to reimbursement from Plaintiffs third-party tort recovery. (Am. Compl. ¶¶ 53, 58, 64, 70, 76, 83, 88, 93; See Am. Compl. Exs. 1-8.) As a *607 result of these claims for reimbursement presented by Defendant Rawlings and Aetna, Plaintiff Jean-Pierre paid Rawlings $545 on January 13, 2004 out of her third-party settlement. (Am. Compl. ¶ 95.) The Amended Complaint does not allege that any other Plaintiff made a payment from his or her settlement to a health insurance carrier or subrogation agent.

THE STANDARD AND THE SCOPE OF REVIEW

A complaint will be dismissed pursuant to Federal Rule of Civil Procedure 12(b)(6) if a Plaintiff “fail[s] to state a claim upon which relief can be granted.” Fed. R.Civ.P. 12(b)(6). The Court must read the complaint generously, accepting the truth of and drawing all reasonable inferences from well-pleaded factual allegations. See York v. Ass’n of the Bar of the City of N.Y, 286 F.3d 122, 125 (2d Cir.2002); see also Mills v. Polar Molecular Corp., 12 F.3d 1170, 1174 (2d Cir.1993). “To survive dismissal, the plaintiff must provide the grounds upon which his claim rests through factual allegations sufficient ‘to raise a right to relief above the speculative level.’ ” ATSI Commc’ns, Inc. v. Shaar Fund Ltd., 493 F.3d 87, 98 (2d Cir.2007) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 127 S.Ct. 1955, 1965, 167 L.Ed.2d 929 (2007)). Dismissal under Rule 12(b)(6) is required when a complaint fails to allege sufficient facts to state a claim that is “plausible on its face.” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007).

In addition to the exhibits attached to the Amended Complaint, the parties have submitted numerous documents to the Court on this motion. It is well established that the Court can consider documents attached as exhibits to the complaint or incorporated by reference into the complaint, when ruling on a motion to dismiss. Gryl ex rel. Shire Pharms. Group PLC v. Shire Pharms. Group PLC, 298 F.3d 136, 140 (2d Cir.2002). Pursuant to a Court order dated Nov. 4, 2009, Plaintiffs’ counsel provided the Court with the Plaintiffs’ exact third-party settlement dates to supplement the record. While Plaintiffs did not plead the specific settlement dates in the Amended Complaint, they referred to them and relied upon them throughout their complaint. With regard to Plaintiffs Prescott and Ram, Defendant HRI submitted Closing Statements filed by Plaintiffs’ counsel, Goldberg, with the New York Office of Court Administration to demonstrate when they settled their claims with third-parties. (See Nagy Decís. Exs. 3.) The Court may also properly consider these documents of public record. See Byrd v. City of New York,

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668 F. Supp. 2d 604, 2009 U.S. Dist. LEXIS 126264, 2009 WL 3805587, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kesselman-v-the-rawlings-co-llc-nysd-2009.