Benton v. Vanderbilt University
| Decision Date | 24 October 2000 |
| Docket Number | No. 3-99-0796.,3-99-0796. |
| Citation | 118 F.Supp.2d 877 |
| Parties | Larry Eugene BENTON, for himself and other similarly situated persons, Plaintiffs, v. The VANDERBILT UNIVERSITY, Defendant. |
| Court | U.S. District Court — Middle District of Tennessee |
Philip Leon Davidson, Nashville, TN, for Larry Eugene Benton.
John Shannon Bryant, Walker, Bryant & Tipps, Nashville, TN, for Vanderbilt University.
Pending before the court is the plaintiff's Motion to Remand for lack of Subject Matter Jurisdiction (Docket No. 11) and the defendant's Response (Docket No. 17). For the reasons stated herein, the plaintiff's motion will be GRANTED.
On December 13, 1998, the plaintiff was injured in an automobile accident, when the car in which he was a passenger was struck by a vehicle driven by Zella Lynn. ) Mr. Benton's injuries required hospitalization and prolonged physical therapy. Id., para. 2.1. Mr. Benton has medical insurance through his employer, Bridgestone/Firestone, which is provided through Blue Cross/Blue Shield of Tennessee ("BCBST"). Id., para. 2.3.
Mr. Benton's injuries were treated at Vanderbilt Hospital ("Vanderbilt"), which has signed an Institutional Agreement ("Agreement") with BCBST to serve as a Preferred Provider in its Preferred Provider Network. Id., paras. 2.4-2.5. Under the terms of that Agreement, Vanderbilt agreed to provide medical services to BCBST plan members and to seek reimbursement from BCBST. ) In exchange for becoming a Preferred Provider, Vanderbilt agreed to accept a reduced amount as payment for the provided services than would otherwise be charged. Id. According to section 6.1 of the Agreement,
[s]uch reimbursement as is described in this section shall represent the maximum amount payable to [Vanderbilt] for Covered Services and [Vanderbilt] shall not bill any BCBST Member for any contractual difference between billed charges and such reimbursement. [Vanderbilt] agrees that in no event, including, but not limited to, non-payment by BCBST (including non-payment as a result of [Vanderbilt's] failure to submit charges in accordance with Section 6.8), rebundling or down coding of charges by BCBST (as provided in Section 6.8), BCBST's insolvency, or breach of this Agreement, shall [Vanderbilt] bill, charge, collect a deposit from, seek compensation from, or have any recourse against BCBST Members or persons, other than BCBST, acting on behalf of BCBST Members, for Covered Services provided pursuant to this Agreement.
Id. In addition, section 6.2 provides that the "only charges for which a BCBST Member may be liable and be billed shall be those [Vanderbilt] services not covered under the applicable Member Benefit Agreement or for applicable deductibles, copayments and/or coinsurance." Id., para. 6.2. The plaintiff claims that the defendant, Vanderbilt, did not bill BCBST for the medical services provided to him as a result of his accident. )
The plaintiff filed a civil suit against Lynn in Coffee County Circuit Court, and Lynn has apparently admitted liability for the automobile accident. Id. at 2.2. On January 25, 1999, Vanderbilt filed a hospital lien under T.C.A. § 29-22-101, et seq., against any settlement or judgment recovered by Benton in the suit against Lynn. Id. at 2.6; Docket No. 1, para. 2.6.
On July 13, 1999, the plaintiff filed a class action suit against Vanderbilt in the Circuit Court for Davidson County, Tennessee for abuse of process and breach of contract. The plaintiff alleges that Vanderbilt's hospital lien has injured his financial standing and interfered with his right to compromise and to settle his tort claim against Mr. Lynn. In addition, the plaintiff claims that the filing of the lien was a breach of the Agreement between BCBST and Vanderbilt, and that, as a third party beneficiary of that Agreement, the plaintiff was injured by the breach.
On August 18, 1999, Vanderbilt removed the case from Davidson County Circuit Court to this court. (Docket No. 1) Vanderbilt claims that this court has original subject matter jurisdiction pursuant to 28 U.S.C. § 1331, because all or part of the relief sought by the plaintiff arises under the laws of the United States, including the Employment Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001, et seq. Id. The plaintiff filed a motion to remand the case for lack of subject matter jurisdiction on the grounds that the plaintiff's claims are solely state claims. (Docket No. 11) The defendant has responded that the case is a superseding ERISA action under the civil enforcement provisions of 29 U.S.C. § 1132(a) and is thus removable to federal court as a federal cause of action. (Docket No. 17)
Under 28 U.S.C. § 1441(a), "any civil action brought in a State court of which the district courts of the United States have original jurisdiction, may be removed by the defendant or the defendants, to the district court of the United States for the district and division embracing the place where such action is pending." The district courts have original jurisdiction over "federal question" cases, those cases "arising under the Constitution, laws or treaties of the United States." 28 U.S.C. § 1331. The defendant removed this case from the Davidson County Circuit Court on the ground that this case presents a federal question regarding an ERISA claim.
