KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY

CourtDistrict Court, M.D. North Carolina
DecidedDecember 13, 2022
Docket1:22-cv-00595
StatusUnknown

This text of KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY (KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court, M.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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

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:

1 ERISA’s civil enforcement provision, 29 U.S.C. § 1132, is also referred to as ERISA § 502. (a) Persons empowered to bring a civil action A civil action may be brought-- (1) by a participant or beneficiary-- . . . (B) to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan; . . . (3) by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates any provision of this subchapter or the terms of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan; 29 U.S.C. § 1132. Before addressing the parties’ contentions, the Court begins with an overview of the relevant legal framework and controlling precedent. “ERISA is a comprehensive statute designed to promote the interests of employees and their beneficiaries in employee benefit plans.” Peters v. Aetna Inc., 2 F.4th 199, 215 (4th Cir. 2021) (quoting Ingersoll-Rand Co. v. McClendon, 498 U.S. 133, 137 (1990)). It “authorizes a broad range of remedies for cognizable violations, including recovery of ‘plan benefits, attorney’s fees and other statutory relief.” Id. (quoting 10 Vincent E. Morgan, Business and Commercial Litigation in Federal Courts § 106:45 (4th ed. Dec. 2020 update)). At issue here are two kinds of ERISA action, an action for benefits under § 1132(a)(1)(B) and an action for appropriate equitable relief under § 1132(a)(3). An action for benefits under § 1132(a)(1)(B) allows a plan participant or beneficiary to “to recover benefits due to [her] under the terms of [her] plan, to enforce [her] rights under the terms of the plan, or to clarify [her] rights to future benefits under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B).

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KOMAN v. RELIANCE STANDARD LIFE INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/koman-v-reliance-standard-life-insurance-company-ncmd-2022.