Harrison v. Metropolitan Life Ins. Co.
| Decision Date | 28 February 2006 |
| Docket Number | No. 05 CIV. 6386(VM).,05 CIV. 6386(VM). |
| Citation | 417 F.Supp.2d 424 |
| Parties | Gail HARRISON, Plaintiff, v. METROPOLITAN LIFE INSURANCE COMPANY, Horizon Blue Cross Blue Shield of New Jersey, and Empire Blue Cross Blue Shield of New York, Defendants. |
| Court | U.S. District Court — Southern District of New York |
Richard A. Dienst, Richard A. Dienst, Esq., New York, NY, for Plaintiff.
Allan Michael Marcus, Lester, Schwab, Katz and Dwyer LLP, Randy M. Mastro, Gibson, Dunn & Crutcher LLP, New York, NY, for Defendants.
DECISION AND ORDER
Plaintiff Gail Harrison ("Harrison") brought this action in New York Supreme Court as the beneficiary of a life insurance plan of her deceased husband, John H. Harrison ("John Harrison"). Defendants Metropolitan Life Insurance Company ("MetLife"), Horizon Blue Cross Blue Shield of New Jersey ("Horizon"), and Empire Blue Cross Blue Shield of New York ("Empire") removed the proceeding to federal court pursuant to 28 U.S.C. §§ 1441 and 1446. Harrison alleges breach of contract, breach of common law fiduciary duties, violation of New York Insurance Law § 3203(b)(1)(B), and breach of fiduciary duties pursuant to the federal Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132(a)(3). Harrison seeks monetary damages for each cause of action. Empire and MetLife (collectively, "Defendants"), move to dismiss the Complaint pursuant to Fed.R.Civ.P. 12(b)(6) for failure to state a claim.
Defendants' motion is granted in part and denied in part. It is granted with respect to Harrison's common law breach of contract and breach of fiduciary duty claims. These claims are preempted by ERISA and are accordingly dismissed. The motion is also granted with respect to Harrison's claim of violation of New York Insurance Law § 3203(b)(1)(B) because that provision does not apply to the life insurance plan offered to Empire employees, nor does it give rise to a private cause of action for damages. Defendants' motion is also granted with respect to Harrison's claim for breach of fiduciary duty pursuant to ERISA § 502(a)(3) (" § 502(a)(3)") because the relief sought pursuant to § 502(a)(3) is available under ERISA § 502(a)(1)(B) (" § 502(a)(1)(B)"). Finally, for the reasons set forth below, Defendants' motion to dismiss is denied with respect to Harrison's claim pursuant to § 502(a)(1)(B).
In ruling on Defendants' motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6), the Court accepts the following facts, which are alleged in Harrison's Complaint, as true for this purpose. See Chambers v. Time Warner, Inc., 282 F.3d 147, 152 (2d Cir.2002) (citing Gregory v. Daly, 243 F.3d 687, 691 (2d Cir.2001)).
This case arises from a tragic incident in which Harrison's late husband, John Harrison, shot and killed two co-workers before fatally shooting himself. The shootings occurred on September 16, 2002. At the time of the shootings, John Harrison was employed by Empire as Assistant Vice President of Fraud Control. John Harrison maintained a life insurance policy through a group life insurance plan (the "Plan") offered to Empire employees through MetLife. The Plan is governed by ERISA. Defendants are Plan fiduciaries pursuant to ERISA.
The Plan offered a minimum death benefit equal to the insured's base salary for one year. Participants also had the option of choosing a higher death benefit amount. John Harrison elected death benefits equal to five times his base salary, or $650,000. The Plan contained a provision excluding coverage for benefits in excess of the minimum benefit level if the insured committed suicide within two years of the "effective date" of the insured's participation in the Plan (the "suicide exclusion"). Specifically, the Summary Plan Description for the Plan (the "SPD") stated that "Life Benefits under options 2, 3, 4, and 5 will not be paid to the Beneficiary if you commit suicide within 2 years from the effective date of this certificate." (Compl. at ¶ 23.)
After John Harrison's death, Harrison, as beneficiary under the Plan, attempted to recover benefits due. MetLife paid Harrison $130,000, an amount equal to John Harrison's base salary. However, MetLife denied Harrison's claim for an additional $520,000 in benefits allegedly due as a result of John Harrison's election of the optional higher coverage. MetLife denied Harrison's claim for the additional $520,000 on the grounds that payment of those benefits was precluded by the Plan's suicide exclusion. MetLife concluded that John Harrison's suicide on September 16, 2002, was within two years of the effective date of his participation in the Plan and therefore warranted the denial. Harrison appealed MetLife's decision through the Plan's administrative remedies. The appeal was denied.
John Harrison's employment with Empire commenced in September 2001. Prior to his employment with Empire, John Harrison was employed by Horizon. During his employment at Horizon, from November 1992 through approximately September 9, 2001, he participated in a life insurance plan offered to Horizon employees (the "Horizon Plan").
