United States District Court, W.D. Louisiana, Monroe Division
Decided: November 6, 2014.
Order Filed: September 23, 2014
[Copyrighted Material Omitted]
For Carl Dewayne Wright, Plaintiff: Oscar P Barnes, III, LEAD ATTORNEY, Richard L Fewell, Jr, Law Office of Richard L Fewell Jr, W Monroe, LA.
For Louisiana Corrugated Products L L C, U S Corrugated Inc, Defendants: Steven M Oxenhandler, LEAD ATTORNEY, Joseph H L Perez-Montes, Michael J O'Shee, Trevor S Fry, Gold Weems et al, Alexandria, LA.
For Vantage Health Plan Inc, Defendant: Layna S Cook, LEAD ATTORNEY, Daniel P Guillory, Errol J King, Jr, Baker Donelson et al (BR), Baton Rouge, LA.
ROBERT G. JAMES, UNITED STATES DISTRICT JUDGE. MAG. JUDGE KAREN L. HAYES.
ROBERT G. JAMES, UNITED STATES DISTRICT JUDGE
The Report and Recommendation of the Magistrate Judge having been considered, no objections thereto having been filed, and finding that same is supported by the law and the record in this matter,
IT IS ORDERED, ADJUDGED, AND DECREED that Defendants' Joint Motion for Partial Summary Judgment [Doc. No. 31] is hereby GRANTED, and judgment is entered in favor of Defendants declaring 1) that Plaintiff's state law claim for unpaid benefits under the Plan is completely preempted by ERISA and, thus, recast as a claim under ERISA § 502(a)(1)(B), and 2) that Plaintiff's state law claims for penalties and detrimental reliance under Louisiana Revised Statute § 22:1821 and Louisiana Civil Code Article 1967, respectively, are conflict-preempted by ERISA.
IT IS FURTHER ORDERED, ADJUDGED, AND DECREED that Plaintiff's state law claims for penalties and detrimental reliance under Louisiana Revised Statute § 22:1821 and Louisiana Civil Code Article 1967, respectively, are hereby DISMISSED WITH PREJUDICE, as preempted.
IT IS FURTHER ORDERED that Defendant Vantage Health Plan, Inc.'s " Motion to Dismiss pursuant to Rule 12(b)(6) for Failure to Exhaust Administrative Remedies and in the Alternative, for Summary Judgment" [Doc. No. 11], and Defendants Louisiana Corrugated Products, LLC, and U.S. Corrugated, Inc.'s Motion for Judgment on the Pleadings (converted to a motion for summary judgment) [Doc. No. 17] are each GRANTED IN PART. Plaintiff's recast claim for unpaid benefits under ERISA § 502(a)(1)(B) are hereby DISMISSED WITHOUT PREJUDICE. Defendants' motions [Doc. Nos. 11 & 17] otherwise are DENIED.
IT IS FURTHER ORDERED that this matter is hereby STAYED for a period of 60 days, so Plaintiff may exhaust administrative remedies, and, thereafter, amend his Complaint to assert his then exhausted § 502(a)(1)(B) claim. If Plaintiff instead desires to forego his § 502(a)(1)(B) claim and proceed solely with his COBRA claim, he shall file a notice in the record no later than November 21, 2014.
REPORT AND RECOMMENDATION
KAREN L. HAYES, UNITED
STATES MAGISTRATE JUDGE.
Before the undersigned magistrate judge on reference from the District Court are three motions: 1) motion to dismiss pursuant to Rule 12(b)(6) and in the alternative for summary judgment [doc. # 11] filed by defendant, Vantage Health Plan, Inc. (" Vantage" ); 2) motion for judgment on the pleadings [doc. # 17] filed by defendants, Louisiana Corrugated Products, LLC and U.S. Corrugated, Inc. (collectively, " LAC" ); and 3) motion for partial summary judgment [doc. # 31] filed jointly by defendants, Vantage and LAC. As explained in greater detail below, it is recommended that defendants' joint motion for partial summary judgment [doc. # 31] be GRANTED; that defendants' motion to dismiss pursuant to Rule 12(b)(6) and in the alternative for summary judgment [doc. # 11] and motion for judgment on the pleadings (converted motion for summary judgment) [doc. # 17] both be GRANTED-IN-PART; and that the matter be stayed for a period of 60 days.
On March 11, 2014, Carl DeWayne Wright filed the instant suit for damages in the 4th Judicial District Court for the Parish of Ouachita, State of Louisiana, against his former employer -- LAC, and the issuer of his employer's group health care policy -- Vantage. (Petition, ¶ ¶ 1-4). Wright alleges that in January 2014, Vantage pre-authorized his surgery with neurosurgeon, Bernie McHugh, M.D. (Petition, ¶ ¶ 8-10; Jan. 7, 2014, Letter from Vantage to Dr. McHugh, Petition, Exh. A). Wright underwent the surgery on January 6, 2014. (Petition, ¶ 11). On January 16, 2014, Vantage notified Dr. McHugh's staff that it had denied coverage for the surgery because Vantage learned that Wright had been discharged from employment prior to the surgery. Id., ¶ ¶ 12-13.
Wright alleges that he was not notified of his " alleged termination" as required by the Consolidated Omnibus Budge Reconciliation Act (" COBRA" ), and thus, did not have the opportunity to obtain replacement health care insurance. Id., ¶ 14. He further contends that he relied to his detriment on Vantage's post-surgery, pre-authorization. Id., ¶ 15.
Wright alleges that as a result of defendants' conduct and omissions, he has been deprived of further necessary medical care, which has protracted his disabilities. Id., ¶ 16. Thus, he seeks damages for prolonged pain and suffering, loss of income, increased and extended medical expense, the cost of the unpaid treatment rendered by Dr. McHugh, out of pocket medical expenses, reduction in his chances of recovery because of the delay in treatment, and the reduction in, and/or loss of portability of insurance coverage. Id., ¶ 17. He also seeks reasonable attorney's fees for failure to provide proper and required notice of termination. Id., ¶ 18.
On April 3, 2014, Wright amended his petition to assert claims for statutory penalties and attorney's fees stemming from defendants' conduct, including their failure to provide proper notice of termination and to pay insurance benefits as required. See 1st Suppl. & Amend. Petition. The next
day, LAC removed the case to federal court on the basis of federal question jurisdiction, 28 U.S.C. § 1331. (Notice of Removal). Vantage joined in, and consented to ...