Willitts v. Life Insurance Company of North America (CIGNA)

CourtDistrict Court, D. Massachusetts
DecidedFebruary 25, 2021
Docket1:18-cv-11908
StatusUnknown

This text of Willitts v. Life Insurance Company of North America (CIGNA) (Willitts v. Life Insurance Company of North America (CIGNA)) 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
Willitts v. Life Insurance Company of North America (CIGNA), (D. Mass. 2021).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS

* JAMES A. WILLITTS, SR., * * Plaintiff, * * v. * * Civil Action No. 18-cv-11908-ADB LIFE INSURANCE COMPANY OF NORTH * AMERICA and GDF SUEZ ENERGY * NORTH AMERICA INC./ENGIE NORTH * AMERICA, INC., * * Defendants. * *

MEMORANDUM AND ORDER ON DEFENDANTS’ MOTIONS TO DISMISS

BURROUGHS, D.J. Plaintiff James A. Willitts, Sr., who is now proceeding pro se,1 brings this action against his former employer GDF Suez Energy North America Inc./Engie North America Inc. (“Engie”) and the employee disability insurance company, Life Insurance Company of North America (“LINA” and, with Engie, “Defendants”), claiming that Defendants failed to honor terms of his insurance benefits policy contract and that Engie wrongfully terminated him. [ECF No. 37 (“Am. Compl.”)].

1 Willitts had counsel when he filed his amended complaint, but his attorney withdrew before Willitts filed his opposition to Defendants’ motions to dismiss. See [ECF No. 32 (May 8, 2019 Notice of Appearance); ECF No. 37 (Sept. 12, 2019 filing of amended complaint); ECF No. 70 (July 7, 2020 Order granting motion to withdraw); ECF No. 72 (Aug. 19, 2020 opposition to motions to dismiss)]. Currently before the Court are Defendants’ motions to dismiss, [ECF Nos. 64 (LINA), 66 (Engie)], and Willitts’ motion for clarification, [ECF No. 74].2 For the reasons set forth below, Defendants’ motions are GRANTED and Willitts’ motion is DENIED as moot.3 I. BACKGROUND

For purposes of this Order, the Court draws the relevant facts from Willitts’ operative complaint, [Am. Compl.], and the documents attached thereto, Lydon v. Local 103, Int’l Brotherhood of Elec. Workers, 770 F.3d 48, 53 (1st Cir. 2014), and views them in the light most favorable to him, Ruivo v. Wells Fargo Bank, N.A., 766 F.3d 87, 90 (1st Cir. 2014). Willitts began working for Engie in April 2014. [Am. Compl. ¶ 7]. As part of his employment, he contracted to participate in the group disability benefits insurance plan, which is insured by LINA and administered by CIGNA.4 [Id. ¶¶ 8, 10]. On September 12, 2016, Willitts filed a short-term disability claim. [Id. ¶ 15]. Around the same time, he took a leave from work, pursuant to the Family Medical Leave Act (“FMLA”), which permits employees to take up to twelve weeks of leave under certain circumstances. See [ECF No. 39 at 15 (doctor’s letter

regarding FMLA leave)]. In a letter dated October 28, 2016, CIGNA informed Willitts that his short-term disability benefits had been approved only for the period September 16, 2016 through September 29, 2016. [Am. Compl. ¶ 16; ECF No. 38 at 55]. CIGNA’s letter stated that CIGNA would “continue to monitor [Willitts’] condition, and periodically, [would] request updated information to confirm [his] restrictions and limitations.” [ECF No. 38 at 55]. CIGNA informed

