Davis v. The Prudential Insurance Company of America
OPINION. Signed by Honorable Judge Myron H. Thompson on 9/29/2015. (wcl, )
IN THE DISTRICT COURT OF THE UNITED STATES FOR THE
MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION
CHARLES M. DAVIS,
THE PRUDENTIAL INSURANCE
COMPANY OF AMERICA,
CIVIL ACTION NO.
insurance claim for disability benefits.
removed this case from state court to this federal court
under 28 U.S.C. § 1441, asserting that Davis’s claims are
‘completely preempted’ by the Employee Retirement Income
Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et
seq., and thus the court has jurisdiction under 28 U.S.C.
The case is now before this court on Prudential’s
motion to dismiss for failure to state a claim.
granted, and the complaint will be dismissed, albeit
without prejudice and with leave to amend.
I. LEGAL STANDARD
In considering a defendant’s motion to dismiss, the
court accepts the plaintiff’s allegations as true, Hishon
v. King & Spalding, 467 U.S. 69, 73 (1984), and construes
the complaint in the plaintiff’s favor, Duke v. Cleland,
5 F.3d 1399, 1402 (11th Cir. 1993).
“The issue is not
whether a plaintiff will ultimately prevail but whether
the claimant is entitled to offer evidence to support the
Scheuer v. Rhodes, 416 U.S. 232, 236 (1974).
To survive a motion to dismiss, a complaint need not
contain “detailed factual allegations,” Bell Atl. Corp.
v. Twombly, 550 U.S. 544, 545 (2007), “only enough facts
to state a claim to relief that is plausible on its
Id. at 574.
Davis’s workplace disability claim. Davis worked as a
customer service representative at a bottling plant in
southeast Alabama for some time before stopping due to
severe headaches and visual dysfunction in mid-2012.
Based on these conditions, he filed a disability claim
with Prudential under a benefits plan provided by his
Davis’s file, Prudential denied his claim. About a month
later, Prudential denied the claim for a second time
after examining additional medical records.
Davis filed suit in an Alabama state court against
Prudential for wrongful denial of his benefit claim.
alleges that Prudential breached its contract because it
“refused ... and has continued to refuse” coverage, and
that it has been unjustly enriched as a result. The
breach of contract and unjust enrichment counts are the
only causes of action in the complaint.
Prudential removed the case to this court and now
seeks to dismiss the case.
And, even if his claims are not preempted,
exhaustion and to exhaust his remedies, both of which are
required under ERISA.
Before reaching the merits, the court must consider
Chacon-Botero v. U.S. Atty. Gen., 427 F.3d 954, 956 (11th
Cir. 2005). Prudential removed the current action from a
state court to this federal court, alleging that this
court has federal-question jurisdiction under 28 U.S.C.
A defendant may remove any civil action where the
district court would have had original jurisdiction.
28 U.S.C. § 1441. A court has original federal-question
jurisdiction if a federal issue is apparent on the face
of the plaintiff’s complaint.
Merrell Dow Pharm.
Inc. v. Thompson, 478 U.S. 804, 808 (1986). Under this
well-pleaded complaint rule, “a defense that raises a
well-pleaded complaint rule--that the federal question
must be apparent on the face of the complaint--in cases
where Congress “so completely pre-empt[s] a particular
area that any civil complaint raising this select group
Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 63-64
(1987); Jones v. LMR Intern., Inc., 457 F.3d 1174, 1178
(11th Cir. 2006).
ERISA, which applies to “any employee benefit plan
... established or maintained ... by any employer engaged
in commerce or in any industry or activity affecting
commerce,” is one such case of complete preemption. 29
U.S.C. § 1003(a).
The Eleventh Circuit Court of Appeals
has adopted a two-part test to determine whether ERISA
completely preempts a state-law claim: “(1) whether the
plaintiff could have brought its claim under § 502(a);
plaintiff’s claim.” Connecticut State Dental Ass'n v.
Anthem Health Plans, Inc., 591 F.3d 1337, 1345 (11th Cir.
