Mccravy v. Metro. Life Ins. Co., C.A. No.: 2:08–1933–PMD.

• Decision Date: 12 June 2009
• Docket Number: C.A. No.: 2:08–1933–PMD.
• Citation: 743 F.Supp.2d 511
• Court: U.S. District Court — District of South Carolina
• Parties: Debbie McCRAVY, Plaintiff,v.METROPOLITAN LIFE INSURANCE COMPANY, Defendant.

743 F.Supp.2d 511

Debbie McCRAVY, Plaintiff,

v.METROPOLITAN LIFE INSURANCE COMPANY, Defendant.

C.A. No.: 2:08–1933–PMD.

United States District Court, D. South Carolina, Charleston Division.

June 12, 2009.

Robert Edward Hoskins, Foster and Foster, Greenville, SC, for Plaintiff.James Derrick Quattlebaum, Joshua D. Spencer, Haynsworth Sinkler Boyd, Greenville, SC, for Defendant.

ORDER

PATRICK MICHAEL DUFFY, District Judge.

This matter is before the Court for review of Metropolitan Life Insurance Company's decision to not disburse benefits to Debbie McCravy under an accidental death and dismemberment plan governed by ERISA.¹ Defendant has filed a Memorandum in Support of Preemption of Plaintiff's State Law Claims, which, with the agreement of the parties, this Court treats as a Rule 12 Motion to Dismiss. For the reasons set forth herein, the Court grants in part and denies in part Defendant's Motion.

BACKGROUND

Plaintiff Debbie McCravy (“Plaintiff” or “McCravy”) is a full-time employee of Bank of America, and as an employee is eligible to participate in Bank of America's life insurance and accidental death and dismemberment plan (“the Plan”), which was issued and administered by Defendant Metropolitan Life Insurance Company (“Defendant” or “MetLife”), making it a fiduciary to Plaintiff under ERISA. There were several different aspects to this plan. If McCravy, the insured, were to suffer an accidental death or dismemberment, her beneficiaries would receive benefits. Also, if any of McCravy's dependents were to suffer an accidental death or dismemberment, McCravy, the insured, would receive benefits.

In 2007, McCravy's daughter, Leslie McCravy (“Leslie”), was tragically killed. Leslie was 25 years of age at the time of her death. Up until the time of her death, Leslie was named as a covered dependent on McCravy's insurance plan. McCravy had paid premiums, which had been accepted and retained by MetLife, to insure Leslie's life. Plaintiff asserts that this was a representation to her that Leslie was covered under the Plan, and claims that if Leslie had not been covered, she would have sought out different insurance coverage for her daughter. Plaintiff, who was the beneficiary of the policy in the event of her daughter's death, filed a claim for benefits under the Plan.

However, MetLife denied this claim on the grounds that Leslie was not eligible for coverage under the Plan because she was no longer a child within the definition of the Plan. The Plan provides that insureds may purchase accidental death and dismemberment coverage for “eligible dependent children.” The Plan goes on to specifically define eligible dependent children as the children of the insured who are unmarried, dependent upon the insured for financial support, and either (a) under the age of 19 or (b) under the age of 24 if enrolled full-time in a college, high school, or other equivalent educational program. Since Leslie was 25 at the time of her death, she no longer fit the Plan's description of eligible dependent children, and therefore, in Defendant's view, was ineligible for coverage under the Plan. Plaintiff appealed MetLife's denial of her claim, but the denial was affirmed.

Plaintiff initiated the action against Defendant by filing a Complaint in this Court on May 18, 2008. Plaintiff seeks damages on a claim that Defendant's actions constituted breach of fiduciary duty under ERISA, 29 U.S.C. § 1104. In the alternative that if it is determined that Leslie was not eligible for coverage under the Plan, Plaintiff stated that the claim would therefore not be governed by ERISA. However, Plaintiff asserted that she would still be entitled to damages under state law claims for (1) negligence, (2) promissory estoppel, and (3) breach of insurance contract.

On July 14, 2008, the Court issued an ERISA case management Order instructing both parties how to proceed in the case provided they both agreed that all claims were governed by ERISA. However, the parties did not agree that this was the case, and on September 17, 2008, Defendant filed a “Memorandum in Support of Preemption of Plaintiff's State Law Claims,” arguing that Plaintiff's three state law claims were preempted by ERISA. On September 22, Plaintiff filed a Reply to this Memorandum. In turn, Defendant filed a Reply to Plaintiff's Reply on October 2, to which Plaintiff filed a Sur–Reply on October 7. Plaintiff then filed two separate Notices of Supplemental Authority, the first on November 13 and the second on November 18. Defendant filed a Reply to these Notices on November 25, to which Plaintiff filed a Reply the same day.

