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Dunivin v. Life Insurance Company of North America

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

March 23, 2018

REBECCA DUNIVIN, Plaintiff,
v.
LIFE INSURANCE COMPANY OF NORTH AMERICA and CLOUD PEAK ENERGY RESOURCES, LLC, Defendants,

          OPINION, MEMORANDUM AND ORDER

          HENRY EDWARD AUTREY UNITED STATES DISTRICT JUDGE.

         This matter is before the court on Defendant Life Insurance Company of North America d/b/a Cigna Insurance Company's Motion to Dismiss Count III, [Doc. No. 11]. Plaintiff opposes the motion. For the reasons set forth below, the Motion is granted.

         Facts and Background

         On May 17, 2017, Plaintiff filed this action against defendants Life Insurance Company of North America d/b/a Cigna Insurance Company and Cloud Peak Energy Resources, LLC 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.

         In her Complaint, Plaintiff alleges that she was a full-time employee of Cloud Peak since July 17, 2006 until January 30, 2010.

         During her employment, Plaintiff became permanently and totally disabled through injury or sickness or both. She was not able to perform the material and substantial duties of his job during the first twenty-four (24) months of her disability, and thereafter has not been able to perform the material and substantial duties of any gainful job for which she is reasonably fitted by his education, training, or experience.

         Plaintiff alleges that Cigna determined she was disabled, but later changed the decision to claim she was not disabled. Her claim for Long Term Disability benefits from Cigna was denied on September 2, 2014.

         Plaintiff supported her claim with objective medical evidence including medical records from her treating physicians, including a report from her primary care physician and her back surgeon. Plaintiff also included a recorded statement from herself and a neighbor who served as a caregiver and completed household services and drove Plaintiff to and from the doctor.

         Plaintiff claims Defendants conjured up a false valid review by focusing only on the records that suggested a less severe disability that were not supported by the record as a whole.

         Despite her written requests, defendants failed to provide her with all the documents she requested.

         Plaintiff seeks to recover benefits owed under the Plan, damages, interest, attorneys' fees, and penalties for defendants' failure to produce the Plan documents.

         Defendant 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 administrator functions.[1]

         Motion to Dismiss Standard

         A 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 ...


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