Oscar Vasquez v. Union Security Insurance Company et al

Filing 11

ORDER GRANTING Defendant's Motion to Dismiss Plaintiff's Complaint 6 by Judge Dean D. Pregerson. (MD JS-6. Case Terminated.) (jp)

1
2

O

3
4
5
6
7
8

UNITED STATES DISTRICT COURT

9

CENTRAL DISTRICT OF CALIFORNIA

10
11

OSCAR VASQUEZ, an
individual,

12
Plaintiff,
13
v.
14
15
16
17

UNION SECURITY INSURANCE
COMPANY, a Kansas
corporation; ASSURANT
EMPLOYEE BENEFITS, a Kansas
corporation; FORTIS BENEFITS
INSURANCE COMPANY, a Kansas
corporation,

18
Defendants.
19
___________________________

)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)

Case No. CV 12-01523 DDP (PJWx)
ORDER GRANTING DEFENDANT’S MOTION
TO DISMISS PLAINTIFFS’S
COMPLAINT

[Docket No. 6]

20
21

Presently before the court is Defendant Union Security

22

Insurance Company’s Motion to Dismiss Complaint.

23

the parties’ moving papers, the court grants the Motion and adopts

24

the following Order.

25

I. BACKGROUND

Having reviewed

26

Plaintiff filed his Complaint against Defendant Union Security

27

Instance Company (“USIC”), also known as Assurant Employee Benefits

28

and formerly known as Fortis Benefits Insurance, in state court, on

1

December 19, 2011.

2

him as a beneficiary of an employee welfare benefit plan issued by

3

USIC to Saturn Airport Marina, policy number G 4,027,296 (the

4

“Plan”). Plaintiff’s Complaint alleges seven causes of action: 1)

5

breach of written contract of insurance policy; 2) breach of

6

covenant of good faith and fair dealing; 3) negligent

7

misrepresentation; 4) conversion; 5) fraud and intentional

8

misrepresentation; 6) violation of Business and Professional Code §

9

17200, et seq; and 7) declaratory relief.

10

He seeks to recover benefits allegedly owed to

USIC now moves to dismiss Plaintiff’s Complaint.

USIC argues

11

that: 1) all of the claims in Plaintiff’s Complaint are state law

12

claims and directly relate to his claim for benefits under an

13

employee welfare benefit plan governed by the Employee Retirement

14

Income Security Act of 1974, 29 U.S.C. § 1001 (“ERISA”), and 2)

15

each of Plaintiff’s claims are preempted by the broad preemption

16

provided under ERISA and fail as a matter of law.

17

II. LEGAL STANDARD

18

A complaint will survive a motion to dismiss when it contains

19

“sufficient factual matter, accepted as true, to state a claim to

20

relief that is plausible on its face.” Ashcroft v. Iqbal, 129 S.

21

Ct. 1937, 1949 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S.

22

544, 570 (2007)).

23

must “accept as true all allegations of material fact and must

24

construe those facts in the light most favorable to the plaintiff.”

25

Resnick v. Hayes, 213 F.3d 443, 447 (9th Cir. 2000).

26

complaint need not include “detailed factual allegations,” it must

27

offer “more than an unadorned, the-defendant-unlawfully-harmed-me

28

accusation.”

When considering a Rule 12(b)(6) motion, a court

Iqbal, 129 S. Ct. at 1949.
2

Although a

Conclusory allegations or

1

allegations that are no more than a statement of a legal conclusion

2

“are not entitled to the assumption of truth.” Id. at 1950. In

3

other words, a pleading that merely offers “labels and

4

conclusions,” a “formulaic recitation of the elements,” or “naked

5

assertions” will not be sufficient to state a claim upon which

6

relief can be granted. Id. at 1949 (citations and internal

7

quotation marks omitted).

