Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_14-cv-00721/USCOURTS-almd-2_14-cv-00721-0/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 UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF ALABAMA

NORTHERN DIVISION

SUSAN TILL, )

 )

Plaintiff, )

 )

v. ) CASE NO. 2:14-CV-721-WKW

 ) [WO]

LINCOLN NATIONAL LIFE )

INSURANCE COMPANY, et al., )

 )

Defendants. )

MEMORANDUM OPINION AND ORDER

Plaintiff Susan Till sues Defendants Lincoln National Life Insurance 

Company (“Lincoln”), Gilliard Health Services, Inc. Disability Plan (Plan 504), 

and Gilliard Health Services, Inc. Group Term Life Plan (Plan 503) (collectively 

“the Plans”) for various violations of the Employee Retirement Income Security 

Act of 1974 (“ERISA”). See 29 U.S.C. § 1101 et seq. Before the court is 

Defendants’ motion to dismiss. (Doc. # 9.)

1

 Plaintiff opposes the motion to 

dismiss (Doc. # 14) and has filed a motion to strike Defendants’ Document # 9-1, 

the “Summary Plan Description,” attached to Defendants’ motion to dismiss (Doc. 

# 15). Defendants have replied to Plaintiff’s opposition brief and oppose her 

motion to strike. (Docs. # 17, 18.) Upon consideration of the complaint, the 

parties’ arguments, and relevant law, the court concludes that Defendants’ motion 

 

1 All references to page numbers in this opinion are to the pages created by CM/ECF.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 1 of 16
2

to dismiss is due to be granted in part and denied in part and that Plaintiff’s motion 

to strike is due to be denied.

I. JURISDICTION AND VENUE

The court has subject-matter jurisdiction pursuant to 28 U.S.C. § 1331 and 

29 U.S.C. § 1132(e). Defendants do not contest personal jurisdiction or venue.

II. STANDARDS OF REVIEW

When evaluating a motion to dismiss pursuant to Federal Rule of Civil 

Procedure 12(b)(6), the court must take the facts alleged in the complaint as true 

and construe them in the light most favorable to the plaintiff. Resnick v. AvMed, 

Inc., 693 F.3d 1317, 1321–22 (11th Cir. 2012). To survive Rule 12(b)(6) scrutiny, 

“a complaint must contain sufficient factual matter, accepted as true, to ‘state a 

claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 

(2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). “[F]acial 

plausibility” exists “when the plaintiff pleads factual content that allows the court 

to draw the reasonable inference that the defendant is liable for the misconduct 

alleged.” Id. (citing Twombly, 550 U.S. at 556).2

 

2

In her brief, Plaintiff characterizes Defendants’ motion to dismiss as a motion to strike 

redundant or duplicative relief per Rule 12(f), and she consequently offers a Rule 12(f) standard 

of review. The court rejects Plaintiff’s position and finds that Defendants have properly raised 

their arguments pursuant to Rule 12(b)(6).

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 2 of 16
3

III. BACKGROUND

Plaintiff resides in Butler County, Alabama, and was employed as a 

radiology technician by Gilliard Health Services, d/b/a Evergreen Medical Center 

(“Gilliard”). Gillard purchased long term disability insurance and group life 

insurance for its employees, including Plaintiff. Lincoln sold and underwrote 

Plaintiff’s policies.

On December 4, 2012, Plaintiff injured her back at work while assisting a 

heavy patient on and off an x-ray table. She immediately stopped working on 

December 5, 2012, because she was experiencing pain in her lower back and legs –

pain that persists today. Plaintiff’s doctors have diagnosed her with spondylotic

disease of the thoracic spine and multilevel spondylotic disease of the lumbar 

spine3and have concluded, after consulting with neurosurgeons, that Plaintiff’s

back problems are too severe for operation and that surgery would not likely yield 

any significant benefits.

Plaintiff alleges that she meets the Disability Plan’s definition of “disabled,” 

but Lincoln refuses to extend long term disability benefits to her. Per the disability 

insurance policy, Plaintiff says she should have been provided with twenty-four 

months of benefits under the policy’s “own occupation” definition for disability. 

During that period, Plaintiff said that she had a “total disability,” which is defined 

 

3

Spondylitis is an inflammation of the vertebrae.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 3 of 16
4

as an insured’s inability to perform each of the main duties of her regular 

occupation. Following the passage of that twenty-four month period, Plaintiff 

claims she will remain totally disabled and eligible to receive additional benefits 

for her inability to work in any “gainful occupation,” which is defined as her 

ability to earn a certain amount of her pre-disability earnings. The Social Security 

Administration has deemed Plaintiff incapable of working in any occupation and 

has designated her disabled as of December 5, 2012.

