Mapp v. American General Assurance Co.

589 F. Supp. 2d 1257, 46 Employee Benefits Cas. (BNA) 1514, 2008 U.S. Dist. LEXIS 100590
CourtDistrict Court, M.D. Alabama
DecidedDecember 12, 2008
DocketCivil Action 3:08cv298-MHT
StatusPublished

This text of 589 F. Supp. 2d 1257 (Mapp v. American General Assurance Co.) is published on Counsel Stack Legal Research, covering District Court, M.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mapp v. American General Assurance Co., 589 F. Supp. 2d 1257, 46 Employee Benefits Cas. (BNA) 1514, 2008 U.S. Dist. LEXIS 100590 (M.D. Ala. 2008).

Opinion

OPINION AND ORDER

MYRON H. THOMPSON, District Judge.

Plaintiff Benjamin Mapp filed this lawsuit against defendant American General Assurance Company, asserting that it failed to pay benefits due to him after he suffered a heart attack in September 2006. Mapp originally filed suit in state court, asserting state-law claims of breach of contract and bad faith. American General removed to this court, contending: first, Mapp’s state-law claims are preempted by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001-1461 and thus this court has federal-question jurisdiction; and, second, the court has diversity-of-citizenship jurisdiction. Two motions are before the court: Mapp’s motion to remand and American General’s motion to dismiss. For the reasons that follow, Mapp’s remand motion will be granted and American General’s dismissal motion will be left to resolution by the state court after remand.

I. STANDARD OF REVIEW

A defendant may remove a civil action brought in state court to federal court if the action could have been brought in federal court in the first instance. 28 U.S.C. § 1441(a). The party seeking removal has, under 28 U.S.C. § 1446, the burden of establishing the court’s jurisdiction over the subject matter of the case. Williams v. Best Buy Co., 269 F.3d 1316, 1319 (11th Cir.2001). Typically, the court’s subject-matter jurisdiction is prem *1260 ised on either federal-question jurisdiction or diversity-of-citizenship jurisdiction. A court has federal-question jurisdiction when the case arises under the Constitution, laws, or treaties of the United States, 28 U.S.C. § 1331; it has diversity-of-citizenship jurisdiction when the amount in controversy exceeds $ 75,000 and the plaintiff and the defendant are citizens of different States. 28 U.S.C. § 1332(a).

In a removal action, the burden is on the defendant to plead the basis for jurisdiction. Fowler v. Safeco Ins. Co. of America, 915 F.2d 616, 617 (11th Cir.1990). A defendant may submit affidavits, depositions, or other evidence to support removal. Id. at 617. Even after removal, either party may move to remand to state court on the basis of any defect in the removal, including lack of subject-matter jurisdiction. 28 U.S.C. § 1447(c).

Federal courts must strictly construe removal statutes “[bjeeause removal jurisdiction raises significant federalism concerns.” Univ. of S. Ala. v. Am. Tobacco Co., 168 F.3d 405, 411 (11th Cir.1999) (citation omitted). Thus, any doubt about jurisdiction is resolved in favor of remand. Id.; see also Burns v. Windsor Ins. Co., 31 F.3d 1092, 1095 (11th Cir.1994) (“where plaintiff and defendant clash about jurisdiction, uncertainties are resolved in favor of remand”).

II. BACKGROUND FACTS

In the fall of 2004, Norbord Industries applied for a group policy with American General for a critical-illness plan. Nor-bord’s application form indicated that all regular full-time employees under the age of 70 would be eligible for the plan; there would be no waiting period to be eligible; and the effective date would be January 1, 2005. These were the least restrictive selections possible based on what was laid out on the application form, which required applicants to select the class of employees eligible for coverage; the minimum number of enrolled employees necessary to keep the group policy in force; an effective date; and any optional features. Norbord did not have any input into the terms of the plan that American General offered to Norbord employees.

Based on Norbord’s application, American General issued a group policy. The policy named Norbord the “Policyholder” and indicated that it was a legal contract between American General and the policyholder. It also stated that the plan was “delivered in and governed by the laws” of Alabama. Although it was not apparent from the face of the document, Continental American Insurance Company administered the critical-illness policy on behalf of American General. Continental American’s internal records indicated that a Nor-bord employee was the contact person for any changes to the group policy. Norbord was responsible for informing the company when an employee was terminated.

When the plan was first offered to Nor-bord employees, a licensed insurance agent from American General came to Norbord’s various mills to explain the plan to employees, provide quotes, and assist with applications for the plan. Participation in the plan was voluntary, but the American General plan was the only critical-illness plan Norbord offered its employees.

Employees who enrolled received a policy in their own names, which was mailed to them at their home addresses by American General. Employees also paid the full cost of premiums. Norbord advanced the premiums in one monthly lump-sum payment to American General and deducted the cost from enrolled employees’ pay. American General did not compensate Norbord for offering the plan.

Norbord made a pamphlet about the critical-illness plan available to its employees. American General created the pam *1261 phlet, and Norbord’s name was not anywhere on it. Norbord did not include the plan in its cafeteria-plan summary description and did not consider the critical-illness plan part of the package of group-benefit plans offered through Norbord. Further, Norbord did not maintain enrollment or claim forms or administer claims for the plan. Norbord listed the toll-free number for American General on its internal-benefit-enrollment website, but the website had no link to enrollment or claim forms or policy information as it did for group benefits.

On September 20, 2006, Mapp, a Nor-bord employee, suffered a heart attack that required him to undergo coronary-artery-bypass surgery. Mapp had previously enrolled in the critical-illness plan. His understanding was that, under the plan, American General would pay him $ 20,000 in the event that he suffered a heart attack. Mapp submitted a timely claim for benefits, which the insurance company denied in July 2007. On October 30, 2007, Mapp filed suit in state court, asserting breach of contract and bad faith.

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Bluebook (online)
589 F. Supp. 2d 1257, 46 Employee Benefits Cas. (BNA) 1514, 2008 U.S. Dist. LEXIS 100590, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mapp-v-american-general-assurance-co-almd-2008.