United States District Court, E.D. Louisiana
ORDER & REASONS
E. FALLON U.S. DISTRICT COURT JUDGE.
before the Court are Defendant's Motion to Dismiss and
Motion for Summary Judgement. R. Docs. 16, 17. Each motion is
opposed, R. Docs. 23, 24, and Defendant has filed replies, R.
Docs. 29, 31. Because the motions are interrelated, the Court
rules on them collectively as follows.
Mary Beth Chauvin filed this action against Defendant Symetra
Life Insurance Company (“Symetra”) challenging
its denial of short and long term disability benefits under
the Employee Retirement Income Security Act
(“ERISA”). R. Doc. 9-2. Plaintiff alleges that
through her employment with the Terrebone Parish School Board
(“School Board”), she was a fully vested
participant of an employee welfare plan administered by
Defendant. R. Doc. 9-2 at 3.
has been disabled since December 2016 as a result of
fibromyalgia, diabetes, anxiety, and depression. R. Doc. 9-2
at 3. According to Plaintiff, her treating physicians have
certified that she is unable to work due to her disability,
and the School Board considers her medically disabled. R.
Doc. 9-2 at 3.
the complaint does not specify the timing of the events, it
appears as though Plaintiff submitted claims after the onset
of her disability, which were denied by Defendant.
See R. Doc. 9-2 at 3. Plaintiff alleges
Defendant denied them without providing a full and fair
review. R. Doc. 9-2 at 3. In particular, Plaintiff alleges
Defendant failed to consider that continuing to work would
exacerbate her disability and jeopardize her health. R. Doc.
9-2 at 3. Plaintiff further submits that, in denying her
claims, Defendant was motivated by a financial conflict of
interest. R. Doc. 9-2 at 4. Having appealed the denials of
both her short and long term disability claims and thus
exhausted her administrative remedies, Plaintiff now seeks
enforcement of the policies and reasonable attorney fees
under ERISA. R. Doc. 9-2 at 4-5. Plaintiff further seeks
damages and attorney fees for Defendant's failure to
timely pay benefits pursuant to Louisiana Revised Statute
section 22:1821,  and for unpaid benefits, consequential
damages, and attorney fees for breach of contract. R. Doc.
9-2 at 6.
timely answered the first amended complaint, admitting it
issued and administered a disability policy to the School
Board and denied Plaintiff's claims because it determined
she was not disabled under the terms of the policy, but
generally denying the other allegations. R. Doc. 10-2. In its
defense, Defendant argues that because the School Board is a
governmental entity, the disability plans are not governed by
ERISA. R. Doc. 10-2 at 8. Defendant also contends it had just
cause to deny Plaintiff's claims for both short and long
term disability benefits. R. Doc. 10-2 at 8. In particular,
Defendant alleges Plaintiff failed to provide written notice
and proof of claims as required by the policies. R. Doc. 10-2
at 8. Defendant argues that even if the Court finds the plan
is governed by ERISA, its “claims decisions were not
arbitrary or an abuse of discretion, ” and that
Plaintiff's state law claims are preempted by ERISA. R.
Doc. 10-2 at 9. Defendant seeks attorney fees and costs
related to the defense of this action. R. Doc. 10-2 at 9.
LAW & ANALYSIS
Defendant' Motion to Dismiss (R. Doc. 17)
filed a motion to dismiss for lack of subject matter
jurisdiction. R. Doc. 17. Defendant argues that federal
question jurisdiction is lacking because the disability
policy at issue is not subject to ERISA, and that diversity
jurisdiction is lacking because the terms of the policies
expressly limit Plaintiff's potential recovery to an
amount that cannot exceeded $75, 000. R. Doc. 17-1.
opposition, Plaintiff focuses only on diversity jurisdiction
and objects to Defendant's method of calculating the
amount in controversy. R. Doc. 24. Plaintiff provides her own
calculation methodology and explains why the amount in
controversy is greater than the jurisdictional
minimum. R. Doc. 24. Further, Plaintiff urges this
Court to exercise supplemental jurisdiction over her state
law claims in the event the Court dismisses the ERISA claim
and finds that diversity jurisdiction is lacking. R. Doc. 24
Legal Standard - 12(b)(1)
courts are courts of limited jurisdiction. They possess only
that power authorized by the Constitution and statute, which
is not to be expanded by judicial decree.” Kokkonen
v. Guardian Life Ins. Co. of Am., 511 U.S. 375, 377
(1994) (citations omitted). Parties “may neither
consent to nor waive federal subject matter
jurisdiction.” Simon v. Wal-Mart Stores, Inc.,
193 F.3d 848, 850 (5th Cir. 1999). Accordingly, “[a]
case is properly dismissed for lack of subject matter
jurisdiction when the court lacks the statutory or
constitutional power to adjudicate the case.” Home
Builders Ass'n of Miss., Inc. v. City of Madison,
143 F.3d 1006, 1010 (5th Cir. 1998).
Rule of Civil Procedure 12(b)(1) governs challenges to a
district court's subject matter jurisdiction. Although
“[t]he standard of review applicable to motions to
dismiss under Rule 12(b)(1) is similar to that applicable to
motions to dismiss under Rule 12(b)(6), ” a 12(b)(1)
motion can consist of either a facial attack on the pleadings
or a broader, factual attack that examines matters outside
the pleadings. Williams v. Wynne, 533 F.3d 360,
364-65 n. 2 (5th Cir. 2008). When a defendant makes a factual
attack, “the district court must resolve disputed facts
without giving a presumption of truthfulness to the
plaintiff's allegations.” Vantage Trailers,
Inc. v. Beall Corp., 567 F.3d 745, 748 (5th Cir. 2009).
Accordingly, “[l]ack of subject matter jurisdiction may
be found in any of one of three instances: (1) the complaint
alone; (2) the complaint supplemented by undisputed facts
evidenced in the record; or (3) the complaint supplemented by
undisputed facts plus the court's resolution of disputed
facts.” Ramming v. United States, 281 F.3d
158, 161 (5th Cir. 2001). “The burden of proof for a
Rule 12(b)(1) motion to dismiss is on the party asserting