Lincoln denied Plaintiff’s first claim on March 18, 2013. Plaintiff alleges 

that Lincoln hired a third party to find a “reasonable” basis for denying the claim. 

She asserts that the third party misclassified her job as “light” even though her 

employer provided documentation showing that she performed heavy lifting. 

Plaintiff appealed the denial with the assistance of counsel and submitted 

additional evidence of her disabilities, but Lincoln denied the claim again on 

November 1, 2013. She appealed a second time, presenting years of medical 

record evidence to satisfy Lincoln, but Lincoln denied the claim a third time on 

July 9, 2014. She alleges that Lincoln concocted new reasons to deny the claim 

each time she appealed.

Plaintiff asserts that Lincoln is a Plan fiduciary charged with certain duties 

under ERISA and that Lincoln has breached several of its duties. She also alleges 

that Lincoln is a de facto Plan administrator, and that it failed to provide requested 

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 4 of 16
5

documents to her, pursuant to federal law, which supported its decisions to deny 

benefits. The complaint does not set out numbered counts against Defendants. 

Plaintiff seeks to recover “all benefits under the Plan to which she may be 

entitled,” “waiver of premium benefits under disability, life, accidental death and 

dismemberment or accident policies,” and “any other benefits available through 

[t]he Plan.” (Doc. # 1, at ¶ 2.) Plaintiff further seeks an award of past benefits, 

prejudgment interest, costs and expenses including attorney’s fees, a declaratory 

judgment concerning Plaintiff’s entitlement to future benefits, and other injunctive 

relief. (See Doc. # 1, at 17–18.) She requests, as an alternative form of relief, that 

the court “remove Lincoln from its fiduciary role in the administration of [t]he 

Plan(s), and to appoint a special master to substitute for [Lincoln].” (Doc. # 1, 

at 17–18.)

IV. DISCUSSION

A. Failure to State Claims Against the Plans

1. The Arguments

The Plans contend that all of Plaintiff’s complaints are directed at Lincoln

and that there is no factual basis to support the Plans’ joinder as defendants in this 

action because Lincoln made all of the relevant decisions to deny Plaintiff’s claims 

for disability benefits. 

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 5 of 16
6

Plaintiff responds that the Plans are “ultimately charged with the 

responsibility of providing the benefits at issue after the [plan] administrator . . . 

determines the participant’s eligibility.” (Doc. # 14, at 6.) She asserts that while 

“ERISA Plans may contract with insurers like Lincoln to administer and pay the 

Plans’ liability, the Plans’ liability is forever the Plans’ liability.” (Doc. # 14, at 6.) 

Plaintiff concedes that the Plans may at some point be dismissed from the case, but 

that such a decision cannot be made until the Plans produce certain documents to 

her. It is possible, she says, that she may be “entitled to other benefits that are in 

addition to her disability income protection benefit” for which the Plans “are 

involved or at least ultimately responsible.” (Doc. # 14, at 9.) This possibility of 

the Plans’ liability, she argues, is “implicit in all of [her] allegations about her 

disability income protection benefit insured by Lincoln.” (Doc. # 14, at 10 n.5.) 

She also posits that it is possible that “the document or instrument establishing the 

terms for Plaintiff’s disability income protection benefit conflicts with the terms of 

coverage provided by Lincoln, such that [she] is entitled to receive this benefit 

from the Plans.” (Doc. # 14, at 9.) Plaintiff avers that she anticipated this 

possibility by requesting generally “an order requiring Defendant[s] to provide 

[her] with any additional benefits to which [she] would be entitled. . . .” (Doc. # 1, 

at 18 ¶ g.)

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 6 of 16
7

In reply, Defendants note that Plaintiff failed to respond to or contradict any 

of the various cases cited in their motion to dismiss, each of which supports the 

proposition that an ERISA plan is not a proper defendant where the insurer 

administers the plan’s benefits. Defendant further contends that “Plaintiff’s 

response focuses on possibility instead of plausibility,” and that Rule 8 requires 

allegations that plausibly give rise to entitlement to relief. (Doc. # 17, at 3.)

