Larkin v. UnitedHealthcare Insurance Company, No. 2:2017cv02061 - Document 18 (E.D. La. 2017)
Court Description: ORDER AND REASONS finding as moot 6 Motion to Dismiss for Failure to State a Claim; Granting 9 Motion to Dismiss for Failure to State a Claim. Plaintiff's claims for short term disability benefits, statutory penalties under Louisiana Revised Statutes §§ 22:658 and 22:1892, and nonpecuniary damages arising out of a breach of contract are DISMISSED WITH PREJUDICE. Signed by Judge Sarah S. Vance on 10/3/2017. (cg)
Download PDF
<![CDATA[
Larkin v. UnitedHealthcare Insurance Company Doc. 18 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF LOUISIANA LAURA M. LARKIN CIVIL ACTION VERSUS NO. 17-20 61 UNITEDHEALTHCARE INSURANCE COMPANY SECTION “R” (2) ORD ER AN D REASON S Before the Court are defendant’s two partial m otions to dism iss. 1 For the following reasons, the Court denies as m oot the first m otion to dism iss 2 and grants the second m otion to dism iss. 3 I. BACKGROU N D This case arises out of a dispute over the paym ent of disability insurance benefits. 4 Defendant UnitedHealthcare Insurance Company issued a group disability insurance policy to Louisiana State University and Agricultural and Mechanical College. 5 Plaintiff Laura Larkin was an em ployee of Louisiana State University and participated in this group 1 2 3 4 5 R. Doc. 6; R. Doc. 9. R. Doc. 6. R. Doc. 9. R. Doc. 1. Id. at 1 ¶ 5; R. Doc. 6-3 at 2. Dockets.Justia.com disability plan. 6 Plaintiff alleges that she has been diagnosed with fibromyalgia and scleredem a and that she suffers from chronic pain, fatigue, m uscle weakness, num bness, debilitating headaches, m alaise, and cognitive im pairm ent. 7 On or around J anuary 4, 20 16, plaintiff took disability leave from her job and applied for benefits under defendant’s policy. 8 Defendant denied plaintiff’s claim for long term disability benefits. 9 Plaintiff filed an appeal with accom panying medical evidence, which was also denied. 10 Plaintiff asserts that defendant based its denial of benefits on outdated criteria, an incorrect diagnosis, and the opinions of non-specialist physicians. 11 On March 10 , 20 17, plaintiff filed a com plaint against defendant for short term and long term disability benefits, statutory penalties, physical and em otional distress dam ages, costs, and attorneys’ fees. 12 Plaintiff invoked diversity jurisdiction under 28 U.S.C. § 1332. 13 On J uly 28, 20 17, defendant filed its first partial m otion to dism iss under Federal Rule of Civil Procedure 6 7 8 9 10 11 12 13 R. Doc. 1 at 1 ¶ 3. R. Doc. 7 at 3 ¶ 44. Id. at 3 ¶ 45. Id. at 3-4 ¶ 46. Id. at 4. Id. at 2-3 ¶ 43. R. Doc. 1. Id. at 1. 2 12(b)(6). 14 Plaintiff tim ely am ended her com plaint, incorporating the contents of her original com plaint and including additional allegations. 15 In response, defendant filed a second partial m otion to dism iss. 16 II. LEGAL STAN D ARD To survive a Rule 12(b)(6) m otion to dism iss, the plaintiff m ust plead “sufficient factual m atter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (20 0 9) (quoting Bell Atl. Corp. v. Tw om bly , 550 U.S. 544, 570 (20 0 7)). A claim is facially plausible when the plaintiff pleads facts that allow the court to “draw the reasonable inference that the defendant is liable for the m isconduct alleged.” Id. at 678. A court m ust accept all well-pleaded facts as true and m ust draw all reasonable inferences in favor of the plaintiff. See Lorm and v. US Unw ired, Inc., 565 F.3d 228, 232 (5th Cir. 20 0 9). A legally sufficient com plaint m ust establish m ore than a “sheer possibility” that the plaintiff’s claim is true. Iqbal, 556 U.S. at 678. It need not contain detailed factual allegations, but it m ust go beyond labels, legal conclusions, or form ulaic recitations of the elem ents of a cause of action. Id. 14 15 16 R. Doc. 6. R. Doc. 7. R. Doc. 9. 