Lewis v. Aetna U.S. Healthcare, Inc.

78 F. Supp. 2d 1202, 1999 U.S. Dist. LEXIS 18942, 1999 WL 1133761
CourtDistrict Court, N.D. Oklahoma
DecidedOctober 20, 1999
Docket4:99-cv-00104
StatusPublished
Cited by15 cases

This text of 78 F. Supp. 2d 1202 (Lewis v. Aetna U.S. Healthcare, Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lewis v. Aetna U.S. Healthcare, Inc., 78 F. Supp. 2d 1202, 1999 U.S. Dist. LEXIS 18942, 1999 WL 1133761 (N.D. Okla. 1999).

Opinion

ORDER

HOLMES, District Judge.

This matter comes before the Court on Defendant’s notice of removal (Docket # 1) and Defendant’s motion to dismiss (Docket # 8). This case was originally filed on December 21, 1998, in the District Court for Tulsa County, Oklahoma. Defendant undertook to remove the case to federal court by filing a notice of removal on February 5, 1999. Defendant filed its motion to dismiss on February 26, 1999. A hearing was held in this matter on July 8, 1999.

I

To prevail on a motion to dismiss, a defendant must establish that there is no set of circumstances under which the plaintiff would be entitled to relief. See Jenkins v. McKeithen, 395 U.S. 411, 89 S.Ct. 1843, 23 L.Ed.2d 404 (1969); Ash Creek Mining Co. v. Lujan, 969 F.2d 868, 870 (10th Cir.1992). Accordingly, for purposes of resolving the issues here, the Court accepts as true the allegations in Plaintiffs original Petition. See Ash Creek Mining, 969 F.2d at 870.

Plaintiffs Petition states two causes of action arising from Defendant’s prolonged refusal to pay life insurance benefits due Plaintiff upon the death of her common law spouse. The first cause of action asserts that Defendant’s failure to perform its obligations to Plaintiff under the policy constituted a breach of contract. The second cause of action, for bad faith, alleges that “Defendant’s unreasonable delay in paying life insurance benefits constitutes a breach of the covenant of good faith and fair dealing,” and seeks punitive as well as compensatory damages.

For purposes of the instant motion, the Court also accepts as admitted each of the eight requests for admissions that were served on Defendant contemporaneously with Plaintiffs Petition and never answered. See Okla. Stat. Ann. tit. 12, § 3236 (West 1996). These requests for admission establish that, at the time of his *1204 death, Plaintiffs common law spouse was covered by a policy issued by Defendant, that Defendant denied coverage erroneously and eventually paid Plaintiff the benefits due her under the policy.

In its notice of removal, Defendant asserts that because Plaintiff states in her Petition that the dependent life insurance policy at issue in this action was part of an employee benefit package, Plaintiffs claims of breach of contract and bad faith refusal to pay benefits under the policy are governed by the Employment Retirement Insurance Security Act (“ERISA”), 29 U.S.C. § 1001, et seq. Based on this assertion, Defendant argues that Plaintiffs action raises a question of federal law and is therefore removable to federal court under 28 U.S.C. § 1441(a). Furthermore, in its motion to dismiss, Defendant reiterates its assertion that ERISA applies to the insurance policy at issue and confirms that it did in fact eventually pay Plaintiff the benefits due her under the policy.

Plaintiff claims that Defendant is liable to Plaintiff for its failure to pay Plaintiff promptly the death benefits due her under the subject life insurance policy. As noted above, Plaintiff asserts one cause of action for breach of contract and a second cause of action in tort for breach of the implied-in-law covenant of good faith and fair dealing under Christian v. American Home Assurance Co., 577 P.2d 899 (Okla.1977). In her response to Defendant’s motion to dismiss, Plaintiff asserts first that this plan is not covered by ERISA and second, even if covered by ERISA, her claims avoid preemption under the statute’s saving clause, 29 U.S.C. § 1144(b)(2)(A).

State laws that “relate to any employee welfare benefit plan” are generally preempted by ERISA. 29 U.S.C. § 1144. ERISA’s “relate to” preemption is conspicuous for its breadth. See FMC Corp. v. Holliday, 498 U.S. 52, 58, 111 S.Ct. 403, 112 L.Ed.2d 356 (1990); Straub v. W. Union Tel. Co., 851 F.2d 1262, 1263 (10th Cir.1988). Both of Plaintiffs causes of action relate to the alleged bad faith delay in paying a claim under her employer’s group insurance coverage. The record is uncontroverted that Columbia Doctor’s Hospital presented the dependent life insurance coverage at issue here as part of its benefits package for its employees. Thus, the policy qualifies as an “employee welfare benefit plan.” See 29 U.S.C. § 1002(1) (1994). Plaintiffs claims against Aetna clearly relate to the plan. See Peckham v. Gem State Mut. of Utah, 964 F.2d 1043 (10th Cir.1992). Therefore, Plaintiffs claim that this plan is not subject to ERISA at all is without merit. Since Plaintiff does not assert that her contract cause of action is nevertheless exempt under the saving clause, her claim for breach of contract clearly must fail, because ERISA limits relief to benefits due under the policy, which have been paid in this case. 1 Accordingly, the only remaining issue is whether, as Plaintiff argues, her tort claim under Christian avoids preemption by falling within ERISA’s statutory saving clause. That clause states, in applicable part: “Except as provided in subpara-graph (B), nothing in this subchapter shall be construed to exempt or relieve any person from any law of any State which regulates insurance, banking, or securities.” 2 29 U.S.C. § 1144(b)(2)(A) (1994). Plaintiff argues that a Christian tort action constitutes enforcement of a state rule that “regulates insurance” under the test for construing the saving clause recently announced by the United States Supreme Court in UNUM Life Ins. Co. of America v. Ward, 526 U.S. 358, 119 S.Ct. 1380, 143 L.Ed.2d 462 (1999).

*1205 The question presented is whether ERISA preempts a Christian cause of action, or whether, in light of UNUM, such a cause of action “regulates insurance” and therefore avoids preemption pursuant to ERISA’s saving clause, 29 U.S.C. § 1144(b)(2)(A).

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Bluebook (online)
78 F. Supp. 2d 1202, 1999 U.S. Dist. LEXIS 18942, 1999 WL 1133761, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lewis-v-aetna-us-healthcare-inc-oknd-1999.