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Yost v. Anthem Life Insurance Co.

United States District Court, M.D. Pennsylvania

July 30, 2019

ERIC YOST, individually and on behalf of a class of similarly situated individuals, Plaintiff,
v.
ANTHEM LIFE INSURANCE COMPANY Defendant.

          MEMORANDUM OPINION

          Robert D. Mariani, United States District Judge

         I. INTRODUCTION

         Here the Court considers Defendant Anthem Life Insurance Company's Motion to Dismiss Plaintiffs Complaint (Doc. 11). With this Motion, Defendant asserts the above-captioned matter ("Yost II”) should be dismissed because it is duplicative of the action docketed at 3:16-CV-00079 ("Yost I"). (Doc. 12 at 5.) The Court concludes Defendant's Motion is properly granted because Yost II is duplicative of Yost I in all relevant respects.

         II. BACKGROUND

         The factual background set out in the Yost I Complaint (Doc. 1) is the same as that set out in the Amended Complaint in Yost I (Civ. A. No. 3:16-CV-00079 Doc. 26).[1]

         Therefore, the recitation of facts recently set out the Memorandum Opinion considering a motion filed in Yost I (Doc. 94 at 6-7) is applicable here:

Plaintiff Eric Yost was insured for disability benefits under a Group Plan issued by Defendant through Finisar Corporation, Plaintiffs former employer. (Doc. [1] ¶ 6.) On February 2, 2013, Plaintiff was injured in a motor vehicle accident, rendering him temporarily disabled. (Id. ¶ 7.) As a result of his temporary disability, Plaintiff submitted a claim for short term disability benefits to Defendant, (Id. ¶ 8.) Thereafter, Defendant paid disability benefits in the amount of $5, 654.40 to Plaintiff for the period beginning February 4, 2013 and ending April 23, 2013. (Id. ¶ 9.) As a result of his injury, Plaintiff sought damages against the alleged tortfeasor. (Id. ¶ 10.) The tortfeasor's insurer settled the action and made payment to Plaintiff in compensation for the personal injuries he sustained in the motor vehicle accident. (Id. ¶ 11.) Defendant then asserted a claim for reimbursement of the short term disability benefits paid to the Plaintiff in the amount of $6, 997.25. (Id. ¶¶ 12, 14.) The parties then attempted to negotiate a settlement as to the reimbursement Defendant asserted it was owed by Plaintiff. (Id. ¶¶ 14-20.) Defendant has continued to assert a claim for reimbursement of the short term disability benefits paid to the Plaintiff. (Id. ¶ [29].) As a result, Plaintiffs counsel "has been forced to refuse to distribute to Mr. Yost the money in dispute" (id. ¶ [30]), leaving Plaintiff "subject to suit and loss of benefits based on the dispute over the subject funds" (id.).

(Doc. 94 at 6-7.) Plaintiff seeks recovery on behalf of himself and similarly situated individuals. (Doc. 1 ¶ 5.) He avers that the subrogation demand "is contrary to the policy and law." (Doc. 1 ¶ 22.)

         Plaintiffs Complaint contains five counts: Count I for Declaratory Relief related to "the policies and law" (Doc. 1 ¶¶ 70, 73); Count II for Violation of Employee Welfare Benefit Plan and Policy; Count III for Breach of Fiduciary Duty - Duty of Loyalty related to ERISA's fiduciary obligations; Count IV for Action for ERISA Relief; and Count V for Relief Demanded. (Doc. 1 at 16-41.)

         III. STANDARD OF REVIEW

         With this Motion, Defendant moves the Court "to dismiss Plaintiffs Complaint pursuant to Fed.R.Civ.P. 12(b)(6) and/or Fed.R.Civ.P. 16(c)(2)(A)." (Doc. 11 at 1.) Defendant does not identify the basis for seeking relief under Rule 16(c)(2)(A).[2] (See Docs. 11, 12.) Therefore, the Court considers Defendant's Motion under the applicable Rule 12(b)(6) standard.

         A complaint must be dismissed under Federal Rule of Civil Procedure 12(b)(6) if it does not allege "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). "A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Ashcroft v. Iqbal, 556 U.S. 662, 678, (2009).

         "While a complaint attacked by a Rule 12(b)(6) motion to dismiss does not need detailed factual allegations, a plaintiffs obligation to provide the 'grounds' of his 'entitlement to relief requires more than labels and conclusions, and a formulaic recitation of a cause of action's elements will not do." Twombly, 550 U.S. at 555 (internal citations and alterations omitted). "[T]he presumption of truth attaches only to those allegations for which there is sufficient 'factual matter' to render them 'plausible on [their] face'... Conclusory assertions of fact and legal conclusions are not entitled to the same presumption." Schuchardt v. President of the United States, 839 F.3d 336, 347 (3d Cir. 2016) (citing Iqbal, 556 U.S. at 679).

         "Although the plausibility standard 'does not impose a probability requirement,' it does require a pleading to show 'more than a sheer possibility that a defendant has acted unlawfully.'" Connelly v. Lane Const. Corp., 809 F.3d 780, 786 (3d Cir. 2016) (citing Twombly, 550 U.S. at 556 and Iqbal, 556 U.S. at 678). "The plausibility determination is 'a context-specific task that requires the reviewing court to draw on its judicial experience and common sense.'" Id. at 786-87 (citing Iqbal, 556 U.S. 679).

         IV. ANALYSIS

         Defendant argues that Yost II is based on the same disability benefits claim and the same accident as Yost I, and although the Yost II Complaint eliminates reference to the Pennsylvania Motor Vehicle Financial Responsibility Law "("MVFRL"), the violations of "law" asserted in Yost II are "hopelessly vague and conclusory." (Doc. 12 at 5.) Defendant also contends that Yost II should be dismissed because it is an impermissible attempt ...


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