Rollin v. Transamerica Life Insurance Company

CourtDistrict Court, E.D. California
DecidedJuly 3, 2025
Docket1:25-cv-00194
StatusUnknown

This text of Rollin v. Transamerica Life Insurance Company (Rollin v. Transamerica Life Insurance Company) is published on Counsel Stack Legal Research, covering District Court, E.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rollin v. Transamerica Life Insurance Company, (E.D. Cal. 2025).

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 EASTERN DISTRICT OF CALIFORNIA 10 11 CAROL A. ROLLIN, No. 1:25-cv-00194-KES-HBK 12 Plaintiff, 13 v. ORDER GRANTING DEFENDANT’S MOTION TO DISMISS AND DISMISSING 14 TRANSAMERICA LIFE INSURANCE FIRST AMENDED COMPLAINT WITH COMPANY, LEAVE TO AMEND 15 Defendant. Doc. 24 16

17 18 Plaintiff Carol A. Rollin brings this claim against defendant Transamerica Life Insurance 19 Company (“Transamerica”) alleging breach of contract, breach of the implied covenant of good 20 faith and fair dealing, and financial elder abuse in violation of the Elder Abuse and Dependent 21 Adult Civil Protection Act, California Welfare and Institutions Code, section 15600 et seq. 22 Doc. 21. Transamerica moves to dismiss for failure to state a claim. Doc. 24. The parties’ briefs 23 have been considered and, for the reasons set forth below, Transamerica’s motion to dismiss is 24 granted and Rollin’s first amended complaint is dismissed with leave to amend. 25 I. Procedural History 26 Rollin initiated this action by filing a complaint on February 13, 2025. Doc. 1. On 27 April 3, 2025, Transamerica moved to dismiss the complaint for failure to state a claim. Doc. 13. 28 In lieu of opposing the motion, Rollin filed a first amended complaint. Doc. 21 (“FAC”). 1 On May 1, 2025, Transamerica again moved to dismiss for failure to state a claim, arguing 2 that the first amended complaint does not set forth sufficient facts that, if true, would state a claim 3 upon which relief could be granted.1 Doc. 24. In support of its motion, Transamerica filed a 4 declaration and request for judicial notice of the long-term care insurance policy at issue for 5 Rollin’s claims. Docs. 25, 26. On May 15, 2025, Rollin filed an opposition to the motion to 6 dismiss.2 Doc. 27. On May 22, 2025, the Court granted Transamerica’s ex parte application for 7 an extension of time to file a reply in support of its motion, Doc. 30, and on June 2, 2025, 8 Transamerica filed its reply, Doc. 32. 9 II. Facts3 10 In her first amended complaint, Rollin alleges Transamerica issued to her a long-term care 11 policy and that she paid all premiums due under the policy.4 FAC ¶¶ 6–7. The policy lists “[t]he 12

13 1 Transamerica brings its motion under Rule 12(b)(6) as to all claims and separately also moves to dismiss Rollin’s third cause of action, for financial elder abuse, under Rule 9(b). Doc. 24 at 15. 14 As this Order resolves the motion to dismiss on Rule 12(b)(6) grounds, the Court need not 15 address Transamerica’s contention that Rule 9(b) applies and that Rollin failed to meet its requirements. 16 2 Rollin does not oppose Transamerica’s request for judicial notice nor dispute the authenticity of 17 the attached policy. See Doc. 27. The request for judicial notice, Doc. 26, is therefore granted. Moreover, the insurance policy is rightfully considered in connection with Transamerica’s motion 18 to dismiss because it is incorporated by reference into the first amended complaint. See Knievel 19 v. ESPN, 393 F.3d 1068, 1076 (9th Cir.2005) (“[T]he incorporation by reference doctrine [applies] to situations in which the plaintiff's claim depends on the contents of a document, the 20 defendant attaches the document to its motion to dismiss, and the parties do not dispute the authenticity of the document, even though the plaintiff does not explicitly allege the contents of 21 that document in the complaint.”). See Engers v. Allstate Ins. Co., 682 F. Supp. 2d 1094, 1097 (E.D. Cal. 2009) (considering defendant’s request for judicial notice of long-term care policy in 22 similar case and finding policy incorporated by reference into complaint). 23 3 The Court presumes the factual allegations in the first amended complaint to be true for 24 purposes of evaluating the motion to dismiss. See Murguia v. Langdon, 61 F.4th 1096, 1106 (9th Cir. 2023). As noted, the terms of the insurance policy at issue are also properly considered, and 25 are therefore recited herein, given that the policy is incorporated by reference into the first amended complaint. 26

