Rehabilitation Institute of Chicago v. Group Administrators, Ltd.

844 F. Supp. 1275, 1994 U.S. Dist. LEXIS 9556, 1993 WL 597376
CourtDistrict Court, N.D. Illinois
DecidedFebruary 7, 1994
Docket93 C 907
StatusPublished
Cited by11 cases

This text of 844 F. Supp. 1275 (Rehabilitation Institute of Chicago v. Group Administrators, Ltd.) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rehabilitation Institute of Chicago v. Group Administrators, Ltd., 844 F. Supp. 1275, 1994 U.S. Dist. LEXIS 9556, 1993 WL 597376 (N.D. Ill. 1994).

Opinion

ORDER

NORGLE, District Judge.

Before the court are defendant Group Administrators, Ltd.’s (“GAL”) objections to Magistrate Judge Rosemond’s Report and Recommendation (“Report”). Pursuant to 28 U.S.C. § 636(b)(1)(B), the court referred GAL’s motion to dismiss and plaintiff Rehabilitation Institute of Chicago’s (“RIC”) motion for remand to the Magistrate Judge.

The Magistrate Judge conducted a hearing and issued a nineteen-page Report. The Report was filed on December 16, 1993. The Magistrate Judge’s Report recommends that this court deny GAL’s motion to dismiss and grant RIC’s motion for remand. The court has reviewed the Report and arguments of counsel de novo. 28 U.S.C. § 636(b)(1). The *1277 court finds the Report to be thorough, accurate, and the decision proper.

The court further finds GAL’s objections to be without merit. The material defect in GAL’s argument stems from its mischarac-terization of RIC’s complaint in an attempt to bring the case within the scope of various decisions cited by GAL. Simply stated, GAL is making a federal case out of a state contract case under the guise of the Employee Retirement Income Security Act of 1974 (“ERISA”). RIC files its action under the doctrine of promissory estoppel as recognized under Illinois law. RIC is not, as GAL characterizes, bringing an action against GAL seeking benefits under a health insurance plan governed by ERISA. The cause of action is that GAL, as an entity, breached its promise to provide compensation for medical services rendered by RIC. RIC is not a plan beneficiary or a participant. RIC’s cause of action is not focused on the ERISA plan that GAL administers; rather, it is focused on the alleged promise made by GAL and relied upon by RIC. The existence of an ERISA plan is coincidental to the complaint alleged. Thus, the court agrees with the well reasoned decision of the Magistrate Judge’s Report.

The court adopts and incorporates the Magistrate Judge’s Report and the holdings contained therein pursuant to 28 U.S.C. § 636(b)(1). Accordingly, GAL’s motion to dismiss is denied and RIC’s motion for remand is granted.

REPORT AND RECOMMENDATION.

ROSEMOND, United States Magistrate Judge.

TO THE HONORABLE CHARLES R. NORGLE, SR., a District Judge of the United States District Court for the Northern District of Illinois.

Plaintiff Rehabilitation Institute of Chicago commenced this action on January 13, 1993 in the Circuit Court of Cook County, Illinois, Law Division. On February 11, 1993, defendant Group Administrators filed a Notice of Removal petitioning this Court to remove the case pursuant to 28 U.S.C. §§ 1441 and 1443, and a Motion to Dismiss pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure. Plaintiff has contested defendant’s Motion to Dismiss and has filed a Motion to Remand the case to state court. Defendant’s motion to dismiss is hereby denied, and plaintiffs motion to remand is granted, for the reasons set forth below.

BACKGROUND.

When considering a motion to dismiss for failure to state a claim, the Court must accept all well-pleaded facts as true, and draw all reasonable inferences therefrom in favor of the plaintiff. 1 The motion to dismiss may be granted only if the plaintiff can prove no set of facts upon which relief may be granted. 2 The well-pleaded facts for this case are as follows:

Plaintiff Rehabilitation Institute (“Rehab Institute”) is a domestic charitable corporation which maintains a hospital and renders medical services. 3 From April 8 through April 14 and from April 16 through June 6, 1991, Rehab Institute rendered hospital and medical services to Daniel Casey. The total cost of these services was $59,211.46. 4

On April 15, 1991, Rehab Institute contacted an agent of defendant Group Administrators, the administrator of Casey’s health insurance plan under the Employee Retirement Income Security Act of 1974 (ERISA), 5 for the purpose of determining whether or not Casey’s care — which apparently was necessitated by self-inflicted injuries — was covered under the ERISA plan. Defendant responded shortly thereafter by assuring Rehab Institute that there was no exclusion for *1278 self-inflicted injuries, and by describing specifically the coverage that was available. 6 As a result of these assurances, Rehab Institute provided Casey with the care he needed. 7

Subsequently, however, Group Administrators refused to reimburse Rehab Institute for the care it provided, and has continued to do so despite repeated demands for payment. This litigation ensued, with plaintiff maintaining that defendant should be estopped under Illinois law from refusing to remit payment for services that it represented were covered by Casey’s ERISA plan. Rather than deny plaintiffs allegations, defendant maintains that plaintiffs complaint fails to state a claim upon which relief may be granted. Specifically, defendant maintains that plaintiffs complaint fails to state a cause of action under Illinois law for equitable estoppel, and that even if the complaint does state a cause of action under Illinois law, the cause of action is preempted by ERISA. 8 Plaintiff concedes that state law claims are generally preempted by ERISA. However, it has attempted to distinguish its claim by arguing that because it is a third-party health care provider who is neither a beneficiary nor an assignee of the ERISA plan, its claim for damages is not “related to” the ERISA plan. 9

ANALYSIS.

A. Sufficiency of the Estoppel Claim.

Before proceeding to the preemption issue, the Court must determine whether plaintiffs complaint pleads a cause of action under Illinois law. Rehab Institute’s complaint asserts that it is entitled to recover the funds it spent in treating Daniel Casey under the doctrine of promissory estoppel. Promissory estoppel is generally invoked in situations where some performance has been rendered by a party despite the lack of a binding contract. 10

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844 F. Supp. 1275, 1994 U.S. Dist. LEXIS 9556, 1993 WL 597376, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rehabilitation-institute-of-chicago-v-group-administrators-ltd-ilnd-1994.