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Thomas v. Prudential Insurance Company of America

United States District Court, M.D. Louisiana

May 19, 2015

JARILYN G. THOMAS
v.
THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, ET AL

RULING AND ORDER

BRIAN A. JACKSON, Chief Judge.

Before the Court are two motions to dismiss: the Motion to Dismiss Plaintiff's Complaint as Untimely (Doc. 12) filed by Defendant The Prudential Insurance Company ("Prudential"), and the Motion to Dismiss Plaintiff's Complaint as Untimely (Doc. 13) filed by Defendants Ochsner Clinic Foundation and Ochsner Clinic Foundation Health and Welfare Benefit Plan (together, "Ochsner").[1] Both motions seek to dismiss Plaintiff Jarilyn G. Thomas's Complaint for Benefits and Attorney's Fees Under ERISA (Doc. 1) for being untimely filed pursuant to terms of the employer-sponsored disability benefits plan under which she seeks relief. Thomas opposes both motions to dismiss. (Doc. 16). With leave of Court, Prudential and Ochsner filed a joint reply memorandum in response to Thomas's opposition. ( See Doc. 20). Oral argument is not necessary. The Court has jurisdiction pursuant to 28 U.S.C. § 1331. For reasons explained fully herein, Defendants' motions are both GRANTED.

I. BACKGROUND

On December 1, 2014. Thomas filed suit in this matter, alleging she was denied benefits to which she was entitled under the Ochsner Clinic Foundation Health and Welfare Benefit Plan (the "Plan"), an employee benefit plan as defined by the Employment Retirement Income Security Act ("ERISA, " 29 U.S.C. 1001, et seq. ) administered by the Ochsner Clinic Foundation and Participating Subsidiaries. (Doc. 1 at ¶ I). Thomas specifies that her cause of action arises in relation to long-term disability ("LTD") benefits under an employee benefit plan governed by ERISA. (Doc. 1-1 at p. 1).

Thomas claims that, since approximately June 26, 2009, while employed by the Ochsner Clinic Foundation, Thomas became disabled by health problems, rendering her incapacitated and permanently unable to perform her job duties as Registration Coordinator, or any other job for which she would be reasonably qualified. (Doc. 1 at ¶ IV). According to Thomas, Ochsner Clinic Foundation breached a special duty to Thomas to administer the Plan and provide her the benefits to which she was "clearly entitled, " and Prudential breached a special fiduciary duty to ensure Thomas's receipt of benefits as the issuer of applicable disability insurance policies. (Doc. 1 at ¶ VI-IX). Thomas alleges breaches of contractual obligations, duties, and special fiduciary duties under the Plan, the insurance policy underwritten by Prudential, ERISA, and "general princip[les] of fairness." (Doc. 1 at ¶ IX).

II. STANDARD OF REVIEW

A motion to dismiss under Federal Rule of Civil Procedure ("Rule") 12(b)(6) tests the sufficiency of the complaint against the legal standard set forth in Rule 8, which requires "a short and plain statement of the claim showing that the pleader is entitled to relief." Fed.R.Civ.P. 8(a)(2).

"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) ( Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). "Determining whether a complaint states a plausible claim for relief [is]... a context-specific task that requires the reviewing court to draw on its judicial experience and common sense." Id. at 679. "[F]acial plausibility" exists "when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. at 678 ( Twombly, 550 U.S. at 556).

Hence, the complaint need not set out "detailed factual allegations, " but something "more than labels and conclusions, and a formulaic recitation of the elements of a cause of action" is required. Twombly, 550 U.S. at 555. When conducting its inquiry, the Court "accepts all well-pleaded facts as true and views those facts in the light most favorable to the plaintiff." Bustos v. Martini Club Inc., 599 F.3d 458, 461 (5th Cir. 2010) (quotation marks omitted).

The U.S. Supreme Court has noted that Rule 12(b)(6) requires dismissal whenever a claim is based on an invalid legal theory:

Nothing in Rule 12(b)(6) confines its sweep to claims of law which are obviously insupportable. On the contrary, if as a matter of law it is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations, ... a claim must be dismissed, without regard to whether it is based on an outlandish legal theory, or on a close but ultimately unavailing one.

Neitzke v. Williams, 490 U.S. 319, 327 (1989) (quotation marks and citations omitted). However, "[f]ederal pleading rules... do not countenance dismissal of a complaint for imperfect statement of the legal theory supporting the claim asserted." Johnson v. City of Shelby, Miss., 574 U.S. ___, ___, 135 S.Ct. 346, 346 (2014) (per curiam).

III. DISCUSSION

Here, Prudential and Oschner seek to dismiss with prejudice Thomas's complaint as untimely under the Plan's clear terms. Specifically, Defendants argue that the contractual limitations period on Thomas's LTD benefits claim ended on March ...


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