Matthews v. United Healthcare Services Inc

• Court: District Court, N.D. Texas
• Decided: September 9, 2020
• Docket: 3:19-cv-01212
• Status: Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF TEXAS DALLAS DIVISION

LISA G. MATTHEWS, § § Plaintiff, § § v. § Civil Action No. 3:19-CV-01212-E § UNITED HEALTHCARE SERVICES, § INC., et al., § § DefendantMs. EMORANDUM OP§I NION AND ORDER

Before the Court is Defendant United HealthCare Services, Inc.’s Motion to DGRisAmNisTsE foDr Lack of Personal Jurisdiction (Doc. No. 1B3a).c kFogrr oreuansdons that follow, the Motion is .

This is a suit for benefits under a health insurance policy. Plaintiff Lisa G. Matthews filed this lawsuit in state court against United HealthCare Services (UHS) and several other defendants. UHS filed a special appearance and removed the case to federal court on the basis of diversity jurisdiction. Plaintiff filed a motion to remand, which was denied. The Court ruled that all Defendants except UHS were improperly joined. In her complaint, Plaintiff alleges that she is a resident of Collin County, Texas, and has a temporary residence in Panama. She alleges that UHS is a Minnesota corporation and that the Court has jurisdiction over UHS because “it has engaged in business” in Texas within the meaning of the Texas Long Arm statute. She further alleges that UHS has purposefully established minimum contacts with Texas and1 the exercise of personal jurisdiction over UHS will not offend traditional notions of fair play and substantial justice. According to the complaint, UHS has maintained purposeful, systematic, and continuous contacts with Texas. As for the merits of her suit, Plaintiff alleges that, in January 2017, she purchased a

single member United HealthCare health insurance policy through WorldWide Medical Assurance, Ltd. Corporation, an affiliate of UHS. In her application, Plaintiff disclosed certain medical conditions, including a previous surgery on her C5 disc. Magda Crespo, “WorldWide’s and [UHS’s] agent,” informed Plaintiff that WorldWide approved her policy, but was going to exclude her entire spine from coverage. Plaintiff agreed only to an exclusion of coverage as to her cervical spine. WorldWide later informed her that it would exclude from coverage only the cervical spine for a period of two years after the policy issuance date of February 1, 2017. Plaintiff alleges she would not have purchased her policy if it excluded

her lumbar or thoracic spine. Plaintiff was issued a United HealthCare insurance card and was directed to submit claims to UHS. UHS provided her with a benefit guide that stated, “UnitedHealthcare has one of the largest single proprietary networks with over 900,000 doctors and health care professionals and over 5,600 hospitals.” In May 2017, Plaintiff fell twice, suffering lower back and leg pain. She saw a doctor in Panama who ordered an MRI. Because her back continued to hurt, she made an appointment with a doctor in Addison, Texas. That doctor diagnosed her with lumbar spinal stenosis and other conditions. He recommended surgery that would involve two separate

procedures on the same day. UHS preauthorized the spinal surgery and hospitalization. Plaintiff alleges that under her policy and verification of benefits letter, once she paid a $3,000 deductible and related co-pay amount2s and 30% coinsurance, she would be covered at 100%. She asserts her verification of benefits letter says she has an insurance policy “administered by [WorldWide] in conjunction with United Healthcare.” The complaint further alleges that Plaintiff underwent surgery on October 13, 2017,

at Methodist Hospital in Dallas, Texas. In January 2018, WorldWide notified Plaintiff that her claim related to the surgery was denied due to her pre-existing conditions. Although Plaintiff later received correspondence from WorldWide stating that it would pay invoices related to her surgery, she alleges that UHS has failed to pay for the majority of her medical care. Plaintiff asserts claims against UHS for breach of the insurance contract, violations of the Texas Insurance Code, and violations of the Texas Deceptive Trade Practices Act. She also seeks a declaratory judgment that UHS is legally obligated to pay her medical providers for claims related to her surgery, among other things.