2 Through his motion for clarification, Willitts seeks additional information regarding the fact that LINA was acquired by another insurance company. See [ECF No. 74]. 3 Given that LINA is being dismissed from the case, its relationship with the company that acquired it and that company’s potential vicarious liability are irrelevant. 4 CIGNA is not a party to this case. Willitts that his claim would remain open through November 11, 2016, invited him to send additional medical paperwork if his disability extended beyond September 30, 2016 so that CIGNA could consider providing additional benefits, and noted that if he did not send additional paperwork, CIGNA would “assume [his] disability period has ended.” [Id.]. Willitts followed

up on his claims for two years but never received benefits beyond those he received for the fourteen-day period beginning September 16, 2016.5 [Am. Compl. ¶ 20]. Engie terminated Willitts on or about December 6, 2016. [Id. ¶¶ 22, 60]. Willitts alleges that Engie’s “termination of Willets [sic] employment was based on the fact that his physician cannot furnish ‘return to work/fitness for duty.’” [Id. ¶ 22]. On June 1, 2020, the Court dismissed six of the eight counts in Willitts’ operative complaint, finding that five of Willitts’ state law claims were preempted by the Employee Retirement Income Security Act of 1974 (“ERISA”) and that Willitts’ ERSIA claim failed because Willitts had not shown that Defendants abused their discretion in declining to extend his short-term disability benefits beyond September 29, 2016. [ECF No. 63 at 19]. The remaining

claims are: (1) a claim under Massachusetts General Laws Chapter 93A against both Engie and LINA for unfair or deceptive practices (Count VIII); and (2) a claim for wrongful termination/retaliation against Engie (Count IX). [Am. Compl. ¶¶ 57–66]. Willitts alleges that Defendants violated Chapter 93A by, among other things, acting unfairly and deceptively and violating other laws designed to protect the public’s health and safety, which resulted in injuries including his wrongful termination, violations of ERISA, and significant physical and emotional distress. [Id. ¶ 58]. With respect to his wrongful termination/retaliation claim, Willitts alleges

5 The amended complaint does not make clear whether, as part of the “follow ups,” Willitts submitted the additional medical paperwork referenced in CIGNA’s letter. See [Am. Compl. ¶¶ 18–20]. that Engie terminated him in December 2016 because he filed a short-term disability claim in September 2016. [Id. ¶¶ 59–66]. He also seems to allege that he was terminated because one of his medical providers had recommended to Engie, in September 2016, that Willitts exercise his rights under the FMLA. [Id. ¶ 61].

II. LEGAL STANDARD In reviewing a motion to dismiss under Rule 12(b)(6), the Court must accept as true all well-pleaded facts, analyze those facts in the light most favorable to the plaintiff, and draw all reasonable factual inferences in favor of the plaintiff. See Gilbert v. City of Chicopee, 915 F.3d 74, 80 (1st Cir. 2019). “[D]etailed factual allegations” are not required, but the complaint must set forth “more than labels and conclusions,” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007), and must contain “factual allegations, either direct or inferential, respecting each material element necessary to sustain recovery under some actionable legal theory,” Gagliardi v. Sullivan, 513 F.3d 301, 305 (1st Cir. 2008) (quoting Centro Medico del Turabo, Inc. v. Feliciano de Melecio, 406 F.3d 1, 6 (1st Cir. 2005)). The alleged facts must be sufficient to “state a claim to

relief that is plausible on its face.” Twombly, 550 U.S. at 570. “To cross the plausibility threshold a claim does not need to be probable, but it must give rise to more than a mere possibility of liability.” Grajales v. P.R. Ports Auth., 682 F.3d 40, 44–45 (1st Cir. 2012) (citing Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009)). “A determination of plausibility is ‘a context-specific task that requires the reviewing court to draw on its judicial experience and common sense.’” Id. at 44 (quoting Iqbal, 556 U.S. at 679). “[T]he complaint should be read as a whole, not parsed piece by piece to determine whether each allegation, in isolation, is plausible . . . .” Hernandez-Cuevas v. Taylor, 723 F.3d 91, 103 (1st Cir. 2013) (quoting Ocasio-Hernández v. Fortuño-Burset, 640 F.3d 1, 14 (1st Cir. 2011)).

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