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LLC v. Aetna, Inc.

United States District Court, D. New Jersey

February 23, 2015

TRI 3 ENTERPRISES, LLC, et al., Plaintiffs,
AETNA, INC., et al., Defendants.



This matter comes before the Court upon Plaintiffs, Tri 3 Enterprises, LLC, on behalf of themselves and all others similarly situated ("Plaintiffs") request for leave to file a First Amended Complaint [Docket Entry No. 85] to join additional parties, Integrated Orthopedics, Inc. (doing business as Wabash Medical, Inc.), WMI Enterprises, LLC, Compression Therapy, LLC, CMW Medical, LLC, and Hoosier Med, LLC.; and Defendants, Aetna Health Inc., Aetna Insurance Company of Connecticut, Aetna Life Insurance Company, Aetna, Inc.; and Corporate Health Insurance, Inc., oppose Plaintiffs' Motion to Amend [Docket Entry No. 87]. The Court has fully reviewed and considered all arguments made in support of, and in opposition to, Plaintiffs' motion. The Court considers Plaintiffs' motion without oral argument pursuant to L.Civ.R. 78.1(b). For the reasons set forth more fully below, Plaintiffs' motion is GRANTED.


On May 16, 2011, Tri 3 Enterprises filed a class action complaint in the United States District for the District of the Northern District of Illinois, against the Defendants challenging the conduct of Aetna's Special Investigations Unit ("SIU"). Specifically, Plaintiffs allege that Defendants sent them overpayment letters demanding payment, that these letters were adverse benefit determinations, and that they violated ERISA because they did not contain the notice and appeal rights that are required when a claim for benefits is denied. ( See Complaint; Docket Entry No. 1). Plaintiffs seek a return on all moneys recouped from putative class members, payment on all claims subject to pre-payment review, and an order enjoining all future recoupment efforts. ( Id .).

On June 24, 2011, this matter was transferred to this Court, the United States District Court for the District of New Jersey. ( See Opinion; Docket Entry No. 15).

On August 15, 2011, Defendants moved to dismiss Plaintiffs' Complaint for failure to state a claim pursuant to Federal Rule of Civil Procedure 12(b)(6). ( See Motion to Dismiss; Docket Entry No. 26). On April 24, 2012, Defendants' Motion to Dismiss was granted. ( See Order; Docket Entry No. 50).

On May 4, 2012, Plaintiffs filed a Notice of Appeal of the Court's April 2012 dismissal of the Complaint. ( See Notice of Appeal; Docket Entry No. 51). On August 16, 2012, the Third Circuit Court of Appeals, on procedural grounds, vacated and remanded the Order of the District Court. ( See USCA Judgment; Docket Entry No. 54).

On December 19, 2013, Defendants answered Plaintiffs' Complaint, and named ten Counterclaim Defendants against Plaintiffs and several of its related entities alleging that they had engaged in a multi-year scheme to defraud Defendants by submitting false and fraudulent claims for insurance. ( See Answer; Docket Entry No. 61).

On March 25, 2014, an Initial Pretrial Conference was held. During said conference, the Court consolidated this action (Civil Action No. 11-3921) with the Association of New Jersey Chiropractors (ANJC) action (Civil Action No. 09-3761) for purposes of discovery. ( See Scheduling Order; Docket Entry No. 81). The Scheduling Order set July 11, 2014 as the deadline to amend the pleadings and/or join parties. ( Id .). By Letter Order on July 11, 2014, the deadline for motions to amend new pleadings and join new parties was extended from July 11, 2014 until July 14, 2014. ( See Letter Order; Docket Entry No. 84).

On July 14, 2014, Plaintiffs filed the instant Motion for Leave to File a First Amended Class Action Complaint. ( See Motion to Amend; Docket Entry No. 85). Plaintiffs are now seeking to amend their Complaint to add five additional parties.[1]



Plaintiffs argue they should be permitted to file a First Amended Complaint because Federal Rule of Civil Procedure 15(a)(2) provides: "[t]he court should freely give leave when justice so requires. Pilvalisvl Lockheed Martin Corp ., 2013 WL 1164498 (D.N.J. Mar. 20, 2013)(citing Heyl & Patterson Intern., Inc. v. F.D. Rich Hous. of Virgin Islands, Inc ., 663 F.2d 419(3d Cir. 1981)). Moreover, Plaintiffs argue this is particularly so when the motion to amend is the first request to amend the complaint and that motion is timely made. ( See Motion to Amend; Docket Entry No. 85).

Plaintiffs further assert, Federal Rule of Civil Procedure 17(a)(3) provides that "the court may not dismiss an action for failure to prosecute in the name of the real party in interest until, after an objection, a reasonable time has been allowed for the real party in interest to ratify, join, or be substituted into the action." ( Id . at 5 citing Fed.R.Civ.P. 17(a)(3)). Plaintiffs claim that Defendants did not object to this case proceeding in the name of Tri 3 Enterprises, LLC. Further, Plaintiffs argue that because Tri 3 Enterprises ...

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