United States District Court, W.D. Kentucky, Louisville
JAMES W. HOWARD II PLAINTIFF
THE PRUDENTIAL INSURANCE COMPANY OF AMERICA DEFENDANT
Charles R. Simpson III, Senior Judge.
matter is before the Court on the partial motion of Defendant
the Prudential Insurance Company of America
(“Prudential”) to dismiss Count II of the first
amended complaint and on its motion to strike the requests
for extra-contractual and punitive damages, as well as the
jury demand under Federal Rule of Civil Procedure 12(b)(6),
ECF No. 15. Plaintiff James W. Howard II did not respond. For
the reasons explained below, the Court will grant
Prudential's partial motion to dismiss Count II. The
Court will also grant Prudential's motion to strike the
requests for extra-contractual and punitive damages, and the
Allegations in the First Amended Complaint
2015, Howard was operating his vehicle in Louisville
Kentucky. First Am. Compl. ¶ 4, ECF No. 13. He was
traveling eastbound on Greenwood Road. Id. Howard
experienced a medical emergency and became incapacitated at
the wheel. Id. His son, a juvenile, was a passenger
in the vehicle. Id. ¶ 5. The son attempted to
take control of the steering wheel as the vehicle continued
to accelerate. Id. The vehicle veered off the
roadway's right shoulder, struck a culvert, severed a
utility pole, and collided with a fence. Id. ¶
6. It then crossed Russell Avenue, and stuck a street sign,
fire hydrant, large shrubbery, and finally another utility
was mechanically extracted from the vehicle and taken to the
University of Louisville Hospital with life-threatening
injuries. Id. ¶ 7. As a result of these
injuries, his left hand was amputated at the wrist.
Id. ¶ 8. It was determined that Howard had
suffered a seizure while operating his vehicle, which
resulted in his incapacitation and the subsequent collision.
Id. ¶ 9. Howard had been diagnosed with Type I
diabetes and might have been hypoglycemic at the time of the
motor vehicle accident. Id. ¶ 10.
the time of the motor vehicle accident, Howard was employed
by the United Parcel Service. Id. ¶ 11. He was
insured under an Accidental Death and Dismemberment Policy
(“the policy”) issued by Prudential. Id.
Within ninety days of his motor vehicle accident, Howard made
a valid claim for payment of benefits under the policy
because of his left hand's amputation. Id.
¶¶ 12, 15.
policy pays benefits for “accidental loss, ”
meaning the loss of a person's hand or foot by severance
at or above the wrist or ankle. Id. ¶ 13. The
loss of the beneficiary's hand or foot must result
directly from an accidental bodily injury and occur within
ninety days after the accident. Id. ¶ 14. The
policy does not, however, pay benefits for losses resulting
from sickness, or from medical or surgical treatment of
sickness. Id. ¶ 16.
February 2016, Howard was notified that Prudential had denied
his claim for benefits under the policy. Id. ¶
12. Prudential explained that it had denied the claim because
the loss of Howard's left hand resulted indirectly from
sickness, or from the medical or surgical treatment of
sickness. Id. ¶ 17. According to Prudential,
Howard's insulin treatment for diabetes caused him to
become hypoglycemic, which led to his seizure and eventual
loss of his hand. Id.
also explained that it had denied the claim for benefits
under the policy because the loss of Howard's hand
resulted directly from sickness, or from the medical or
surgical treatment of sickness. Id. ¶ 18.
Prudential asserts that Howard's insulin treatment for
diabetes caused him to become hypoglycemic, which then caused
him to suffer a seizure that led to the motor vehicle
accident, which caused him to sustain an injury to his left
hand that then led to the amputation of the hand.
Id. Howard's medical records, however, indicate
only that he became incapacitated while driving because of a
possible seizure and that his left hand was amputated as a
direct result of injuries he sustained in the motor vehicle
accident. Id. ¶ 19.
asserts two causes of action against Prudential in the first
amended complaint. First, Howard claims that Prudential's
denial of his claim for benefits under the policy violates
the Employment Retirement Income Security Act of 1974
(ERISA), 29 U.S.C. § 1132(a)(1)(B) (Count I).
Id. ¶ 24. Second, Howard alleges that
Prudential's actions violated the Kentucky Unfair Claims
Settlement Practices Act (KUCSPA), Ky. Rev. Stat. §
304.12-230 (Count II). Id. ¶ 25. Howard
requests a jury trial, an award of exemplary, compensatory,
and punitive damages, an award of reasonable costs and
attorney fees, and any other appropriate relief. Id.
now moves to dismiss Howard's claim asserted under the
KUCSPA and to strike the requests for extra-contractual and
punitive damages, and the jury demand under Federal Rule of
Civil Procedure 12(b)(6). Mot. Dismiss 1, ECF No. 15. Rule
12(b)(6) provides that a party may move to dismiss a cause of
action for “failure to state a claim upon which relief
can be granted.” To survive a motion to dismiss, a
complaint must contain sufficient facts to state a claim that
is “plausible on its face.” Bell Atl. Corp.
v. Twombly, 55 U.S. 544, 570 (2007). A complaint states
a plausible claim for relief when the court may “draw
the reasonable inference that the defendant is liable for the
misconduct alleged.” Ashcroft v. Iqbal, 556
U.S. 662, 678 (2009). A court is not required to accept legal
conclusions or “threadbare recitals of the elements of
a cause of action.” Id. When resolving a
motion to dismiss, the court must “construe the
complaint in the light most favorable to the plaintiff,
accept its allegations as true, and draw all reasonable
inferences in favor of the plaintiff.” Wesley v.
Campbell, 779 F.3d 421, 428 (6th Cir. 2015) (quoting
Directv, Inc. v. Treesch, 487 F.3d 471, 476 (6th
argues that the Court should dismiss Howard's claim
asserted under the KUCSPA and requests for extra-contractual
and punitive damages because they are preempted by ERISA as a
matter of law. Mem. Supp. Mot. Dismiss 4-9, ECF No. 15-1.
Prudential also claims that the Court should strike