ROCHE et al v. AETNA, INC. et al

Filing 77

OPINION. Signed by Judge Noel L. Hillman on 10/24/2016. (dmr)

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW JERSEY
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JAY MINERLEY, Individually and
as Class Representative,
Plaintiff,
v.
AETNA, INC., AETNA HEALTH,
INC. (a NJ corp.), AETNA
HEALTH INSURANCE CO., AETNA
LIFE INSURANCE CO., and THE
RAWLINGS COMPANY, LLC,
Defendants.

Civil No. 13-1377 (NLH/KMW)

APPEARANCES:
KLEHR HARRISON HARVEY BRANZBURG LLP
By: Charles A. Ercole, Esq.
Carianne P. Torrissi, Esq.
457 Haddonfield Road, Suite 510
Cherry Hill, New Jersey 08002
and
KANNEBECKER LAW
By: Charles Kannebecker, Esq.
104 West High Street
Milford, Pennsylvania 18337
Counsel for Plaintiff
LOWEY DANNENBERG COHEN & HART, P.C.
By: Uriel Rabinovitz, Esq.
Richard W. Cohen, Esq. (pro hac vice)
Gerald Lawrence, Esq. (pro hac vice)
One North Broadway, Suite 509
White Plains, New York 10601-2310
Counsel for Defendants

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OPINION

HILLMAN, United State District Judge:
This suit concerns alleged violations of New Jersey’s
insurance regulation laws brought by Plaintiff Jay Minerley
(“Plaintiff” or “Minerley”) both individually and as putative
class representative against Defendants Aetna, Inc., Aetna
Health, Inc., Aetna Health Insurance Co., and Aetna Life
Insurance Co. (collectively, the “Aetna Defendants”) and The
Rawlings Company, LLC (“Rawlings”, and collectively with the
Aetna Defendants, “Defendants”).
Presently before the Court is Defendants’ Motion for
Reconsideration (“Defendants’ Motion” or “Defs.’ Mot.”) [Dkt.
No. 48].

For the reasons set forth below, Defendants’ Motion

will be DENIED.
I.

FACTUAL BACKGROUND AND PROCEDURAL HISTORY
The Court, in an Opinion dated March 1, 2016 [Dkt. No. 45],

reported at Roche v. Aetna, Inc., --- F. Supp. 3d ---, Civ. No.
13-1377 (NLH/KMW), 2016 WL 797553 (D.N.J. Mar. 1, 2016)
(“Summary Judgment Opinion”), granted-in-part and denied-in-part
Defendants’ Motion for Summary Judgment.

The Court set out the

factual background and procedural history of this case in its
Summary Judgment Opinion, 2016 WL 797553, at *1–2, and will
restate only what is relevant for the disposition of Defendants’
Motion.

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In support of their early motion for summary judgment,
Defendants submitted to the Court a declaration from one of
their employees and a certificate of coverage that Defendants
claim covered Minerley.

Summ. J. Op., 2016 WL 797553, at *4.

The certificate submitted by Defendants asserted that the
governing law covering the insurance certificate was “Federal
law and the laws of Pennsylvania.”

Id.

Plaintiff submitted a

different insurance agreement that was provided to him by his
employer.

Id.

His document stated that the governing law for

the insurance agreement was “Federal law and the laws of New
Jersey.”

Id.

The Court, faced with this dispute of material fact, could
not adjudicate which plan document actually covered Minerley.
Id. at *5.

However, the Court concluded that Minerley’s plan

would be a plan covered by ERISA, and found his claims preempted
by ERISA § 502(a), and so dismissed the complaint.

Id. at *5–8.

Defendants sought to preclude Minerley from amending his
complaint to replead claims under ERISA § 502(a) on the grounds
of futility.

Id. at *9.

Defendants argued that it would be

futile “because (1) they would conflict with the express
language of his plan’s reimbursement terms; (2) they are
asserted against the wrong Defendants; (3) he has failed to
exhaust; and (4) his claims are barred under the voluntary
payment doctrine.”

Id. at *9.

The Court determined that the
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first three grounds argued by Defendants required assessment of
the plan language, and due to the dispute over which plan
document covered Minerley, the Court could not evaluate whether
those three grounds presented a reason to preclude Minerley from
amending his complaint.

Id.

rejected Defendants’ argument.

On the fourth ground, the Court
Id.

Defendants then timely filed this Motion for
Reconsideration.

As explained in the Summary Judgment Opinion,

the Court exercises subject matter jurisdiction pursuant to 28
U.S.C. § 1331 and 29 U.S.C. § 1132(f) over Plaintiff’s ERISA
claims.
II.

See Summ. J. Op., 2016 WL 797553, at *2.

LEGAL STANDARD
In this District, Local Civil Rule 7.1(i) governs motions

for reconsideration.

Local Civil Rule 7.1(i) will apply rather

than Federal Rule of Civil Procedure 59 where no final judgment
has been entered, but only a partial grant or denial of summary
judgment.

See Warner v. Twp. of S. Harrison, 885 F. Supp. 2d

725, 747–48 (D.N.J. 2012).
the request is the same.

However, the standard for evaluating
Id.

“The scope of a motion for reconsideration . . . is
extremely limited.”
Cir. 2011).

Blystone v. Horn, 664 F.3d 397, 415 (3d

“The purpose of a motion for reconsideration is ‘to

correct manifest errors of law or fact or to present newly

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discovered evidence.’”