2009) (citing Aetna Health Inc. v. Davila, 542 U.S. 200,
210 (2004)). If an ERISA claim is completely preempted,
“state law claims that seek relief available under ERISA
are recharacterized as ERISA claims” for the purpose of
jurisdiction and thus “arise under federal law.” LMR, 457
F.3d at 1178.
Davis’s claims meet both prongs of the test. First,
Davis could have brought the claims under ERISA.
§ 502(a) states that a participant or beneficiary of an
employee insurance plan may bring an action to recover
benefits or enforce his rights under a plan.
In this case, neither party disputes that the
long-term disability plan is an employee insurance plan
subject to ERISA.1
Davis, as a participant, is suing for
Prudential refused to pay benefits.
Rather than suing
under state law, Davis could have brought an action for
denial of benefits under § 502(a).
Second, the theories upon which Davis based his
claims “did not arise independently” from his ERISA plan.
Anthem, 591 F.3d at 1346.
There is no independent legal
1. In Davis’s opposition to the motion to dismiss, he
does not address jurisdiction or preemption. However,
when rebutting Prudential’s contention that he failed to
exhaust the company’s administrative remedies, he does
not contend that ERISA does not apply. Instead, he argues
that he met the exhaustion requirement under ERISA,
suggesting that he accepts ERISA’s applicability.
duty in an ERISA case if “interpretation of the terms of
[the] benefit plan forms an essential part” of the
legal claim. Davila, 542 U.S. at 213.
Here, Davis argues
that Prudential should have paid him disability benefits
under the plan, but did not. To determine the merits of
Davis’s legal claims, the court would have to understand
the terms of the disability plan and whether Davis’s
ailments fell under these terms. In other words, the
interpretation of the plan. As such, no other independent
legal duty supports the claims.
Because Davis could have brought his legal claims
under § 502(a) and did not have an independent basis for
the claims, they are completely preempted by federal law.
Therefore, the claims arise under federal law, and the
court has proper federal-question jurisdiction.
B. Defensive Preemption
Given that there is subject-matter jurisdiction, the
court turns to Prudential’s motion to dismiss. Prudential
first argues that Davis’s complaint should be dismissed
because ERISA preempts his state-law claims.
“Unlike complete preemption, which
is jurisdictional, defensive preemption is a substantive
defense, justifying dismissal of preempted state law
claims.” LMR, 457 F.3d at 1179.
ERISA preempts “any and
all State” law claims if the claims relate to an ERISA
29 U.S.C. § 1444(a) (emphasis added); id.
whether a law relates to an ERISA plan
is one of Congressional intent.
Shaw v. Delta Air Lines,
2. Courts have recognized that “[c]omplete preemption
is narrower than defensive preemption.” Anthem Health
Plans, 591 F.3d at 1343 (internal quotation marks
omitted). In other words, if a state-law claim is
completely preempted under the narrower test, it will
likely also be preempted under the broader defensive
Congress did not simply intend to counteract state laws
connection with or reference to such a plan.”
97; LMR, 457 F.3d at 1179-80.
Under this broad standard,
courts have regularly dismissed breach-of-contract and
provider’s failure to pay a claim.
See, e.g., LMR, 457
fraud claims against employer who failed to fund the
Davis claims that Prudential breached its contract
and was unjustly enriched when it refused to pay his
These two claims not only reference
the ERISA plan, but are based entirely on the plan.
are classic examples of state-law claims that relate to
an ERISA plan and are thus preempted under federal law.
Because Davis’s only claims are state-law claims and
are both preempted under ERISA, the court grants the
motion to dismiss.3
An appropriate judgment will be entered granting
DONE, this the 29th day of September, 2015.
/s/ Myron H. Thompson
UNITED STATES DISTRICT JUDGE
3. The court also questions whether Davis’s
contention that Prudential “has continued to refuse
coverage” meets the exhaustion pleading requirement. The
court need not decide this issue, or whether Davis
actually exhausted Prudential’s appeals process, given
that both of Davis’s claims are preempted by federal law.
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