Morris v. Highmark Life Insurance

255 F. Supp. 2d 16, 30 Employee Benefits Cas. (BNA) 1964, 2003 U.S. Dist. LEXIS 5851, 2003 WL 1821512
CourtDistrict Court, D. Rhode Island
DecidedApril 8, 2003
DocketC.A. 01-396L
StatusPublished
Cited by9 cases

This text of 255 F. Supp. 2d 16 (Morris v. Highmark Life Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Morris v. Highmark Life Insurance, 255 F. Supp. 2d 16, 30 Employee Benefits Cas. (BNA) 1964, 2003 U.S. Dist. LEXIS 5851, 2003 WL 1821512 (D.R.I. 2003).

Opinion

DECISION AND ORDER

LAGUEUX, Senior District Judge.

Plaintiff filed the present action in Rhode Island Superior Court alleging breach of contract and bad faith for failure to pay long-term disability benefits under plaintiffs employee benefit plan. Defendant removed the case to this Court and filed a motion for summary judgment. Plaintiff subsequently filed an amended complaint adding an ERISA count.

There are three issues currently before this Court. The first is whether this is an ERISA case. If it is an ERISA case, the second issue is whether plaintiffs bad faith claim is preempted by ERISA. The third issue is whether plaintiffs breach of contract claim is preempted by ERISA. This writer will address these issues seriatim.

After close examination of existing case law, this Court concludes that this is an ERISA case and that plaintiffs breach of contract and bad faith claims are preempted by ERISA. Therefore, this Court grants defendant’s motion for summary judgment on those counts. As defendant did not move for summary judgment on plaintiffs ERISA count, that claim will be dealt with in due course.

I. Background

John Morris (“plaintiff’) filed this present action against Highmark Life Insurance Company (“defendant”) in the Rhode Island Superior Court on July 17, 2001 alleging breach of contract for failure to pay long-term disability benefits pursuant to a disability insurance contract issued to him through his former employer, Griggs & Browne. Plaintiff also alleges defendant acted in bad faith in denying those benefits. After unsuccessfully appealing defendant’s decision to deny the benefits through an internal review process, plaintiff brought this action seeking damages and attorneys fees pursuant to R.I. Gen. Laws § 9-1-33 (1997).

Plaintiff filed a claim for disability benefits with defendant after he was injured in a motor vehicle accident on January 13, 1996. Soon after the accident, plaintiff underwent a cervical discetomy and fusion. Plaintiff alleges that he continues to suffer from neck pain, headaches, and sleep deprivation as well as from depression and decreased concentration as a result of the pain. Plaintiff asserts that the injury left him permanently impaired as defined by the American Medical Association Guidelines on Permanent Impairment and that his treating surgeon has indicated that plaintiff is unable to return to work as a pest control technician on account of being completely disabled. Defendant, however, contends that plaintiffs treating physician claimed that the surgery was successful and that as a result of that medical opinion, plaintiff is able to work. Defendant points to the fact that plaintiff was denied Social Security benefits.

After plaintiff filed his complaint, defendant removed the case to this federal court on August 22, 2001 on the basis of diversity jurisdiction and federal question jurisdiction contending that the case is governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (2000) (“ERISA”). Defendant claims that although it allowed plaintiff to supplement the claim file with additional medical evidence during the internal appeal process, neither the initial record nor the supplementary medical information provided any objective support for plaintiffs disability claim. As a result, defendant asserts that it properly denied plaintiffs claim for benefits. The claim was denied initially, on appeal and after three reconsiderations. Defendant now contends that plaintiffs benefits package *20 is governed by ERISA, and that as such, plaintiffs remedies are limited to those provided by ERISA’s remedial scheme.

Although plaintiff did not assert an ERISA count in his original complaint, this Court granted plaintiff leave to amend the complaint; Plaintiff filed the amended complaint alleging an ERISA count on October 21, 2002. At this time, however, this Court need only consider defendant’s motion for summary judgment on the state breach of contract and bad faith claims, because defendant did not seek summary judgment on the ERISA count.

II. Discussion

A. Jurisdiction

Plaintiff brought this action in the Rhode Island Superior Court on July 17, 2001 alleging state law claims of bad faith and breach of contract. On August 22, 2001, defendant removed the case pursuant to this Court’s federal question jurisdiction and diversity jurisdiction.

Ordinarily, “federal defenses including preemption do not by themselves confer federal jurisdiction over a well-pleaded complaint alleging only violations of state law.” Hotz v. Blue Cross and Blue Shield of Massachusetts, Inc., 292 F.3d 57, 59 (1st Cir.2002)(emphasis in original). Thus, a defendant usually would be required to rely on diversity jurisdiction for removal purposes in a case such as this. Nevertheless, the doctrine of complete preemption is applicable here. The First Circuit in Danca v. Private Health Care Systems, Inc., 185 F.3d 1, 4 (1st Cir.1999) explained that when a state law claim “implicates an area of federal law for which Congress intended a particularly powerful preemptive sweep, the cause is deemed federal no matter how pleaded.” Under the civil enforcement provisions of ERISA, federal removal jurisdiction is permitted “over any state law claims that in substance seek relief that is otherwise within the scope of those ERISA remedy provisions.” Hotz, 292 F.3d at 59. 1 Thus, the complete preemption doctrine applies to a state law suit alleging bad faith and breach of contract for the improper processing of a benefits claim under an ERISA plan. Danca, 185 F.3d at 5. Defendant, therefore, properly removed the present case to federal court.

B. Standard for Summary Judgment

Rule 56(c) of the Federal Rules of Civil Procedure sets forth the standard for ruling on summary judgment motions:

The judgment sought shall be rendered forthwith if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.

Fed.R.Civ.P. 56(c). The critical inquiry is whether a genuine issue of material fact exists. A genuine issue is one “supported by such evidence that a reasonable jury, drawing favorable inferences, could resolve it in favor of the nonmoving party.” Hershey v. Donaldson, Lufkin & Jenrette Securities Corp.,

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Robertson Stephens, Inc. v. Chubb Corp.
473 F. Supp. 2d 265 (D. Rhode Island, 2007)
Stamp v. Metropolitan Life Insurance
466 F. Supp. 2d 422 (D. Rhode Island, 2006)
Desrosiers v. Hartford Life & Accident Insurance
354 F. Supp. 2d 119 (D. Rhode Island, 2005)
Hollaway v. UNUM Life Insurance Co. of America
2003 OK 90 (Supreme Court of Oklahoma, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
255 F. Supp. 2d 16, 30 Employee Benefits Cas. (BNA) 1964, 2003 U.S. Dist. LEXIS 5851, 2003 WL 1821512, Counsel Stack Legal Research, https://law.counselstack.com/opinion/morris-v-highmark-life-insurance-rid-2003.