Wall v. Reliance Standard Life Ins. Co.
| Decision Date | 01 June 2021 |
| Docket Number | Civ. Action No. 20-2075 (EGS) |
| Parties | LUCAS WALL, Plaintiff, v. RELIANCE STANDARD LIFE INSURANCE CO., Defendant. |
| Court | U.S. District Court — District of Columbia |
Plaintiff Lucas Wall ("Mr. Wall"), proceeding pro se, brings this lawsuit against Reliance Standard Life Insurance Company ("Reliance") seeking $10,000 in damages for: (1) harassment; (2) invasion of privacy; and intentional infliction of emotional distress arising out of the termination of his disability benefits. Compl., ECF No. 1-1 at 1-2. Mr. Wall filed his claim in the Small Claims and Conciliation Branch of the Superior Court of the District of Columbia, and Reliance removed the action to this court, alleging federal jurisdiction based on the Employment Retirement Income Security Act of 1974 ("ERISA") and 29 U.S.C. §§ 1132(e)(1) and 1132(f). Notice of Removal, ECF No. 1 at 2.
Pending before the Court is Mr. Wall's Motion for Leave to File Second Amended Complaint. See ECF No. 21. Upon
consideration of the motion, opposition, reply, and the applicable law, Mr. Wall's motion is GRANTED IN PART AND DENIED IN PART.
Mr. Wall alleges that his long-term disability benefits ("benefits") are provided by a policy underwritten and administered by Reliance for the employees of the American Association of State Highway & Transportation Officials, by whom he was employed from June 2008 until March 2012. Id. at 19-20. In March 2012, Mr. Wall became "Totally Disabled" due to Non-24-Hour Sleep/Wake Disorder. Id. at 20. Mr. Wall received benefits until January 29, 2020, when Reliance notified him that it was terminating his benefits. Id. at 21. Mr. Wall alleges that Reliance's "termination of [his] benefits was based in great part on a November 10, 2019, 'peer review' of his medical records by Defendant Dr. David Brodner." Id. Mr. Wall further alleges that in response to his appeal of the termination decision, Reliance "commissioned another 'peer review' by Defendant Dr. Tajuddin Jiva" and that Reliance denied his appeal on July 29, 2020. Id. at 21-22 Thereafter, Reliance had Mr. Wall undergo an Independent Medical Examination ("IME"), after which the termination of his benefits was reversed. Id. at 22. In response to the notification he received that his benefits were being reinstated, Mr. Wall "demanded [Reliance] revise theletter with five specific paragraphs ensuring [he] will be protected from its arbitrary and capricious decisionmaking in the future." Id. at 23.
Based on these alleged facts, Mr. Wall's Amended Complaint asserts the following claims: (1) demand for payment of interest, costs & fees, & judicial relief to ensure continued [] benefits under ERISA against Reliance, including violations of ERISA; (2) bad faith against all defendants and breach of implied contractual covenant of good faith and fair dealing, and violations of Pennsylvania insurance law by Reliance; (3) intentional infliction of emotional distress against all defendants; (4) negligence against all defendants; (5) harassment against Reliance; (6) invasion of privacy against Reliance; (7) medical malpractice against Dr. Brodner and Dr. Jiva. See id. at 24-62.
On September 14, 2020, Mr. Wall filed a Motion for Leave to File Amended Complaint, see ECF No. 16; but withdrew that motion on September 24, 2020, see ECF No. 20. On the same day, however, Mr. Wall filed a Motion for Leave to File Second Amended Complaint, see ECF No. 21; which the Court will construe as a Motion for Leave to File an Amended Complaint since Mr. Wall withdrew his first request for leave to file an amended complaint.
Federal Rule of Civil Procedure 15 provides that a plaintiff may amend his complaint more than 21 days after a responsive pleading has been filed with the consent of the defendant or the leave of court, see Fed. R. Civ. P. 15(a); and that "[t]he court should freely give leave when justice so requires," see Fed. R. Civ. P. 15(a)(2). "Courts may deny a motion to amend a complaint as futile . . . if the proposed claim would not survive a motion to dismiss." James Madison Ltd. By Hecht v. Ludwig, 82 F.3d 1085, 1099 (D.C. Cir. 1996) (citing Foman v. Davis, 371 U.S. 178, 182 (1962)). "[I]n assessing an argument that an amendment would be futile, the court must assess the proposed amendments under the same standard as would be applied to a motion to dismiss." Oladokun v. Corr. Treatment Facility, 5 F. Supp. 3d 7, 13 (D.D.C. 2013). "Because amendments are to be liberally granted, the non-movant bears the burden of showing why an amendment should not be allowed." Abdullah v. Washington, 530 F. Supp. 2d 112, 115 (D.D.C. 2008), app. dismissed, No. 08-7022, 2008 U.S. App. Lexis 9082 (D.C. Cir. Mar. 12, 2008) (citing Dove v. WMATA, 221 F.R.D. 246, 2476 (D.D.C. 2004).
A motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6) tests the legal sufficiency of a complaint. Browning v. Clinton, 292 F.3d 235, 242 (D.C. Cir. 2002). A complaint must contain "a short and plain statement of the claim showing that the pleader is entitled to relief, in order to give the defendant fair notice of what the . . . claim is and the grounds upon which it rests." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, (2007) (internal quotation marks omitted).
Despite this liberal pleading standard, to survive a motion to dismiss, a complaint "must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face." Ashcroft v. Iqbal, 556 U.S. 662, 678, (2009) (internal quotation marks omitted). A claim is facially plausible when the facts pled in the complaint allow the court to "draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. The standard does not amount to a "probability requirement," but it does require more than a "sheer possibility that a defendant has acted unlawfully." Id.
"[W]hen ruling on a defendant's motion to dismiss [pursuant to Rule 12(b)(6)], a judge must accept as true all of the factual allegations contained in the complaint." Atherton v. D.C. Office of the Mayor, 567 F.3d 672, 681 (D.C. Cir. 2009) (internal quotation marks omitted). "In determining whether acomplaint fails to state a claim, [the Court] may consider only the facts alleged in the complaint, any documents either attached to or incorporated in the complaint and matters of which [the Court] may take judicial notice." EEOC v. St. Francis Xavier Parochial Schl., 117 F.3d 621, 624 (D.C. Cir. 1997). In addition, the court must give the plaintiff the "benefit of all inferences that can be derived from the facts alleged." Kowal v. MCI Commc'ns Corp., 16 F.3d 1271, 1276 (D.C. Cir. 1994). A "pro se complaint is entitled to liberal construction." Washington v. Geren, 675 F. Supp. 2d 26, 31 (D.D.C. 2009) (citation omitted). Even so, "[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements" are not sufficient to state a claim. Iqbal, 556 U.S. at 678.
In Count I, Mr. Wall demands payment of interest, costs and fees from Reliance; judicial relief to ensure continued benefits under ERISA from Reliance, and contends that Reliance violated ERISA when it terminated his benefits for six months. Am. Compl., ECF No. 21 at 24-36.
ERISA's civil enforcement provision provides that "[a] civil action may be brought—(1) by a participant or beneficiary— ... (B) to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or toclarify his rights to future benefits under the terms of the plan." 29 U.S.C. § 1132(a)(1)(B).
Reliance argues that Mr. Wall's motion should be denied because he filed his Superior Court complaint prior to exhausting his administrative remedies as the appeal of the termination of his benefits was pending, and that his claims against Reliance are moot because Mr. Wall's benefits have since been reinstated. Opp'n, ECF No. 22 at 4-6. Reliance also argues that Mr. Wall's claims for interest, costs, or fees are "null" for the same reason. Id. at 11. Mr. Wall does not dispute that he filed his Superior Court complaint before he exhausted his administrative remedies, Reply, ECF No. 23 at 2; however, there is also no dispute that those remedies have been exhausted at this time.
"It is well established that, barring exceptional circumstances, plaintiffs seeking a determination pursuant to ERISA of rights under their pension plans 'must ... exhaust available administrative remedies under their ERISA-governed plans before they may bring suit in federal court.'" Communications Workers of America v. American Tel. and Tel. Co., 40 F.3d 426, 431 (D.C. Cir. 1994) (internal quotation marks and citations omitted). However, "[b]ecause ERISA itself does not specifically require the exhaustion of remedies available underpension plans, courts have applied this requirement as a matter of judicial discretion." Id. at 432. Among the reasons for applying this requirement is to avoid judicial review where "a plan's own remedial procedures [] resolve[s] [the] claims." Id.
Mr. Wall has now exhausted his administrative remedies and his benefits have been reinstated by Reliance. He seeks to amend his complaint to add, among other things, certain ERISA claims. As explained below, Mr. Wall states certain claims under ERISA. Accordingly, there is no reason for the Court to apply the exhaustion requirement at this time and dismiss Mr. Wall's complaint. The Court rejects Reliance's argument that Mr. Wall's claims are moot because his benefits have been reinstated, because Mr. Wall seeks to amend his complaint to assert different ERISA claims.
Mr. Wall alleges that Reliance has not paid the interest on the long-term disability benefits that were withheld for...
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