UHS moves to dismiss the claims against it for lack of personal jurisdiction under Federal Rule of Civil Procedure 12(b)(2). UHS is a Minnesota corporation with its principal place of business in Minneapolis. UHS contends it is not subject to general or specific jurisdiction in Texas. Applicable Law

When a nonresident defendant presents a motion to dismiss for lack of personal jurisdiction, the plaintiff bears the burden of establishing the district court’s personal jurisdiction overI nt hree DdeePfeunyd Oarntth, othpoauedgihc ss, hIne cn.eed only make a prima facie case at the Rule

12(b)(2) stage. , 888 F.3d 753, 778 (5th Cir. 2018). The Court accepts the plaintiff’s uncontroverted, nonconclusorCya framcotunaal va.l lLeegoa tSihoinps M ags mtrtu.,e I annc.d resolves all controverted allegations in the plaintiff’s fa3v or. , 924 F.3d 190, 193 (5th Cir. 2019). The Court may determine the jurisdictional issue by reSctueaivritn vg. aSpffaiddaevmitasn, interrogatories, depositions, and other recognized methods of discovery. , 772 F.2d 1185, 1192 (5th Cir. 1985).

A federal court sitting in diversity in Texas may exercise personal jurisdiction over a foreign defendant if permitted by (1) tDhiee cTee-Lxiassa lIonndgu-sa.r, mIn cs.t va.t uDties,n aeny dE n(2te)r tsh., eI ndcu.e process clause of the Fourteenth Amendment. , 943 F.3d 239, 249 (5th Cir. 2019). Because the Texas long-arm statute extends to the limitsId o. f federal due process, the two-step inquiry collapses into one federal due process analysis. Federal due process is satisfied if two requirements are met: (1) the nonresident purposely availed itself of the benefits and protections of the forum State by establishing “minimum contacts” with the State; and (2) the exeIdrc.ise of jurisdiction does not offend “traditional notions of fair

play and substantial justice.” at 249–50. The “purposeful availment requirement ensures that a defendant will not be haled into a jurisdiction solely as a result of random, fortuiItdo.us, or attenuated cBounrtgaecrt sK, oinrg o fC tohrep .u nv.i lRatuedrzael wacictzivity of another party or a third person.” at 250 (quoting , 471 U.S. 462, 475, (1985))I.d A. defendant’s “minimum contacts” may give rise to either general or specific jurisdiction. Supreme Court decisions have recognized two types of personal jurisdiction: “general” (sometimes calledB r“isatlol-lp-Murypeorss eS”q)u ijbubri sCdoi.c vt.i oSnu paenrido r“ sCpoeucritf iocf” C(as.ometimes called “case-linked”) jurisdiction. , 137 S. Ct. 1773,

1779–80 (2017). “For an individual, the paradigm forum for the exercise of general jurisdiction is the individual’s domicile; for a corporaItdion, it is an equivalGenoot dpyleaacer , Dounnel oinp which the corporation is fairly regarded as at4 h ome.” . at 1780 (quoting Tires Operations, S.A. v. Brown any , 564 U.S. 915, 924 (2011)). A court with general jurisdiction may hear claim against tIhda.t defendant, even if all the incidents underlying the claim occurred in a different State. at 1780. But “only a limited set of affiliIadt.ions with aD afoimrulemr

wAGil lv r. eBnaduemr aan d,efendant amenable to” general jurisdiction in that State. (quoting 571 U.S. 117, 137 (2014)). General jurisdiction exists wheSna nag nhoan vr. eNsaidveign8t dSheifpeMndaannatg’se mcoenntta Pctrsiv watiteh, Ltthde. forum State are continuous and systematic. , 882 F.3d 96, 101 (5th Cir. 2018). General jurisdictiIodn. is difficult to establish and requires extensive contacts between a defendant and forum. at 101–0B2N. ASF c Roryp. Coora. vti. oTny risr e“lalt home” in its place of incorporation and its principal place of business. , 137 S.Ct. 1549, 1558 (2017). In an exceptional case, a corporate defendant’s operations in another forum may bIed .so substantial