Lazaridis v. Wehmer, 591 F.3d 666, 669

(3d Cir. 2010) (citing Max’s Seafood Cafe ex rel. Lou-Ann, Inc.
v. Quinteros, 176 F.3d 669, 677 (3d Cir. 1999)).

A motion for

reconsideration “must rely on one of three grounds:

(1) an

intervening change in controlling law; (2) the availability of
new evidence; or (3) the need to correct clear error of law or
prevent manifest injustice.”

Id. (citing N. River Ins. Co. v.

CIGNA Reinsurance Co., 52 F.3d 1194, 1218 (3d Cir. 1995)).
“A party seeking reconsideration must show more than a
disagreement with the Court’s decision, and recapitulation of
the cases and arguments considered by the court before rendering
its original decision fails to carry the moving party’s burden.”
Facteon, Inc. v. Comp Care Partners, LLC, Civ. No. 13-6765, 2015
WL 519414, at *1 (D.N.J. Feb. 9, 2015) (quoting G–69 v. Degnan,
748 F. Supp. 274, 275 (D.N.J. 1990)).

“A motion for

reconsideration should not provide the parties with an
opportunity for a second bite at the apple.”

Tishcio v. Bontex,

Inc., 16 F. Supp. 2d 511, 533 (D.N.J. 1998) (citation omitted).
III. DISCUSSION
Defendants ask this Court to reconsider its determination
that there was a genuine dispute of material fact regarding
Minerley’s insurance contract.

They argue that the Court made a

clear error of fact by the Group Agreement Cover Sheet and

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Certificate of Coverage submitted by Defendants (the “Aetna
Documents” [Dkt. No. 21-3]) and the Group Insurance Policy Cover
Sheet and Group Insurance Certificate submitted by Minerley (the
“Minerley Documents” [Dkt. No. 24-3]).
[Dkt. No. 49] at 1.)

(See Def.’s Mot. Br.

Plaintiff responds that Defendants are

merely re-litigating the same issue and fail to raise anything
that indicates the Court made a clear error of fact.

(See Pl.’s

Opp. [Dkt. No. 52] at 7–9.)
The Court has reviewed the Aetna Documents and the Minerley
Documents again, and declines to depart from its earlier ruling.
As the moving parties in seeking summary judgment, Defendants
bore the burden of demonstrating that there was no genuine
dispute of material fact.
U.S. 317, 330 (1986).

See Celotex Corp. v. Catrett, 477

A dispute of material fact is genuine if

the evidence is such that a reasonable fact finder could return
a verdict for the nonmoving party.

See Anderson v. Liberty

Lobby, Inc., 477 U.S. 242, 248 (1986).

The Court may not weigh

the evidence and determine the credibility of competing evidence
on a motion for summary judgment; rather, the Court must
determine if there is a genuine issue for trial.

Id. at 249.

Defendants did not carry their burden of demonstrating no
genuine dispute of material fact in briefing the original
motion, and their arguments in the instant motion are
unavailing.

Defendants argue that the Minerley Documents only
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“govern[ ] the vendor-customer relationship” between Minerley’s
employer and the Aetna Defendants, and that the Aetna Documents
“govern[ ] the health benefits insurance relationship” between
Minerley and the Aetna Defendants.

(Defs.’ Mot. Br. at 2.)

However, Minerley contests this assertion, and Minerly does so
with an affidavit and competing paperwork.
Further, the Minerley Documents include a Group Insurance
Certificate, which Defendants do not address.
Br. at 3–4; Minerley Documents at PageID 819).

(See Defs.’ Mot.
Instead,

Defendants point to the fact that their certificate says that it
“describes the rights and obligations of members and [Aetna].”
(Defs.’ Mot. Br. at 4 (citing Aetna Documents at PageID 688).)
However, the certificate in the Minerley Documents includes
identical language that the certificate “describes the rights
and obligations of members and [Aetna].”

(Compare Minerley

Documents at PageID 819 with Aetna Documents at PageID 688.)
Neither the Minerley Documents nor the Aetna Documents
actually indicate that Minerley is a party to the contract, but
both reference “members” and the rights and obligations of those
members.

On the basis of the documents, declarations, and

affidavits submitted by the parties, a reasonable fact finder
could find that the Minerley Documents apply to Minerley and not
the Aetna Documents, and so there is a genuine dispute of
material fact.

The burden in summary judgment was on Defendants
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in the first instance, and Defendants failed to meet their
burden.
Defendants also contend that Minerley has admitted that the
Aetna Documents control.
is misplaced.

(Defs.’ Mot. Br. at 2.)

This argument

While the Court did construe certain admissions

of Minerley’s former co-plaintiff Tim Singleton to put a plan
document at issue, the facts about Singleton’s position were
entirely different.

Singleton did not put forth an affidavit or

competing documentation; he merely asserted that he was not
covered by a certain plan.

See Summ. J. Op. at *5.

Conversely,

Minerley has not only asserted certain plan documents do not
apply to him, he has provided different documents that he
swears, under oath, he believes apply to him instead.
Defendants’ Motion presents merely disagreement with the
Court’s decision, and does not present a clear error of fact
that must be corrected to prevent a manifest injustice.
Defendants have failed to meet their burden in the instant
motion, and failed to meet their burden on summary judgment.
Accordingly, reconsideration is improper.

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IV.

CONCLUSION
For the foregoing reasons, Defendants’ Motion will be

denied.

An appropriate order accompanies this opinion.

Date: October 24, 2016
At Camden, New Jersey
s/ Noel L. Hillman
NOEL L. HILLMAN, U.S.D.J.

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