3 In other words, the face of the com plaint m ust contain enough factual m atter to raise a reasonable expectation that discovery will reveal relevant evidence of each elem ent of the plaintiff’s claim. Lorm and, 565 F.3d at 257. The claim m ust be dism issed if there are insufficient factual allegations to raise a right to relief above the speculative level, Tw om bly , 550 U.S. at 555, or if it is apparent from the face of the com plaint that there is an insuperable bar to relief, Jones v. Bock, 549 U.S. 199, 215 (20 0 7). III. D ISCU SSION A. Firs t Mo tio n to D is m is s Defendant’s first m otion to dism iss is directed at plaintiff’s original com plaint. 17 The filing of an amended com plaint does not necessarily m oot a pending m otion to dism iss. See 6 Wright & Miller, Federal Practice and Procedure § 1476 (3d. ed. 20 17). But defendant has filed a second m otion to dism iss directly addressing the amended com plaint. 18 Defendant’s second m otion reiterates its original request that the Court dism iss plaintiff’s claim s for short term disability benefits, certain statutory penalties, and nonpecuniary damages. 19 Because defendant’s two m otions m ake the same 17 18 19 R. Doc. 6. R. Doc. 9. Id. 4 arguments and seek the same relief, the Court finds that defendant’s first m otion to dism iss is m oot. 20 See Melson v. Vista W orld Inc. and Assoc., No. 12-135, 20 12 WL 60 0 2680 , at *12 (E.D. La. 20 12) (explaining that, “[w]hen a new Rule 12(b)(6) m otion is filed that specifically addresses an amended com plaint, ‘it surely m akes sense to disregard’” the original m otion) (quoting Steven Gensler, 1 Federal Rules of Civil Procedure, Rules and Com mentary Rule 15). B. Sh o rt Te rm D is ability Be n e fits an d Statu to ry Pe n altie s Defendant argues that plaintiff’s claim for short term disability benefits m ust be dism issed because these benefits are not covered by the policy. 21 The Court has reviewed the insurance policy, and finds that it covers only long term disability benefits. 22 Plaintiff concedes that she is not entitled to short term disability benefits. 23 Thus, the Court dism isses this claim . 20 Defendant adm its that its first m otion is effectively m oot. See R. Doc. 9 at 2. Defendant’s second motion to dism iss and plaintiff’s second m em orandum in opposition each incorporate the argum ents contained in their original pleadings. See R. Doc. 9; R. Doc. 10 . Accordingly, the Court will refer back to the first m otion to dism iss and the first mem orandum in opposition in considering the current m otion. 21 R. Doc. 6-1 at 5; R. Doc. 9-1 at 2. 22 R. Doc. 6-3. The Court m ay consider this docum ent on a Rule 12(b)(6) m otion because the insurance policy is referenced in plaintiff’s com plaint and is central to her claim . See In re Katrina Canal Breaches Litig., 495 F.3d 191, 20 5 (5th Cir. 20 0 7). 23 R. Doc. 10 at 1. 5 Defendant also contends that Louisiana Revised Statutes § 22:1821 provides the sole possible basis for statutory penalties in this m atter, and asks the Court to dism iss plaintiff’s claim s under § 22:658 and § 22:1892. 24 Plaintiff concedes that § 22:1821 is the appropriate statutory penalty provision, and consents to the dism issal of her other statutory penalty claim s. 25 Accordingly, the Court dism isses plaintiff’s claims under § 22:658 and § 22:1892. C. N o n p e cu n iary D am age s Plaintiff asserts that she is entitled to dam ages for em otional distress and other nonpecuniary loss under Louisiana Civil Code articles 1998 and 1997. 26 Article 1998 perm its nonpecuniary dam ages in a breach of contract action under two circum stances: (1) “when the contract, because of its nature, is intended to gratify a nonpecuniary interest and, because of the circum stances surrounding the formation or the nonperform ance of the contract, the obligor knew, or should have known, that his failure to perform would cause that kind of loss”; or (2) “when the obligor intended, through 24 R. Doc. 6-1 at 2. Louisiana Revised Statutes § 22:658 is unrelated to statutory penalties, and § 22:1892 does not apply to health and accident policies. 25 R. Doc. 10 at 1. 26 R. Doc. 8 at 4-7. 