United States District Court, E.D. Missouri, Eastern Division
OPINION, MEMORANDUM AND ORDER
EDWARD AUTREY UNITED STATES DISTRICT JUDGE.
matter is before the court on Defendant Life Insurance
Company of North America, d/b/a Cigna Insurance Group's
Motion to Dismiss, [Doc. No. 14]. Plaintiff opposes the
motion. For the reasons set forth below, the Motion is
17, 2017, Plaintiff filed this action against defendants Life
Insurance Company of North America d/b/a Cigna Insurance
Group and Southeast Missouri Hospital under the Employee
Retirement Income Security Act of 1974 (ERISA), 29 U.S.C.
§§ 1001-1461, to recover benefits owed under an
employee welfare benefit plan and damages from
defendants' breach of their fiduciary duties and failure
to provide certain documents upon request.
Complaint, Plaintiff alleges that he was a full-time employee
of Southeast Hospital for sixteen years and had worked seven
years for Arch Air.
his employment, Plaintiff became permanently and totally
disabled while working as a nurse at Southeast Hospital. He
was not able to perform the material and substantial duties
of his job during the first twenty-four (24) months of his
disability, and thereafter has not been able to perform the
material and substantial duties of any gainful job for which
he is reasonably fitted by his education, training, or
alleges he submitted his claim for benefits on March 14,
2013, in which he alleged he was totally and permanently
disabled such that he could not perform any job in the open
labor market that he was qualified to perform based on his
education, training, and work experience and could not earn
over 80% of his indexed earnings. Plaintiff alleged that his
disability resulted from a combination of physical and mental
deficits. Plaintiff supported his claim with documentation
from his treating physicians and a vocational expert and
claim was denied based on the functional capacity evaluation
by physical therapist and a transferable skills analysis
based on the therapist's report. Plaintiff alleges that
the report misrepresents the true nature of the testing
because Plaintiff could not finish the testing due to his
physical condition. Further, Plaintiff contends that the
therapist had an intern administer the testing and he did not
physically observe all of the testing.
his written requests, defendants failed to provide him with
all the documents he requested.
seeks to recover benefits owed under the Plan, damages,
interest, attorneys' fees, and penalties for
defendants' failure to produce the Plan documents.
Life Insurance Company of North America moves to dismiss
Plaintiff's complaint under Federal Rule of Civil
Procedure 12(b)(6). Defendant argues that Plaintiff's
claim under 29 U.S.C. § 1132(c) fails against it because
it is not the plan administrator. Plaintiff also responds
that Life Insurance Company of North America can be held
liable for § 1132(c) penalties for failing to provide
him with the Plan documents because it performed plan
to Dismiss Standard
motion to dismiss under Rule 12(b)(6) challenges the legal
sufficiency of the complaint. See Carton v. General Motor
Acceptance Corp., 611 F.3d 451, 454 (8th Cir. 2010);
Young v. City of St. Charles, 244 F.3d 623, 627 (8th
Cir. 2001). To survive a motion to dismiss, the complaint
must include “enough facts to state a claim to relief
that is plausible on its face.” Bell Atlantic Corp.
v. Twombly, 550 U.S. 544, 570 (2007). To meet the
plausibility standard, the complaint must contain “more
than labels and conclusions.” Id. at 555.
Rather, the complaint must contain “factual content
that allows the court to draw the reasonable inference that
the defendant is liable for the misconduct alleged.”
Ashcroft v. Iqbal, 129 S.Ct. 1937, 1949 (2009).
complaint must be liberally construed in the light most
favorable to the plaintiff. Eckert v. Titan Tire
Corp., 514 F.3d 801, 806 (8th Cir. 2006). The
Court must accept the facts alleged as true, even if
doubtful. Twombly, 550 U.S. at 555. Thus, a
well-pleaded complaint may proceed even if ...