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Hackney v. Lincoln National Life Insurance Co.

United States District Court, W.D. Kentucky, Louisville Division

August 12, 2014

JAMES W. HACKNEY, Plaintiff,
v.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, Defendant.

MEMORANDUM OPINION AND ORDER

THOMAS B. RUSSEll, Senior District Judge.

This matter is before the Court upon Defendant The Lincoln National Life Insurance Company's (Lincoln) Motion to Dismiss Count II and Count III of the Amended Complaint asserting claims for breach of fiduciary duty under 29 U.S.C. § 1132(a)(3). (Docket No. 55.) Plaintiff James W. Hackney has responded. (Docket No. 63.) Defendant Lincoln has replied. (Docket No. 65.) This matter is now fully briefed and ripe for adjudication. For the following reasons, the Court will GRANT Defendant's Motion to Dismiss Count II and Count III of the Amended Complaint asserting claims for breach of fiduciary duty under 29 U.S.C. § 1132(a)(3).[1] (Docket No. 55.)

BACKGROUND

Because this matter is before the Court on a Motion to Dismiss, the Court will presume as true all of the factual allegations in Hackney's Amended Complaint, (Docket No. 31). See Total Benefits Planning Agency, Inc. v. Anthem Blue Cross & Blue Shield, 552 F.3d 430, 434 (6th Cir. 2008). Accordingly, the following Background is drawn primarily from the Amended Complaint, (Docket No. 31), and the factual allegations made therein presumed as true for purposes of considering the Motion to Dismiss.

Hackney was previously employed by Vascular Solutions, Inc., as the National Director of Marketing. Hackney was classified as a full-time executive employee and as part of his compensation was eligible to participate in a group long term disability insurance policy issued by Lincoln. Hackney elected to participate under the policy and paid the applicable premiums. On October 6, 2010, he became disabled under the policy and has remained continuously disabled and unable to function on a fulltime basis in any gainful employment. On March 2, 2011, Hackney submitted a claim to Lincoln seeking to receive the long term disability monthly benefits.

On May 3, 2011, when there had been no decision on the claim, Hackney filed suit seeking, among other relief, to recover the long term disability benefits. On January 4, 2012, this Court remanded the claim to Lincoln to provide "a full review consistent with the terms of the policy." (Docket No. 23, at 10.) By letter dated May 25, 2012, Lincoln issued a decision denying Hackney's claim. Hackney appealed this decision by letter dated November 5, 2012, without waiving his claim that an appeal was not required based on the policy and the Employee Retirement Income Security Act (ERISA) claim regulations. Lincoln denied Hackney's appeal by letter dated January 17, 2013. (Docket No. 63, at 4.) Hackney submitted a second appeal by letter dated May 16, 2013, without waiving his claim that he had exhausted the administrative process under the policy and ERISA. (Docket No. 63, at 5.)

As of the date of the filing of the Amended Complaint, (Docket No. 31), Lincoln had not reached a decision on Hackney's second appeal.[2] Hackney brings claims for: (1) breach of contract; (2) breach of fiduciary duty; (3) disgorgement and make whole relief; and (4) attorneys' fees and costs. (Docket No. 31, at 9-12.) Count I of the Amended Complaint alleges that Lincoln breached the long term disability (LTD) policy by: (1) improperly denying Hackney's claim for long term disability benefits; (2) relying on unlicensed medical opinions; and (3) applying a policy provision requiring a second appeal which was prohibited by law. (Docket No. 31, at 9.) This claim is made under 29 U.S.C. § 1132(a)(1)(B), whereby a civil action may be brought by a participant or beneficiary "to recover benefits due to him under the terms of his plan, or to clarify his rights to future benefits under the terms of the plan."

Count II of the Amended Complaint alleges breach of fiduciary duty because Lincoln "violated the time lines for rendering a final decision" and "relied on non-examining medical opinions (record reviews) to deny claims." (Docket No. 31, at 10.) This claim is made under 29 U.S.C. § 1132(a)(3), whereby a participant or beneficiary may bring a civil action "(A) to enjoin any act or practice which violates any provision of this subchapter or the terms of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan."

Count III requests "make whole relief" based on an alleged breach of a fiduciary duty by Lincoln. (Docket No. 31, at 10.) This claim is also made under 29 U.S.C. § 1132(a)(3). The Court assumes the factual basis for the breach of fiduciary duty claim in Count III is the alleged misconduct described in Count II.

STANDARD

The Federal Rules of Civil Procedure require that pleadings, including complaints, contain a "short plain statement of the claim showing that the pleader is entitled to relief." Fed.R.Civ.P. 8(a)(2). A defendant may move to dismiss a claim or case because the complaint fails to "state a claim upon which relief can be granted." Fed.R.Civ.P. 12(b). When considering a Rule 12(b)(6) motion to dismiss, the court must presume all of the factual allegations in the complaint are true and draw all reasonable inferences in favor of the nonmoving party. Total Benefits Planning Agency, Inc., 552 F.3d at 434 (citing Great Lakes Steel v. Deggendorf, 716 F.2d 1101, 1105 (6th Cir. 1983)). "The court need not, however, accept unwarranted factual inferences." Id. (citing Morgan v. Church's Fried Chicken, 829 F.2d 10, 12 (6th Cir. 1987)).

Even though a "complaint attacked by a Rule 12(b)(6) motion to dismiss does not need detailed factual allegations, a plaintiff's obligation to provide the grounds of his entitlement to relief requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (citations omitted). Instead, the plaintiff's "[f]actual allegations must be enough to raise a right to relief above the speculative level on the assumption that all the allegations in the complaint are true (even if doubtful in fact)." Id. (citations omitted). A complaint should contain enough facts "to state a claim to relief that is plausible on its face." Id. at 570. A claim becomes plausible "when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Ashcroft v. Iqbal, 129 S.Ct. 1937, 1949 (2009) (citing Twombly, 550 U.S. at 556). If, from the well-pleaded facts, the court cannot "infer more than the mere possibility of misconduct, the complaint has alleged-but has not show[n]'-that the pleader is entitled to relief.'" Id. at 1950 (citing Fed.R.Civ.P. 8(a)(2)). "Only a complaint that states a plausible claim for relief survives a motion to dismiss." Id.

DISCUSSION

Defendant Lincoln contends that the claims for breach of fiduciary duty under 29 U.S.C. § 1132(a)(3) in Counts II and III are prohibited because they are premised upon the same conduct or request the same relief as a claim for a denial of benefits under 29 ...


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