Le v. Unum Ins. Co. of Am.

336 F. Supp. 3d 642
CourtDistrict Court, W.D. Louisiana
DecidedAugust 21, 2018
DocketCIVIL ACTION CASE NO. 17-833
StatusPublished

This text of 336 F. Supp. 3d 642 (Le v. Unum Ins. Co. of Am.) is published on Counsel Stack Legal Research, covering District Court, W.D. Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Le v. Unum Ins. Co. of Am., 336 F. Supp. 3d 642 (W.D. La. 2018).

Opinion

NANNETTE JOLIVETTE BROWN, CHIEF JUDGE

This is an action brought by Plaintiff Paula Le ("Plaintiff") for denial of long-term disability benefits under an employee welfare benefit plan ("the plan"), written through her employer, the Opelousas General Health System ("OGHS"), and insured by Defendant Unum Life Insurance Company *645of America ("Defendant").1 The parties have filed cross motions for summary judgment on the issue of whether the plan is governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. ("ERISA").2 Having considered the motions, the memoranda, the record, and the applicable law, the Court will grant Plaintiff's motion, deny Defendant's motion, and hold that the employee benefit plan established and maintained by OGHS is a "governmental plan," which is exempt from ERISA coverage pursuant to 29 U.S.C. § 1003(b)(1).

I. Background

A. Factual Background

Plaintiff was involved in a serious vehicular collision on March 20, 2013, in which she sustained spinal injuries.3 As a result of those injuries, Plaintiff underwent several surgical procedures performed by Dr. George Raymond Williams.4 Plaintiff also underwent several procedures as a result of injuries to her hands and arms.5 Since undergoing these surgeries, Plaintiff has been declared totally and permanently disabled.6

At the time of her injury, Plaintiff was insured under an employee benefit plan, written through her employer, OGHS, and insured by Defendant.7 Plaintiff applied for benefits and was awarded long-term disability benefits beginning September 12, 2013.8 On or about January 5, 2017, Plaintiff received notification that her disability benefits were being terminated, which Plaintiff alleges was done without just cause.9

B. Procedural Background

On May 10, 2017, Plaintiff filed a petition in the 27th Judicial District Court for the Parish of St. Landry, State of Louisiana, seeking damages as a result of the allegedly unreasonable denial of benefits under the plan.10 In the petition, Plaintiff brings claims for alleged violations of Louisiana law, asserting that OGHS "operates as a political subdivision" and the plan is therefore exempt from coverage under ERISA.11

On June 28, 2017, Defendant removed the case to the United States District Court for the Western District of Louisiana.12 In the Notice of Removal, Defendant asserts that this Court has original jurisdiction over this matter under 28 U.S.C. § 1331.13 Specifically, Defendant contends that Plaintiff's claim is for benefits under an employee benefit plan governed by the ERISA and is completely preempted by ERISA.14

On September 27, 2017, Plaintiff filed a motion for summary judgment on the issue *646of whether the plan is governed by ERISA.15 On October 18, 2017, Defendant filed an opposition to Plaintiff's motion for summary judgment.16 On October 27, 2017, with leave of Court, Plaintiff filed a reply brief in further support of the motion for summary judgment.17

On October 2, 2017, Defendant filed a cross motion for summary judgment on the issue of whether the plan is governed by ERISA.18 On October 24, 2017, Plaintiff filed an opposition to Defendant's motion for summary judgment.19 On November 7, 2017, with leave of Court, Defendant filed a reply brief in further support of the motion for summary judgment.20 On July 26, 2018, the case was reassigned to the undersigned Chief United States District Judge.21

II. Parties' Arguments

A. Plaintiff's Motion for Summary Judgment

1. Plaintiff's Arguments in Support of the Motion

Plaintiff contends that her employer, OGHS, is a political subdivision of the State of Louisiana, and as such the plan is exempt from ERISA.22 Therefore, Plaintiff submits that the plan is not an ERISA plan and moves for summary judgment on this issue.23

Plaintiff cites Hightower v. Texas Hospital Association , where the Fifth Circuit held that if a plan was "established or maintained for its employees by the Government of the United States, by the government of any State or political subdivision thereof, or by any agency or instrumentality of any of the foregoing," the plan was exempt from coverage under Title I of ERISA.24 Here, Plaintiff asserts that the plan was established and maintained by OGHS for the benefit of the employees of Opelousas General Hospital employees.25 Furthermore, Plaintiff argues that OGHS is a political subdivision of the State of Louisiana.26

Plaintiff contends that in Bertrand v. Sandoz the Louisiana Supreme Court held that Hospital District No. 2 ("HSD"), which Plaintiff contends later became OGHS, is a political subdivision of the State.27 Plaintiff cites Buller v. American United Life Ins. Co. , a case decided by a district judge in the Western District of Louisiana, holding that OGHS is a political subdivision of the State and that a policy established by OGHS for its employees *647was exempt from ERISA coverage.28 Plaintiff also cites Andrus v. Unum Life Insurance Company of America , a case decided by a district judge in the Eastern District of Louisiana, holding that OGHS is a political subdivision of the State and that the same policy at issue in this case was exempt from ERISA coverage.29 Thus, Plaintiff asserts that "there can be no question that Opelousas General Health System is a governmental entity," and "any Plan or Policy established and/or maintained by Opelousas General Health System and/or Opelousas General Hospital is exempt under ERISA."30 Accordingly, Plaintiff urges the Court to grant the motion for summary judgment and find that the plan is exempt from ERISA coverage.31

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Bluebook (online)
336 F. Supp. 3d 642, Counsel Stack Legal Research, https://law.counselstack.com/opinion/le-v-unum-ins-co-of-am-lawd-2018.