2. Analysis

In Peters v. Hartford Life & Accident Insurance Co., 367 F. App’x 69, 71 

(11th Cir. 2010), opinion vacated on reconsideration, No. 08-16070, 2014 WL 

4441213 (11th Cir. Sept. 10, 2014), the Circuit affirmed a district court’s dismissal 

of a plaintiff’s employer on the grounds that “[t]he proper party defendant in an 

action concerning ERISA benefits is the party that controls administration of the 

plan.” Id. (citing Garren v. John Hancock Mut. Life Ins. Co., 114 F.3d 186, 187 

(11th Cir. 1997)).4 The question is, therefore, whether the Plans must be joined in 

the absence of any allegation of wrongdoing on their part.

In two recent decisions from the Northern District of Alabama, Smith v. Life 

Ins. Co. of N. Am., No. 1:13-CV-2047-VEH, 2014 WL 1330936, at *3 (N.D. Ala. 

Mar. 31, 2014), Caudle v. Life Ins. Co. of N. Am., No. 1:14-CV-545-VEH, 2014 

 

4

The Eleventh Circuit recalled its mandate and vacated the 2010 Peters opinion after a 

member of the original panel discovered that he had a conflict of interest at the time that he 

participated in the case. Peters, 2014 WL 4441213, at *1. After the newly constituted panel

reviewed the case, it also affirmed the district court’s dismissal of the employer.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 7 of 16
8

WL 2999178, at *3 (N.D. Ala. June 27, 2014), Judge Hopkins dismissed without 

prejudice employer plans as defendants from the cases where the plaintiffs’ 

complaints failed to plausibly assign any wrongdoing to the plans.

5

Upon consideration of the case authorities cited by Defendants and the 

Rule 8 pleading standard elucidated by the Supreme Court in Twombly and Iqbal, 

the court concludes that the Plans are due to be dismissed without prejudice 

because Plaintiff has not alleged sufficient facts to support their joinder in this 

action. If Plaintiff becomes aware of facts supporting her causes of action against 

the Plans, she may move for leave to amend her complaint.

B. Failure to State a Claim for Breach of Fiduciary Duty

1. The Arguments

Lincoln argues that the court should dismiss Plaintiff’s breach of fiduciary 

duty claim, arising under Section 502(a)(3), because a Section 502(a)(3) claim is 

not allowed when a plaintiff has an adequate ERISA remedy for the recovery of 

benefits under Section 502(a)(1)(B). Notably, Plaintiff’s complaint lacks any 

enumerated counts to indicate that she has alleged discrete causes of action under 

certain sections of ERISA. She does allege, however, that Lincoln breached

fiduciary duties owed to her. (Doc. # 1, at ¶¶ 54, 56, 75–76.) 

 

5 Defendants note that Plaintiff’s counsel in this action served as the plaintiffs’ counsel in 

both Smith and Caudle.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 8 of 16
9

Plaintiff first responds by generally arguing that the Federal Rules of Civil 

Procedure permit her to plead claims or theories of liability in the alternative. 

(Doc. # 14, at 14 (citing Fed. R. Civ. P. 8(a)(3), which allows for the pleading 

party’s “demand for the relief” to “include relief in the alternative or different 

types of relief”).) She notes that other courts, including this one, have allowed 

ERISA plaintiffs to raise dual claims at the pleading stage, even though they would 

ultimately be barred from recovering under both (a)(1)(B) and (a)(3) at summary 

judgment or trial. See Silva v. Metro. Life Ins. Co., 762 F.3d 711, 726 (8th Cir. 

2014) (citing Black v. Long Term Disability Ins., 373 F. Supp. 2d 897, 902–03 

(E.D. Wis. 2005)); Poole v. Life Ins. Co. of N. Am., 984 F. Supp. 2d 1179, 1188

(M.D. Ala. 2013) (Watkins, J.).6

Secondly, Plaintiff responds more specifically that the “equitable reliefs” she 

seeks – namely that Lincoln be removed and replaced as the administrator and that 

the court issue an affirmative injunction against Lincoln requiring it to follow 

ERISA – “are uniquely § 502(a)(3) remedies” that “are not available under 

§ 502(a)(1)(B)” and which cannot be supplanted by an award of benefits. (Doc. 

# 14, at 19.)

 

6

In Poole, this court relied on Jones v. American General Life & Accident Insurance Co., 

370 F.3d 1065, 1069 (11th Cir. 2004), to permit alternative pleading where the plaintiff pleaded 

allegations of breach of fiduciary duty that were factually distinct from allegations of failure to 

pay benefits. 984 F. Supp. 2d at 1188.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 9 of 16
10

These requested equitable remedies are distinct from a cause of action for 

breach of fiduciary duty under Section 502(a)(3), which is what Defendants want 

dismissed from this case. Thus, Defendants reply that Plaintiff misrepresents the 

issue and ignores Eleventh Circuit precedent. Defendants emphasize the directive 

in Jones that “the district court should . . . consider[ ] whether the allegations 

supporting the Section 502(a)(3) claim [a]re also sufficient to state a cause of 

action under Section 502(a)(1)(B), regardless of the relief sought.” 370 F.3d 

at 1073. (See Doc. # 17, at 4–5.)