and of such a nature as to render the corporation at home in that State. The general jurisdictioDn aiinmqlueirry does not focus solely on the magnitude of the defendant’s in-state contacts. , 571 U.S. at 139 n.20. It calls instead Ifdo.r an appraisal of a corporation’s activities in their entirety, nationwide and worldwide. IAd .corporation that operates in many places can scarcely be deemed at hIdo. m e in all of them. Otherwise, “at home” would be synonymous with “doing business.” Bristol-Myers . Specific jurisdiction is very different. , 137 S. Ct. at 1780 For a court to exercise specific jurisdicItdio. n, the lawsuit must arise out of or relate to the defendant’s

contacts with the forum. In other words, there must be “an affiliation between the forum and the underlying controversy, principally, [an] activity or an occurrIde.nce that taGkoeosd pyleaacre, in the forum State and is therefore subject to5 t he State's regulation.” (quoting 564 U.S. at 919). For this reason, “specific jurisdiction is confined to adjudication of Iids.sues deriving from, or connected with, the veryA cnoanlytrsoisv ersy that establishes jurisdiction.”

1. General Jurisdiction UHS argues that there is no basis for asserting general jurisdiction over it in Texas. It is a Minnesota corporation with its principal place of business in Minnesota. UHS asserts that Plaintiff’s conclusory allegations that the company is subject to general jurisdiction because it does business in Texas and has systematic and continuous contacts in the State are insufficient. Plaintiff filed a response to the motion and attached a declaration from herself and her attorney, as well as a copy of her Texas driver’s license, her United HealthCare insurance

card and information from United HealthCare titled, “Getting the Most From Your Health Care Coverage.” She has also included many pages of claims documents related to her surgery. Plaintiff responds that UHS deliberately sought to benefit by availing itself of the jurisdiction of this State by forming contractual relationships with Plaintiff’s medical providers and enrolling Plaintiff in a plan with providers located in Texas. Plaintiff also relies on the fact that UHS sought and obtained permission from the Texas Secretary of State to conduct business here and has a registered agent for service of process here. Plaintiff maintains this shows UHS engaged in continuous and systematic contacts in Texas.

The Fifth Circuit has consistently impJoohsnesdt othne v h. Miguhl stitdaantdaa Sryds s. eInt tb’ly C tohrep S.upreme Court when ruling on general jurisdiction issues. , 523 F.3d 602, 611 (5th Cir. 2008). Plaintiff has not demonst6r ated that this is an exceptional case such that UHS, a Minnesota corporation, is also “at home” in Texas. She has not alleged or provided evidence of the extent of UHS’s corporate activities. Her conclusory allegations about UHS’s continuous and systematic contacts aSreee i nWseunffcihceie Snite.m Seor ivs. Ltheea rfjaectt A tchqaut iUsiHtiSo nh aCso rap r.egistered

agent for service of process in Texas. , 966 F.2d 179, 181–82 (5th Cir. 1992). The Court concludes Plaintiff has not established that UHS is subje ct to general jurisdiction. 2. Specific Jurisdiction UHS also argues it is not subject to specific jurisdiction in Texas. It asserts that Plaintiff cannot show that her claims arise from UHS’s contacts in the State. It argues she obtained the insurance policy in Panama, where she lived at the time, from WorldWide, a Panamanian company. Her later decision to travel to Texas for treatment cannot form the

basis for jurisdiction. UHS asserts that even if it had contracted with a Texas resident, that would be insufficient to establish jurisdiction. Plaintiff responds that UHS deliberately committed acts which were purposefully directed at Texas and that her claims arise from these contacts. Plaintiff contends she is a United States citizen and Texas resident. In making the decision to purchase the policy, she relied upon WorldWide’s representations that UHS was “the PPO provider for medical services in the State of Texas, and that UHS would administer and pay her claims.” In support of her argument that specific jurisdiction exists, Plaintiff cites the fact that UHS sent her 9

