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Werner v. Group Health Plan

April 20, 2010

DALE WERNER, PLAINTIFF,
v.
GROUP HEALTH PLAN, INC., A COVENTRY HEALTH CARE PLAN, DEFENDANT.



The opinion of the court was delivered by: J. Phil Gilbert District Judge

MEMORANDUM AND ORDER

This matter comes before the Court on Plaintiff Dale Werner's (hereinafter "Werner") Motion to Remand (Doc. 12) and memorandum in support thereof. Defendant Group Health Plan, Inc. (hereinafter "Group Health") filed a Response (Doc. 18) thereto.

For the following reasons, the Court DENIES the instant motion.

BACKGROUND

I. Facts

In considering motions to remand, courts generally accept all factual allegations in the complaint as true and draw all reasonable inferences from those facts in favor of the plaintiff. See Rutz v. Barnes-Jewish Hosp., Case No. 04-cv-0748-MJR, 2005 WL 1389053, at *2 (S.D. Ill. June 3, 2005); see also Klassy v. Physicians Plus Ins. Co., 276 F. Supp. 2d 952, 953 (W.D. Wis. 2003). The Court, accepting all of the allegations in Werner's Complaint (Doc. 4-2) as true and drawing all reasonable inferences in his favor, finds as follows:

At all times relevant to this case, Wernermaintained health insurance through a policy issued by Group Health, which included both his wife and dependent child as beneficiaries under the policy. In July 2008, Werner's wife received pre-certification from an agent of Group Health for a costly medical procedure that she was to undergo the following month. Upon and following such pre-certification, agents of Group Health repeatedly assured Werner that no premium was due on the policy and that a credit balance existed in his favor. Werner and his wife relied on these assurances, and she underwent the procedure as planned.

Group Health paid at least two of the service providers involved in the medical procedure. However, shortly thereafter, Group Health cancelled Werner's health insurance policy, requested repayment for the bills it previously paid as to Werner's wife's procedure, refused to pay the remaining outstanding claims for said procedure, and refused to negotiate or settle any of the outstanding claims with Werner.

II. Relevant Procedural Posture

On August 19, 2009, Werner filed suit against Group Health in Madison County, Illinois, asserting claims of breach of contract, fraud, consumer fraud in violation of the Illinois Consumer Fraud and Deceptive Business Practices Act, 815 ILCS 505/1, et seq., unfair and/or improper claims practice in violation of Section 154.5 of the Illinois Insurance Code, promissory estoppel, and negligent misrepresentation.*fn1 Werner's claims would not remain in state court for long, as Group Health timely removed the matter to this Court on October 22, 2009.

Group Health believes federal jurisdiction to be appropriate for the following two reasons: 1) Werner's claims have been completely preempted by the Employee Retirement Income Security Act of 1974 (hereinafter "ERISA"), 29 U.S.C. § 1001, et seq., and; 2) diversity jurisdiction exists pursuant to 28 U.S.C. § 1332. Werner contests both of these purported bases of federal jurisdiction in the instant motion. Following a general overview of the law governing removal and remand, the Court will addressthe parties' arguments concerning ERISA preemption. As will be seen, the Court need not address issues relating to diversity jurisdiction given that federal jurisdiction exists pursuant to 28 U.S.C. § 1331.*fn2

ANALYSIS

I. Removal Generally

A defendant may remove a case filed in state court to federal court so long as there is original federal jurisdiction over the case. 28 U.S.C. § 1441(a) (2006); Chase v. Shop 'N Save Warehouse Foods, 110 F.3d 424, 427 (7th Cir. 1997). The party invoking the Court's jurisdiction bears the burden of showing that the case is properly brought. McNutt v. Gen. Motors Acceptance Corp. of Ind., 298 U.S. 178, 189 (1936); Del Vecchio v. Conseco, Inc., 230 F.3d 974, 979 (7th Cir. 2000); Am. Bankers Life Assur. Co. of Fla. v. Evans, 319 F.3d 907, 909 (7th Cir. 2003). Statutes that provide for removal are to be construed narrowly, and any doubts concerning removal should be resolved in favor of remand. Doe v. ...


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