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Byrd v. Wellpoint Flexible Benefit Plan

United States District Court, E.D. Missouri, Eastern Division

May 2, 2017




         This matter is before the Court on Motion to Dismiss (ECF No. 6) filed by defendants Anthem Life Insurance Company and Anthem Flexible Benefit Plan (collectively, “Defendants”).[1] The essence of the motion is that Plaintiff's claim for long-term disability (“LTD”) benefits should be judicially estopped, as it was not disclosed in Plaintiff's bankruptcy proceeding, In re Rochelle Byrd, Case No. 16-44756 (Bankr. E.D. Mo 2016) (“Bankruptcy Case”). The matter is fully briefed, Plaintiff having filed her opposition (ECF No. 16) and Defendants having filed a reply (ECF No. 18). The parties have consented to the jurisdiction of the undersigned United States Magistrate Judge pursuant to 28 U.S.C. § 636(c). For the reasons discussed below, the motion to dismiss is denied.

         I. Standard

         Defendants filed the instant motion under Federal Rule of Civil Procedure 12(b)(6), which provides for dismissal based on the “failure to state a claim upon which relief can be granted.” To survive a motion to dismiss a complaint must show “‘that the pleader is entitled to relief, ' in order to ‘give the defendant fair notice of what the . . . claim is and the grounds upon which it rests.'” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007) (quoting Conley v. Gibson, 355 U.S. 41, 47 (1957)). “When ruling on a defendant's motion to dismiss, a judge must accept as true all of the factual allegations contained in the complaint.” Erickson v. Pardus, 551 U.S. 89, 94 (2007). All reasonable inferences from the complaint must be drawn in favor of the nonmoving party. Martin v. Iowa, 752 F.3d 725, 727 (8th Cir. 2014).

         Plaintiff asserts that the Motion to Dismiss under Rule 12(b)(6) should be converted to a motion for summary judgement by operation of Rule 12(d). Rule 12(d) provides: “If, on a motion under Rule 12(b)(6) or 12(c), matters outside the pleadings are presented to and not excluded by the court, the motion must be treated as one for summary judgment under Rule 56.” Fed.R.Civ.P. 12(d). Specifically, Plaintiff alleges that because Defendants' motion includes reference to filings in the Bankruptcy Case, the motion should be treated as one for summary judgment.

         “In this circuit, Rule 12(b)(6) motions are not automatically converted into motions for summary judgment simply because one party submits additional matters in support of or opposition to the motion.” State ex rel. Nixon v. Coeur D'Alene Tribe, 164 F.3d 1102, 1107 (8th Cir. 1999). A court may take judicial notice of public records and may consider them on a motion to dismiss. Stahl v. U.S. Dep't of Agric., 327 F.3d 697, 700 (8th Cir.2003). Here, the pleadings in the Bankruptcy Case are public records, and thus there is no need to convert the motion to dismiss into one for summary judgment. Therefore, the Court has not taken any of Plaintiff's evidentiary submissions (ECF No. 17) into account.

         II. Factual Background

         As noted above, the Court must treat all well-pled factual allegations in the Complaint as true. Plaintiff is a 47 year-old female who was employed by Anthem, Inc. as a Medicare Sales Manager in St. Louis from December 3, 2012 through February 24, 2016. (Complaint, ECF No. 1 at ¶¶ 4-5, 13) As part of her employment, Plaintiff was eligible for LTD insurance coverage. (Id. at ¶¶ 6-9) The LTD coverage was provided as part of an employee benefits plan (Defendant Anthem Flexible Benefit Plan, or “Plan”), which is subject to the requirements of the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. (Id. at ¶¶ 1, 7-9) The claims administrator for the Plan was Defendant Anthem Life Insurance Company (“Anthem Life”). (Id. at ¶ 12)

         Beginning on February 24, 2016, Plaintiff was unable to perform the duties of her job due to behavioral health conditions. (Id. at ¶ 17) She took leave under the Family and Medical Leave Act and was approved by her employer for short-term disability (“STD”) benefits. (Id. at ¶ 18) Plaintiff was eligible for STD benefits for 180 days and received them for that period. (Id.)

         On July 1, 2016, Plaintiff filed for bankruptcy in the Bankruptcy Court of the Eastern District of Missouri. (ECF No. 7-1) She filed under Chapter 13 of the Bankruptcy Code, 11 U.S.C. § 1301 et seq. (Id. at 2, 4)

         On July 27, 2016, as the 180-day STD period was running short, Anthem Life sent Plaintiff a notice that she may be eligible for LTD benefits, along with the paperwork for applying for those benefits. (ECF No. 1 at ¶ 22) Plaintiff completed the forms and submitted pertinent medical records to Anthem Life for review. (Id. at ¶ 23)

         On August 18, 2016, Plaintiff filed a motion to convert her bankruptcy from a Chapter 13 case to a proceeding under Chapter 7, 11 U.S.C. § 701 et seq. (ECF No. 7-3) The Bankruptcy Court granted the request on August 23, 2016. (ECF No. 7-4)

         On September 21, 2016, Defendant Anthem Life sent a letter to Plaintiff informing her that it was denying her claim for LTD benefits. (ECF No. 1 at ¶ 32) Plaintiff ...

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