United States District Court, E.D. Kentucky, Northern Division, Ashland
MEMORANDUM OPINION AND ORDER
R. Wilhoit, Jr. United States District Judge
matter is before the Court upon Defendants The Lincoln Life
Insurace Company ad Lincoln National Corporation's Motion
to Dismiss, or in the Alternative, Motion fr Summary Judgment
[Docket No. 8]. The matter has been fully briefed by the
parties [Docket Nos. 10 and 13]. The for the reasons stated
herein, the Court fends that the Complaint fails to state a
claim upon which relief can be granted.
case arises for a dispute regarding benefts under a group
long term disability policy issued by Defendant The Lincoln
National Life Insurance Company ("Lincoln") to
Plaintiffs employer, Diversicare Healthcare Services, Inc.
Lincoln issued the policy to Diversicare to fund benefits
under its employee welfare benefit plan. [Docket No. 1-1,
Declaration of Thomas J. Vargo].
2016, while employed by Diversicare, Plaintiff suffered a
stroke and was unable to work. [Amended Complaint, Docket No.
7, ¶¶ 7-8]. Lincoln first awarded benefits under
the subject plan from November 6, 2016 to June 6, 2017.
[Docket No. 8-1, ¶ 6]. Lincoln originally denied
Plaintiffs requests for benefits beyond June of 2017.
[Amended Complaint, Docket No. 7, ¶ 12]. Plaintiff
appealed. Id. at ¶ 13. Following the appeal and
submission of additional records, Lincoln paid benefits to
Plaintiff for the period June 6, 2017 to December 31, 2017.
[Docket No. 8-1, ¶ 7].
an additional appeal was pending, Plaintiff filed this
lawsuit against Lincoln, alleging negligence (Count I),
negligent infliction of emotional distress (Count II),
outrage (Count III), fraudulent misrepresentation (Count IV),
violations of Kentucky's Consumer Protection Act, KRS
§367.170 (Count V).
the aforementioned appeal and review, Lincoln issued a
favorable determination on April 22, 2019. Id. at,
¶ 8. It appears from the record that Plaintiff continues
to receive monthly disability benefits from Lincoln.
two weeks later, Plaintiff Amended her Complaint to include
allegations of bad faith (Count VI) and violations of
Kentucky's Unfair Claims Settlement Practices Act, KRS
§304.12-230. [Docket No. 7].
seeks dismissal of all claims alleged herein, arguing that
they are preempted by the Employee Retirement Income Security
Act, 26 U.S.C. § 219, et seq.
Rule of Civil Procedure 12(b)(6) provides for the dismissal
of a complaint that fails to state a claim upon which relief
can be granted. The purpose of Rule 12(b)(6) is to permit a
defendant to test whether, as a matter of law, the plaintiff
is entitled to relief even if everything alleged in the
complaint is true. Mayer v. Mylod, 988 F.2d 635, 638
(6th Cir. 1993). To survive a motion to dismiss under
12(b)(6), plaintiffs "factual 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." Assoc. of Cleveland Fire Fighters v. City of
Cleveland, Ohio, 502 F.3d 545, 548 (6th Cir. 2007)
(citing Bell Atlantic v. Twombly, 127 S.Ct. 1955,
1974 (2007)). "[A] plaintiffs 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." Id.
The Court must determine not whether the plaintiff will
ultimately prevail but whether the plaintiff is entitled to
offer evidence to support his claims. Scheuer v.
Rhodes, 416 U.S. 232, 236 (1974). In making this
determination, the Court must construe the complaint in the
light most favorable to plaintiff and accept as true all
well-pleaded factual allegations. Mixon v. Ohio, 193
F.3d 389, 400 (6th Cir. 1999).
parties do not dispute that this case is governed by the
Employee Retirement Income Security Act ("ERISA").
The Policy referenced in Plaintiffs Amended Complaint is a
group long term disability insurance policy issued by Lincoln
to Diversicare, Plaintiffs employer. Lincoln issued the
Policy to Plaintiffs employer to fund benefits under
Diversicare's employee welfare benefit plan. The Plan is
an "employee welfare benefit plan" governed by
ERISA because it is funded by Diversicare and was for the
purpose of providing benefits to its employees. 29 U.S.C.
argues that because the Plan is governed by ERISA, Plaintiffs