6 his failure, to aggrieve the feelings of the obligee.” La. Civ. Code art. 1998. The am ended complaint fails to state a claim under either criterion. Plaintiff first argues that her disability insurance policy served the nonpecuniary interest of providing peace of m ind, and that the intent of the contract is a question of fact for the jury. 27 But plaintiff’s argum ent applies equally to all insurance contracts, and Louisiana courts have repeatedly held that “a com m ercial insurance policy is not designed to gratify nonpecuniary interests, it is m eant to protect pecuniary interests.” Sher v. Lafay ette Ins. Co., 988 So. 2d 186, 20 2 (La. 20 0 8); see also Bankston v. Alexandria N eurosurgical Clinic, 583 So. 2d 1148, 1151 (La. App. 3 Cir. 1991); Nickels v. Guarantee Trust Life Ins. Co., 563 So. 2d 924, 927 (La. App. 1 Cir. 1990 ); Tano Corp. v. La. Health Serv. & Indem . Co., 355 So.2d 60 4, 60 6 (La. App. 4 Cir. 1978). Accordingly, the Court finds that plaintiff’s disability insurance policy was not intended to gratify a nonpecuniary interest. The state appellate decisions cited by plaintiff are inapposite because those cases involved contracts related to the purchase, construction, or renovation of homes, which by the nature of the contract could involve substantial and fact-specific nonpecuniary interests. See Heath v. Brandon Hom es, Inc., 825 So. 2d 1262, 27 R. Doc. 8 at 4. 7 1268-69 (La. App. 2 Cir. 20 0 2) (finding significant nonpecuniary interests in the construction of plaintiff’s “dream hom e”); see also Cascio v. Carpet, 968 So. 2d 844, 852 (La. App. 2 Cir. 20 0 7); Stonecipher v. Mitchell, 655 So. 2d 1381, 1384-85 (La. App. 2 Cir. 1995); Johnston v. N orcondo, 572 So. 2d 20 3, 20 5 (La. App. 1 Cir. 1990 ). Plaintiff further contends that, even if the disability insurance contract does not serve a nonpecuniary interest, she has stated a claim under the second basis for nonpecuniary dam ages in Article 1998. 28 See La. Civ. Code art. 1998 (perm itting nonpecuniary dam ages “when the obligor intended, through his failure, to aggrieve the feelings of the obligee”). The amended com plaint alleges that “Defendant either intended to cause Plaintiff em otional distress and m ental anguish when denying her benefits or acted with such reckless disregard that it should have known that such m ental anguish and em otional distress would result from its actions.”29 Plaintiff’s assertion that defendant intended to cause her em otional distress is merely a “form ulaic recitation of the elem ents of a cause of action” without factual support in the com plaint. See Iqbal, 556 U.S. at 678. To recover under this theory, plaintiff m ust show that defendant’s actions were 28 R. Doc. 8 at 7. R. Doc. 7 at 1 ¶ 36. Plaintiff’s original com plaint m akes the sam e allegations. See R. Doc. 1 at 3 ¶ 20 ; Id. at 4 ¶ 23. 8 29 “calculated to inflict grief, vexation, or inconvenience on the other party.” Pinero v. Jackson Hew itt Tax Serv., Inc., 594 F. Supp. 2d 710 , 718 (E.D. La. 20 0 9) (quoting 6 Saul Litvinoff, Louisiana Civil Law Treatise § 6.16 (2d ed.)). The original and am ended complaints contain no factual allegations suggesting that defendant was m otivated by a desire to aggrieve plaintiff’s feelings. 30 See id. Plaintiff also fails to cite any authority to support the proposition that “reckless disregard” is sufficient to show an intent to aggrieve under Article 1998. 31 Although plaintiff alleges that defendant acted in bad faith, bad faith is not equivalent to an intent to aggrieve. See W egener v. Lafay ette Ins. Co, 60 So. 3d 1220 , 1230 (La. 20 11) (distinguishing between insurer’s breach of duty of good faith and an intent to aggrieve plaintiffs); Sher, 988 So.2d at 20 2, 20 7 (finding sufficient evidence that insurer’s failure to pay was “vexatious,” but no proof of an intent to aggrieve); see also Pinero, 594 F. Supp. 2d at 718; Tom linson v. Allstate Indem . Co., No. 0 6-617, 20 0 7 WL 325361, at *2 (E.D. 30 On the contrary, plaintiff repeatedly alleges that defendant acted out of financial self-interest. See R. Doc. 1 at 4-5 ¶ 30 -31; R. Doc. 7 at 1 ¶ 37; Id. at 5 ¶ 52. 