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.

KOK v. FIRST UNUM LIFE INS. CO.

July 27, 2001

PAUL KOK, PLAINTIFF,
v.
FIRST UNUM LIFE INSURANCE COMPANY AND PLASMACO, INC., DEFENDANTS.



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

 
MEMORANDUM DECISION AND ORDER GRANTING DEFENDANT PLASMACO'S MOTION TO DISMISS AND DENYING PLAINTIFF'S MOTION TO DISMISS

Plaintiff Paul Kok brings an action for recovery of benefits and a statement of rights under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. § 1132, and for breach of contract, specific performance, and "malicious interference with contract" against defendants First UNUM Life Insurance Company ("UNUM") and Plasmaco, Inc. ("Plasmaco"). This case was filed in the Supreme Court of the State of New York, County of Westchester, and properly was removed to this Court pursuant to 28 U.S.C. § 1441 and 1446 on the basis of federal question jurisdiction.

Defendant Plasmaco moves to dismiss the claims against it, and defendant UNUM counterclaims for the amount of benefits that plaintiff wrongfully received. Plaintiff moves to dismiss UNUM's counterclaim, or in the alternative, for a more definite statement of the Complaint.

FACTUAL BACKGROUND

Plasmaco offered a Long Term Disability Plan to its employees, which was administered by UNUM. Plaintiff was a full time employee of Plasmaco from September 1996 through May 1998.

On or about August 3, 1997, while working for Plasmaco, plaintiff became disabled. UNUM paid benefits to plaintiff for twenty-four months, after which time they were terminated.

Plaintiff claims that he is totally and permanently disabled, and unable to perform the duties of a gainful occupation. According to plaintiff, under the terms of Long Term Disability Plan Rules and Regulations, when an employee is unable to be employed after twenty-four months of payments, defendants are required to pay continued benefits. Plaintiff argues that defendants unilaterally, and without administrative hearing, refused to conclude that he was permanently and totally disabled, and therefore did not pay him benefits to which he was entitled. He seeks recovery of those benefits.

Defendant Plasmaco moves to dismiss the claims against it on the grounds that a claim for benefits under ERISA must be brought against UNUM, because UNUM — not Plasmaco — was the administrator of the plan.

Plaintiff moves to dismiss UNUM's counterclaim for reimbursement of certain benefits on the grounds that such reimbursement is prohibited by the plain terms of the benefit plan.

For the reasons stated below, Plasmaco's motion to dismiss the claims against it is granted. Plaintiff's motions to dismiss the counterclaim, or for a more definitive statement, are denied.

DISCUSSION

Rule 12(b)(6) of the Federal Rules of Civil Procedure provides for dismissal of a complaint that fails to state a claim upon which relief can be granted. The standard of review on a motion to dismiss is heavily weighted in favor of the plaintiff. The Court is required to read a complaint generously, drawing all reasonable inferences from the complaint's allegations. California Motor Transport Co. v. Trucking Unlimited, 404 U.S. 508, 515, 92 S.Ct. 609, 30 L.Ed.2d 642 (1972). "In ruling on a motion to dismiss for failure to state a claim upon which relief may be granted, the court is required to accept the material facts alleged in the complaint as true." Frasier v. General Electric Co., 930 F.2d 1004, 1007 (2d Cir. 1991). The Court must deny the motion "unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief." Stewart v. Jackson & Nash, 976 F.2d 86, 87 (2d Cir. 1992) (quoting Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957)).

1. Defendant Plasmaco's Motion to Dismiss is Granted

In a recovery of benefits claim, only the plan and its administrators may be held liable. Leonelli v. Pennwalt Corp., 887 F.2d 1195, 1199 (2d Cir. 1989). In this case, UNUM is the claim ...


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.