Huss v. Green Spring Health Services, Inc., CIV.A.98-59 MMS.

• Decision Date: 19 August 1998
• Docket Number: No. CIV.A.98-59 MMS.,CIV.A.98-59 MMS.
• Citation: 18 F.Supp.2d 400
• Parties: Doris HUSS, Mother, Administratrix and Personal Representative of the Estate of Jacob Carl Stefanide, Plaintiff, v. GREEN SPRING HEALTH SERVICES, INC., t/a Green Spring of Eastern Pennsylvania, Amerihealth Insurance Co., n/k/a/ QCC Insurance Company, Amerihealth HMO, Inc., Keystone Health Plan East, Inc., and Independence Blue Cross Corporation, Defendants.
• Court: U.S. District Court — District of Delaware

18 F.Supp.2d 400

Doris HUSS, Mother, Administratrix and Personal Representative of the Estate of Jacob Carl Stefanide, Plaintiff, v. GREEN SPRING HEALTH SERVICES, INC., t/a Green Spring of Eastern Pennsylvania, Amerihealth Insurance Co., n/k/a/ QCC Insurance Company, Amerihealth HMO, Inc., Keystone Health Plan East, Inc., and Independence Blue Cross Corporation, Defendants.

No. CIV.A.98-59 MMS.

United States District Court, D. Delaware.

August 19, 1998.

Francis G.X. Pileggi of Manta and Welge, Wilmington, Delaware, for plaintiff.

Joseph Grey of Prickett, Jones, Elliott, Kristol & Schnee, Wilmington, Delaware; Of Counsel: E. Dale Adkins, III, and M. Bradley Hallwig of Anderson, Coe & King, L.L.P., Baltimore, Maryland, for defendant Green Spring Health Services, Inc., t/a Green Spring of Eastern Pennsylvania.

John A. Parkins, Jr., Richards, Layton & Finger, Wilmington, Delaware; Of Counsel: Jay H. Calvert, Jr., and Thomas P. Hogan, Jr. of Morgan, Lewis & Bockius LLP, Philadelphia, Pennsylvania, for defendants Amerihealth HMO, Inc., Keystone Health Plan East, Inc., Amerihealth Insurance Co., n/k/a/ QCC Insurance Company, and Independence Blue Cross Corporation.

OPINION

MURRAY M. SCHWARTZ, Senior District Judge.

INTRODUCTION

On February 2, 1998, plaintiff Doris Huss, mother of Jacob Stefanide, brought this action against Green Spring Health Services, Inc. ("Green Spring"), AmeriHealth Insurance Co. ("AmeriHealth"), QCC Insurance Company ("QCC"), AmeriHealth HMO, Inc. ("AmeriHealth"),¹ Keystone Health Plan East, Inc. ("Keystone"), and Independence Blue Cross Corporation ("Blue Cross"). Plaintiff, who is the administratrix and personal representative of Jacob's estate, alleges the defendants' breach of contract, breach of fiduciary duty and medical malpractice led to Jacob's suicide. Plaintiff asserts jurisdiction pursuant to 28. U.S.C. § 1332, diversity jurisdiction, and seeks compensatory and punitive damages only.² Defendants' filed motions to dismiss pursuant to Fed.R.Civ.P. 12(b)(6), arguing that plaintiff's state law claims are preempted by the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001 et seq.³ For the following reasons, defendants' motions will be granted.

STANDARD OF REVIEW

The purpose of a 12(b)(6) analysis is to determine "not whether a plaintiff will ultimately prevail but whether the claimant is entitled to offer evidence to support the claim." Scheuer v. Rhodes, 416 U.S. 232, 236, 94 S.Ct. 1683, 40 L.Ed.2d 90 (1974). In considering a motion to dismiss under Rule 12(b)(6), the court is "required to accept as true all allegations in the complaint and all reasonable inferences that can be drawn from them after construing them in the light most favorable to the non-movant." Jordan v. Fox, 20 F.3d 1250, 1261 (3d Cir.1994) (citing Rocks v. City of Philadelphia, 868 F.2d 644, 645 (3d Cir.1989)); D.P. Enters., Inc. v. Bucks County Community College, 725 F.2d 943, 944 (3d Cir.1984). Further, in determining whether a claim should be dismissed under Rule 12(b)(6),

a court looks only to the facts alleged in the complaint and its attachments without reference to other parts of the record. Moreover, a case should not be dismissed for failure to state a claim unless it clearly appears that no relief can be granted under any set of facts that could be proved consistently with the plaintiff's allegations.

Jordan, 20 F.3d at 1261 (citing Hishon v. King & Spalding, 467 U.S. 69 73, 104 S.Ct. 2229, 81 L.Ed.2d 59 (1984); D.P. Enters., 725 F.2d at 944)). The moving party has the burden of persuasion. Kehr Packages, Inc. v. Fidelcor, Inc., 926 F.2d 1406, 1409 (3rd Cir.1991).

STATEMENT OF FACTS

Jacob Stefanide was suffering from a depressive psychiatric disorder. On December 16, 1997, Jacob's mother called Green Spring⁴ in order to obtain a referral to a psychiatrist, thereby fulfilling one of the preconditions for coverage under the Keystone benefit plan. Although the family's coverage became effective on December 3, 1997 and all premiums had been paid, Green Spring and/or Keystone erroneously informed Jacob's mother on December 16 that no members of the family were enrolled. On December 19, 1997, Jacob's mother called Green Spring a second time to try to arrange for emergency medical care for her son. She was again inaccurately told that no members of her family were enrolled in the Keystone Health Plan. On December 23, 1997, a representative of AmeriHealth, which administered the benefit plan, met with Jacob's mother and advised her that the Member Services department would re-enroll all members of the family as policyholders on that date. At approximately 4:00 p .m. on December 23, 1997, Jacob committed suicide. On the same day, after Jacob's death, Green Spring called Jacob's mother to give her the name of a psychologist for Jacob.

