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Nara L. Turner v. Cigna Group Insurance; Life Insurance Company of North America

May 24, 2011


The opinion of the court was delivered by: Kugler, United States District Judge:



This matter arises out of the allegedly improper denial of life insurance benefits by an insurance provider. Presently before the Court is the motion to dismiss the Complaint filed by Defendant Life Insurance Company of North America ("LINA") pursuant to Federal Rule of Civil Procedure 12(b)(6). LINA argues that dismissal is appropriate because the Employee Retirement Income Security Act of 1974 ("ERISA") preempts all of Plaintiff's claims. For the following reasons, LINA's motion to dismiss is GRANTED.


LINA is an insurance company that provides accidental insurance coverage for its subscribers. The Complaint alleges that CIGNA Group Insurance ("CIGNA") "is an insurance company authorized to transact business in the State of New Jersey, and was the issuer of a policy of accidental death insurance to David W. Turner . . . ."*fn2 (Compl. at 1). LINA underwrote a policy of accidental death insurance issued to David W. Turner. Plaintiff is the surviving spouse of Mr. Turner.

On October 5, 2008, Mr. Turner died as the result of a boating accident. At the time of his death, Mr. Turner had an accidental death insurance policy with LINA. Plaintiff was the beneficiary of Mr. Turner's life insurance policy at the time of his death. Shortly after Mr. Turner's death, Plaintiff notified LINA and requested death benefits under the terms of Mr. Turner's accidental death insurance policy. On December 4, 2008, LINA denied Plaintiff's claim. The Complaint alleges that Defendants denied Plaintiff's claim for benefits under the terms of the policy "citing as their sole reason the allegation that coverage was excluded due to 'intentionally self-inflicted injury, suicide or any attempt thereat [sic] while sane or insane.'" (Compl. at 2). Plaintiff also claims that despite her repeated requests, "[Defendants] refused . . . to honor [her] claim as the beneficiary under the policy as required by the contract of insurance." (Id. at 2).

Plaintiff filed a lawsuit in the Superior Court of New Jersey on June 24, 2010. The Complaint alleges claims for breach of contract (Count Two); breach of the implied covenant of good faith and fair dealing (Count Three); intentional or negligent infliction of emotional distress (Count Four); negligence (Count Five); misr epresentation (Count Seven); bad faith (Count Eight); and unjust enrichment (Count Nine). Count Six alleges that Defendants unlawfully administered Plaintiff's request for benefits in violation of "one or more statutes and/or administrative code regulations," (Compl. at 4), and Count Ten alleges that Defendants committed "improper acts and/or omissions," (id. at 5). On August 31, 2010, LINA filed a pre-answer motion to dismiss. (Doc. No. 5). LINA contends that Counts Two, Three, Four, Five, Seven, Eight and Nine are preempted by ERISA, and that Counts Six and Ten fail to state a cause of action under Federal Rule of Civil Procedure 12(b)(6).*fn3 The parties submitted their respective briefs and the motion is ripe for review.


Under Federal Rule of Civil Procedure 12(b)(6), a court may dismiss an action for failure to state a claim upon which relief may be granted. With a motion to dismiss, "courts accept all factual allegations as true, construe the complaint in the light most favorable to the plaintiff, and determine whether, under any reasonable reading of the complaint, the plaintiff may be entitled to relief." Fowler v. UPMC Shadyside, 578 F.3d 203, 210 (3d Cir. 2009) (internal quotations omitted). In other words, a complaint survives a motion to dismiss if it contains sufficient factual matter, accepted as true, to "state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007).

In making that determination, a court must conduct a two-part analysis. Ashcroft v. Iqbal, 129 S. Ct. 1937, 1949-50 (2009); Fowler, 578 F.3d at 210-11. First, the Court must separate factual allegations from legal conclusions. Iqbal, 129 S. Ct. at 1949. "Threadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice." Id.

Second, the court must determine whether the factual allegations are sufficient to show that the plaintiff has a "plausible claim for relief." Id. at 1950. Determining plausibility is a "context-specific task" that requires the court to "draw on its judicial experience and common sense." Id. A complaint cannot survive where a court can only infer that a claim is merely possible rather than plausible. See id.


A.Express Preemption Under ERISA

ERISA governs the rights and obligations of participants and beneficiaries of employee benefit plans. "Congress enacted ERISA [1] 'to protect . . . the interests of participant benefit plans and their beneficiaries' by setting out substantive regulatory requirements for employee benefit plans and [2] to 'provid[e] for appropriate remedies, sanctions, and ready access to the Federal Courts.'" Aetna Health Inc. v. Davila, 542 U.S. 200, 208 (2004) (quoting 29 U.S.C. ยง 1001(b)). "ERISA includes expansive pre-emption provisions, . . . which are intended to ensure that employee ...

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