Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_14-cv-00043/USCOURTS-almd-2_14-cv-00043-0/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1001 E.R.I.S.A.: Employee Retirement

---

IN THE DISTRICT COURT OF THE UNITED STATES FOR THE 

MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION

CHARLES M. DAVIS, )

)

Plaintiff, )

) CIVIL ACTION NO.

v. ) 2:14cv43-MHT

) (WO) 

THE PRUDENTIAL INSURANCE )

COMPANY OF AMERICA, )

)

Defendant. )

OPINION

Plaintiff Charles M. Davis brings this lawsuit

against defendant Prudential Insurance Company of

America, claiming breach of contract and unjust

enrichment based on Prudential’s refusal to pay his

insurance claim for disability benefits. Prudential

removed this case from state court to this federal court

under 28 U.S.C. § 1441, asserting that Davis’s claims are

‘completely preempted’ by the Employee Retirement Income

Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et

Case 2:14-cv-00043-MHT-WC Document 22 Filed 09/29/15 Page 1 of 11
seq., and thus the court has jurisdiction under 28 U.S.C.

§ 1331. 

The case is now before this court on Prudential’s

motion to dismiss for failure to state a claim. For the

reasons that follow, the dismissal motion will be

granted, and the complaint will be dismissed, albeit 

without prejudice and with leave to amend.

I. LEGAL STANDARD

In considering a defendant’s motion to dismiss, the

court accepts the plaintiff’s allegations as true, Hishon

v. King & Spalding, 467 U.S. 69, 73 (1984), and construes

the complaint in the plaintiff’s favor, Duke v. Cleland,

5 F.3d 1399, 1402 (11th Cir. 1993). “The issue is not

whether a plaintiff will ultimately prevail but whether

the claimant is entitled to offer evidence to support the

claims.” Scheuer v. Rhodes, 416 U.S. 232, 236 (1974). 

To survive a motion to dismiss, a complaint need not

contain “detailed factual allegations,” Bell Atl. Corp.

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v. Twombly, 550 U.S. 544, 545 (2007), “only enough facts

to state a claim to relief that is plausible on its

face.” Id. at 574.

II. BACKGROUND

This case arises out of Prudential’s denial of

Davis’s workplace disability claim. Davis worked as a

customer service representative at a bottling plant in

southeast Alabama for some time before stopping due to

severe headaches and visual dysfunction in mid-2012.

Based on these conditions, he filed a disability claim

with Prudential under a benefits plan provided by his

employer. After considering the medical records in

Davis’s file, Prudential denied his claim. About a month

later, Prudential denied the claim for a second time

after examining additional medical records. 

Davis filed suit in an Alabama state court against

Prudential for wrongful denial of his benefit claim. He

alleges that Prudential breached its contract because it

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Case 2:14-cv-00043-MHT-WC Document 22 Filed 09/29/15 Page 3 of 11
“refused ... and has continued to refuse” coverage, and

that it has been unjustly enriched as a result. The

breach of contract and unjust enrichment counts are the

only causes of action in the complaint.

Prudential removed the case to this court and now

seeks to dismiss the case. 

III. DISCUSSION

Prudential argues that the complaint should be

dismissed because ERISA preempts Davis’s state-law

claims. And, even if his claims are not preempted,

Prudential further contends, Davis failed to plead

exhaustion and to exhaust his remedies, both of which are

required under ERISA. 

A. Jurisdiction

Before reaching the merits, the court must consider

whether it has subject-matter jurisdiction. See

Chacon-Botero v. U.S. Atty. Gen., 427 F.3d 954, 956 (11th

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Cir. 2005). Prudential removed the current action from a

state court to this federal court, alleging that this

court has federal-question jurisdiction under 28 U.S.C.

§ 1331.

A defendant may remove any civil action where the

district court would have had original jurisdiction. See

28 U.S.C. § 1441. A court has original federal-question

jurisdiction if a federal issue is apparent on the face

of the plaintiff’s complaint. See Merrell Dow Pharm.

Inc. v. Thompson, 478 U.S. 804, 808 (1986). Under this

well-pleaded complaint rule, “a defense that raises a

federal question is inadequate to confer federal

jurisdiction.” Id. There is an exception to the

well-pleaded complaint rule--that the federal question

must be apparent on the face of the complaint--in cases

where Congress “so completely pre-empt[s] a particular

area that any civil complaint raising this select group

of claims is necessarily federal in character.”

Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 63-64

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(1987); Jones v. LMR Intern., Inc., 457 F.3d 1174, 1178

(11th Cir. 2006). 

ERISA, which applies to “any employee benefit plan

... established or maintained ... by any employer engaged

in commerce or in any industry or activity affecting

commerce,” is one such case of complete preemption. 29

U.S.C. § 1003(a). The Eleventh Circuit Court of Appeals

has adopted a two-part test to determine whether ERISA

completely preempts a state-law claim: “(1) whether the

plaintiff could have brought its claim under § 502(a);

and (2) whether no other legal duty supports the

plaintiff’s claim.” Connecticut State Dental Ass'n v.

