Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

MICHAELSON-COHN v. ANTHEM LIFE & HEALTH INS. CO.

May 19, 1997

CHARLES A. COHN and LYNN B. MICHAELSON-COHN, Plaintiffs,
v.
ANTHEM LIFE AND HEALTH INSURANCE COMPANY, an insurance corporation, Defendant.



The opinion of the court was delivered by: NORGLE

 CHARLES R. NORGLE, SR., District Judge:

 Before the court is Plaintiffs/Counter-Defendants' Motion to Dismiss Counterclaim. For the following reasons, the motion is granted.

 I. FACTS

 Charles A. Cohn ("Cohn") and Lynn B. Michaelson-Cohn ("Michaelson-Cohn") (collectively, "the Cohns") filed a six-count Complaint for Declaratory Judgment in the circuit court of Lake County, Illinois, on October 28, 1996. The Cohns sought a determination that certain medical expenses incurred by Michaelson-Cohn are covered by the couple's insurance policy with Anthem Life and Health Insurance Company ("Anthem"). Anthem removed the action to federal court based on preemption by the Employee Retirement Income Security Act, 29 U.S.C. ยง 1001 ("ERISA"), and filed its Answer, Affirmative Defenses, and Counterclaim. The Counterclaim attempts to state a claim for unjust enrichment against the Cohns.

 Anthem seeks to force the Cohns to repay $ 11,000 to Anthem, the amount which Anthem allegedly paid in error ("Payment"). Anthem apparently paid the $ 11,000 to the hospital for treatment not covered by the insurance policy. Anthem did not name the hospital in its Counterclaim.

 The Counterclaim indicates that all parties were aware of the nature of the claims. It alleges that Anthem repeatedly sent letters to the Cohns, clearly denying coverage for the treatments. Nevertheless, Anthem made the Payment for those treatments, as a result of "an inadvertent clerical/computer error." (Countercl. at P 3.) It is the Cohns position that, regardless of whether the policy provided coverage, Anthem may not recover the Payment.

 II. DISCUSSION

 The Cohns filed their Motion to Dismiss Counterclaim under Federal Rules of Civil Procedure 12(b)(6) and 12(b)(7). First, the Cohns argue that Anthem has failed to state a claim for unjust enrichment, as the Counterclaim does not explicitly identify the actual recipient of the Payment. Second, the Cohns assert that Anthem may not state a claim for unjust enrichment, as a written contract governs the relationship between the parties. Third, and finally, the Cohns posit that the hospital which treated Michaelson-Cohn is a necessary and indispensable party as defined in Federal Rule of Civil Procedure 19; the Cohns recite this argument without citation to relevant case law. The court will address each argument in turn.

 When considering a Rule 12(b)(6) motion to dismiss, the court must accept all allegations as true. Flynn v. Kornwolf, 83 F.3d 924, 925 (7th Cir. 1996). In addition, the court must draw all reasonable inferences in favor of the non-movant. Id. The test under Rule 12(b)(6) is whether it appears beyond doubt that the plaintiff (here, Counter-Plaintiff) can prove no set of facts in support of a claim which would entitle it to relief. Antonelli v. Sheahan, 81 F.3d 1422, 1427 (7th Cir. 1996).

 1. Anthem's Failure to Name the Recipient of the $ 11,000

 Federal notice pleading standards require that a complaint (or counterclaim, cross-claim, or third-party complaint) contain, inter alia, "a short and plain statement of the claim showing that the pleader is entitled to relief." See generally, Fed. R. Civ. P. 8(a). The key issue is whether the complaint puts the defendant (or, in the instant case, the Counter-Defendant) on notice of the kinds of claims asserted against it. Leatherman v. Tarrant County Narcotics Intel. & Coord. Unit, 507 U.S. 163, 113 S. Ct. 1160, 1163, 122 L. Ed. 2d 517 (1993). The Counterclaim states that Anthem made the Payment for some of Michaelson-Cohn's medical expenses "despite the fact that no coverage was afforded for said expenses." (Countercl. at P 4.) Anthem alleges that the Cohns, rather than the hospital, received and unjustly obtained a benefit from the Payment. In their Motion to Dismiss Counterclaim, the Cohns themselves refer to "the obvious facts that these funds would have been paid not to the plaintiffs but to" the hospital. (Mot. ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.