Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-01768/USCOURTS-azd-2_12-cv-01768-0/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 28:1441 Petition for Removal- Contract Default

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Chris Komarnisky, 

Plaintiff, 

v. 

United Healthcare Insurance Company, 

Defendant.

No. CV-12-01768-PHX-DGC

ORDER 

 Plaintiff, Dr. Chris Komarnisky, filed a complaint against Defendant on July 16, 

2012 in the San Marcos Justice Court for Maricopa County. Defendant United 

Healthcare Insurance Company (“UHIC”) removed the matter to this Court on 

August 17, 2012. Doc. 1. On August 24, 2012, UHIC filed a motion to dismiss pursuant 

to Rule 12(b)(6) on the grounds that the claims are pre-empted by the exclusive remedial 

provisions of the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 

U.S.C §§ 1001. Doc. 7. Plaintiff filed a response on December 6, 2012 (Doc. 11), and 

UHIC filed a reply on December 17, 2012 (Doc. 12). No party has requested oral 

argument. For the reasons that follow, the Court will grant UHIC’s motion to dismiss. 

UHIC is the administrator of an ERISA health plan sponsored by Wells Fargo & 

Company. Doc. 7 at 1-2. Plaintiff is a doctor that provided chiropractic services for 

Terri Genevay, a participant in the Wells Fargo health plan. Doc. 7 at 1-2. Plaintiff 

alleges that the plan applied payment for 27 chiropractic visits to Ms. Genevay’s 

deductible rather than compensating him. Plaintiff brings state law breach of contract 

claims, presumably as his patient’s assignee, against UHIC. Defendant argues that 

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Plaintiff’s state law claims are preempted by exclusive remedial provisions of ERISA and 

that the plan participant did not exhaust administrative remedies. 

 State causes of action that duplicate, supplement, or supplant the civil enforcement 

provisions of ERISA are preempted by § 502(a). Aetna Health, Inc. v. Davila, 542 U.S. 

200, 208-09 (2004). The state law claims do not need to precisely duplicate the elements 

of an ERISA claim to be preempted. Id at 216. In the Ninth Circuit, ERISA participants 

also must exhaust the plan’s internal administrative procedures before bringing suit. 

Vaught v. Scottsdale Healthcare Corp. Health Plan, 546 F.3d 620, 626 (9th Cir. 2008). 

UHIC argues that the state law breach of contract claims arise from a dispute 

regarding coverage under an ERISA plan, 29 U.S.C. § 1002(1), and are preempted. 

Plaintiff argues that UHIC’s preemption arguments are attempts to delay the litigation 

and, because the claim is relatively small, the parties should “keep it simple and get this 

over with.” Doc. 11 at 2. Plaintiff’s arguments do not respond to the legal merits of the 

UHIC’s motion, nor does he dispute that the plan is governed by ERISA. In the absence 

of any argument to the contrary, the Court finds that the state law claims “duplicate, 

supplement, or supplant[]” the ERISA civil enforcement remedy and are preempted. 

Davila, 542 U.S. at 208. 

 Additionally, Plaintiff does not respond directly to UHIC’s argument that the plan 

participant failed to exhaust her administrative remedies. Plaintiff does not dispute that 

Mrs. Genevay never availed herself of the plan’s internal procedures for benefit denial 

disputes, and his appeal on her behalf was not initiated until several months after he filed 

this complaint. The Court also finds that this claim is barred by failure to exhaust 

administrative remedies. Vaught, 546 F.3d at 626. 

 IT IS ORDERED that Defendant’s motion to dismiss (Doc. 7) is granted. The 

Clerk is directed to terminate this action. 

 Dated this 12th day of February, 2013. 

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