The issue before the Court in this matter is whether or not Plaintiff's three claims brought under state law are preempted by ERISA. However, the procedural posture of this matter is somewhat unusual, in that no formal motion has been filed. Instead, Defendant filed a document entitled Memorandum in Support of Preemption of Plaintiff's State Law Claims. The basis for this Memorandum is that Defendant claims that all of Plaintiff's claims are essentially claims that Defendant breached its fiduciary duty to Plaintiff under ERISA, and therefore all of Plaintiff's state law claims fail as a matter of law and should be dismissed from this action. Accordingly, this Court treats this Memorandum as a Motion to Dismiss under Federal Rule of Procedure 12(b)(6).²

STANDARD OF REVIEW

A Rule 12(b)(6) motion should be granted only if, after accepting all well-pleaded allegations in the complaint as true, it appears certain that the plaintiff cannot prove any set of facts in support of his claims that entitles him to relief. See Edwards v. City of Goldsboro, 178 F.3d 231, 244 (4th Cir.1999). The complaint should not be dismissed unless it is certain that the plaintiff is not entitled to relief under any legal theory that might plausibly be suggested by the facts alleged. See Mylan Labs., Inc. v. Matkari, 7 F.3d 1130, 1134 (4th Cir.1993). Further, “[u]nder the liberal rules of federal pleading, a complaint should survive a motion to dismiss if it sets out facts sufficient for the court to infer that all the required elements of the cause of action are present.” Wolman v. Tose, 467 F.2d 29, 33 n. 5 (4th Cir.1972).

ANALYSIS

I. Defendant's Claim that Plaintiff's State Law Claims are Preempted by ERISA

ERISA pre-empts “any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.” White v. Provident Life & Accident Ins. Co., 114 F.3d 26, 29 (4th Cir.1997). “The scope of ERISA's pre-emption is deliberately expansive, and designed to establish pension plan regulation as exclusively a federal concern.” Wilmington Shipping Co. v. New England Life Ins. Co., 496 F.3d 326, 342 (4th Cir.2007); see also Aetna v. Davila, 542 U.S. 200, 210, 124 S.Ct. 2488, 159 L.Ed.2d 312 (2004) (“The purpose of ERISA is to provide a uniform federal regulatory regime over employee benefit plans. To this end, ERISA includes expansive preemption provisions which are intended to ensure that employee benefit plan regulation would be ‘exclusively a federal concern.’ ”) (internal citation omitted). Both the language and legislative history of that Act show that Congress intended ERISA to be the sole remedy for claims arising out of disputes regarding employee benefit plans. The Supreme Court has held that ERISA:

set[s] forth a comprehensive civil enforcement scheme that represents a careful balancing of the need for prompt and fair claims settlement procedures against the public interest in encouraging the formation of employee benefit plans. The policy choices reflected in the inclusion of certain remedies and the exclusion of others under the federal scheme would be completely undermined if ERISA-plan participants and beneficiaries were free to obtain remedies under state law that Congress rejected in ERISA.

Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 54, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987) (quoting

Massachusetts Mut. Life Ins. Co. v. Russell, 473 U.S. 134, 146, 105 S.Ct. 3085, 87 L.Ed.2d 96 (1985)) (emphasis in original).

ERISA specifically provides that it preempts any and all state laws which would give a party recourse for a provider's failure to comply with an obligation under an employee benefit plan. “[T]he provisions of [ERISA] shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan.” 29 U.S.C. § 1144. If a Plaintiff was allowed to vindicate his rights under an employee benefit plan through state law causes of action, this would effectively create a way around the provisions of ERISA, and threaten the stability and uniformity of federal employee benefit and pension law.

The Supreme Court of the United States has held that “[a] law ‘relates to’ an employee benefit plan, in the normal sense of the phrase, if it has a connection with or reference to such a plan.” Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96–97, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983). “Although the phrase ‘relates to’ has an expansive connotation, ERISA's preemptive scope is not unlimited, for ‘[i]f “relate to” were taken to extend to the furthest stretch of its indeterminacy, then for all practical purposes pre-emption would never run its course, for really, universally, relations stop nowhere.’ ” Great–West Life & Ann. Ins. Co. v. Inf. Sys. & Networks Corp., 523 F.3d 266, 270 (4th Cir.2008) (quoting N.Y. State Conf. of Blue Cross & Blue Shield Plans v. Travelers Ins. Co., 514 U.S. 645, 655, 115 S.Ct. 1671, 131 L.Ed.2d 695 (1995)). Section 1132 of ERISA provides the remedial provisions that are to be applied in situations where a participant or a beneficiary in an employee benefit plan claims that benefits were improperly and unlawfully withheld.

In the present matter, Plaintiff is claiming that she was entitled to certain benefits of her life insurance plan, which was provided to her as an employee of Bank of America. She claims that her...