In his Complaint, the plaintiff asserted claims of abuse of process and breach of contract, relating to the defendant's contract with Blue Cross / Blue Shield of Tennessee to provide medical services to insureds such as the plaintiff. ) On its face, the Complaint presents only state law claims. As the Supreme Court noted in Metropolitan Life Ins. Co. v. Taylor, "[i]t is long settled law that a cause of action arises under federal law only when the plaintiff's well-pleaded complaint raises issues of federal law." 481 U.S. 58, 63, 107 S.Ct. 1542, 1546, 95 L.Ed.2d 55 (1987) (citing Gully v. First Nat'l Bank, 299 U.S. 109, 57 S.Ct. 96, 81 L.Ed. 70 (1936); Louisville & Nashville R. Co. v. Mottley, 211 U.S. 149, 29 S.Ct. 42, 53 L.Ed. 126 (1908)). "One corollary of the well-pleaded complaint rule developed in the case law, however, is that Congress may so completely pre-empt a particular area that any civil complaint raising this select group of claims is necessarily federal in character." Id. at 63-64, 107 S.Ct. at 1546; see also Warner v. Ford Motor Co., 46 F.3d 531, 532-33 (6th Cir.1995). In these cases, federal subject matter exists, and the case is removable to federal court, even if the complaint alleges only state law causes of action.
In Metropolitan Life, the Court found that such "complete preemption" may apply in cases involving ERISA plans, making the cases removable to federal court. See 481 U.S. at 66, 107 S.Ct. at 1547. Under ERISA, state law may be preempted if it "relates to" an ERISA plan, under 29 U.S.C. § 1144(a). See Cromwell v. Equicor-Equitable HCA Corp., 944 F.2d 1272, 1275 (6th Cir.1991). As the Sixth Circuit has noted, "[t]he phrase `relate to' is given broad meaning such that a state law cause of action is preempted if `it has connection with or reference to that [ERISA] plan.'" Id. (quoting Metropolitan Life Ins. Co. v. Mass., 471 U.S. 724, 730, 732-33, 105 S.Ct. 2380, 2385-86, 85 L.Ed.2d 728 (1985); Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983)).
If a cause of action is found to relate to an ERISA plan, then it may be preempted, but "ERISA preemption, without more, does not convert a state claim into an action arising under federal law." Metropolitan Life, 481 U.S. at 64, 107 S.Ct. at 1547. As the Sixth Circuit has found, Warner, 46 F.3d at 534. In order to be completely preempted, and thus removable to federal court, the court must find that the state law cause of action "should be characterized as a superseding ERISA action `to recover benefits due him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan,' as provided in § 1132(a)(1)(B)." Warner, 46 F.3d at 534; see also Toumajian v. Frailey, 135 F.3d 648, 654 (9th Cir.1998).
Under section 1132(a)(1)(B), "a civil action may be brought by a participant or beneficiary to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan." 29 U.S.C. § 1132(a)(1)(B) (1994). There are two separate elements that must be met for this cause of action. First, the plaintiff must be eligible to bring a claim under § 1132. The defendant has not challenged plaintiff's status as a plan member.1 Second, the claims made by the plaintiff must be re-characterized as an action to recover benefits, to enforce rights, or to clarify rights to future benefits under the terms of his ERISA plan. If these elements are met, then the case was properly removed to this court.
The burden of establishing that removal was proper rests with the defendant as the removing party. See Her Majesty the Queen v. Detroit, 874 F.2d 332, 339 (6th Cir.1989). "When the party asserting federal jurisdiction finds its allegations challenged, it must submit evidence substantiating its claims." Community Ins. Co. v. Rowe, 85 F.Supp.2d 800, 804 (S.D.Ohio 1999) (citing Amen v. City of Dearborn, 532 F.2d 554, 560 (6th Cir. 1976)). "The removing defendant's burden is to prove, by a preponderance of the...
To continue reading
Request your trial
-
Coker v. Purdue Pharma Co.
...rights against Defendants, and therefore Plaintiff could not enforce any ERISA rights against Defendants. See Benton v. Vanderbilt Univ., 118 F.Supp.2d 877, 884 (M.D.Tenn.2000). Finally, the language of § 1132(a), referring specifically to rights or benefits "under the terms of the plan," r......
-
Hechter v. Nationwide Fire Ins. Co.
...the option of leaving with one year of benefits). This Court finds Benton v. Vanderbilt University particularly instructive. 118 F. Supp. 2d 877 (M.D. Tenn. 2000). In Benton, plaintiff, a participant in employee benefit plan, brought a state-court action against a hospital after receiving t......
-
Consumer Protection and Deceptive Trade Practices
...memorandum in support, Plaintiff’s state-law claims are not preempted by ERISA. See, e.g., Benton v. Vanderbilt University , 118 F. Supp. 2d 877 (M.D. Tenn. 2000) (no ERISA preemption where the defendant healthcare provider was not a party to an ERISA agreement). 11. Plaintiff further moves......