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.

LEO v. LAIDLAW

March 4, 1999

JIM LEO, PLAINTIFF,
v.
LAIDLAW, INC. AND AMERICAN MEDICAL RESPONSE, INC., DEFENDANTS.



The opinion of the court was delivered by: Alesia, District Judge.

MEMORANDUM OPINION AND ORDER

Before the court is defendants Laidlaw, Inc. and American Medical Response, Inc.'s motion to dismiss plaintiff Jim Leo's complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). For the following reasons, the court grants defendants' motion to dismiss.

I. BACKGROUND

The complaint alleges the following facts which, for the purpose of ruling on defendants' motion to dismiss, are taken as true. Hishon v. King & Spalding, 467 U.S. 69, 73, 104 S.Ct. 2229, 81 L.Ed.2d 59 (1984). Defendants Laidlaw, Inc. and American Medical Response, Inc. are related corporations. Before December 1, 1996, defendants established a Group Health Care Coverage Plan ("the Plan") for their employees. Defendants were the administrators of the Plan. Defendants contracted with Aetna Life Insurance Co. ("Aetna") to be an agent for defendants as the Plan's administrators.

Before December 14, 1996, plaintiff Jim Leo ("Leo") was an employee of defendant and was entitled to coverage under the Plan. On December 14, 1996, Leo resigned as an employee. After he resigned, Leo was entitled to continued coverage under the Plan pursuant to the Consolidated Omnibus Budget Reconciliation Act ("COBRA"), which is a part of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq.

On or before December 31, 1996, defendants delivered Leo a written notice ("the notice") that incorrectly informed him that by complying with the applicant requirements set forth in the notice, Leo's rights to healthcare benefits under the Plan would continue with Chicago HMO. Defendants enclosed a form with the notice that Leo was to fill out and mail back if he elected to continue coverage. On December 31, 1996, Leo filled out the applicant section of the form and signed it. Shortly after doing so, he mailed the form and the fee for the initial monthly premium to Aetna as he was directed to do by defendants. Aetna received the form before the due date. Since the time that he had elected to continue coverage, Leo made timely payments of his required premium payment to Aetna.

Approximately mid-February of 1997, Aetna sent Leo an identification card for his elected dental coverage but not an identification card for his elected medical coverage. This made Leo suspect that the notice that defendants had sent him was inaccurate. Approximately mid-March of 1997 and many times thereafter, Leo made written and oral requests that Aetna provide accurate notice of his COBRA rights to medical coverage. Aetna repeatedly notified Leo that he did not have any COBRA rights to medical coverage. Beginning in June of 1997, Leo also made many written and oral requests that defendants provide him accurate notice of his COBRA rights to medial coverage. Defendants told Leo that they did not know what his rights to medical coverage were.

On February 12, 1998, Aetna sent Leo a COBRA notice which incorrectly notified him that he had medical coverage with Chicago HMO. On March 12, 1998, Aetna notified Leo that he had no medical coverage. On June 25, 1998, Aetna notified Leo that he did have medical coverage with Aetna U.S. Healthcare and not his elected Chicago HMO.

As a result of the above, Leo was deprived of knowledge of his medical insurance rights for the full term of its existence. In addition, Leo had to hire an attorney to investigate and advise him of his rights to represent him in pursuit of his rights.

On November 2, 1998, Leo filed suit against defendants in this court for violation of his COBRA rights. This court has subject matter jurisdiction over the case pursuant to 29 U.S.C. § 1132(e). In his complaint, Leo requests the following relief: (1) a refund of the premiums that he paid; (2) $110 per day for defendants "failure to notify him of his Cobra medical insurance rights for 541 days"; (3) costs, disbursements, and reasonable attorney's fees; and (4) any other relief that this court deems appropriate.

On January 4, 1999, defendants filed a motion to dismiss, arguing that (1) Leo does not have standing to sue under ERISA and (2) Leo's allegations fail to state a claim under ERISA. The court addresses defendants' motion below.

II. DISCUSSION

A. Standard for deciding a Rule 12(b)(6) motion to dismiss

When deciding a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), the court must accept all factual allegations in the complaint as true and draw all reasonable inferences in favor of the plaintiff. Cromley v. Board of Educ. of Lockport, 699 F. Supp. 1283, 1285 (N.D.Ill. 1988). If, when viewed in the light most favorable to the plaintiff, the complaint fails to state a claim upon which relief can be granted, the court must dismiss the case. See FED.R.CIV.P. 12(b)(6); Gomez v. Illinois State Bd. of Educ., 811 F.2d 1030, 1039 (7th Cir. 1987). However, the court may dismiss the complaint only if it appears beyond a doubt that the plaintiff can prove no set of facts in support of his claim that would entitle him to relief. Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957). Even under the liberal notice pleading standard of the ...


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.