Soderman v. Horan

165 F.R.D. 8, 34 Fed. R. Serv. 3d 1409, 1996 U.S. Dist. LEXIS 1944, 1996 WL 75846
CourtDistrict Court, D. Massachusetts
DecidedFebruary 16, 1996
DocketCivil Action No. 95-40029-NMG
StatusPublished
Cited by1 cases

This text of 165 F.R.D. 8 (Soderman v. Horan) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Soderman v. Horan, 165 F.R.D. 8, 34 Fed. R. Serv. 3d 1409, 1996 U.S. Dist. LEXIS 1944, 1996 WL 75846 (D. Mass. 1996).

Opinion

MEMORANDUM AND ORDER

GORTON, District Judge.

Pending before this Court is a motion by defendant, CIGNA Dental Health, Inc. (“CDH”), to dismiss plaintiffs complaint pursuant to Fed.R.Civ.P. 12(b)(6).1 Plaintiff filed the above-entitled matter in the Massa[9]*9chusetts Superior Court on January 13,1995. On February 23, 1995, CDH removed the action to federal court, on the ground that it was governed by the provisions of the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et seq. Five days later, CDH filed its motion to dismiss for failure to state a claim upon which relief can be granted. For the following reasons, defendant’s motion will be allowed.

I. Factual Background

When considering a motion to dismiss, this Court accepts as true the allegations of the complaint and draws all reasonable inferences in favor of the plaintiff. Carreiro v. Rhodes Gill and Co., Ltd., 68 F.3d 1443, 1446 (1st Cir.1995). Plaintiffs complaint asserts the following relevant factual allegations:

1. Plaintiff, Milda C. Soderman (“Soderman”) is a resident of Webster and a participant in a dental care plan (“the Dental Plan”) offered by The Norton Company, her husband's employer. The Dental Plan, administered by CDH, allows participants to be reimbursed for a percentage of charges for dental care provided by a plan dentist chosen by the participant from, a number of available plan dentists. CDH performs certain administrative duties for the Dental Plan in which plaintiff is a participant.

2. Plaintiff had been referred to a Dr. McCracken for implant and reconstruction services. When Soderman sought to assign to CDH her obligation to pay for the treatment, however, CDH refused and required her to' obtain treatment from defendant, Dr. John J. Horan (“Dr. Horan”), a plan dentist who practices in Worcester.

3. During the course of his treatment of plaintiff, which extended from December, 1989 through September, 1993, Dr. Horan rendered negligent care and caused various injuries to plaintiff.

4. With respect to defendant CDH, the relevant allegations of plaintiffs complaint are ¶¶ 12-14, as follows:

12. [CDH] was negligent in its representation to [plaintiff] that [Dr. Horan] was ... competent to undertake the treatment that she needed and that said negligence is a proximate cause of [her] ensuing dental problems.

13. [CDH] was negligent in that it failed to properly obtain information or, indeed, research the capabilities of [Dr. Horan] before referring Mrs. Soderman to him____

14. [CDH] knew or should have known that [Dr. Horan] was not capable of providing to [her] the type of treatment that she needed and the said negligence of [CDH] was a proximate cause of the ensuing injuries and dental care that [she] will be in need of.

II. Preemption of Plaintiffs Claims by ERISA

The Dental Plan at issue in the case at bar is an employee welfare plan that falls within the purview of ERISA. This is so because the Plan is one which provides employees, “through the purchase of insurance or otherwise, ... medical, surgical, or hospital care or benefits, or benefits in the event of sickness, accident [or] disability — ” 29 U:S.C. § 1002(1). Plaintiff is an eligible participant in the Plan because she is a dependent of an employee whose employer offers such health benefits.

Although plaintiffs claims purport to arise under state common law, it is well established that such claims, however pleaded, are governed exclusively by ERISA. E.g., Ingersoll-Rand Co. v. McClendon, 498 U.S. 133, 111 S.Ct. 478, 112 L.Ed.2d 474 (1990); Vartanian v. Monsanto Co., 14 F.3d 697 (1st Cir.1994). Section 514 of ERISA supersedes “any and all State laws insofar as they ... relate to any employee benefit plan....” 29 U.S.C. § 1144(a) (emphasis added). The term “State laws” is defined by ERISA to include “all laws, decisions, rules, regulations or other State action having the effect of law.” 29 U.S.C. § 1144(c)(1). The Supreme Court has established that a law “relates to” an employee benefit plan for purposes of section 514 “if it has a connection with or reference to such a plan.” Ingersoll-Rand Co., 498 U.S. at 139, 111 S.Ct. at 483 (quoting Shaw v. Delta Air Lines, Inc., 463 U.S. 85, [10]*1096-97, 103 S.Ct. 2890, 2899-900, 77 L.Ed.2d 490 (1983)).

In Ingersoll-Rand Co., the Supreme Court determined that ERISA expressly preempts a cause of action where a plaintiff, in order to prevail, must plead, and the court must find, that an ERISA plan exists. 498 U.S. at 140, 111 S.Ct. at 483; see also Vartanian v. Monsanto Co., 14 F.3d at 700 (plaintiffs misrepresentation claim preempted by ERISA where “the existence of the [ERISA plan] is inseparably connected to any determination of liability under state common law of misrepresentation”).

The case of Altieri v. Cigna Dental Health, Inc., 753 F.Supp. 61 (D.Conn.1990), is instructive in this regard. As in the ease at bar, the plaintiff in Altieri sued CDH and a dentist for injuries suffered as a result of allegedly negligent care. The Altieri plaintiff, like Soderman, alleged that CDH failed, among other things, to investigate the dentist’s competence prior to recommending him to patients enrolled in the Dental Plan it administered. 753 F.Supp. at 62. The district court dismissed plaintiffs claims against CDH, determining that the causes of action asserted against the defendant “related to” the plan and were preempted. Id. at 64. Specifically, the Altieri court noted that the plaintiffs state law claims (which included negligence, misrepresentation, and breach of contract) “all have one central feature: the circumstances of [the plaintiffs] medical treatment under his employer’s [dental] services plan for employees.” Id. (internal quotation omitted).2

In the case at bar, plaintiffs claims against CDH effectively allege that defendant acted wrongfully in performing its administrative tasks relating to the provision of benefits under a group Dental Plan governed by ERISA In essence, the complaint alleges that:

1) CDH negligently misrepresented the competence of Dr. Horan to plaintiff (¶ 12),

2) CDH negligently selected Dr. Horan as a provider of dental services under the Plan (¶ 13), and

3) CDH negligently referred plaintiff to Dr. Horan (¶ 14).

Those claims undoubtedly “relate to” an ERISA plan within the meaning of § 514(a) of ERISA because, in order to prove her allegations, Soderman must plead, and the court must find, that an ERISA plan exists. Indeed, as in Altieri,

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165 F.R.D. 8, 34 Fed. R. Serv. 3d 1409, 1996 U.S. Dist. LEXIS 1944, 1996 WL 75846, Counsel Stack Legal Research, https://law.counselstack.com/opinion/soderman-v-horan-mad-1996.