McGrath v. Liberty Life Assurance Company of Boston
Filing
9
OPINION: Defendant Liberty Life Assurance Company of Boston's Motion to Dismiss Plaintiff's Complaint Pursuant to Fed. R. Civ. P. 12(b)(6) (d/e 5 ) is GRANTED. Plaintiff Mark A. McGrath's Complaint (d/e 1 ) is DISMISSED WITHOUT PREJ UDICE. Plaintiff is given 21 days from the date of this Opinion to file an amended complaint. If Plaintiff does not file an amended complaint within the time allotted, this case will be CLOSED. SEE WRITTEN OPINION. Entered by Judge Sue E. Myerscough on 3/29/2018. (MJC, ilcd)
E-FILED
Thursday, 29 March, 2018 12:36:40 PM
Clerk, U.S. District Court, ILCD
IN THE UNITED STATES DISTRICT COURT
OF THE CENTRAL DISTRICT OF ILLINOIS
SPRINGFIELD DIVISION
MARK A. MCGRATH,
Plaintiff,
v.
LIBERTY LIFE ASSURANCE
COMPANY OF BOSTON,
Defendant.
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Case No. 17-cv-03095
OPINION
SUE E. MYERSCOUGH, U.S. District Judge:
Before the Court is Defendant Liberty Life Assurance Company
of Boston’s Motion to Dismiss Plaintiff’s Complaint Pursuant to Fed.
R. Civ. P. 12(b)(6) (d/e 5). Defendant’s motion is GRANTED.
Plaintiff Mark A. McGrath’s Complaint is DISMISSED WITHOUT
PREJUDICE.
I. BACKGROUND
The majority of the following facts come from Plaintiff’s
Complaint (d/e 1). The Court accepts these facts as true in ruling
on a motion to dismiss. Tamayo v. Blagojevich, 526 F.3d 1074,
1081 (7th Cir. 2008). Additional facts come from the benefit denial
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letter, dated April 21, 2005, sent by Defendant to Plaintiff, a copy of
which is attached as Exhibit A to Defendant’s memorandum of law
in support of its motion to dismiss. Although not attached to
Plaintiff’s Complaint, the benefit denial letter is referenced in the
Complaint, see Complaint, ¶ 13, and is a document critical to the
Complaint. Therefore, the Court can consider the denial letter in
ruling on Defendant’s motion to dismiss. See Phillips v. Prudential
Ins. Co. of Am., 714 F.3d 1017, 1019-20 (7th Cir. 2013).
Plaintiff, a supply chain manager for Safran USA from
September 1996 through December 2013, was a participant of the
Safran USA Long Term Disability Plan (Safran Plan). The Safran
Plan was underwritten and administered by Defendant.
On October 26, 2013, Plaintiff’s medical impairments
prevented him from performing his work activity. Plaintiff applied
to Defendant for disability benefits and received said benefits from
April 25, 2014, to April 21, 2015.1 In addition, Plaintiff applied for
Social Security disability benefits. On August 11, 2014, the Social
1 Although Plaintiff alleges that he received disability benefits until April 24,
2016, see Complaint, ¶¶ 8, 10, the benefit denial letter from Defendant notes
that benefits would not be paid beyond April 21, 2015. See Benefit Denial
Letter (d/e 6-1), at 1. Plaintiff acknowledges that the denial of his benefits
occurred on April 21, 2015. See Complaint, ¶ 13.
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Security Administration determined that Plaintiff was disabled
under sections 216(i) and 223(d) of the Social Security Act
beginning on October 26, 2013. Although Defendant was aware of
the Social Security Administration’s decision, Defendant sent
Plaintiff a benefit denial, dated April 21, 2015. The benefit denial
letter stated that Defendant had determined that disability benefits
were not payable to Plaintiff beyond April 21, 2015. Benefit Denial
Letter (d/e 6-1), at 1. The denial letter also stated that any written
request for review of Defendant’s decision had to be sent within 180
days of Plaintiff’s receipt of the letter. Id. at 6.
Plaintiff did not send a request for an administrative review to
Defendant within 180 days of the April 21, 2015, denial. After the
administrative review deadline had passed, Plaintiff’s attorney
contacted Defendant and requested a voluntary administrative
review. Defendant’s representative could not guarantee the review
requested.
On April 6, 2017, Plaintiff filed a Complaint (d/e 1), asserting
a claim under the Employee Retirement Income Security Act of
1974 (ERISA). Plaintiff seeks the payment of disability benefits by
Defendant pursuant to the terms of the Safran Plan. On April 21,
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2017, Defendant filed its Motion to Dismiss Plaintiff’s Complaint
Pursuant to Fed. R. Civ. P. 12(b)(6), arguing that Plaintiff’s
Complaint must be dismissed because Plaintiff failed to exhaust his
administrative remedies before filing this suit. Plaintiff did not file a
response to the motion to dismiss.