DISCUSSION

I. Jurisdiction

Green Spring asserts it cannot remain a defendant because no diversity exists between plaintiff and Green Spring. Plaintiff is a Delaware resident and Green Spring is a Delaware corporation. For diversity jurisdiction under 28 U.S.C. § 1332, all defendants must be diverse from all plaintiffs. See Strawbridge v. Curtiss, 3 Cranch 267, 7 U.S. 267, 2 L.Ed. 435 (1806); see also ERWIN CHEMERINSKY, FEDERAL JURISDICTION § 5.3.3, at 280-281 (2d ed.1994). If "complete diversity" does not exist, in other words, "where co-citizens appear[] on both sides of a dispute, jurisdiction [is] lost." State Farm Fire & Casualty Co. v. Tashire, 386 U.S. 523, 530-531, 87 S.Ct. 1199, 18 L.Ed.2d 270 (1967). Consequently, the Court can not exercise diversity jurisdiction over any of the defendants.

Despite the failure of plaintiff's asserted basis for jurisdiction, the Third Circuit Court of Appeals has taught that the Court should "consider[] whether the suit raises a federal question to support jurisdiction on grounds other than diversity." Virgin Islands Housing Auth. v. Coastal Gen. Const., 27 F.3d 911, 914-915 n. 2 (3d Cir.1994); see also 5 CHARLES A. WRIGHT & ARTHUR R. MILLER, FEDERAL PRACTICE AND PROCEDURE § 1210, at 121 (stating that "[a] reference to the wrong statute or an erroneous basis of jurisdiction will be corrected by the court if it can determine the appropriate statute or jurisdictional source from the complaint"), quoted with approval in Boarhead Corp. v. Erickson, 923 F.2d 1011, 1018 (3d Cir.1991). Because the complaint clearly sounds in ERISA, the Court will assert federal question jurisdiction pursuant to 28 U.S.C. § 1331.

II. Pre-emption

The primary question before the Court is whether plaintiff's breach of contract, breach of fiduciary duty, and medical malpractice claims are preempted by ERISA. ERISA was intended to protect the interests of employees and their beneficiaries by supplanting piecemeal state regulation of employee benefit plans with comprehensive, uniform federal regulation of such plans. See 29 U.S.C. § 1001(b); FMC Corp. v. Holliday, 498 U.S. 52, 56-60, 111 S.Ct. 403, 112 L.Ed.2d 356 (1990). In an attempt to achieve this goal, among others, ERISA "supersede[s] any and all State laws insofar as they may now or hereafter relate to any employee benefit plan[⁵] not exempt under section 1003(b) of this title."⁶ 29 U.S.C. § 1144(a).

The preemption analysis is guided by congressional intent, see Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 45, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987), and ERISA's preemption clause was "deliberately expansive ... to establish pension plan regulation as exclusively a federal concern." See id. at 46, 107 S.Ct. 1549 (internal quotation omitted).⁷ Plaintiff concedes that whether ERISA preempts such state claims depends on whether the claims "relate to" an ERISA plan. 29 U.S.C. § 1144(a). A state law "relates to" an employee benefit plan if it has "a connection with or reference to such a plan." Shaw v. Delta Air Lines, 463 U.S. 85, 96-97, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983). Therefore, although preemption is not limitless,⁸ a state law may "relate to" an employee benefit plan even if the law was not created to affect the plan, see id. at 47-48, 107 S.Ct. 1549, or the effect is only indirect. See Ingersoll-Rand Co. v. McClendon, 498 U.S. 133, 138-139, 111 S.Ct. 478, 112 L.Ed.2d 474 (1990).

The Supreme Court has taught Congress clearly intended that "all suits brought by beneficiaries or participants asserting improper processing of claims under ERISA-regulated plans be treated as federal questions governed by § 502(a)." Pilot Life, 481 U.S. at 56, 107 S.Ct. 1549. As a result, the Supreme Court has held that ERISA's preemption clause applied to a plaintiff's claims of tortious breach of contract, breach of fiduciary duties and fraud in the inducement arising out of an insurance company's failure to pay benefits owed. See id. at 48, 57, 107 S.Ct. 1549. Cf. Ingersoll-Rand, 498 U.S. at 140, 111 S.Ct. 478 (holding that state tort claims arising out of a wrongful discharge allegedly committed in an effort to avoid paying out pension benefits were preempted); Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 64, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987) (stating that state law claims for breach of contract, wrongful termination, and retaliation were preempted).

Although the Third Circuit Court of Appeals has not specifically addressed the question presented in the case at bar, the appellate court has discussed the relationship between state medical malpractice claims and ERISA's enforcement provision. In Dukes v. U.S. Healthcare, Inc., 57 F.3d 350 (3d Cir.), cert. denied, 516 U.S. 1009, 116 S.Ct. 564, 133 L.Ed.2d 489 (1995), plaintiffs from two cases joined for decision were suing a health maintenance organization for injuries arising from the medical malpractice of several affiliated hospitals and health care professionals. See id. at 351. In one case a health facility had refused to perform a blood test, leading to a delayed detection of a high blood sugar level and, allegedly, to the...