8

“When there are well-pleaded factual allegations, a court should

9

assume their veracity and then determine whether they plausibly

10

give rise to an entitlement of relief.” Id. at 1950. Plaintiffs

11

must allege “plausible grounds to infer” that their claims rise

12

“above the speculative level.” Twombly, 550 U.S. at 555-

13

56. “Determining whether a complaint states a plausible claim for

14

relief” is a “context-specific” task, “requiring the reviewing

15

court to draw on its judicial experience and common sense.” Iqbal,

16

129 S. Ct. at 1950.

17

III. DISCUSSION

18

ERISA applies to any employee welfare benefit plan that is

19

established or maintained by an employer engaged in commerce or in

20

any industry or activity affecting commerce. 29 U.S.C. §

21

1003(a)(1). A “welfare benefit plan” is a “plan, fund or program .

22

. . established or maintained by an employer . . . for the purposes

23

of providing for its participants . . . medical, surgical or

24

hospital care for benefits, or benefits in the event of sickness,

25

accident, disability, death, or unemployment. . . .”

26

1002(1).

27

benefits under a plan governed by ERISA, and completely preeempts

28

application of state law to an action based upon an insurer’s

29 U.S.C. §

ERISA provides the exclusive remedies for claims for

3

1

alleged failure to pay benefits under the terms of an ERISA plan.

2

29 U.S.C. § 1144(a).

3

by an employer, however, fall under a “safe harbor” provision, and

4

are exempt from ERISA coverage.

5

Plans which are not maintained or established

29 C.F.R. § 2510.3-1(j).

Here, Plaintiff appears to argue that ERISA preemption cannot

6

apply here because Plaintiff has not alleged that his employer is

7

involved in the Plan.

8

Plaintiff’s artful pleading, which makes no explicit reference to

9

Saturn Airport Marina’s involvement, cannot alone exempt the Plan

(Opp. at 3, 6-7.)

Plaintiff is wrong.

10

from ERISA coverage.

11

408 F.3d 1222, 1226 (9th Cir. 2005).

12

numerous references to the Plan, quotes portions of the Plan, and

13

purports to include the Plan as an attachment to the complaint.

14

(Complaint ¶¶ 20. 41.)

15

exhibit to the instant motion, is thus incorporated by reference

16

into the Complaint.

17

908 (9th Cir. 2003).

18

See Cleghorn v. Blue Shield of California,
Plaintiff’s complaint makes

The Plan, which is also attached as an

See United States v. Ritchie, 342 F.3d 903,

The plain language of the Plan establishes that Plaintiff’s

19

employer is involved in the Plan, and that ERISA does apply.

20

Plan describes the employer, Saturn Airport Marina, as the

21

policyholder, and sets out terms by which full time employees will

22

receive disability benefits.

23

Furthermore, the Plan provides that Saturn Airport Marina pays all

24

Plan costs.

25

welfare benefit plan subject to and regulated by ERISA pursuant to

26

29 U.S.C. § 1002.

(Id. At 215.)

The

(Mot. Ex. A at 212, 226, 231)

The Plan is, therefore, is an employee

27

Plaintiff’s breach of contract claim is based exclusively on

28

the contractual relationship with USIC that arises from the Plan.
4

1

Because this claim is based solely on his claim for benefits under

2

the Plan, the breach of contract claim is preempted by ERISA. 29

3

U.S.C. § 1144(a).

4

faith claim with allegations independent of his claim for benefits

5

under the Plan. Thus, Plaintiff’s bad faith claim is also preempted

6

by ERISA. None of the allegations that Plaintiff lists in support

7

of his claims pertains to any activity beyond his claim for

8

benefits under the Plan.

9

avoid ERISA by filing solely state law claims, none of the claims

10

Moreover, Plaintiff fails to support his bad

Thus, despite Plaintiff’s attempts to

in the Complaint are excluded from ERISA coverage.

11

IV. Conclusion

12

For the reasons stated above, UCIC’s Motion to Dismiss

13

Plaintiff’s Complaint is GRANTED.

14
15
16

IT IS SO ORDERED.

17
18
19

Dated:July 25, 2012
DEAN D. PREGERSON
United States District Judge

20
21
22
23
24
25
26
27
28
5