Stewart v. Pershing Health System

182 F. Supp. 2d 856, 26 Employee Benefits Cas. (BNA) 1379, 2001 U.S. Dist. LEXIS 3148, 2001 WL 1397327
CourtDistrict Court, E.D. Missouri
DecidedFebruary 13, 2001
Docket2:00 CV 82 DDN
StatusPublished

This text of 182 F. Supp. 2d 856 (Stewart v. Pershing Health System) is published on Counsel Stack Legal Research, covering District Court, E.D. Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stewart v. Pershing Health System, 182 F. Supp. 2d 856, 26 Employee Benefits Cas. (BNA) 1379, 2001 U.S. Dist. LEXIS 3148, 2001 WL 1397327 (E.D. Mo. 2001).

Opinion

182 F.Supp.2d 856 (2001)

Lisa STEWART and James Stewart, Plaintiffs,
v.
PERSHING HEALTH SYSTEM, Defendant.

No. 2:00 CV 82 DDN.

United States District Court, E.D. Missouri, Eastern Division.

February 13, 2001.

*857 Timothy H. Bosler, Chillicothe, MO, for Plaintiffs.

Richard H. Kuhlman, Blackwell Sanders Peper Martin LLP, St. Louis, MO, Shelly Runion, Blackwell Sanders Peper Martin LLP, Kansas City, MO, for Defendant.

MEMORANDUM

NOCE, United States Magistrate Judge.

This matter is before the court upon the motions of defendant Pershing Health System to dismiss or in the alternative, to strike defendant Pershing Health Systems (Doc. No. 9) and plaintiffs' motion to remand (Doc. No. 21). The parties have consented to the exercise of authority by the undersigned United States Magistrate Judge pursuant to 28 U.S.C. § 636(c).

*858 Plaintiffs Lisa Stewart and James Stewart commenced this action in the Circuit Court of Linn County, alleging negligent and fraudulent misrepresentation on the part of plaintiff Lisa Stewart's employer, defendant Pershing Health Systems. She alleged that in January 1998 her employer announced an open enrollment for a new health insurance plan ("Plan"). She further alleged that her employer represented to her that there would be no exclusions under the Plan for those enrolling during the open enrollment period.[1] Finally, she alleged that based on these representations, she enrolled in the Plan with her husband, James, and she canceled her private health insurance. In June 1998, her husband, plaintiff James Stewart, was injured while working as a self-employed farmer. Ultimately, the Plan denied coverage for plaintiff James Stewart's injury because of an exclusion which denied coverage for injuries received while engaged in self-employment. Plaintiffs sought actual and punitive damages from defendant Pershing Health System for negligent and fraudulent misrepresentation.

Defendant removed the action from the Circuit Court of Linn County to this court. Defendant now moves for dismissal, arguing that plaintiffs' cause of action is against the Plan and that it is preempted by the Employee Retirement Income Security Act, 29 U.S.C. § 1001, et seq. ("ERISA") because plaintiffs are actually seeking plan benefits. Defendants further argue that plaintiffs fail to allege a cause of action under ERISA and that their petition should be dismissed.

Plaintiffs have moved to remand the action back to the Circuit Court of Linn County, arguing that the Plan is not a critical factor to establishing liability and that plaintiffs are not suing for plan benefits. Rather, they argue that their claim arose from facts that occurred before the Plan went into effect. Plaintiffs also argue that courts have held that negligent and fraudulent misrepresentation claims are not preempted by ERISA and that, therefore, this court does not have jurisdiction.

As a threshold issue, this court must determine whether removal was appropriate. If it was not, the court does not have subject matter jurisdiction and the court must grant plaintiffs' motion to remand to state court. Defendant's motion to dismiss and its alternative motion to strike also must be denied as moot. "For a federal court to have subject matter jurisdiction over a case, the parties must be completely diverse or a federal question must appear on the face of the plaintiff's well-pleaded complaint." Tovey v. Prudential Ins. Co. of America, 42 F.Supp.2d 919, 922 (W.D.Mo.1999). The face of plaintiffs' complaint reveals the following:

21. As a direct result of negligent misrepresentation made by the Hospital before the Plaintiffs' enrollment and as an inducement for Plaintiff's enrollment into the Plan, James Stewart is now unable to purchase health insurance coverage except as a family member under his wife's employee coverage.
22. If Lisa Stewart would have known that the Plan excluded injuries occurring to a self-employed insured even if the insured was not covered under a Worker's Compensation Plan, Lisa Stewart would not have enrolled herself and James Stewart in the Plan.
23. The conduct of the Hospital in failing to provide written material prior to enrollment and failing to provide accurate information upon direct inquiry concerning exclusions, the Hospital conduct *859 is in conscious disregard of the rights of the Plaintiffs and is willful, wanton and malicious conduct entitling the Plaintiffs to recover punitive damages.

Petition attached to Notice of Removal, filed October 13, 2000 (Doc. No. 1), at 4.

The court notes that plaintiffs allege Missouri common law claims of negligent and fraudulent misrepresentation. Nowhere in the complaint do plaintiffs allege a claim under ERISA. Defendant relies on 29 U.S.C. § 1144(a) which provides the following:

[T]he provisions of this subchapter and subchapter III of this chapter shall supercede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in section 1003(a) of this title and not exempt under section 1003(b) of this title.

29 U.S.C. § 1144(a).

However the Eighth Circuit has held that "[u]nder the `well-pleaded complaint' rule, `a case may not be removed to federal court on the basis of a federal defense, including the defense of preemption, even if the defense is anticipated in the plaintiff's complaint.'" Lyons v. Philip Morris Inc., 225 F.3d 909, 912 (8th Cir.2000) (quoting Franchise Tax Board v. Construction Laborers Vacation Trust, 463 U.S. 1, 14, 103 S.Ct. 2841, 77 L.Ed.2d 420 (1983)). The court in Lyons continued:

However, the well-pleaded complaint rule does not apply if Congress has evidenced an intent that federal law completely displace state law. "Once an area of state law has been completely pre-empted, any claim purported based on that pre-empted state law is considered, from its inception, a federal claim, and therefore arises under federal law."
In Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 52-56, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987), the Supreme Court held that the comprehensive civil remedies in § 502(a) of ERISA, 29 U.S.C. § 1132(a) completely preempt state law remedies.

Id. (quoting Caterpillar v. Williams, 482 U.S. 386, 393, 107 S.Ct. 2425, 96 L.Ed.2d 318 (1987)). Lyons finally noted that "[c]auses of actions within the scope of, or that relate to, the civil enforcement provisions of 502(a) are removable to federal court despite the fact the claims are couched in terms of state law." Id. (quoting Hull v. Follon,

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Bluebook (online)
182 F. Supp. 2d 856, 26 Employee Benefits Cas. (BNA) 1379, 2001 U.S. Dist. LEXIS 3148, 2001 WL 1397327, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stewart-v-pershing-health-system-moed-2001.