Brown v. Aetna Life Ins. Co.

Citation975 F.Supp.2d 610
Decision Date27 September 2013
Docket NumberNo. EP–13–CV–131–KC.,EP–13–CV–131–KC.
PartiesRicky BROWN, Plaintiff, v. AETNA LIFE INSURANCE COMPANY, Energy Transfer Partners GP, L.P., and Energy Transfer Partners GP, L.P. Long Term Disability Plan, Defendants.
CourtU.S. District Court — Western District of Texas

OPINION TEXT STARTS HERE

Jeffrey B. Pownell, Attorney at Law, Joseph Isaac, Scherr & Legate, PLLC, El Paso, TX, for Plaintiff.

Christina L. McCracken, Gordon & Rees LLP, Dallas, TX, Jaclyn A. Hermes, Fulbright & Jaworski LLP, Houston, TX, for Defendants.

ORDER

KATHLEEN CARDONE, District Judge.

On this day, the Court considered Defendant Aetna Life Insurance Company's Motion and Brief in Support of its Motion to Dismiss for Failure to State a Claim for Relief (FRCP 12(b)(6)), and, In the Alternative, Motion to Strike (FRCP 12(f)) (“Aetna's Motion”), ECF No. 12, as well as Defendant Energy Transfer Partners GP, L.P.'s and Defendant Energy Partners GP, L.P. Long Term Disability Plan's Motion to Dismiss for Failure to State a Claim and Motion to Strike (“Energy Defendants' Motion”), ECF No. 13, in the above-captioned case (the “Case”). For the reasons set forth below, Aetna's Motion is GRANTED in part and DENIED in part. Likewise, Energy Defendants' Motion is GRANTED in part and DENIED in part.

I. BACKGROUNDA. Procedural History

On February 21, 2013, Plaintiff filed his Original Complaint in County Court at Law No. 5 in El Paso, Texas. Defs.' Notice of Removal Ex. 1 (Plaintiff's Original Complaint”), ECF No. 1–1. In the Original Complaint, Plaintiff claimed that Defendants are liable under 29 U.S.C. § 1132(a)(1)(B) for denying Plaintiff benefits under an employee benefit plan (the Plan) governed by the Employee Retirement Income Security Act, 29 U.S.C. §§ 1001–1461 (ERISA). Pl.'s Original Compl. ¶¶ 21–23. Plaintiff's Original Complaint included requests for extracontractual and punitive damages, as well as a demand for a jury trial. Id. ¶¶ 25, 27–28, 31. On April 19, 2013, Defendant Energy Transfer Partners GP, L.P. (Energy) and Defendant Energy Partners GP, L.P. Long Term Disability Plan (Energy Plan) (collectively, “Energy Defendants) removed the Case and invoked this Court's jurisdiction under 28 U.S.C. § 1331. Defs.' Notice of Removal, ECF No. 1.

Defendant Aetna Life Insurance Company (Aetna) then filed its Motion to Strike on May 8, 2013. [Aetna's] Motion and Brief in Support of its Motion to Strike (FRCP 12(f)), ECF No. 3 (the Motion to Strike). In the Motion to Strike, Aetna challenged the availability of extracontractual and punitive damages for violations of 29 U.S.C. § 1132(a)(1)(B), as well as Plaintiff's right to a jury trial for claims brought under this provision. Id. at 3–4.

On May 28, 2013, nearly three weeks after Aetna filed the Motion to Strike, but before the Court had an opportunity to rule on it, Plaintiff filed an Amended Complaint. Pl.'s Am. Compl., ECF No. 6. The Amended Complaint retains Plaintiff's original claim for denial of benefits under 29 U.S.C. § 1132(a)(1)(B) (“Count I”), and raises three new claims under various provisions of ERISA and federal common law. Id. ¶¶ 27–40. The first new claim (“Count II”) alleges that Defendants failed to comply with ERISA's disclosure obligations set forth in 29 U.S.C. §§ 1132(c), 1022(a), and 1024(b). Pl.'s Am. Compl. ¶¶ 31–33. The second (“Count III”) alleges that Defendants breached their fiduciary duties to Plaintiff under 29 U.S.C. §§ 1104(a)(1), 1132(a)(3), and 1109(a). Pl.'s Am. Compl. ¶¶ 34–38. The third new claim (“Count IV”) alleges that principles of federal common law estoppel and equity preclude Defendants from denying Plaintiff past and future disability benefits. Pl.'s Am. Compl. ¶¶ 39–40.

On June 26, 2013, Aetna filed Aetna's Motion in the Case. Aetna's Motion seeks to dismiss Counts II–IV against Aetna pursuant to Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim upon which the Court may grant relief. Aetna's Mot. 1. Aetna's Motion does not seek to dismiss Count I under Rule 12(b)(6). See id. Aetna's Motion also seeks to strike from the Amended Complaint Plaintiff's request for extracontractual and punitive damages, as well as Plaintiff's request for a jury trial. Id.

On the same day, Energy Defendants filed Energy Defendants' Motion. Like Aetna's Motion, Energy Defendants' Motion seeks to dismiss Counts II–IV, but not Count I, against Energy Defendants pursuant to Rule 12(b)(6). Energy Defendants' Mot. 1–2. Energy Defendants also seek to strike Plaintiff's claims for extracontractual and punitive damages and request for a jury trial. Id. at 2.

