United States District Court, W.D. Pennsylvania
ANTHONY PATCHELL, on his own behalf and on behalf of all others similarly situated, and AMANDA PATCHELL, his wife, Plaintiffs,
CIGNA HEALTH AND LIFE INSURANCE COMPANY, and LIFE INSURANCE COMPANY OF AMERICA, Defendants.
GIBSON UNITED STATES DISTRICT JUDGE
before the Court is Defendants' Motion to Dismiss
Plaintiffs' Amended "Class Action and ERISA
Complaint." (ECF No. 27.) Although Plaintiffs have not
responded to Defendants' Motion to Dismiss (ECF No. 27)
or Memorandum of Law in Support thereof (ECF No. 28), the
deadline for Plaintiffs' response-March 2, 2018-has
passed and, thus, Defendants' Motion to Dismiss is ripe
reasons that follow, this Court will GRANT
Jurisdiction and Venue
Court has subject matter jurisdiction pursuant to 28 U.S.C.
1331 because Plaintiffs' claims are brought under the
Employee Retirement Income Security Act ("ERISA").
Venue is proper in this district pursuant to 28 U.S.C. §
1391(b)(2) because a substantial portion of the events or
omissions giving rise to Plaintiffs' claims occurred in
the Western District of Pennsylvania.
commenced this action on September 7, 2017 by filing a
Complaint before this Court. (ECF No. 1.) Defendants filed
their first Motion to Dismiss on November 13, 2017. (ECF No.
12.) However, prior to a decision on this first Motion to
Dismiss, this Court granted Plaintiffs' request to file
an Amended Complaint. (ECF No. 22.)
filed their Amended Complaint on January 24, 2018. (ECF No.
26.) Plaintiffs' Amended Complaint is organized into six
counts: (1) a claim under ERISA to recover overpayment for
breach of fiduciary duty, by Mr. Patchell and Ms. Patchell;
(2) a claim for loss of consortium by Ms. Patchell; (3) a
claim for ERISA violations by the purported class of
Plaintiffs; (4) a claim incorporating by reference Count I on
behalf of the entire class of Plaintiffs; (5) a motion for a
preliminary injunction on behalf of Mr. Patchell; and (6) a
claim seeking disgorgement of profits by Mr. Patchell and the
purported class of Plaintiffs. (Id. at 9-19.)
February 9, 2018, Defendants filed the pending Motion to
Dismiss Plaintiffs' Amended "Class Action and ERISA
Complaint" and an accompanying Memorandum of Law in
support thereof. (ECF Nos. 27, 28.) To date Plaintiffs'
have neither responded to nor moved for an extension of the
deadline to respond to Defendants' Motion to Dismiss
Plaintiffs' Amended "Class Action and ERISA
Patchell obtained a Life Insurance Policy Company of North
America ("LINA") Disability Policy (the
"Policy") through his employer. (ECF No. 26 at
¶ 6.) In February 2010, a judge determined that Mr.
Patchell is permanently disabled. (Id. at ¶
12.) Thereafter, Mr. Patchell began receiving short-term
disability ("STD") benefits from LINA pursuant to
his Policy. (Id. at ¶¶ 12-16.) At some
unspecified point, Mr. Patchell began receiving long-term
disability ("LTD") benefits under his Policy.
(Id. at ¶ 35.)
Patchell's LTD benefit totaled $4, 513.00 per month,
which resulted in Mr. Patchell receiving a monthly check for
$2, 868.00. (Id. at ¶ 17.) Of this
monthly payment, $1721.40 went to Mr. Patchell and $1, 147.60
went to Mr. Patchell's counsel as an attorney's fee.
(Id. at ¶ 18.)
January 7, 2016, LINA suspended all payments to Mr. Patchell
after it determined that it had overpaid him because Mr.
Patchell's monthly benefit did not take into account
offsets due to Social Security benefits received by his
children. (Id. at ¶ 23.) LINA "clawed
back" these overpayments by withholding Mr.
Patchell's future LTD payments under his Policy.
(Id. at ¶¶ 19, 23, 24, 41.)
Patchell had previously disclosed his children's Social
Security benefits to LINA on a questionnaire he completed
prior to receiving STD benefits. (Id. at ¶ 24.)
did not attach Mr. Patchell's Policy to their Amended
Complaint. However, the Defendants attached the Policy to
their motion to dismiss. (See ECF No. 28-1.)
The Court May Consider the Policy at the Motion to Dismiss
decide a motion to dismiss, courts generally consider only
the allegations contained in the complaint, exhibits attached
to the complaint and matters of public record."
Schmidt v. Skolas, 770 F.3d 241, 249 (3d Cir. 2014)
(quoting Pension Benefit Guar. Corp. v. White Consol.
Indus., Inc., 998 F.2d 1192, 1196 (3d Cir. 1993));
see also Borough of Moosic v. Darwin Nat. Assur.
Co., 556 Fed.Appx. 92, 95 (3d Cir. 2014)
("Generally, a district court ruling on a motion to
dismiss may not consider matters extraneous to the
pleadings.") (internal citations omitted).
an exception to the general rule is that a 'document
integral to or explicitly relied upon in the
complaint' may be considered 'without converting the
motion to dismiss into one for summary
judgment.'" Schmidt, 770 F.3d at 249 (quoting
In re Burlington Coat Factory Sec. Litig., 114 F.3d
1410, 1426 (3d Cir. 1997)) (emphasis in original); see
also Schuchardt v. President of the United States, 839
F.3d 336, 353 (3d Cir. 2016) (stating that a court deciding a
12(b)(6) motion may consider "documents] integral to
or explicitly relied upon in the complaint")
(emphasis in original) (internal citations omitted).
are integral when the plaintiff's claims are based on the
document." Hearbest, Inc. v. Adecco USA, No.
13CV1026, 2013 WL 4786232, at *3 (W.D. Pa. Sept. 6, 2013)
(quoting In re Donald J. Trump Casino Sec.
Litig., 7 F.3d 357, 368 n. 9 (3d Cir. 1993)); Ayco
Co., L.P. v. Upton, No. 12CV0712, 2012 WL 3746193, at *3
(W.D. Pa. Aug. 29, 2012); Langweiler v. Borough of
Newtown, No. CIV.. A 10-3210, 2011 WL 1809264, at
*5 (E.D. Pa. May 12, 2011); Apple Am. Grp., LLC
v. GBC Design, Inc., No. CV 3:15-325, 2018 WL 948772, at
*10 (W.D. Pa. Feb. 15, 2018) (Gibson, J.)
Court finds that the Policy is integral to Plaintiffs'
Amended Complaint. All of Plaintiffs' claims are based on
their central allegation that LINA improperly suspended Mr.
Patchell's LTD benefits owed to him under the Policy.
(See, generally, ECF No. 26.) Moreover, the Amended
Complaint references Mr. Patchell's Policy on numerous
occasions. (See, e.g., Id. at ¶¶ 6, 10,
11, 19, 20, 21, 22.) Thus, the Policy is "integral
to" Plaintiffs' Amended Complaint. Therefore, the
Court may consider the ...