31 Nor does plaintiff allege any facts to indicate that defendant was or should have been aware of special circum stances that would cause plaintiff to suffer greater emotional distress from a denial of benefits than other applicants for long term disability insurance. 9 La. 20 0 7). Plaintiff therefore fails to state a claim for nonpecuniary dam ages under the intent prong of Article 1998. Finally, plaintiff argues that defendant’s alleged bad faith justifies nonpecuniary damages under Louisiana Civil Code Article 1997. 32 Article 1997 provides that “[a]n obligor in bad faith is liable for all the dam ages, foreseeable or not, that are a direct consequence of his failure to perform.” La. Civ. Code art. 1997. But Article 1997 m ust be read in conjunction with Article 1998. In Young v. Ford Motor Co., Inc., 595 So. 2d 1123 (La. 1992), the Louisiana Suprem e Court exam ined the structure of the Civil Code and explained that Article 1994 sets out liability for dam ages for failure to perform a conventional obligation, Article 1997 provides that an obligor in bad faith is liable for “all the dam ages, foreseeable or not, that are a direct consequence of his failure to perform,” and “Article 1998 then sets forth the requirements for the recovery of nonpecuniary dam ages.” Id. at 1129 (em phasis added). The Young court denied mental anguish dam ages because the plaintiff failed to show that his contract had a nonpecuniary purpose. Id. at 1134. The award of nonpecuniary dam ages in a breach of contract action is governed by Article 1998, and Article 1997 does not provide a standalone 32 R. Doc. 8 at 5-6. 10 basis to recover dam ages for em otional distress. 33 See Nolan v. Com m onw ealth Nat’l Ins. Co., 688 So. 2d 581, 585 (La. App. 2 Cir. 1996) (finding that the rem ediation of m oral dam ages is addressed by Article 1998, and that Article 1997 does not cover unforeseen nonpecuniary dam ages); cf. W egener, 60 So. 3d at 1229-30 (holding that Article 1998 serves to lim it nonpecuniary damages only in breach of contract cases, and does not apply to a separate cause of action for an insurer’s breach of its statutory duty of good faith). Because plaintiff does not satisfy the requirem ents set out in Article 1998, she cannot recover nonpecuniary dam ages on her breach of insurance contract claim . This claim m ust therefore be dism issed. D . D is m is s al w ith Pre ju d ice Plaintiff filed an am ended com plaint in response to defendant’s first m otion to dism iss, and she has not requested further leave to amend. Plaintiff also concedes that she is not entitled to short term benefits and that she is not entitled to penalties under Louisiana Revised Statutes §§ 22:658 and 22:1892. Further, the Court finds that plaintiff has had sufficient opportunity to cure the deficiencies in her complaint, and that another 33 Plaintiff relies on several state appellate decisions to argue that a finding of bad faith supports nonpecuniary dam ages under Article 1997. See R. Doc. 8 at 5-6. But those cases were decided before Young v. Ford Motor Co., 595 So.2d 1123 (La. 1992), and are inconsistent with recent Louisiana caselaw. 11 am endment would be futile. See Fom an v. Davis, 371 U.S. 178, 182 (1962). The Court therefore dism isses plaintiff’s claims at issue on the m otion with prejudice. IV. CON CLU SION For the foregoing reasons, the Court DENIES defendant’s first m otion to dism iss 34 as m oot. The Court GRANTS defendant’s second m otion to dism iss. 35 Plaintiff’s claim s for short term disability benefits, statutory penalties under Louisiana Revised Statutes §§ 22:658 and 22:1892, and nonpecuniary damages arising out of a breach of contract are DISMISSED WITH PREJ UDICE. 3rd New Orleans, Louisiana, this _ _ _ _ _ day of October, 20 17. _____________________ SARAH S. VANCE UNITED STATES DISTRICT J UDGE 34 35 R. Doc. 6. R. Doc. 9. 12
]]>
Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You
should read the full case before relying on it for legal research purposes.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
