Willingway Hospital, Inc. v. Blue Cross & Blue Shield of Ohio

870 F. Supp. 1102, 1994 WL 653519
CourtDistrict Court, S.D. Georgia
DecidedNovember 28, 1994
DocketCiv. A. CV 693-075
StatusPublished
Cited by16 cases

This text of 870 F. Supp. 1102 (Willingway Hospital, Inc. v. Blue Cross & Blue Shield of Ohio) is published on Counsel Stack Legal Research, covering District Court, S.D. Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Willingway Hospital, Inc. v. Blue Cross & Blue Shield of Ohio, 870 F. Supp. 1102, 1994 WL 653519 (S.D. Ga. 1994).

Opinion

ORDER

EDENFIELD, Chief Judge.

Before the Court is the Defendant’s motion to dismiss for want of personal jurisdiction. The Court GRANTS the Defendant’s motion, finding that the Defendant lacks sufficient contacts with this jurisdiction to satisfy due process requirements.

I. Background

This case springs from a dispute between a Georgia Hospital and an Ohio medical insurance company. On May 24, 1993, the Plaintiff, Willingway Hospital (hereinafter “Will-ingway”), filed suit in the Superior Court of Bulloch County, Georgia, to collect a $45,-658.79 health insurance claim, which the Defendant, Blue Cross & Blue Shield of Ohio (hereinafter “BCBS”) refused to pay. Will-ingway’s claim stems from its treatment of James Rudolph, a member of a group health insurance policy issued by BCBS. As Rudolph’s assignee, Willingway contends that it has the right to recover the unpaid insurance proceeds.

BCBS removed this action from the Superior Court of Bulloch County, Georgia, to this Court on July 16, 1993, asserting federal question jurisdiction under 28 U.S.C. § 1331. See Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 67, 107 S.Ct. 1542, 1548, 95 L.Ed.2d 55 (1987). Willingway’s claims are governed by the Employee Retirement Income Security Act of 1974, as amended (hereinafter “ERISA”), 29 U.S.C. §§ 1001-1461.

Willingway provided medical services to James Rudolph during two periods: from January 28, 1991 to March 11,1991 and from August 31, 1992 to October 12, 1992. (Complaint at 1 and 2). Rudolph’s insurance policy required that beneficiaries obtain pre-cer-tification for treatment. While Willingway alleges in its complaint that it obtained pre-certification authorizing five days of treatment (Complaint at 2), BCBS has supplied an affidavit stating that it did not provide any pretreatment authorization. (Waldron Aff. at 3).

Despite an anti-assignment clause in Rudolph’s BCBS policy (Def. Mot. Sum. Jdgt., Ex. 2, at 29), Rudolph executed an assignment of benefits to Willingway to collect the $49,415.95 due for the treatment. (Complaint at 1-2). To date, BCBS has only paid $3,757.16, claiming that the remaining treatment, totalling $45,658.79, was not medically necessary. (Ans. at 2).

II. Personal Jurisdiction

A. Burden of Proof

Because this Court has chosen not to conduct a discretionary evidentiary hear *1104 ing on the defendant’s motion to dismiss for lack of personal jurisdiction, Willingway has the burden of establishing a prima facie case of personal jurisdiction over BCBS. Madam v. Hall, 916 F.2d 1510, 1514 (11th Cir.1990); Morris v. SSE, Inc., 843 F.2d 489, 492 (11th Cir.1988), appeal after remand, 912 F.2d 1392 (11th Cir.1990); DeLong Equip. Co. v. Washington Mills Abrasive Co., 840 F.2d 843, 845 (11th Cir.1988). To do so Willing-way must present enough evidence to withstand a motion for directed verdict. Madam, 916 F.2d at 1514. The Court must accept as true all facts alleged in the complaint that are uncontroverted by the defendant’s affidavits. E.g., Madam, 916 F.2d at 1514; Cable/Home Communication Corp. v. Network Prod., Inc., 902 F.2d 829, 855 (11th Cir.1990). Where, however, the defendant’s affidavits and the plaintiffs assertions conflict, the Court must construe all reasonable inferences in favor of the plaintiff. E.g., Madam, 916 F.2d at 1514; Cable/Home Communication, 902 F.2d at 855.

B. Personal Jurisdiction vs. Service of Process

In determining whether to exercise personal jurisdiction, courts generally should first establish whether a defendant can properly be served with process under the applicable statutory authority, and then inquire if that service comports with the constitutional principles of due process. Sun Bank, N.A. v. E.F. Hutton & Co., 926 F.2d 1030, 1033 (11th Cir.1991) (diversity case); Go-Video, Inc. v. Akai Elec. Co., 885 F.2d 1406, 1413 (9th Cir.1989) (federal question case).

In federal question cases it is imperative that these two inquiries remain separate, see Charles Wright and Arthur Miller, 4 Federal Practice and Procedure § 1063 (1987), because federal statutes that provide nationwide service of process do not necessarily provide nationwide personal jurisdiction. Service of process and personal jurisdiction are linked only in so far as they both must be satisfied before a case can go forward. Id.

The U.S. Supreme Court has only spoken on how personal jurisdiction relates to nationwide service of process once. In Omni Capital Int'l v. Rudolf Wolff & Co., 484 U.S. 97, 104, 108 S.Ct. 404, 409, 98 L.Ed.2d 415 (1987), the Court commented on the distinction between the two concepts when it provided:

[Bjefore a court may exercise personal jurisdiction over a defendant, there must be more than notice to the defendant, and a constitutionally sufficient relationship between the defendant and the forum. There also must be a basis for the defendant’s amenability to service of summons. Absent consent, this means there must be authorization for service of summons on the defendant.

Id.

In Omni the Court was confronted with a federal question case where the controlling federal statute was silent as to service of process. The Court looked to Rule 4(e) of the Federal Rules of Civil Procedure, which provides that when determining jurisdiction, a federal court looks to either a federal statute or to the long-arm statute of the state in which the court sits. Id. at 105, 108 S.Ct. at 410. Since the statute in Omni did not provide for service of process, the Court concluded that the Louisiana Long-Arm Statute must be applied. Id. at 111, 108 S.Ct. at 413.

In so holding Omni does not reach the precise issue in this case, namely how is personal jurisdiction determined when a federal statute does provide for national service of process. The lower courts have generally gravitated towards applying a “national contacts” test. Wright and Miller, § 1067.1;

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870 F. Supp. 1102, 1994 WL 653519, Counsel Stack Legal Research, https://law.counselstack.com/opinion/willingway-hospital-inc-v-blue-cross-blue-shield-of-ohio-gasd-1994.