Vaughn v. Aetna Life Insurance Company
Filing
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OPINION AND ORDER denying as moot Aetnas Motion to Dismiss Plaintiffs Complaint and to Strike Plaintiffs Jury Demand 2 , granting Aetnas Partial Motion to Dismiss Count II of Plaintiffs First Amended Complaint for Breach of Fiduciary Duties 11 and denying Plaintiff Stephanie D. Vaughns Motion for Leave to Add a Party 6 . Signed by Judge William S. Duffey, Jr on 2/27/17. (ddm)
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF GEORGIA
ATLANTA DIVISION
STEPHANIE D. VAUGHN,
Plaintiff,
v.
1:16-cv-01107-WSD
AETNA LIFE INSURANCE
COMPANY,
Defendant.
OPINION AND ORDER
This matter is before the Court on Defendant Aetna Life Insurance
Company’s (“Aetna”) Motion to Dismiss Plaintiff’s Complaint and to Strike
Plaintiff’s Jury Demand [2] and Partial Motion to Dismiss Count II of Plaintiff’s
First Amended Complaint for Breach of Fiduciary Duties [11]. Also before the
Court is Plaintiff Stephanie D. Vaughn’s (“Vaughn”) Motion for Leave to Add a
Party [6].
I.
BACKGROUND
A.
Facts
Vaughn is the daughter of James Sheffield (“Sheffield”), deceased, and the
named beneficiary of Sheffield’s life insurance. ([8] ¶¶ 4, 8). At the time of his
death on October 24, 2012, Sheffield was an employee of Lafarge North America
Inc. (“Lafarge”), and he participated in a life insurance policy plan (“the Plan”)
sponsored and administered by Lafarge. (Id. ¶¶ 6-7). Sheffield was, at the time of
his death, on approved disability. (Id. ¶ 6).
The Plan was a part of Sheffield’s employment benefit package and was
issued by Aetna. (Id. ¶ 7). Sheffield continuously carried the life insurance and
made premium contributions until his death. (Id.). According to the annual
personal benefits information as of July 5, 2011, Sheffield had both basic and
supplemental life-insurance coverage with total coverage amounts of $330,000.
After Sheffield’s death, Aetna furnished Vaughn with Sheffield’s basic
life-insurance benefits of $130,000, but denied her claim as to his supplemental
life-insurance benefits of $200,000 because of the lack of medical evidence to
support a permanent and total disability. (Id. ¶ 9).
Vaughn’s Complaint alleges that Sheffield “had cardiovascular disease,”
which caused “angina and mental atrophy” and “other documented debilitating and
incapacitating physical and mental conditions[,] which caused him to leave his
employment on August 6, 2010.” (Id. ¶ 10). The Complaint alleges that Sheffield
was “permanently and totally disabled” under the Plan. (Id.).
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B.
Procedural History
On March 11, 2016, Vaughn filed her original Complaint alleging breach of
contract and other state law claims arising under a contract of supplemental life
insurance. On April 5, 2016, Aetna removed, to this Court, the action filed in the
State Court of Fulton County. ([1]). On April 6, 2016, Aetna moved to dismiss
the original Complaint and to strike Plaintiff’s jury demand because the Plan was
issued under the Employee Retirement Income Security Act of 1974 (“ERISA”)
and thus is governed by ERISA. ([2]).
On May 5, 2016, Vaughn filed her First Amended Complaint (“Complaint”)
to conform with the requirements of ERISA and requested leave to add Lafarge as
a party. ([6], [8]). The Complaint alleges that Aetna failed to pay Vaughn
supplemental life-insurance benefits under the ERISA plan (Count I) and that
Aetna and Lafarge breached their fiduciary duties (Count II). ([8] at 5, 7). On
May 23, 2016, Aetna moved to dismiss Count II of Vaughn’s Complaint. ([11]).
II.
DISCUSSION
A.
Aetna’s Motion to Dismiss Plaintiff’s Original Complaint and to
Strike Plaintiff’s Jury Demand
Rule 15(a) of the Federal Rules of Civil Procedure allows a plaintiff to file
one amended complaint as a matter of course, if the amended complaint is filed
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either within twenty-one (21) days of service of the original complaint or within
twenty-one (21) days of the defendant’s filing of a responsive pleading or Rule 12
motion to dismiss. Fed. R. Civ. P. 15(a)(1). Amended complaints outside of these
time limits may be filed only “with the opposing party’s written consent or the
court’s leave.” Fed. R. Civ. P. 15(a)(2).
Here, Plaintiff’s First Amended Complaint was filed as a matter of course
under Rule 15. Plaintiff’s First Amended Complaint thus “supersedes” the
previous complaint and “becomes the operative pleading in the case.” Lowery
v. Ala. Power Co., 483 F.3d 1184, 1219 (11th Cir. 2007). Aetna’s Motion to
Dismiss Plaintiff’s Complaint and to Strike Plaintiff’s Jury Demand [2] is denied
as moot.
B.
Aetna’s Motion to Dismiss Count II
1.
Legal Standard
On a motion to dismiss pursuant to Rule 12(b)(6) of the Federal Rules of
Civil Procedure, the Court must “assume that the factual allegations in the
complaint are true and give the plaintiff[] the benefit of reasonable factual
inferences.” Wooten v. Quicken Loans, Inc., 626 F.3d 1187, 1196 (11th Cir.