claims summaries notifying her that it had processed 91 claims from her medical providers in the Dallas area. Further, she alleges that UHS communicated with Methodist Hospital on a routine basis about Plaintiff’s treatment and7 claims. Plaintiff has not directed this Court to allegations or evidence that sets out a prima facie case of specific jurisdiction. While living in Panama, Plaintiff filled out an application for insurance with WorldWide, a Panamanian company. On the application, Plaintiff

provided an address in Panama. After suffering an injury in Panama, Plaintiff consulted a Texas doctor, who recommended and performed surgery in Texas. Plaintiff argues that she did not purchase her insurance policy just from a Panamanian entity. She asserts she purchased it from WorldWide, as an agent of UHS, and UHS, and in doing so, relied upon representations made by WorldWide that “UHS was the PPO provider for medical services in the State of Texas, and that UHS would administer and pay her claims.” The record includes a 2013 agreement between WorldWide and UHS under which UHS agreed to administer and implement WorldWide insurance policies. The provider network was

described as a network of participating U.S. health care providers who agree to provide health services to covered persons. The network “shall be available in the fifty United States and the District of Columbia.” Perez v. Pan American Life InsuranAclet hCooumghp annoyt binding authority, the Court considers persuasive. 96 F.3d 1442 (5th Cir. 1996) (not designated for publication). In that case, Guatemalan plaintiffs purchased a health insurance policy from Seguros, a Guatemalan corporation that was a subsidiary of Pan American Life Insurance Company. The plaintiffs sought medical treatment for their son in Houston, Texas. After

Seguros refused to pay the plaintiffs’ claims, they sued Seguros and Pan American in Texas. The district court granted Seguros’s motion to dismiss for lack of personal jurisdiction, and the plaintiffs appealed. They argued that S8e guros approved their application to go to Houston for medical care for their son. The Fifth Circuit found that Seguros did not have minimum coIndt.acts with Texas. The insurance policy at issue was solicited and issued in Guatemala. at *2. The worldwide coverage language in the policy, and the fact that a

Seguros representative approved trIeda.tmseeen at lisno TCehxoaisc we aHse naoltth ecnaoreu,g Ihn tco. vs.u Kbajeicset rt hFeo cuonmdaptainony tHoe apletrhs Polnaanl ojuf rCiosdloircatidoon in Texas. ; St. Luke’s Episcopal Hosp. v. La. Health Serv. & Indem. Co. , 615 F.3d 364 (5th Cir. 2010); , No. H-08-1870, 2009 WL 47125, at *5 (S.D. Tex. Jan. 6, 2009) (“The weight of authority, however, holds that an out-of-state insurer does not subject itself to personal jurisdiction in a forum state by verifying coverage for treatment of the insured in that state a nd paying some of the bills for that treatment.”). The contacts on which Plaintiff relies—processing her claims for treatment at

providers in Texas and communicating with a Texas hospital—arose from her unilateral decision to seek medical treatment in Texas, not from any affirmative decision by UHS. Further, even if the Court accepts that UHS contracted with a Texas resident, it is well established that merely contracting with a residentF roefu tdheen sfporruunmg vs.t aOtfefs hiso rien sTuefcfihc.i eSnert vtso., Isnucb.ject the nonresident to the forum’s jurisdiction. , 379 F.3d 327, 344 (5th Cir. 2004). Plaintiff has not shown that Minnesota corporation UHS purposefully directed its activities toward Texas. Therefore, the contacts on which Plaintiff relies are insufficient to create specific jurisdiction. Accordingly, the Court grants

9 UHS’s mSOot iOoRn DanEdR EdDis.m isses Plaintiff’s claims against it without prejudice.

Signed September 9, 2020.

______________________________________ ADA BROWN UNITED STATES DISTRICT JUDGE