KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY

District Court, M.D. North Carolina·Decided December 13, 2022·No. 1:22-cv-00595·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF NORTH CAROLINA

Kristen Mann Koman, ) ) Plaintiff, ) ) v. ) 1:22CV595 ) Reliance Standard Life Insurance Company ) and Unifi, Inc., Employee Welfare Benefit ) Plan, ) ) Defendants. )

MEMORANDUM OPINION AND ORDER LORETTA C. BIGGS, District Judge. In this action, Plaintiff Kristen Mann Koman asserts claims under the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”). (ECF No. 1.) Before the Court is a motion to dismiss Counts II and III of Plaintiff’s Complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). (ECF No. 7.) This motion has been filed by both Defendants: Defendant Reliance Standard Life Insurance Company (“Reliance”) and Defendant Unifi, Inc., Employee Welfare Benefit Plan. For the reasons that follow, the Court will grant Defendants’ motion. I. BACKGROUND Plaintiff alleges that at all times relevant to this action, she was insured under Unifi Inc., Employee Welfare Benefit Plan, Group Policy No. LTD 128021, a long-term disability policy governed by ERISA. (Id. ¶¶ 7, 8, 10.) Under the terms of this policy, Defendants are claims administrators who have exclusive authority to grant or deny benefits, to pay benefits, and to terminate benefits. (Id. ¶ 31.) Plaintiff became disabled in April 2018. (Id. ¶ 4.) She applied for long-term disability benefits a few months thereafter. (Id. ¶ 11.) At that time, Reliance determined that Plaintiff was “Totally Disabled” and began providing monthly benefits to Plaintiff in or about October

2018. (Id. ¶ 14.) However, Reliance later reversed its determination “without any significant change in [Plaintiff’s] condition or ability to work” and “terminated [Plaintiff’s] benefits under the [p]olicy.” (Id. ¶ 19.) Following the termination of benefits, Plaintiff filed an administrative appeal for reinstatement; however, Reliance affirmed the termination decision. (Id. ¶ 22.) Plaintiff then appealed again, and Reliance again affirmed. (Id. ¶¶ 23, 24.) Having exhausted her

administrative remedies, Plaintiff initiated this action pursuant to 29 U.S.C. § 1132. (Id. ¶ 25.) II. DEFENDANTS’ MOTION TO DISMISS A. Standard of Review A motion made under Rule 12(b)(6) challenges the legal sufficiency of the facts in the complaint, specifically whether the complaint satisfies the pleading standard under Rule 8(a)(2). Francis v. Giacomelli, 588 F.3d 186, 192 (4th Cir. 2009). Rule 8(a)(2) requires a “short and plain statement of the claim showing that the pleader is entitled to relief.” Fed. R. Civ. P.

8(a)(2). “[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S 544, 570 (2007)). A claim is plausible when the complaint alleges sufficient facts to allow “the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Johnson v. Am. Towers, LLC, 781 F.3d 693, 709 (4th Cir. 2015) (quoting Iqbal, 556 U.S. at 678). The court “view[s] the complaint in a light most favorable to the plaintiff.” Mylan Lab’ys, Inc. v. Matkari, 7 F.3d 1130, 1134 (4th Cir. 1993). When considering a motion to dismiss, “a [district] court evaluates the complaint in its entirety, as well as documents attached [to] or incorporated into the complaint.” E.I. du Pont de Nemours & Co. v. Kolon Indus., Inc., 637 F.3d 435, 448 (4th Cir. 2011).

B. Discussion Plaintiff’s Complaint contains three claims for relief. (ECF No. 1 ¶¶ 26–47.) Count I is a claim for “Wrongful Denial of Benefits Under ERISA,” (id. ¶¶ 26–36), Count II is a claim for “Breach of Fiduciary Duty Under ERISA,” (id. ¶¶ 37–43) and Count III is a claim for “Breach of Compliance with Claims Procedures Under ERISA,” (id. ¶¶ 44–47). In their motion to dismiss, Defendants contend that Plaintiff’s Counts II and III seek

equitable remedies that are duplicative of an adequate remedy that Plaintiff is pursuing in Count I. (ECF No. 7 at 1.) This adequate remedy is, according to Defendants, recovery of any benefits to which Plaintiff is entitled under the terms of her plan. (ECF No. 8 at 5, 11.) Defendants argue that Counts II and III should therefore be dismissed pursuant to Varity Corp. v. Howe, 516 U.S. 489 (1996), and Korotynska v. Metropolitan Life Insurance Co., 474 F.3d 101 (4th Cir. 2006). (ECF No. 8 at 5–11.)

Plaintiff’s principal response is that Counts II and III should not be dismissed because these two counts “closely track” the language of 29 U.S.C § 1132(a)(1)(B) and § 1132(a)(3) and therefore are “explicitly authorized” by these provisions.1 (ECF No. 12 at 2–3.) These provisions state:

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

KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY, (M.D.N.C. 2022).

KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY (KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Conley v. Gibson
355 U.S. 41 (Supreme Court, 1957)
Hishon v. King & Spalding
467 U.S. 69 (Supreme Court, 1984)
Pilot Life Insurance v. Dedeaux
481 U.S. 41 (Supreme Court, 1987)
Ingersoll-Rand Co. v. McClendon
498 U.S. 133 (Supreme Court, 1990)
Varity Corp. v. Howe
516 U.S. 489 (Supreme Court, 1996)
Great-West Life & Annuity Insurance v. Knudson
534 U.S. 204 (Supreme Court, 2002)
Ashcroft v. Iqbal
556 U.S. 662 (Supreme Court, 2009)
Gagliano v. Reliance Standard Life Insurance
547 F.3d 230 (Fourth Circuit, 2008)
Francis v. Giacomelli
588 F.3d 186 (Fourth Circuit, 2009)
Engelhardt v. Paul Revere Life Ins. Co.
77 F. Supp. 2d 1226 (M.D. Alabama, 1999)
England v. Marriott International, Inc.
764 F. Supp. 2d 761 (D. Maryland, 2011)
Robert Johnson v. American Towers, LLC
781 F.3d 693 (Fourth Circuit, 2015)
Sandra Peters v. Aetna Incorporated
2 F.4th 199 (Fourth Circuit, 2021)
Lamuth v. Hartford Life & Accident Insurance
30 F. Supp. 3d 1036 (W.D. Washington, 2014)