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Batten v. Aetna Life Insurance Co.

United States District Court, E.D. Virginia, Richmond Division

August 17, 2016

MARSHA W. BATTEN, Plaintiff,



         This matter comes before the Court on Defendant Aetna Life Insurance Company's ("Aetna") Motion to Partially Dismiss Plaintiffs Complaint ("Partial Motion to Dismiss") pursuant to Federal Rule of Civil Procedure 12(b)(6).[1] (ECF No. 3.) Plaintiff Marsha Batten ("Batten") has responded to the Partial Motion to Dismiss. (ECF No. 5.) Aetna has not replied, and the time to do so has expired. The Court dispenses with oral argument because the materials before the Court adequately present the facts and legal contentions, and argument would not aid the decisional process. The Court exercises jurisdiction pursuant to 28 U.S.C. § 1331.[2] The Court will grant Defendant's Partial Motion to Dismiss.

         I. Federal Rule of Civil Procedure 12(b)(6) Standard

         "A motion to dismiss under Rule 12(b)(6) tests the sufficiency of a complaint; importantly, it does not resolve contests surrounding the facts, the merits of a claim, or the applicability of defenses." Republican Party of N.C. v. Martin, 980 F.2d 943, 952 (4th Cir. applicability of defenses." Republican Party of N.C. v. Martin, 980 F.2d 943, 952 (4th Cir. 1992) (citing 5 A Charles A. Wright & Arthur R. Miller, Federal Practice and Procedure § 1356 (1990)). In considering a motion to dismiss for failure to state a claim, a plaintiffs well-pleaded allegations are taken as true and the complaint is viewed in the light most favorable to the plaintiff. Mylan Labs., Inc. v. Matkari, 7 F.3d 1130, 1134 (4th Cir. 1993); see also Martin, 980 F.2d at 952. This principle applies only to factual allegations, however, and "a court considering a motion to dismiss can choose to begin by identifying pleadings that, because they are no more than conclusions, are not entitled to the assumption of truth." Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009).

         The Federal Rules of Civil Procedure "require[ ] only 'a short and plain statement of the claim showing that the pleader is entitled to relief, ' in order to 'give the defendant fair notice of what the ... claim is and the grounds upon which it rests.'" BellAtl Corp. v. Twombly, 550 U.S. 544, 555 (2007) (omission in original) (quoting Conley v. Gibson, 355 U.S. 41, 47 (1957)). Plaintiffs cannot satisfy this standard with complaints containing only "labels and conclusions" or a "formulaic recitation of the elements of a cause of action." Id. (citations omitted). Instead, a plaintiff must assert facts that rise above speculation and conceivability to those that "show" a claim that is "plausible on its face." Iqbal, 556 U.S. at 678-79 (citing Twombly, 550 U.S. at 570; Fed.R.Civ.P. 8(a)(2)). "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." Id. at 678 (citing Twombly, 550 U.S. at 556). Therefore, in order for a claim or complaint to survive dismissal for failure to state a claim, the plaintiff must "allege facts sufficient to state all the elements of [his or] her claim." Bass v. E.I. DuPont de Nemours & Co., 324 F.3d 761, 765 (4th Cir. 2003) (citations omitted).

         II. Factual and Procedural Background

         A. Summary of Allegations in Batten's Complaint[3]

         Plaintiff Marsha Batten formerly worked for Bank of America as a Customer Relations Manager. (Compl. ¶ 7.) During her employment there, Batten enrolled in the Bank of America Long Term Group Disability Insurance Policy ("Disability Policy"). (Compl. ¶ 3.) Defendant Aetna underwrote the plan and served as its Claims Administrator. (Compl. ¶¶ 3, 4.)

         Under the Disability Policy, you are disabled if "[y]ou are not able to perform the material duties of your own occupation solely because of: disease or injury; and [y]our work earnings are 80% or less of your adjusted predisability earnings." (Compl. ¶ 8 (emphasis added).) After the first 18 months, the Disability Policy provides that "you will be deemed to be disabled on any day if you are not able to work at any reasonable occupation solely because of: Disease; or Injury." (Id. (emphasis added).)

         Batten suffers from a variety of physical and mental ailments. (Compl. ¶ 9.) On April 13, 2011, Batten received a diagnosis of cervical disk herniation with low-grade myelopathy. (Compl. ¶ 9.) On June 27, 2011, she suffered from ongoing cervical disk disease with radiculopathy and evidence of possible median nerve compression at the wrist. (Id.) Batten also suffered from morbid obesity and used narcotics regularly to control pain. (Id.) On March 18, 2012, the Social Security Administration indicated that it deemed Batten disabled as of October 4, 2010. (Compl. ¶ 9.)

         On January 4, 2010, Batten stopped working for Bank of America because of various health problems. (Compl. ¶ 10.) She applied for and received long-term disability benefits from Aetna from April 4, 2011, until October 3, 2012. (Compl. ¶¶ 10, 12.) On October 4, 2012, Aetna terminated Batten's long-term disability benefits. (Compl. ¶ 15.) Batten alleges that Aetna did not consider all of her relevant medical information and therefore incorrectly concluded that she did not qualify for additional benefits under the Disability Policy. (Id.) Batten's medical condition has continued to deteriorate since January 4, 2010, and had not improved as of October 4, 2012, when Aetna terminated coverage. (Compl. ¶ 13.)

         Batten appealed the termination of her long-term disability benefits in accordance with the terms of the Disability Policy. (Compl. ¶ 17.) She submitted additional medical documentation from her treating physicians confirming that she remained physically unable to perform the duties of her previous job or any other full-time occupation. (Compl. ¶ 18.) Despite the presentation of additional evidence, Aetna refused to reconsider its decision to deny Batten further disability benefits. (Compl. ¶ 19.) Batten has exhausted all administrative remedies under ERISA and the Disability Policy.[4] (Compl. ¶ 29.)

         B. Procedural History

         On August 25, 2015, Batten filed suit against Aetna in this Court under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq. (Compl., ECF No. 1.) Batten raises two claims against Aetna seeking relief under two separate subsections of ERISA § 502(a), codified at 29 U.S.C. § 1132(a).[5] First, she alleges that Aetna wrongly denied her benefits under the Disability Policy in violation of ERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B).[6] (Compl. ΒΆΒΆ 27-30.) Second, Batten alleges that Aetna breached its fiduciary duty under ...

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