Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_07-cv-00323/USCOURTS-caed-1_07-cv-00323-4/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 28:1001 E.R.I.S.A.

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Order Denying Plaintiffs' Motion to Remand and Granting in Part and Denying in Part Defendant's Motion to 

Dismiss First Amended Complaint and Directing Plaintiffs to File Second Amended Complaint 

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RONALD R. ODOM, CA Bar No. 151074 

Legal Department 

BLUE CROSS OF CALIFORNIA 

21555 Oxnard Street, First Floor 

Woodland Hills, CA 91367 

Telephone: (818) 234-3160 

Fax: (818) 348-3546 

Attorneys for Defendant BLUE CROSS OF CALIFORNIA (erroneously filed and served as BC LIFE 

& HEALTH INSURANCE COMPANY) 

UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF CALIFORNIA 

MARIA QUARESMA, an individual and 

Successor in Interest of LEONEL DAROSA, a 

deceased individual, MARSHALL S. FLAM, 

M.D. an individual 

 Plaintiff, 

vs. 

BC LIFE & HEALTH INSURANCE 

COMPANY, a corporation, and DOES 1 

through 10,inclusive, 

 Defendants. 

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CASE NO: 1:07-CV-00323-OWW-NEW 

ORDER DENYING PLAINTIFFS' MOTION 

TO REMAND AND GRANTING IN PART 

AND DENYING IN PART DEFENDANT'S 

MOTION TO DISMISS FIRST AMENDED 

COMPLAINT AND DIRECTING 

PLAINTIFFS TO FILE SECOND 

AMENDED COMPLAINT

Now before the Court are the motion of Plaintiffs' to Remand this action to state court 

and Defendant's motion to dismiss the First Amended Complaint. Having carefully reviewed the 

parties' papers and the relevant legal authority and having heard argument on the motions, the Court 

makes the following orders: 

1. Plaintiffs' motion to remand is DENIED; 

2. Defendant's motion to dismiss is GRANTED IN PART AND DENIED IN PART 

WITH LEAVE TO AMEND: 

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Order Denying Plaintiffs' Motion to Remand and Granting in Part and Denying in Part Defendant's Motion to 

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 a. The First, Second, Third and Thirteenth through Twenty-Third Causes of Action 

are dismissed with leave to amend to allege claims by Dr. Flam for breach of contract and 

misrepresentation based on allegations that Defendants promised or pre-approved reimbursement for 

the cancer treatment at issue. The Fourth through Twelfth Causes of Action are dismissed without 

leave to amend based on ERISA pre-emption to the extent these causes of action include allegations 

that Defendant failed to process Decedent DaRosa's claim within the time limits set forth in California 

Insurance Code § 790.03(h) and 10 California Code of Regulations §§ 2695.2 and 2695.7, and denied 

the claim for reimbursement in violation of California Health & Safety Code § 1367.21 and California 

Insurance Code § 10123.195. 

3. Counsel for Defendant shall prepare and lodge a form of Order within 5 days of the 

filing date of this Memorandum Decision; 

4. Plaintiffs shall file a Second Amended Complaint in compliance with the rulings 

herein within 30 days of the filing date of the Order. 

IT IS SO ORDERED. 

DATED: November 6, 2007 

 /s/ OLIVER W. WANGER 

 Honorable Oliver W. Wanger 

 United States District Court 

 Eastern District of California 

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