II. JURISDICTION
As Plaintiff’s ERISA claim is one by a plan participant to
recover benefits due to him under the terms of a disability plan
offered by his employer, this Court has subject matter jurisdiction
over the claim. See 29 U.S.C. § 1132(e)(1). Additionally, the Court
has subject matter jurisdiction over Plaintiff’s ERISA claim because
it is based on federal law. See 28 U.S.C. § 1331 (“The district
courts shall have original jurisdiction of all civil actions arising
under the Constitution, laws, or treaties of the United States.”).
III. LEGAL 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). Plausibility means alleging factual content that allows a
court to reasonably infer that the defendant is liable for the alleged
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misconduct. See Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 547
(2007). A plaintiff’s complaint must suggest a right to relief,
“raising that possibility above a speculative level.” Kubiak v. City of
Chicago, 810 F.3d 476, 480 (7th Cir. 2016). “[A] plaintiff is not
required to plead facts in the complaint to anticipate and defeat
affirmative defenses.” Independent Trust Corp. v. Stewart
Information Servs. Corp., 665 F.3d 930, 935 (7th Cir. 2012).
However, if the plaintiff's complaint “sets out all of the elements of
an affirmative defense, dismissal under Rule 12(b)(6) is
appropriate.” Id.
When faced with a Rule 12(b)(6) motion to dismiss, the Court
“accept[s] as true all of the well-pleaded facts in the complaint and
draw[s] all reasonable inferences in favor of the plaintiff.” Roberts
v. City of Chicago, 817 F.3d 561, 564 (7th Cir. 2016). However,
“legal conclusions and conclusory allegations merely reciting the
elements of the claim are not entitled to this presumption of truth.”
McCauley v. City of Chicago, 671 F.3d 611, 616 (7th Cir. 2011).
IV. ANALYSIS
The text of 29 U.S.C. § 1132, which provides for civil actions to
redress violations of ERISA, “does not address whether a claimant
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must exhaust [his] administrative remedies before filing suit in
federal court.” Gallegos v. Mount Sinai Med. Ctr., 210 F.3d 803,
807 (7th Cir. 2000). However, the Seventh Circuit has “interpreted
ERISA as requiring exhaustion of administrative remedies as a
prerequisite to bringing suit under the statute.” Edwards v. Briggs
& Stratton Ret. Plan, 639 F.3d 355, 360 (7th Cir. 2011); Zhou v.
Guardian Life Ins. Co. of Am., 295 F.3d 677, 679 (7th Cir. 2002)
(“As a pre-requisite to filing suit, an ERISA plaintiff must exhaust
his internal administrative remedies.”). Dismissal is warranted if a
plaintiff has failed to exhaust administrative remedies. Greene v.
Meese, 875 F.2d 639, 643 (7th Cir. 1989).
“[A]n ERISA claimant’s failure to file a timely administrative
appeal from a denial of benefits is one means by which a claimant
may fail to exhaust [his] administrative remedies.” Edwards, 639
F.3d at 362 (internal quotation marks omitted). “[C]ourts may
excuse a failure to exhaust administrative remedies where there is a
lack of meaningful access to review procedures, or where pursuing
internal plan remedies would be futile.” Schorsch v. Reliance
Standard Life Ins. Co., 693 F.3d 734, 739 (7th Cir. 2012) (internal
quotation marks omitted).
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Here, Plaintiff freely admits that he did not exhaust his
administrative remedies before filing his Complaint. The benefit
denial letter informed Plaintiff that a request for an administrative
review had to be sent in writing to Defendant within 180 days of
Plaintiff’s receipt of the letter. But Plaintiff did not request an
administrative review within that 180-day period. Complaint, ¶ 13.
In addition, Plaintiff’s Complaint contains no factual allegations
suggesting that Plaintiff had no access to meaningful administrative
review or that his pursuit of administrative review would have been
futile. Although Plaintiff’s attorney contacted Defendant after the
review deadline to request a voluntary administrative review and
was told that review could not be guaranteed, Defendant’s failure to
assent to Plaintiff’s request does not amount to a lack of access to
review procedures. See Ames v. Am. Nat. Can Co., 170 F.3d 751,
756 (7th Cir. 1999).
Because Plaintiff has failed to exhaust his administrative
remedies, his Complaint must be dismissed. However, the Court’s
dismissal of Plaintiff’s Complaint is WITHOUT PREJUDICE so that
Plaintiff has an opportunity to plead additional facts relevant to the
issue of whether Plaintiff is excused from exhausting administrative
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remedies.
V. CONCLUSION
For the foregoing reasons, Defendant Liberty Life Assurance
Company of Boston’s Motion to Dismiss Plaintiff’s Complaint
Pursuant to Fed. R. Civ. P. 12(b)(6) (d/e 5) is GRANTED. Plaintiff
Mark A. McGrath’s Complaint (d/e 1) is DISMISSED WITHOUT
PREJUDICE. Plaintiff is given 21 days from the date of this Opinion
to file an amended complaint. If Plaintiff does not file an amended
complaint within the time allotted, this case will be CLOSED.
ENTER: March 29, 2018
/s/ Sue E. Myerscough
SUE E. MYERSCOUGH
UNITED STATES DISTRICT JUDGE
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