The Court granted the Motion to Strike on July 8, 2013. Order, ECF No. 14 (Motion to Strike Order”), 2013 WL 3442042. In granting the Motion to Strike, the Court “confine[d] its analysis to Plaintiff's claim for denial of benefits under 29 U.S.C. § 1132(a)(1)(B), and d[id] not address any aspects of the three new claims raised in Plaintiff's Amended Complaint.” Mot. to Strike Order 3, 11. In other words, the Court only ruled that Plaintiff could not seek extracontractual or punitive damages or obtain a jury trial pursuant to Count I.

Plaintiff filed a response opposing both Aetna's Motion and Energy Defendants' Motion on July 16, 2013. Plaintiff's Response in Opposition to Defendants' Motions to Dismiss For Failure to State A Claim Or Alternative Motions to Strike (Docs. 12, 13), Or Alternative Motion for Leave to Amend (the “Response”), ECF No. 17. Additionally and alternatively, the Response seeks leave to further amend the Amended Complaint in the event that the Court deems any of Counts II–IV vulnerable to a motion to dismiss. Id. at 9.

Energy Defendants filed a Reply to the Response on July 23, 2013. [Energy Defendants'] Reply in Support of [Energy Defendants' Motion] (the “Reply”), ECF No. 19.1 The docket does not reflect that Aetna has filed a similar reply in the Case.

This Order represents the Court's ruling on those issues left open by the Motion to Strike Order; namely, (1) whether to dismiss any or all of Counts II–IV against Aetna, Energy Defendants, or both for failure to state a claim on which relief may be granted; (2) whether extracontractual or punitive damages are available for any of Counts II–IV; and (3) whether Plaintiff is entitled to a jury trial on any of Counts II–IV against any Defendant.

B. Factual Background

Plaintiff alleges the following relevant facts, which the Court assumes to be true for the purposes of this Order:

At all times relevant to this lawsuit, Energy Defendants maintained and Aetna underwrote the Plan for the benefit of Energy's employees. Pl.'s Am. Compl. ¶ 8. The Plan is covered by ERISA. Id. Both Energy Defendants and Aetna at all relevant times participated in and/or exercised control over the administration and management of the Plan. Id.; id. Ex. A, ECF No. 6–1.

Plaintiff previously worked as a truck driver for Energy. Id. ¶ 6. On or about April 29, 2009, Plaintiff was injured at work while acting within the scope of his employment. Id. This injury rendered Plaintiff totally disabled and unable to keep gainful employment. Id. ¶ 7. Plaintiff's physicians, as well as the Department of Veterans Affairs (the “Department”), concurred that Plaintiff was totally and permanently disabled and therefore unemployable. Id. ¶¶ 7, 13.

As a result of his disability, Plaintiff was entitled to receive monthly benefits under the Plan, id. ¶ 9, and Defendants initially approved Plaintiff for such benefits, id. ¶ 10. However, on or about July 28, 2011, Defendants terminated Plaintiff's claim for benefits, claiming that Plaintiff had failed to submit documentation sufficient to establish a continuing disability. Id. ¶¶ 11, 13. Defendants did so even though the Department and Plaintiff's physicians concluded that Plaintiff was totally and permanently disabled and unable to work. Id. Defendants' actions amount to an intentional refusal, without any reasonable basis, to provide Plaintiff the benefits to which he was entitled under the Plan. Id. ¶¶ 11–20, 45. Also, prior to rejecting Plaintiff's claim for benefits, Defendants actively misrepresented to Plaintiff that he would be entitled to the benefits to which he was ultimately denied. Id. ¶¶ 12, 21, 45.

Defendants' actions have damaged Plaintiff by denying him the benefits to which he is entitled. Id. ¶¶ 14, 22. Defendants have further caused Plaintiff loss of income, financial despair, damage to credit and reputation, stress, frustration, anxiety, anger, and mental anguish. Id. ¶¶ 14, 22, 44.

Plaintiff has exhausted all administrative remedies under the Plan except where exhaustion of remedies is not required or where pursuit of administrative remedies would be futile. Id. ¶ 25. Plaintiff has likewise satisfied all conditions precedent necessary to bring Counts I–IV. Id.

II. DISCUSSIONA. Standard

A motion to dismiss pursuant to Rule 12(b)(6) challenges a complaint on the basis that it fails to state a claim upon which relief may be granted. Fed.R.Civ.P. 12(b)(6). When ruling on a Rule 12(b)(6) motion, the Court must accept well-pleaded facts as true and view them in the light most favorable to the plaintiff. Calhoun v. Hargrove, 312 F.3d 730, 733 (5th Cir.2002); Collins v. Morgan Stanley Dean Witter, 224 F.3d 496, 498 (5th Cir.2000). Though a complaint need not contain “detailed” factual allegations, a plaintiff's complaint must allege sufficient facts “to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007); accord Colony Ins. Co. v. Peachtree Constr., Ltd., 647 F.3d 248, 252 (5th Cir.2011). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009).

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