Anthem Health Plans, Inc., 591 F.3d 1337, 1345 (11th Cir.

2009) (citing Aetna Health Inc. v. Davila, 542 U.S. 200,

210 (2004)). If an ERISA claim is completely preempted,

“state law claims that seek relief available under ERISA

are recharacterized as ERISA claims” for the purpose of

jurisdiction and thus “arise under federal law.” LMR, 457

F.3d at 1178.

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Case 2:14-cv-00043-MHT-WC Document 22 Filed 09/29/15 Page 6 of 11
Davis’s claims meet both prongs of the test. First,

Davis could have brought the claims under ERISA. ERISA’s

§ 502(a) states that a participant or beneficiary of an

employee insurance plan may bring an action to recover

benefits or enforce his rights under a plan. 29 U.S.C.

§ 1132(a). In this case, neither party disputes that the

long-term disability plan is an employee insurance plan

subject to ERISA.1

 Davis, as a participant, is suing for

breach of contract and unjust enrichment because

Prudential refused to pay benefits. Rather than suing

under state law, Davis could have brought an action for

denial of benefits under § 502(a).

Second, the theories upon which Davis based his

claims “did not arise independently” from his ERISA plan.

Anthem, 591 F.3d at 1346. There is no independent legal

1. In Davis’s opposition to the motion to dismiss, he

does not address jurisdiction or preemption. However,

when rebutting Prudential’s contention that he failed to

exhaust the company’s administrative remedies, he does

not contend that ERISA does not apply. Instead, he argues

that he met the exhaustion requirement under ERISA,

suggesting that he accepts ERISA’s applicability.

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duty in an ERISA case if “interpretation of the terms of

[the] benefit plan[] forms an essential part” of the

legal claim. Davila, 542 U.S. at 213. Here, Davis argues

that Prudential should have paid him disability benefits

under the plan, but did not. To determine the merits of

Davis’s legal claims, the court would have to understand

the terms of the disability plan and whether Davis’s

ailments fell under these terms. In other words, the

essential part of the claims would be the court’s

interpretation of the plan. As such, no other independent

legal duty supports the claims.

Because Davis could have brought his legal claims

under § 502(a) and did not have an independent basis for

the claims, they are completely preempted by federal law.

Therefore, the claims arise under federal law, and the

court has proper federal-question jurisdiction. 

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B. Defensive Preemption

Given that there is subject-matter jurisdiction, the

court turns to Prudential’s motion to dismiss. Prudential

first argues that Davis’s complaint should be dismissed

because ERISA preempts his state-law claims.

Defensive preemption is a separate inquiry from

complete preemption.2

 “Unlike complete preemption, which

is jurisdictional, defensive preemption is a substantive

defense, justifying dismissal of preempted state law

claims.” LMR, 457 F.3d at 1179. ERISA preempts “any and

all State” law claims if the claims relate to an ERISA

plan. 29 U.S.C. § 1444(a) (emphasis added); id. 

The question whether a law relates to an ERISA plan

is one of Congressional intent. Shaw v. Delta Air Lines,

Inc., 463 U.S. 85, 95 (1983). In enacting ERISA,

2. Courts have recognized that “[c]omplete preemption

is narrower than defensive preemption.” Anthem Health

Plans, 591 F.3d at 1343 (internal quotation marks

omitted). In other words, if a state-law claim is

completely preempted under the narrower test, it will

likely also be preempted under the broader defensive

preemption test. 

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Congress did not simply intend to counteract state laws

meant to affect employee benefit plans, but instead

created a broad preemption for any law that “has

connection with or reference to such a plan.” Id. at

97; LMR, 457 F.3d at 1179-80. Under this broad standard,

courts have regularly dismissed breach-of-contract and

unjust-enrichment claims based on an employer’s or

provider’s failure to pay a claim. See, e.g., LMR, 457

F.3d at 1180 (dismissing as preempted under ERISA

state-law breach-of-contract, unjust-enrichment, and

fraud claims against employer who failed to fund the

benefits plan). 

Davis claims that Prudential breached its contract

and was unjustly enriched when it refused to pay his

disability claim. These two claims not only reference

the ERISA plan, but are based entirely on the plan. They

are classic examples of state-law claims that relate to

an ERISA plan and are thus preempted under federal law. 

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Because Davis’s only claims are state-law claims and

are both preempted under ERISA, the court grants the

motion to dismiss.3

***

An appropriate judgment will be entered granting

Prudential‘s motion to dismiss and dismissing this

lawsuit, albeit without prejudice and with leave to

amend.

 DONE, this the 29th day of September, 2015.

 /s/ Myron H. Thompson 

UNITED STATES DISTRICT JUDGE

3. The court also questions whether Davis’s

contention that Prudential “has continued to refuse

coverage” meets the exhaustion pleading requirement. The

court need not decide this issue, or whether Davis

actually exhausted Prudential’s appeals process, given

that both of Davis’s claims are preempted by federal law.

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