Knisley v. ADVANCIA CORP. DISABILITY BENEFITS PLAN

392 F. Supp. 2d 1074, 2005 U.S. Dist. LEXIS 10633, 2005 WL 226173
CourtDistrict Court, D. Alaska
DecidedJanuary 31, 2005
DocketA04-0081 CV RRB
StatusPublished

This text of 392 F. Supp. 2d 1074 (Knisley v. ADVANCIA CORP. DISABILITY BENEFITS PLAN) is published on Counsel Stack Legal Research, covering District Court, D. Alaska primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Knisley v. ADVANCIA CORP. DISABILITY BENEFITS PLAN, 392 F. Supp. 2d 1074, 2005 U.S. Dist. LEXIS 10633, 2005 WL 226173 (D. Alaska 2005).

Opinion

ORDER GRANTING DEFENDANTS’ MOTION FOR DISMISSAL

BEISTLINE, District Judge.

1. INTRODUCTION

Before the Court are Defendants Advan-cia Corporation Disability Benefits Plan and Advancia Corporation (hereinafter collectively referred to as “Defendants”) with a Motion for Dismissal Pursuant to Fed. R.Civ.P. 12(b)(6) (Docket No. 17). Defendants argue that there is no basis for any of the claims against Advancia Corporation and that the only legally cognizable claim against the Advancia Corporation Disability Benefits Plan is the claim for long-term disability benefits under 29 U.S.C. § 1132(a)(1)(B). 1 Plaintiff Daniel Knisley opposes and argues, to the contrary, that there is no basis for the dismissal of his claims against Defendants. 2

II. FACTS

This is an action to enforce the terms of a Disability Benefits Plan, under the Em *1075 ployee Retirement Income Security Act (ERISA) 502(a)(1)(B) and for other equitable and statutory relief under [29 U.S.C. § 1132(a)(l & 3) ], (E) and (d)(2). 3 .

Generally speaking, Defendant Advancia Corporation provided its employees with a Disability Benefits Plan (the “Plan”) through Defendant Guardian Life Insurance Company of America (“Guardian”). The Plan has a pre-existing condition exclusion, which stipulates: “[n]o benefits are payable for disability due to a preexisting condition, unless the disability starts after you complete at least one full day of active work after the date you are insured under this plan for 12 months in a row.” (Emphasis in original.)

Plaintiff worked for Defendant Advancia Corporation from January 7, 2002, to December 31, 2002, when he took a medical leave of absence due to kidney failure. 4 After December 31, 2002, Plaintiff applied for and received short term disability benefits for 12 weeks. 5 On or about April 7, 2003, Plaintiff was advised that he was being considered for long term disability benefits. Plaintiff resigned on April 18, 2003. On May 7, 2003, Guardian declined long term disability benefits to Plaintiff on the grounds that he had a pre-existing kidney condition prior to being employed at Advancia and had not worked continuously for 12 months. 6 Following an unsuccessful administrative appeal, Plaintiff seeks relief in this Court.

III. STANDARD OF REVIEW

A motion to dismiss for failure to state a claim made pursuant to Federal Rule of Civil Procedure 12(b)(6) tests the legal sufficiency of the claims in the complaint. A claim should only be dismissed if “it appears beyond doubt that a plaintiff can prove no set of facts in support of his claim which would entitle him to relief.” 7 A dismissal for failure to state a claim can be based on either “the lack of a cognizable legal theory or the absence of sufficient facts alleged under a cognizable legal theory.” 8 In reviewing a Fed.R.Civ.P. 12(b)(6) motion to dismiss, “[a]ll allegations of material fact in the complaint are taken as true and construed in the light most favorable to the nonmoving party.” 9 The Court is not required to accept every conclusion asserted in the complaint as true. Rather, the Court “will examine whether concluso-ry allegations follow from the description of facts as alleged by the plaintiff.” 10

IV. DISCUSSION

Before addressing the merits of Defendants’ Motion for Dismissal (Docket No. 17), clarification is necessary regarding two points of on-going contention in this matter. First, in accordance with 29 U.S.C. § 1002(16)(A), the Court concludes Defendant Advancia Corporation is the “Plan Administrator.” Second, having thoroughly reviewed the matter, the Court further concludes the correct standard of review for Guardian’s decision concerning plan benefits is “abuse of discretion.” 11 *1076 Having established the same, the Court examines the sufficiency of Plaintiffs claims in light of Defendants’ Motion for Dismissal.

A. Plaintiffs Claims Against Defendant Advancia Corp. Under 29 U.S.C. §§ 1132(a)(1)(A) and 1132(c) Are Hereby Dismissed.

To begin, inasmuch as Plaintiff has: (1) failed to substantiate a claim under 29 U.S.C. § 1132(a)(1)(A) & (©) that Defendant Advancia Corporation failed to provide a copy of the Summary Plan Description (SPD) in response to any request he allegedly made for the document; 12 and (2) inasmuch as Plaintiff never made any allegations on the issue in the Complaint, 13 Plaintiffs claims against Defendant Advan-eia Corporation under 29 U.S.C. §§ 1132(a)(1)(A) and 1132(c) are hereby DISMISSED.

B. Plaintiffs Claims Against Defendant Advancia Corp. Under 29 U.S.C. § 1132(a)(1)(B) Are Hereby Dismissed.

Inasmuch as Plaintiff does not argue that Defendant Advancia Corporation is subject to suit under 29 U.S.C. § 1132(a)(1)(B), Plaintiffs claims against Defendant Advancia Corporation, pursuant to 29 U.S.C. § 1132(a)(1)(B) are hereby DISMISSED.

C. Plaintiffs Claims Against Defendant Advancia Corp. Under 29 U.S.C. § 1132

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392 F. Supp. 2d 1074, 2005 U.S. Dist. LEXIS 10633, 2005 WL 226173, Counsel Stack Legal Research, https://law.counselstack.com/opinion/knisley-v-advancia-corp-disability-benefits-plan-akd-2005.