Horizon is an "Affiliated Employer" of Empire. As a result of the "Affiliated Employer" relationship between Horizon and Empire, John Harrison's years of service at Horizon were included in calculations of his years of service at Empire for purposes of several seniority-related benefits pertaining to his employment at Empire, including, among others, vesting in Empire's Pension Plan, vacation allotment, and short-term disability allotment. According to the Complaint, John Harrison's period of service at Horizon "was or should have been" credited in calculating the "effective date" of his participation in the Plan. (Compl. at ¶ 19.) Alternatively, Harrison argues that the "effective date" of John Harrison's participation in the Plan dates back to the commencement of his participation in the Horizon Plan because the Empire Plan was a "substitute" or "replacement" for the Horizon Plan. (Compl. at ¶ 87.)
Harrison also asserts that the suicide exclusion does not preclude coverage for the additional optional benefits under the Plan because the term "suicide" in that provision must be interpreted to exclude suicide committed while the insured was insane, and that John Harrison was insane at the time of his death. The Complaint alleges that John Harrison sustained emotional trauma during the September 11, 2001 terrorist attack on the World Trade Center. He was at work at Empire's offices at the World Trade Center when that event occurred. After the attack, John Harrison's mental state gradually deteriorated. According to Harrison, at the time of John Harrison's death in September 2002, he was insane and lacked the mental capacity to resist an impulse to commit suicide.
In considering a motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6), the Court construes the complaint liberally, "accepting all factual allegations in the complaint as true, and drawing all reasonable inferences in the plaintiff's favor." Chambers, 282 F.3d at 152. However, mere "conclusions of law or unwarranted deductions of fact" need not be accepted as true. First Nationwide Bank v. Gelt Funding Corp., 27 F.3d 763, 771 (2d Cir.1994) (quotation marks and citation omitted). The Court should not dismiss a complaint for failure to state a claim "unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief." Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957).
In connection with the instant motion, both parties submitted materials extraneous to the Complaint. Harrison submitted an Affidavit from a report entitled "Psychological Autopsy of John H. Harrison," describing John Harrison's alleged mental state at the time of his suicide. (See Psychological Autopsy of John H. Harrison ("Psychological Autopsy"), attached as Exhibit A to Declaration of Richard A. Dienst in Opposition to Defendants' Motion to Dismiss, dated September 26, 2005.) Defendants submitted several documents related to the Plan, including the SPD (see Empire Blue Cross Blue Shield Group Life Insurance Benefits Plan, attached as Exhibit G to Declaration of Randy M. Mastro in Support of Defendant Empire Blue Cross Blue Shields of New York's Motion to Dismiss, dated August 22, 2005 ("Mastro Decl. 1")); newspaper articles concerning the September 16, 2002 shootings (see Devlin Barrett, Sources: Exec, a former FBI agent, kills 2 co-workers, self Associated Press State and Local Wire, Sept. 16, 2002; Austin Fenner, Ralph R. Ortega, and Michele McPhee, Bloody End to Office Affair, Daily News, Sept. 17, 2002, at 3, attached as Exhibit J to Mastro Decl. 1); and letters exchanged between MetLife and Harrison.1
In deciding a Rule 12(b)(6) motion, courts may consider "any written instrument attached to [the complaint] as an exhibit or any statements or documents incorporated in it by reference ... and documents that the plaintiffs either possessed or knew about and upon which they relied in bringing the suit." Rothman v. Gregor, 220 F.3d 81, 99-89 (2d Cir.2000) (citations omitted); see also Cosmas v. Hassett, 886 F.2d 8, 13 (2d Cir.1989). Harrison cites to the SPD in her Complaint, specifically quoting from the suicide exclusion. Accordingly, the Court may consider the SPD for the purposes of deciding this motion. However, the Court may not consider Defendants' other submissions for purposes of deciding this motion, as those documents were not incorporated by reference or cited to in the Complaint, and there is not sufficient indication that Harrison relied upon the documents in commencing this action. For the same reason, the Court excludes the Psychological Autopsy from consideration for purposes of...
To continue reading
Request your trial
-
Wurtz v. Rawlings Co.
...the first of which is that a plaintiff “could have brought his or her claim under ERISA § 502(a)(1)(B)”); Harrison v. Metro. Life Ins. Co., 417 F.Supp.2d 424, 434 (S.D.N.Y.2006). Section 502(a)(1)(B)'s language is clear: it provides an exclusive civil remedy to “participants or beneficiarie......
-
Shearon v. Comfort Tech Mech. Co.
...any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.” Harrison v. Metro. Life Ins. Co., 417 F.Supp.2d 424, 431 (S.D.N.Y.2006) (Marrero, J.) (dismissing state breach of fiduciary duty claim as preempted by ERISA). Any state law claim that “duplicat......
-
Hills v. Praxair, Inc.
...the elements of a claim, even if it fails to identify the specific laws under which it brings a claim." Harrison v. Metro Life Ins. Co., 417 F. Supp. 2d 424, 431 (S.D.N.Y. 2006) (citing Marbury Mgmt., Inc. v. Kohn, 629 F.2d 705, 712 n. 4 (2d Cir. 1980)). Anticipating this possibility, Aetna......
-
Nat'l Convention Servs. v. Applied Underwriters Captive Risk Assurance Co.
...expressly or impliedly provide for a private right of action as an enforcement mechanism. See, e.g. , Harrison v. Metro. Life Ins. Co. , 417 F.Supp.2d 424, 432 (S.D.N.Y. 2006) ; Soliman v. Daimler AG , No. CV 10–408 (SJF) (AKT), 2011 WL 765885, at *9 (E.D.N.Y. Feb. 9, 2011) (collecting case......