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Javie v. Massachusetts Casualty Insurance Co.

United States District Court, D. New Jersey

August 8, 2019

STEVEN JAVIE, Plaintiff,
v.
MASSACHUSETTS CASUALTY INSURANCE COMPANY, now known as Centre Life Insurance Company, and SUN LIFE ASSURANCE COMPANY OF CANADA U.S., Defendants.

         Not for Publication

          OPINION

          John Michael Vazquez, U.S.D.J.

         This case concerns a former National Basketball Association ("NBA") referee's disability insurance policy. Plaintiff Steven Javie alleges that Defendants Massachusetts Casualty Insurance Company (now known as Centre Life Insurance Company) ("MC"), and Sun Life Assurance Company of Canada (U.S.) ("SL") are unlawfully refusing to pay benefits to Plaintiff that a representative guaranteed to Plaintiff when acquiring the policy. D.E. 1. Currently pending before the Court is Defendants' motion to dismiss Counts II, III, and IV of Plaintiffs' Complaint pursuant to Fed.R.Civ.P. 12(b)(6) and Fed.R.Civ.P. 9(b) for failure to state a claim. D.E. 19. The Court reviewed the parties' submissions in support and in opposition[1] and decided the motion without oral argument pursuant to Fed.R.Civ.P. 78(b) and L. Civ. R. 78.1(b). For the reasons stated below, Defendant's motion to dismiss is granted.

         I. INTRODUCTION[2]

         Plaintiff began working as an NBA referee in 1996. Compl. ¶ 8. In September of the same year, Plaintiff participated in a referee training camp in New Jersey. Id. ¶ 9. As part of this training camp, Plaintiff attended a union meeting hosted by the National Basketball Referees Association ("NBRA") on September 29, 1996. Id. ¶ 9. At the meeting, Steven D. Lucas promoted a supplemental disability insurance policy offered by Defendant MC. Id. ¶ 10. Lucas was a sales representative for Defendant SL, who Defendant MC designated as administrator for MC's disability income products. Id. ¶ 11.

         At the meeting, Lucas represented that the policy would cover NBA referees if they are "totally disabled from being an NBA official," and is "guaranteed... to age 65." Id. ¶ 13. Lucas clarified that "[i]f you can't be an official but you can work in a store some place you go ahead and work there," as you are still considered "totally disabled" under the policy. Id. He emphasized that "[p]ure and simple if you have an injury or accident that keeps you from doing your job and your doctor can attest to it you're going to collects [sic] benefits under this contract. Pure and simple." Id. ¶ 13. In reliance on these representations, Plaintiff purchased a supplemental disability policy (the "Policy") from Defendant MC on November 1, 1996. Id. ¶ 14; D.E. 1, Ex. A.

         While the Policy was in effect, Plaintiff suffered an injury that prevented him from working as an NBA referee. Id. ¶ IV. MC initially acknowledged coverage under the Policy and began paying benefits to Plaintiff. Id. ¶ 18. Plaintiff then secured alternative employment as an analyst for ESPN. Id. ¶ 19. As a result, on May 25, 2017, MC notified Plaintiff that his disability benefits under the Policy would terminate on June 28, 2017 -before Plaintiff turned 65. Id. ¶¶ 19, 20.

         On February 27, 2018, Plaintiff brought his Complaint against Defendants in this Court, alleging the following four Counts: (I) breach of contract against MC, (II) breach of covenant of good faith and fair dealing against MC, (III) bad faith in violation of 42 Pa.C.S. § 8371 against MC, and (IV) fraud against both Defendants. Id. ¶¶ 17-44. Defendants moved to dismiss Counts II, III, and IV of the Complaint pursuant to Fed.R.Civ.P. 12(b)(6) and Fed.R.Civ.P. 9(b) for failure to state a claim. D.E. 19. Plaintiff filed opposition, D.E. 23, to which Defendants replied, D.E. 27.

         II. LEGAL STANDARD

         Rule 12(b)(6)

         Rule 12(b)(6) of the Federal Rules of Civil Procedure permits a defendant to move to dismiss a count for "failure to state a claim upon which relief can be granted[.]" To withstand a motion to dismiss under Rule 12(b)(6), a plaintiff must 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 complaint is plausible on its face when there is enough 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). 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) (internal quotation marks and citations omitted). As a result, a plaintiff must "allege sufficient facts to raise a reasonable expectation that discovery will uncover proof of [his] claims." Id. at 789.

         In evaluating the sufficiency of a complaint, a district court must accept all factual allegations in the complaint as true and draw all reasonable inferences in favor of the plaintiff. Phillips v. Cty. of Allegheny, 515 F.3d 224, 231 (3d Cir. 2008). A court, however, is "not compelled to accept unwarranted inferences, unsupported conclusions or legal conclusions disguised as factual allegations." Baraka v. McGreevey, 481 F.3d 187, 211 (3d Cir. 2007). If, after viewing the allegations in the complaint most favorable to the plaintiff, it appears that no relief could be granted under any set of facts consistent with the allegations, a court may dismiss the complaint for failure to state a claim. DeFazio v. Leading Edge Recovery Sols., 2010 WL 5146765, at *1 (D.N.J. Dec. 13, 2010).

         Rule 9(b)

         "Independent of the standard applicable to Rule 12(b)(6) motions, Rule 9(b) imposes a heightened pleading requirement of factual particularity with respect to allegations of fraud." In re Rockefeller Or. Props,, Inc. Sec. Litig., 311 F.3d 198, 216 (3d Cir. 2002). Pursuant to Rule 9(b), when "alleging fraud or mistake, a party must state with particularity the circumstances constituting fraud or mistake . . . [m]alice, intent, knowledge, and other conditions of a person's mind may be alleged generally." Fed.R.Civ.P. 9(b). A party alleging fraud must therefore support its allegations with factual details such as "the who, what, when, where and how of the events at issue." U.S. ex rel Moore & Co., P.A, v. Majestic Blue Fisheries, LLC,812 F.3d 294, 307 (3d Cir. 2016). Accordingly, "[t]o satisfy the particularity standard, 'the plaintiff must plead or allege the date, time and place of the alleged fraud or otherwise inject precision or some measure of substantiation into a fraud allegation.'" Feingold v. Graff, 516 Fed.Appx. 223, 226 (3d Cir. 2013) (citing Frederico v. Home Depot,507 F.3d 188, 200 (3d Cir. 2007)). This heightened pleading standard is designed to "ensure ...


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