2. Analysis

Claims for the recovery of benefits arise under Section 502(a)(1)(B) of 

ERISA. 29 U.S.C. § 1132(a)(1)(B) (allowing plan beneficiaries “to recover 

benefits due to him under the terms of his plan, to enforce his rights under the 

terms of the plan, or to clarify his rights to future benefits under the terms of the 

plan”). Claims for equitable relief arise under Section 502(a)(3). Id.

at § 1132(a)(3) (allowing plan beneficiaries “(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”).

“Section 502(a)(3) is a ‘catchall’ provision that authorizes only ‘appropriate’ 

equitable relief, and, thus, ‘where Congress elsewhere provided adequate relief for 

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 10 of 16
11

a beneficiary’s injury, there will likely be no need for further equitable relief, in 

which case such relief normally would not be ‘appropriate.’” Jones, 370 F.3d 

at 1073 (quoting Varity Corp. v. Howe, 516 U.S. 489, 515 (1996)). In Varity, the 

Supreme Court held that an ERISA plan participant can sue to recover equitable 

relief for breach of fiduciary duty if there is no relief available to her under another 

subprovision of Section 502(a).

The Eleventh Circuit has interpreted Varity to restrict “an ERISA plaintiff 

who has an adequate remedy under Section 502(a)(1)(B)” from “alternatively 

plead[ing] and proceed[ing] under Section 502(a)(3).” Ogden v. Blue Bell 

Creameries U.S.A., Inc., 348 F.3d 1284, 1287 (11th Cir. 2003). But as the Jones 

court explained, “the relevant concern in Varity, in considering whether the 

plaintiffs had stated a claim under Section 502(a)(3), was whether the plaintiffs 

also had a cause of action, based on the same allegations, under Section 

502(a)(1)(B) or ERISA’s other more specific remedial provisions.” Jones, 370 

F.3d at 1073 (emphasis added). And so the question is “whether the factual 

predicate for [Plaintiff’s] claim could have supported a cause of action under 

§ 1132(a)(1)(B).” Tebbetts v. Blue Cross Blue Shield of Ala., No. 2:07-CV-925-

MEF, 2009 WL 1850537, at *4 (M.D. Ala. June 26, 2009).

Upon review of the allegations in Plaintiff’s complaint relating to Lincoln’s 

alleged breaches of its fiduciary duties, particularly Plaintiff’s detailed allegations 

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 11 of 16
12

in Paragraphs 54(a)–(i), the court concludes that the same factual predicate 

supports Plaintiff’s 502(a)(1)(B) action to recover benefits, to enforce rights, and to 

clarify rights to future benefits. Defendants are correct that Plaintiff may not raise 

a separate cause of action under Section 502(a)(3) for breach of fiduciary duty, and 

any breach of fiduciary duty claim is therefore due to be dismissed.

As for Plaintiff’s arguments that she is entitled to seek certain “equitable 

reliefs” per Section 502(a)(3) which are unavailable under Section 502(a)(1)(B), 

the court declines to determine at this juncture whether all of the forms of relief 

sought in the complaint are allowable, because: (1) Defendants have not asked the 

court to resolve the question; (2) Defendants have not replied fully to Plaintiff’s 

contentions; and (3) there is no need to resolve the question prior to a decision on 

the merits.

C. Failure to State a Claim Against Lincoln for Not Providing Documents

1. The Arguments

Finally, Lincoln argues that Plaintiff’s claims under ERISA for failure to 

furnish documents are due to be dismissed because such claims are properly raised 

against plan administrators. Lincoln points out that Plaintiff’s Long Term 

Disability Insurance Summary Plan Description (hereinafter “the SPD”) identifies 

Gilliard as the Plan Administrator. (See Doc. # 9-1.) Lincoln contends that this 

court may consider the SPD when ruling on the motion to dismiss because the 

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 12 of 16
13

document is central to Plaintiff’s claim and its authenticity is unchallenged. (See

Doc. # 9, at 6 (citing SFM Holdings, Ltd. v. Banc of Am. Sec., LLC, 600 F.3d 1334, 

1337 (11th Cir. 2010)).)

