Afram v. United Food and Commercial Workers Unions and Participating Employers Health and Welfare Fund ( 2013 )

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
______________________________
)
JOSEPH D. AFRAM, )
)
Plaintiff, )
)
v. ) Civil Action No. 12-1389 (RWR)
)
UNITED FOOD AND COMMERCIAL )
WORKERS UNIONS AND )
PARTICIPATING EMPLOYERS )
HEALTH AND WELFARE FUND, )
et al., )
)
Defendants. )
______________________________)
MEMORANDUM ORDER
Plaintiff Joseph Afram, a surgeon, brings suit against the
medical benefits providers for patient G.B. alleging that they
failed to pay for medical services Afram provided to G.B. The
defendants move to dismiss the complaint under Federal Rule of
Civil Procedure 12(b)(6) for failure to state a claim.
A district court can dismiss a complaint under Rule 12(b)(6)
when the complaint “fail[s] to state a claim upon which relief
can be granted[.]” Fed. R. Civ. P. 12(b)(6). “To survive a
motion to dismiss, a complaint must contain sufficient factual
matter, accepted as true, to ‘state a claim to relief that is
plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678
(2009) (citations omitted) (quoting Bell Atl. Corp. v. Twombly,
550 U.S. 544, 570 (2007)).
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Although Afram’s complaint does not specify the cause of
action or statute that he alleges entitles him to relief, the
parties agree that Afram’s claim can be brought only under the
Employee Retirement Income Security Act (“ERISA”), 29 U.S.C.
§ 1001 et seq. See Defs.’ Mot. to Dismiss, Defs.’ Mem. in Supp.
of Mot. to Dismiss at 5; Pl.’s Opp’n to Mot. to Dismiss at 1.
Moreover, because Afram has standing to bring his claim under
ERISA,1 ERISA preempts any other state or common law cause of
action. See 29 U.S.C. § 1144 (stating that ERISA supersedes “any
and all State laws insofar as they may now or hereafter relate to
any employee benefit plan”); see also Krooth & Altman v. N. Am.
Life Assur. Co., 134 F. Supp. 2d 96, 101 (D.D.C. 2001);
Psychiatric Institute of D.C., Inc. v. Wells, Civil Action No.
92-0416 (GHR), 1992 WL 237368, at *3 (D.D.C. Aug. 31, 1992).
To bring a claim for benefits under ERISA, Afram must allege
that he is due benefits under the terms of G.B.’s plan and
“identify a specific plan term that confers the benefit in
question.” Stewart v. Nat’l Educ. Ass’n, 404 F. Supp. 2d 122,
130 (D.D.C. 2005). Afram’s complaint does not identify the plan
1
Afram brings suit against a health and welfare plan
governed by ERISA “and a firm with whom the Fund has contracted
to provide administrative management services.” Defs.’ Mot. to
Dismiss, Defs.’ Mem. in Supp. of Mot. to Dismiss at 1. G.B.
assigned Afram his medical benefits for the medical services
Afram provided. See Compl. (Health Insurance Claim Form) at 3.
Thus, Afram could have brought his claim “to recover benefits due
to him under the terms of [G.B.’s] plan” under ERISA Section
502(a)(1)(B). See 29 U.S.C. § 1132(a)(1)(B).
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term that entitles him to any benefit. Thus, his complaint fails
to state a claim under ERISA, and his complaint will be ordered
dismissed.
In both his opposition and surreply, Afram requests that if
his complaint is found to be deficient, that he be granted leave
to amend his complaint rather than his complaint being dismissed.
Because more than 21 days have elapsed since the defendants
served their motion to dismiss on Afram and the defendants do not
consent to Afram amending his complaint, Afram may amend his
complaint only with the court’s leave. See Fed. R. Civ. P. 15.
However, “[a] request for a court order must be made by motion.”
Fed. R. Civ. P. 7(b)(1). Local Civil Rule 7(i) requires that
“[a] motion for leave to file an amended pleading . . . be
accompanied by an original of the proposed pleading as amended.”
LCvR 7(i). Because Afram has not moved to amend his complaint
and has not submitted his proposed amended complaint, his request
will not be considered. However, because it is not “plain that
[Afram] has no claim to state[,]” Alley v. Resolution Trust
Corp., 984 F.2d 1201, 1207 (D.C. Cir. 1993), the order dismissing
his complaint will be stayed to allow Afram an opportunity to
file a motion to amend his complaint that complies with Rule
7(i). Accordingly, it hereby
ORDERED that the defendants’ motion [4] to dismiss Afram’s
complaint be, and hereby is, GRANTED. It is further
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ORDERED that this order be, and hereby is, STAYED until
April 9, 2013.
SIGNED this 26th day of March, 2013.
/s/
RICHARD W. ROBERTS
United States District Judge