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Yerington v. The Lincoln National Life Insurance Co.

United States District Court, S.D. Ohio, Eastern Division

May 10, 2018

CHRISTOPHER YERINGTON, Plaintiff,
v.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, Defendant.

          Jolson, Judge.

          OPINION AND ORDER

          GEORGE C. SMITH, JUDGE UNITED STATES DISTRICT COURT.

         This matter is before the Court upon Defendant The Lincoln National Life Insurance Company's Motion to Dismiss Plaintiff Christopher Yerington's Amended Complaint (“Lincoln's Motion”) (Doc. 20). The motion is fully briefed and ripe for disposition. For the following reasons, Lincoln's Motion is GRANTED.

         I. BACKGROUND

         Plaintiff Christopher Yerington was employed by Consultant Anesthesiologists, Inc. as a Physician Anesthesiologist from July 1, 2006 to January 17, 2010. (Doc. 10, Am. Compl. ¶ 5). While employed by Consultant Anesthesiologists, Yerington was a participant in a group long-term disability insurance policy (the “Plan”) issued and administered by Defendant The Lincoln National Life Insurance Company (“Lincoln”). (Id. ¶¶ 2, 6). On January 17, 2010, Yerington left his employment with Consultant Anesthesiologists due to a disability, and he was approved for long-term disability benefits under the Plan effective on that date. (Id. ¶¶ 5, 8).

         Benefits under the Plan are determined in part based on what “period” the claimant is in at the time he or she seeks benefits. The “Elimination Period” is defined as “90 calendar days of Disability caused by the same or a related Sickness or Injury, which must be accumulated within a 180 calendar day period.” (Doc. 10-1, Plan at 3). Following the end of the Elimination Period, the claimant enters the “Own Occupation Period” or “OOP.” (Id.) Ordinarily, disability plan documents set forth a beginning and an end date for the OOP, but the Plan document effective as of Yerington's separation of employment on January 17, 2010, defined the OOP as “a period beginning at the end of the Elimination Period and ending CUSTOM WORDING REQUIRED.”[1] (Id.).

         The Plan also provides for benefits to claimants who are engaged in Partial Disability Employment under certain circumstances during the OOP. (Doc. 10-1, Plan at 24). During the first five years he received benefits under the Plan, and at least once thereafter, Yerington inquired with Lincoln as to whether he could engage in employment and still receive benefits, and, if so, to what extent. (Doc. 10, Am. Compl. ¶ 15). Lincoln allegedly “refused at all times to provide accurate and complete answers to his inquiries.” (Id.). As a result of Lincoln's refusal to provide him with a clear answer, Yerington did not avail himself of various employment and earnings opportunities during the OOP. (Id. ¶ 16).

         Yerington commenced this action on August 23, 2017, in the Court of Common Pleas of Franklin County, Ohio. Lincoln timely removed the action to this Court on September 27, 2017. Yerington's current First Amended Complaint (Doc. 10) seeks: (1) an injunction, under 29 U.S.C. § 1132(a)(1)(B) and/or § 1132(a)(3), enjoining Lincoln “from ending the OOP”; and (2) damages in the amount of at least $2, 000, 000, under 29 U.S.C. § 1132(a)(1)(B), incurred by Yerington in forgone employment opportunities as a result of Lincoln's refusal to answer his questions to his satisfaction.[2] Lincoln now moves to dismiss both counts under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim upon which relief can be granted.

         II. STANDARD FOR DISMISSAL UNDER RULE 12(b)(6)

         Under the Federal Rules, any pleading that states a claim for relief must contain a “short and plain statement of the claim” showing that the pleader is entitled to such relief. Fed.R.Civ.P. 8(a)(2). To meet this standard, a party must allege sufficient facts to state a claim that is “plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007). A claim will be considered “plausible on its face” when a plaintiff sets forth “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).

         Rule 12(b)(6) allows parties to challenge the sufficiency of a complaint under the foregoing standards. In considering whether a complaint fails to state a claim upon which relief can be granted, the Court must “construe the complaint in the light most favorable to the plaintiff, accept its allegations as true, and draw all reasonable inferences in favor of the plaintiff.” Ohio Police & Fire Pension Fund v. Standard & Poor's Fin. Servs. LLC, 700 F.3d 829, 835 (6th Cir. 2012) (quoting Directv, Inc. v. Treesh, 487 F.3d 471, 476 (6th Cir. 2007)). However, “the tenet that a court must accept a complaint's allegations as true is inapplicable to threadbare recitals of a cause of action's elements, supported by mere conclusory statements.” Iqbal, 556 U.S. at 663. Thus, while a court is to afford plaintiff every inference, the pleading must still contain facts sufficient to “provide a plausible basis for the claims in the complaint”; a recitation of facts intimating the “mere possibility of misconduct” will not suffice. Flex Homes, Inc. v. Ritz-Craft Corp of Mich., Inc., 491 Fed.Appx. 628, 632 (6th Cir. 2012); Iqbal, 556 U.S. at 679.

         III. DISCUSSION

         Yerington seeks an injunction preventing Lincoln from ever deeming the OOP to be at an end, and damages incurred by Yerington in forgone employment opportunities as a result of his dissatisfaction with Lincoln's answers to his questions regarding available benefits during employment. The Court will address each claim in turn.

         A. ...


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