27 4 In its motion to dismiss, Transamerica clarifies that the policy was issued by Transamerica’s predecessor. See Doc. 24 at 4; see also Doc. 25-1 at 46 (merger endorsement). 28 1 benefits . . . [Rollin] elected” to be included in her coverage, including nursing facility benefits; 2 residential care facility benefits; home health care, adult day care, homemaker services and 3 personal care benefits; hospice care benefits; and an alternative payment benefit, among others. 4 Doc. 25-1 at 5–6. The policy provides in relevant part: 5 BENEFIT ELEGIBILITY 6 To be eligible for benefits provided under this Policy, [Transamerica] must receive a Plan of Care that specifies what care is needed, unless a benefit specifically states 7 that a Plan of Care is not required. The care must be needed because the Insured Person has been certified within the last 12 months by a Licensed Health Care 8 Practitioner as:

9 (1) requiring continual supervision, which may include cueing by verbal prompting, gestures, or other demonstrations, by another 10 person to protect the Insured Person from threats to his or her health or safety, due to Cognitive Impairment; or 11 (2) requiring the presence of another person within arm’s reach due 12 to the inability to perform at least 2 of the 6 Activities of Daily Living, for a period that is expected to last at least 90 days. The 13 other person must be present within arm’s reach in order to assist, supervise or prevent injury by physical intervention.5 14 Doc. 25-1 at 23. The policy lists general exclusions and limitations, including that it “will not 15 pay benefits when an Insured Person is eligible for confinement, treatment, services or care . . . 16 rendered by a member of an Insured Person’s Immediate Family” or benefits “that are not 17 included in an Insured Person’s Plan of Care, unless a benefit specifically states that a Plan of 18 Care is not required.”6 Id. at 15. 19 The Policy further provides that the “Alternative Payment Benefit,” one of the benefits 20 included in the policy, will be paid “[o]nce an Insured Person has been certified to meet the 21 requirements found in the Benefit Eligibility provision for Cognitive Impairment or the inability 22 to perform at least 2 of the 6 Activities of Daily Living and [Transamerica] ha[s] received a Plan 23 of Care.” Id. at 35. It provides that the Alternative Payment Benefit will be paid “in lieu of all 24 other benefits for care or services provided under this Policy.” Id. “The exclusions regarding a 25 26 5 “Plan of Care,” “Insured Person,” “Licensed Health Care Practitioner,” “Cognitive Impairment,” 27 and “Activities of Daily Living” are defined terms in the policy. Doc. 25-1 at 16, 21–22.

28 6 “Immediate Family” is also a defined term in the policy. Doc. 25-1 at 16. 1 member of an Insured Person’s Immediate Family . . . will not apply to the Alternative Payment 2 Benefit provision.” Id. at 15. 3 Rollin alleges that she “became eligible to receive benefits under the terms of her policy” 4 and that she “has initiated and submitted all necessary documentation” to Transamerica “such that 5 her claim should have been approved and paid.” FAC ¶ 8. She claims that, despite this, 6 Transamerica denied the payment of benefits on July 22, 2024. FAC ¶ 8. She appealed, but 7 Transamerica did not respond to the appeal. FAC ¶ 8.

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Bluebook (online)
Rollin v. Transamerica Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rollin-v-transamerica-life-insurance-company-caed-2025.