2010). Although reasonable inferences are made in the plaintiff’s favor,
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“‘unwarranted deductions of fact’ are not admitted as true.” Aldana v. Del Monte
Fresh Produce, N.A., 416 F.3d 1242, 1248 (11th Cir. 2005) (quoting S. Fla. Water
Mgmt. Dist. v. Montalvo, 84 F.3d 402, 408 n.10 (11th Cir. 1996)). Similarly, the
Court is not required to accept conclusory allegations and legal conclusions as true.
See Am. Dental Ass’n v. Cigna Corp., 605 F.3d 1283, 1290 (11th Cir. 2010)
(construing Ashcroft v. Iqbal, 556 U.S. 662 (2009); Bell Atl. Corp. v. Twombly,
550 U.S. 544 (2007)).
“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.’”
Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 570). Mere “labels and
conclusions” are insufficient. Twombly, 550 U.S. at 555. “A claim has facial
plausibility when the plaintiff pleads factual content that allows the court to draw
the reasonable inference that the defendant is liable for the misconduct alleged.”
Iqbal, 556 U.S. at 678 (citing Twombly, 550 U.S. at 556). This requires more than
the “mere possibility of misconduct.” Am. Dental, 605 F.3d at 1290 (quoting
Iqbal, 556 U.S. at 679). The well-pled allegations must “nudge[] their claims
across the line from conceivable to plausible.” Id. at 1289 (quoting Twombly,
550 U.S. at 570).
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2.
Discussion
Under ERISA § 502(a)(1)(B) (codified at 29 U.S.C. § 1132(a)(1)(B)), a
beneficiary in a plan governed by ERISA can sue in federal court “to recover
benefits due to him under the terms of his plan.” 29 U.S.C. § 1132(a)(1)(B).
Under a separate ERISA subsection, § 502(a)(3) (codified at 29 U.S.C.
§ 1132(a)(3)), a beneficiary can “obtain other appropriate equitable relief” for
breach of fiduciary duty. Id. § 1132(a)(3). These two distinct ERISA subsections
are aimed at redressing separate violations, and a claim properly brought under one
cannot proceed alternatively under the other. See, e.g., Jones v. Am. Gen. Life &
Acc. Ins. Co., 370 F.3d 1065, 1073-74 (11th Cir. 2004) (holding § 1132(a)(3)
claim is properly dismissed where the supporting allegations were sufficient to
state a cause of action under § 1132(a)(1)(B), “regardless of the relief sought, and
irrespective of the [plaintiffs’] allegations supporting their other claims”); Katz v.
Comprehensive Plan of Grp. Ins., 197 F.3d 1084, 1088-89 (11th Cir. 1999)
(holding an ERISA plaintiff with an adequate remedy under § 1132(a)(1)(B) could
not alternatively plead and proceed under § 1132(a)(3)).
Aetna asserts that Plaintiff “would have an adequate remedy under Count I
for ‘Plan Benefits’ and ERISA Section 502(a)(1)(B),” so Vaughn “cannot
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simultaneously maintain a claim under Section 502(a)(3) in Count II for ‘Breach of
Fiduciary Duties’ for the same denial of supplemental life insurance benefits.”
([11.1 at 2). Although Vaughn’s Complaint does not specify the subsections she is
bringing her claims under, she acknowledges that she “cannot seek equitable relief
under § 501(a)(1)(B) plan benefits and § 501(a)(3) breach of fiduciary duties
[based on the same allegations].” ([13] at 7). Vaughn, in her brief in opposition to
Aetna’s motion, asserts for the first time that Aetna breached its fiduciary duties
when “Aetna took advantage of the decedent’s incapacity and terminated his
benefits.”1 (Id. at 12). Vaughn’s attempt to assert that there are separate factual
bases for each claim is not supported by the facts pled in her Complaint. Even
assuming the alleged improper termination of her father’s disability benefits was
properly pled, Plaintiff would have an adequate remedy under § 502(a)(1)(B)
based on Aetna’s alleged denial of plan benefit. Plaintiff’s claim for breach of
fiduciary duties (Count II) is dismissed.
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Vaughn asserts that she is not alleging that Aetna breach its fiduciary duties
in denying her claim for benefits. (Id. at 8).
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C.
Motion to Add Party
In her motion to add Lafarge as a defendant, Plaintiff seeks to assert against
Lafarge a claim for breach of fiduciary duty. Vaughn, however, does not assert
allegations sufficient to cure the deficiencies in her breach-of-fiduciary-duties
claim discussed in Section B above. Accordingly, Plaintiff’s motion to add a
party [6] is denied because the amendment would be futile.
III.
CONCLUSION
For the foregoing reasons,
IT IS HEREBY ORDERED that Aetna’s Motion to Dismiss Plaintiff’s
Complaint and to Strike Plaintiff’s Jury Demand [2] is DENIED AS MOOT.
IT IS FURTHER ORDERED that Aetna’s Partial Motion to Dismiss
Count II of Plaintiff’s First Amended Complaint for Breach of Fiduciary Duties
[11] is GRANTED.
IT IS FURTHER ORDERED that Plaintiff Stephanie D. Vaughn’s Motion
for Leave to Add a Party [6] is DENIED.
SO ORDERED this 27th day of February, 2017.
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