Termini v. Life Insurance Co. of North America

464 F. Supp. 2d 508, 2006 U.S. Dist. LEXIS 89273, 2006 WL 3579072
CourtDistrict Court, E.D. Virginia
DecidedDecember 8, 2006
Docket2:06 CV 591
StatusPublished
Cited by4 cases

This text of 464 F. Supp. 2d 508 (Termini v. Life Insurance Co. of North America) is published on Counsel Stack Legal Research, covering District Court, E.D. Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Termini v. Life Insurance Co. of North America, 464 F. Supp. 2d 508, 2006 U.S. Dist. LEXIS 89273, 2006 WL 3579072 (E.D. Va. 2006).

Opinion

MEMORANDUM OPINION

REBECCA BEACH SMITH, District Judge.

This matter is before the court on plaintiffs motion to remand the case to state court, defendant Life Insurance Company of North America’s (“LINA”) motion to dismiss for failure to state a claim, and plaintiffs motion for leave to amend. For the reasons stated below, plaintiffs motion to remand is DENIED, LINA’s motion to dismiss is GRANTED-IN-PART and DENIED-IN-PART, and plaintiffs motion for leave to amend is GRANTED.

I. Factual and Procedural History

Plaintiff, as beneficiary of a decedent formerly employed by Electric Power Research Institute (“EPRI”), brought the present action seeking accidental death and dismemberment benefits under an employee benefits plan that LINA issued to EPRI and administered. 1

For a number of years leading up to the date of his death on May 11, 2005, plaintiffs husband Salvatore Termini (“the decedent”) was an employee of EPRI and participated in the company’s group accidental death and dismemberment plan. Under the terms of the plan, LINA is obligated to pay benefits to eligible persons for the death or loss from bodily injuries “[claused by an accident which happens while an insured is covered by this policy.” On January 1, 2004, LINA issued a renewal accidental death and dismemberment policy to the decedent, which provided $500,000.00 in coverage. The decedent listed plaintiff as the beneficiary of this policy.

On April 30, 2005, while the policy was in full force and effect, the decedent sustained injuries as a result of a fall while jogging. Because of the fall, the decedent suffered a basilar skull fracture and sub-arachnoid hemorrhage. After this incident, the decedent became unconscious and had a hypoxic event, which led to cardiac arrhythmia and eventually his death on May 11, 2005.

Following the decedent’s death, EPRI, on behalf of plaintiff, applied for the proceeds of the policy on or about June 27, 2005. On July 13, 2005, LINA denied the benefits. On August 2, 2005, plaintiff furnished LINA with the identity and location of an eyewitness to the decedent’s fall. On November 15, 2005, LINA denied the benefits without interviewing the eyewitness or contacting the decedent’s physicians. On December 3, 2005, plaintiff appealed *512 this decision, but on April 7, 2006, LINA upheld its denial of the claim.

On August 28, 2006, plaintiff filed a five-count complaint against defendants LINA and CIGNA Group Insurance Companies in the Circuit Court for the City of Chesapeake. Plaintiffs complaint asserts four causes of action against LINA: (1) breach of contract; (2) promissory estoppel; (3) equitable estoppel; and (4) bad faith. Plaintiffs complaint also asserts one cause of action, tortious interference with contractual relations and prospective economic advantage, against CIGNA Group Insurance Companies. Plaintiff seeks $500,000.00 in compensatory damages against LINA and CIGNA Group Insurance Companies, jointly and severally. Plaintiff seeks $750,000.00 in compensatory damages and $350,000.00 in punitive damages against CIGNA Group Insurance Companies. In addition, plaintiff seeks costs, expenses, and reasonable attorneys’ fees.

On October 23, 2006, LINA removed this action to the United States District Court for the Eastern District of Virginia, asserting that this court has federal question jurisdiction pursuant to 28 U.S.C. § 1441(a) as plaintiffs claims are governed by the Employment Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001, et seq. 2 In addition, on October 30, 2006, LINA filed a motion to dismiss and memorandum in support of this motion. On November 8, 2006, plaintiff filed a motion to remand, brief in support of remand, brief in opposition to LINA’s motion to dismiss, motion for leave to amend, and brief in support of motion for leave to amend. On November 15, 2006, LINA filed a reply to plaintiffs brief in opposition to LINA’s motion to dismiss. On November 16, 2006, LINA filed its brief in opposition to plaintiffs motion to remand and brief in opposition to plaintiffs motion for leave to amend. Accordingly, the three motions are now ripe for review.

II. Analysis

A. Motion to Remand

Because the court must first determine whether it has proper subject matter jurisdiction over this case, the court will first address plaintiffs motion to remand. A court must remand a case to state court “[i]f at any time before final judgment it appears that the district court lacks subject matter jurisdiction ....” 28 U.S.C. § 1447(c). The party who is seeking removal bears the burden of establishing federal jurisdiction. See McNutt v. Gen. Motors Acceptance Corp., 298 U.S. 178, 189, 56 S.Ct. 780, 80 L.Ed. 1135 (1936).

The district court will have subject matter jurisdiction over a civil action if a federal question exists. See 28 U.S.C. § 1331. A district court has federal question jurisdiction if the civil action arises “under the Constitution, laws, or treaties of the United States.” Id. It is well-settled that “a cause of action arises under federal law only when the plaintiffs well-pleaded complaint raises issues of federal law.” Metro. Life Ins. Co. v. Taylor, 481 *513 U.S. 58, 63, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987). A federal defense, such as preemption, may generally not form the basis for removal. See Smith v. Logan, 363 F.Supp.2d 804, 808 (E.D.Va.2004) (citing Caterpillar Inc. v. Williams, 482 U.S. 386, 392-93, 107 S.Ct. 2425, 96 L.Ed.2d 318 (1987)). “However, if a state law cause of action has been completely preempted by federal law, any claim based on the completely preempted state law is considered a federal claim arising under federal law.” Id. (citing Caterpillar Inc., 482 U.S. at 393, 107 S.Ct. 2425). The Fourth Circuit has confirmed that this complete preemption exception to the well-pleaded complaint rule applies to removal in the ERISA context. See Makar v. Health Care Corp., 872 F.2d 80, 82 (4th Cir.1989).

Plaintiff urges the court to remand the instant action to state court, because her complaint only expressly seeks damages under state law. 3 Pl.’s Br. in Supp. of Mot. for Remand at 1-2.

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464 F. Supp. 2d 508, 2006 U.S. Dist. LEXIS 89273, 2006 WL 3579072, Counsel Stack Legal Research, https://law.counselstack.com/opinion/termini-v-life-insurance-co-of-north-america-vaed-2006.