Source: http://pa.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180625_0001577.EPA.htm/qx
Timestamp: 2019-04-20 04:50:18+00:00

Document:
FindACase | Hansel v. Aetna Life Insurance Co.
Hansel v. Aetna Life Insurance Co.
AETNA LIFE INSURANCE CO., et al., Defendants.
Plaintiff William Hansel brings claims under the civil enforcement provision of the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1132(a)(1)(B), against Defendants Aetna Life Insurance Company (“Aetna”) and Lincoln National Life Insurance Company (“Lincoln”), seeking disability benefits under an employee benefits plan. Aetna has moved to dismiss Plaintiff's Amended Complaint pursuant to Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim. Because I find Aetna's arguments to be factual, Defendant's Motion to Dismiss is premature. I will therefore deny the Motion.
To survive a motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6), a complaint must “contain sufficient factual matter, accepted as true, to ‘state a claim for relief that is plausible on its face.'” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007)). The plausibility standard requires more than a “sheer possibility that a defendant has acted unlawfully.” Id. To determine the sufficiency of a complaint under Twombly and Iqbal, a court must take the following three steps: (1) the court must “take note of the elements a plaintiff must plead to state a claim;” (2) the court should identify the allegations that, “because they are no more than conclusions, are not entitled to the assumption of truth;” and (3) “where there are well-pleaded factual allegations, [the] court should assume their veracity and then determine whether they plausibly give rise to an entitlement for relief.” Burtch v. Milberg Factors, Inc., 662 F.3d 212, 221 (3d Cir. 2011) (alterations and citations omitted). Plaintiff's claims are analyzed below under this standard.
ERISA permits a plan beneficiary to bring an action “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.” 29 U.S.C. § 1132(a)(1)(B). To succeed in such an action, a plaintiff must show that he was owed benefits under the plan and that benefits were wrongly denied. Manning v. Sanofi-Aventis, U.S. Inc., No. 3:11-cv-1134, 2012 WL 3542284, at *3 (M.D. Pa. Aug. 14, 2012). Additionally, the plaintiff must first have exhausted administrative remedies under the plan or show that exhaustion would be futile. Berger v. Edgewater Steel Co., 911 F.2d 911, 916 (3d Cir. 1990).

References: v. 
 v. 
 § 1132
 v. 
 v. 
 v. 
 § 1132
 v. 
 v.