Nwizu v. The Lincoln National Life Insurance Company et al

Filing 24

ORDER granting 23 Motion to Dismiss; granting 11 Motion to Dismiss for Failure to State a Claim. Signed by Chief Judge James C. Dever III on 12/8/14. (O'Brien, C.)

IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF NORTH CAROLINA
WESTERN DIVISION
No. 5:14-CV-617-D

CORDELLA NWIZU,

)
)
Plaintiff,
)
)
v.
)
)
THE LINCOLN NATIONAL LIFE
)
INSURANCECONWANY,md
)
LAUREL HEALTH CARE CONWANY, )
)
Defendmts. )

ORDER

On September 9, 2014, Cordelia Nwizu ("plaintiff') filed a complaint in Wake County
Superior Court seeking payment on a life insurmce benefits claim. See Compl. [D.E. 1-4]. The
Lincoln National Life Insurmce Compmy ("Lincoln National") timely removed the action [D.E.
1]. On October 17, 2014, Lincoln National filed a motion to dismiss plaintiffs complaint pursuant
to Rule 12(b)(6) of the Federal Rules of Civil Procedure [D.E. 11]. On December 5, 2014, plaintiff
filed a motion to voluntarily dismiss her complaint without prejudice [D .E. 23]. As explained below,
the court grmts both motions.
A motion to dismiss under Rule 12(b)(6) of the Federal Rules of Civil Procedure for "failure
to state a claim upon which relief em be grmted" tests whether the complaint is legally md factually
sufficient. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009); Bell Atl. Corp. v. Twombly, 550 U.S. 544,
555-56 (2007); Vitol. S.A. v. Primerose Shiiming Co., 708 F.3d 527,543 (4th Cir. 2013); Colemm
v. Md. Ct. of Appeals, 626 F.3d 187, 190 (4th Cir. 2010), affd, 132 S. Ct. 1327 (2012); Giarratmo
v. Johnson, 521 F.3d 298,302 (4th Cir. 2008). The courtneednotacceptacomplaint's conclusions
of law. See Iqbal, 556 U.S. at 678-79; Twombly, 550 U.S. at 555; Nemet Chevrolet. Ltd. v.

Consumeraffairs.com, Inc., 591 F.3d 250, 255 (4th Cir. 2009). As for a complaint's factual
sufficiency, a party must plead "enough facts to state a claim to relief that is plausible on its face."
Twombly, 550 U.S. at 570. "[N]aked assertions of wrongdoing" cannot "cross the line between
possibility and plausibility of entitlement to relief." Francis v. Giacomelli, 588 F.3d 186, 193 (4th
Cir. 2009) (quotation omitted); see Vitol, S.A., 708 F.3d at 543. "The plausibility standard is not
akin to a 'probability requirement,' but it asks for more than a sheer possibility that a defendant has
acted unlawfully." Iqbal, 556 U.S. at 678. A plaintiff armed with nothing more than "labels and
conclusions" or a formulaic recitation of the elements of a cause of action cannot proceed.
Twombly, 550 U.S. at 555 & n.3; Vitol, S.A., 708 F.3d at 543; Francis, 588 F.3d at 193.
"Determining whether a complaint states a plausible claim for relief will ... be a contextspecific task that requires the reviewing court to draw on its judicial experience and common sense."
Iqbal, 556 U.S. at 679. Moreover, in considering a motion to dismiss, a court must focus on the
complaint. The court may also consider documents attached to the complaint if they "are integral
to the complaint and authentic." Philips v. Pitt Cnty. Mem'l Hosp., 572 F.3d 176, 180 (4th Cir.
2009); Phillips v. LCI lnt'l, Inc., 190 F.3d 609, 618 (4th Cir. 1999).
In her complaint, plaintiff seeks dependent life insurance benefits pursuant to an insurance
policy (the "Policy"), for which she enrolled through her employer, defendant Laurel Health Care
Company ("Laurel"). See Compl. Lincoln National issued the Policy to Laurel to fund the life
insurance benefits under the Laurel's benefit plan (the "Plan"). See id.

~~

1-17. Plaintiffs

complaint contains six state-law claims arising out of the denial of plaintiffs claim for dependent
life insurance benefits under the Plan and Policy. See id.

~~

18-45.

The Plan and the Policy are governed by the Employee Retirement Income Security Act of
1974, as amended, ("ERISA"), 29 U.S.C. §§ 1001, et seq. Section 514(a) of ERISA provides that
2

ERISA "shall supersede any and all State laws insofar as they may now or hereafter relate to any
employee benefit plan .... " 29 U.S.C. § 1144(a). Because plaintiff's state-law claims all relate to
the Plan and the Policy, ERISA preempts them.

See,~.

Pilot Life Ins. Co. v. Dedeaux, 481 U.S.

41,47-57 (1987); Shaw v. Delta Airlines. Inc., 463 U.S. 85,95-100 (1983); Powell v. Chesapeake
& Potomac Tel. Co. of Va., 780 F.2d 419, 421-24 (4th Cir. 1985). Thus, the court converts

plaintiff's state-law claim for breach of contract to a claim for benefits pursuant to 29 U.S.C. §
1132(a) and dismisses all other state-law claims.

See,~.

Singh v. Prudential Health Care Plan.

Inc .. 335 F.3d 278,290 (4thCir. 2003); Darcangelo v. Verizon Commc'ns, 292 F.3d 181, 195 (4th
Cir. 2002).
As for plaintiff's ERISA claim under29 U.S.C. § 1132(a), a claimant seeking benefits under

an ERISA-qualified employee benefit plan must exhaust her administrative remedies before filing
a lawsuit.

See,~.

Makar v. Health Care Corp. ofMid-Atl., 872 F.2d 80, 82-83 (4th Cir. 1989).

Here, plaintiff has not alleged that she exhausted her administrative remedies. Moreover, under the
terms of the Policy, a claimant must seek an appeal review of a denied claim within 60 days of an
adverse determination. See Policy [D.E. 11] 23-24. This time period comports with Department
of Labor regulations relating to ERISA' s procedural requirement for a full and fair review of benefit
claims. See 29 C.F.R. § 2560.503-1(h)(2)(i).
In her complaint, plaintiff alleges that Lincoln National denied her claim for dependent life
insurance benefits in May 2013. Compl. ~ 16. Plaintiff does not, however, allege that she pursued
an administrative appeal of the denial. The 60-day time period within which plaintiff was required
to pursue her administrative appeal has expired.

Moreover, plaintiff's failure to pursue an

administrative appeal within the allowed time period appears to bar further action by this court on
her claim for benefits.

See,~.

Gayle v. United Parcel Serv., Inc., 401 F. 3d 222, 229-30 (4th Cir.
3

2005). This court's apparent inability to grant relief in these circumstance does not, however,
preclude possible equitable relief from the 60-day deadline by the plan administrator. Cf. id. at 225.
Thus, the court grants plaintiffs motion to dismiss the complaint without prejudice.

In sum, the court GRANTS defendant Lincoln National's motion to dismiss [D.E. 11] and
plaintiffs motion to voluntarily dismiss [D.E. 23] and DISMISSES WITHOUT PREJUDICE
plaintiffs complaint.
SO ORDERED. This _8_ day of December 2014.

Chief United States District Judge

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