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HARTMAN v. WILKES-BARRE GENERAL HOSPITAL

December 5, 2002

JUNE HARTMAN, PLAINTIFF
V.
WILKES-BARRE GENERAL HOSPITAL, WYOMING VALLEY HEALTH CARE SYSTEMS, AND UNUM LIFE INSURANCE COMPANY OF AMERICA, DEFENDANTS



The opinion of the court was delivered by: James M. Munley, United States District Judge.

  MEMORANDUM

Before the court for disposition is the defendants' motion to dismiss in this case involving long-term disability employment benefits. The plaintiff is June Hartman, and the defendants are Wilkes-Barre General Hospital, and Wyoming Valley Health Care Systems and UNUM Life Insurance Company of America. The matter has been fully briefed and argued. For the reasons that follow, the motion to dismiss will be granted.

Background*fn1

The defendant Wilkes-Barre General Hospital a/k/a Wyoming Health Care Systems (hereinafter "hospital") employed the plaintiff from October 1981 through June 2000. The hospital provided short- and long-term disability benefits as well as retirement benefits to the plaintiff.

In October 1999, plaintiff suffered a massive cerebral vascular accident. Apparently, plaintiff discontinued working for a time, but then returned and suffered two transient ischemic attacks that resulted in her total disability and inability to continue any substantial gainful employment as of June 29, 2000. The Social Security Administration adjudicated plaintiff as totally disabled as of June 9, 2000.

Plaintiff applied for, and received, nine weeks of short-term disability benefits through the hospital. She received the benefits from August 19, 2000 until October 11, 2000. On July 27, 2000, plaintiff applied for long-term disability benefits through Defendant UNUM Life Insurance Company of America, the hospital's third-party insurance carrier. UNUM denied the benefits. Plaintiff appealed the decision and UNUM denied the appeal. Again in May 2001, plaintiff requested a review by Defendant UNUM. UNUM denied the request in July 2001. Plaintiff has received no long-term disability benefits.

Plaintiff instituted the instant action to recover the long-term disability benefits. The Defendant Wilkes Barre General Hospital is an employer within the meaning of the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001 et seq., and the policy at issue is an employee benefit plan within the meaning of ERISA. She claims that the decision to deny her benefits is improper as well as a violation of the defendants' fiduciary duties under ERISA. She also asserts the following state law causes of action: breach of contract; promissory estoppel; unjust enrichment; negligence; and breach of the duty of good faith and fair dealing. In addition, plaintiff seeks punitive damages.

The defendants have all moved to dismiss the claims for breach of fiduciary duty, the state law claims, and the punitive damages claim pursuant to FED. R. CIV. P. 12(b)(6). After a careful review, we will grant the defendants' motion.

Jurisdiction

We have jurisdiction over the instant case pursuant to 29 U.S.C. § 1132(e)(1) (providing United States District Courts jurisdiction over ERISA actions) and 29 U.S.C. § 1331 (providing United States District Courts with jurisdiction over "all civil actions arising under the Constitution, laws, or treaties of the United States.").

Standard of Review

When a 12(b)(6) motion is filed, the sufficiency of a complaint's allegations are tested. The issue is whether the facts alleged in the complaint, if true, support a claim upon which relief can be granted. In deciding a 12(b)(6) motion, the court must accept as true all factual allegations in the complaint and give the pleader the benefit of all reasonable inferences that can fairly be drawn therefrom, and view them in the light most favorable to the plaintiff. Morse v. Lower Merion School District, 132 F.3d 902, 906 (3d Cir. 1997). Defendants cite cases that hold that all of the state law claims that the plaintiff is pursuing are pre-empted by ERISA.

Discussion

Defendant's motion to dismiss raises issues that can be broken down into three categories: 1) state law claims; 2) fiduciary claims; and 3) punitive damages ...


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