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Mary Campbell v. Cigna Group Insurance and Life Insurance Company of North America

June 26, 2012

MARY CAMPBELL, PLAINTIFF,
v.
CIGNA GROUP INSURANCE AND LIFE INSURANCE COMPANY OF NORTH AMERICA, DEFENDANTS.



The opinion of the court was delivered by: Arthur J. Schwab United States District Judge

ELECTRONICALLY FILED

MEMORANDUM OPINION RE: DEFENDANTS' MOTIONS TO DISMISS (DOC. NO. 11)

I. Introduction

Presently before the Court are Defendants CIGNA Group Insurance and Life Insurance Company of North America's ("Defendants") Motions to Dismiss Plaintiff Mary Campbell's ("Plaintiff") Amended Complaint. Doc. No. 11. The parties' dispute centers on the denial of a request for benefits pursuant to a life insurance policy ("the Policy") that Plaintiff held with Defendants. Based on the federal questions involved in this Court's Original Jurisdiction, Plaintiff's Complaint was removed from the Court of Common Pleas of Fayette County and placed in this Court on April 5, 2012, pursuant to the Employee Retirement Income Security Act of 1974, as amended ("ERISA") 29 U.S.C.A. §1001. Doc. No. 1. Plaintiff subsequently filed an Amended Complaint on May 24, 2012. Doc. No. 7.

Plaintiff's Amended Complaint alleges that Defendants failed to comply with the original terms of the Policy that Plaintiff held through her employer, Jefferson Regional Medical Center, when Defendants denied her request for benefits due to her insured husband's age. Doc. No. 7, ¶¶ 15-22. Plaintiff alleges further that she relied to her detriment on Defendants' collection of premiums while Defendants had no intention of paying out the policy amount. Id., ¶¶ 23-27. After careful consideration of the Motion to Dismiss (Doc. No. 11) and Brief in Support (Doc. No. 12) and Plaintiff's response thereto (Doc. No. 17), and for the reasons that follow, Defendants' Motion to Dismiss (Doc. No. 11) will be GRANTED IN PART, and DENIED IN PART.

II. Factual Background

When reviewing a Motion to Dismiss under Federal Rule of Civil Procedure 12(b)(6), the Court accepts all factual allegations in the Amended Complaint as true and draws all reasonable inferences in favor of Plaintiff. See Fowler v. UPMC Shadyside, 578 F.3d 203, 210 (3d Cir. 2009). Taking Plaintiff's factual allegations to be true for the purposes of this Memorandum Opinion, the facts of this case are as follows:*fn1

Plaintiff, Mary Campbell, purchased life insurance through her employer, Jefferson Regional Medical Center, with Defendant CIGNA Group Insurance, insuring the life of her husband, Ralph Campbell. Doc. No. 7, ¶¶ 5-7. Defendant Life Insurance Company of North America was the underwriter of the policy, which became effective on January 1, 2008. Id., ¶¶ 7-8. Approximately three years later, Plaintiff's husband passed away on February 24, 2011, at the age of 73. Id., ¶ 9. After her husband's death, Plaintiff requested payment of the $10,000 insurance amount pursuant to her policy with Defendants. Id. ¶ 10. However, Defendants denied Plaintiff's request, and informed her that the benefits under the terms of the policy terminated when her spouse-beneficiary reached the age of 70. Id., ¶¶ 11-13.

Defendants never informed Plaintiff that the benefits under the policy terminated when her husband reached 70 years of age. Id., ¶ 13. Furthermore, Defendants continued to collect premium payments from Plaintiff for three years after her husband reached the age of 70, leading Plaintiff to believe that the policy was valid. Id., ¶ 25. Defendants did so "knowing that they would not pay out the policy." Id., ¶¶ 23-24. Plaintiff relied on Defendants' collection of premiums for those three years, assuming that she would receive the $10,000 life insurance payout pursuant to the policy. Thus, Defendants' refusal to pay Plaintiff was a failure to comply with the original terms of the insurance agreement. Id., ¶ 21.

III. Standard of Review

A.Rule 12(b)(2)

Federal Rule of Civil Procedure 12(b)(2) allows a defendant to challenge a Court's exercise of personal jurisdiction. "Once a defendant challenges a court's exercise of personal jurisdiction over it, the plaintiff bears the burden of establishing personal jurisdiction." D'Jamoos ex rel. Estate of Weingeroff v. Pilatus Aircraft Ltd., 566 F.3d 94, 102 (3d Cir. 2009) (citing Gen. Elec. Co. v. Deutz AG, 270 F.3d 144, 150 (3d Cir. 2001)). To meet its burden, Plaintiff must establish "[a] nexus between the defendant, the forum and the litigation." Deutz AG, 270 F.3d at 150.

"[I]n reviewing a motion to dismiss under Rule 12(b)(2) [the court] 'must accept all of the plaintiff's allegations as true and construe disputed facts in favor of the plaintiff.'" Pinker v. Roche Holdings Ltd., 292 F.3d 361, 368 (3d Cir. 2002) (quoting Carteret Sav. Bank, FA v. Shushan, 954 F.2d 141, 142 n. 1 (3d Cir. 1992)). Plaintiff need only to establish a prima facie case for personal jurisdiction over the defendant to overcome a 12(b)(2) motion. See Miller Yacht Sales, Inc. v. Smith, 384 F.3d 93, 97 (3d Cir.2004). A resolution of a factual issues may be required to establish personal jurisdiction under a 12(b)(2) motion and thus a party may introduce extrinsic evidence beyond the pleadings to do so. See Time Share Vacation Club v. Atl. Resorts, Ltd., 735 F.2d 61, 66 (3d Cir. 1984). "[A]t no point may a plaintiff rely on the bare pleadings alone in order ...


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