Plaintiff counters that Defendants are holding her “to a fact pleading 

requirement instead of a notice pleading requirement.” (Doc. # 14, at 10.) She 

goes on to explain which ERISA regulations support her claim. Further, Plaintiff 

strongly protests the court’s consideration of the SPD and moves to strike it from 

the record. (Doc. # 15.) She challenges the authenticity of the document because 

it has not been previously produced and is not “part of the ERISA record.” (Doc. 

# 15, at 2.)

Lincoln replies that Plaintiff fails to respond to its argument and that she 

does not deny that the SPD does not name Lincoln as plan administrator. With 

respect to Plaintiff’s motion to strike the SPD, Defendants assert that Rule 12(f) 

applies only to pleadings – not motions or supporting documents. (Doc. # 18, 

at 1.)

2. Analysis

ERISA defines “administrator” as “the person specifically so designated by 

the terms of the instrument under which the plan is operated.” 29 U.S.C. 

§ 1002(16)(A). Section 104(b)(4) requires that

[t]he administrator shall, upon written request of any participant or 

beneficiary, furnish a copy of the latest updated summary, plan 

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 13 of 16
14

description,7and the latest annual report, any terminal report, the 

bargaining agreement, trust agreement, contract, or other instruments 

under which the plan is established or operated.

29 U.S.C. § 1024(b)(4). Under Section 502(c)(1)(B), 

[a]ny administrator . . . who fails or refuses to comply with a request 

for any information which such administrator is required by this 

subchapter to furnish to a participant or beneficiary (unless such 

failure or refusal results from matters reasonably beyond the control 

of the administrator) by mailing the material requested to the last 

known address of the requesting participant or beneficiary within 30 

days after such request may in the court’s discretion be personally 

liable to such participant or beneficiary in the amount of up to $100 a 

day from the date of such failure or refusal. . . .

29 U.S.C. § 1132(c)(1)(B). The Eleventh Circuit has held that “the statute only 

permits an award of penalties against the plan administrator.” Byars v. Coca-Cola 

Co., 517 F.3d 1256, 1270 (11th Cir. 2008). 

Although she does not raise the issue, the court notes that Plaintiff has 

alleged that Lincoln is the de facto plan administrator. (Doc. # 1, at ¶¶ 81, 84.) A 

de facto plan administrator – i.e., one who assumes responsibility for or controls 

the provision of plan documents and information – can be a proper defendant. See 

Rosen v. TRW, Inc., 979 F.2d 191, 193–194 (11th Cir. 1992) (“[I]f a company is 

administrating the plan, then it can be held liable for ERISA violations, regardless 

of the provisions of the plan document.”); Hunt v. Hawthorne Assocs., Inc., 119 

F.3d 888, 914 (11th Cir. 1997) (reaffirming the possibility that an entity not named 

 

7 The placement of the comma after “summary” is in the original text of the statute, but is most likely an 

error.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 14 of 16
15

as plan administrator by a plan document may still act in that role). The question 

of whether a defendant is acting as plan administrator is fact intensive and better 

decided at a later stage of this litigation. Accordingly, Lincoln’s motion to dismiss 

Plaintiff’s Section 502(c)(1)(B) claims against it is due to be denied. Further, 

Plaintiff’s motion to strike Document 9-1 is due to be denied as lacking a legal

basis.

V. CONCLUSION

In accordance with the foregoing analysis, it is ORDERED that:

1. Defendants’ motion to dismiss (Doc. # 9) is GRANTED to the extent 

that Plaintiff’s claims against Gilliard Health Services, Inc. Disability Plan (Plan 

504) and Gilliard Health Services, Inc. Group Term Life Plan (Plan 503) are 

DISMISSED without prejudice;

2. The Plans are DISMISSED from the case as Defendants;

3. Defendants’ motion to dismiss (Doc. # 9) is GRANTED to the extent 

that Plaintiff’s claim against Lincoln for breach of fiduciary duty arising under 

Section 502(a)(3) is DISMISSED with prejudice;

4. Defendants’ motion to dismiss (Doc. # 9) is DENIED with respect to 

Plaintiff’s Section 502(c)(1)(B) claim against Lincoln.

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 15 of 16
16

5. Plaintiff’s motion to strike (Doc. # 15) is DENIED.

DONE this 5th day of December, 2014.

 /s/ W. Keith Watkins

 CHIEF UNITED STATES DISTRICT JUDGE

Case 2:14-cv-00721-WKW-WC Document 21 Filed 12/05/14 Page 16 of 16