Opinion
No. 3:99-CV-1163-M.
August 31, 2000.
MEMORANDUM OPINION AND ORDER
Plaintiff Gloria Thomas ("Thomas") sues Aetna Life Insurance Company ("Aetna") for failing to fully investigate her insurance claim and for breach of its duty of good faith and fair dealing. Thomas sues Southwestern Bell Telephone Company ("SWBTC") for wrongful termination. Before the Court are Aetna's Motion for Summary Judgment, filed on January 19, 2000, and SWBTC's Motion for Summary Judgment, filed on April 27, 2000; all briefs in support of those motions; and all responses and replies thereto. Having considered the record and applicable law, for the reasons stated below, the Court GRANTS both motions.
I. Background
The SBC Communications Inc. Disability Income Plan ("SBC Plan") is a self-funded employee benefit plan established and maintained by SWBTC. Aetna provided claims administrative services for the SBC Plan from October 1, 1996 until April 1, 1999, while all benefits under the SBC Plan continued to be self-funded by SBC.
Thomas was an employee of SWBTC when, in August of 1996, she was placed on disability leave due to depression. Thomas received disability benefits until February 10, 1997, the date on which her doctor released her to return to work. On January 31, 1997, Thomas contends that she suffered a contusion to her shoulder and cervical area in a car wreck. She further asserts that she was excused from work for six weeks, until mid-March, but that her pain persisted beyond mid-March, prompting her to seek emergency medical treatment on March 28, 1997. Thomas avers that, on April 10, 1997, she was informed by an Aetna employee that her medical leave did not extend beyond March 14, 1997. According to Thomas, she disputed this information, but Aetna nevertheless contacted SWBTC and informed it that Thomas's medical leave had expired. SWBTC subsequently terminated Thomas's employment.
Thomas filed her claims as a result of the above-mentioned conduct. Specifically, she alleges that Aetna erroneously denied her the full period of disability without thoroughly investigating her claim and that Aetna breached its duty of good faith owed to Thomas by erroneously informing SWBTC that her medical leave had expired. As to her claim against SWBTC for wrongful termination, Thomas claims that SWBTC wrongfully relied on the inaccurate disability report provided by Aetna because SWBTC had actual knowledge of her disability. Thomas claims that, due to the allegedly wrongful termination, she not only suffered her loss of employment, but also severe mental anguish.
II. The Summary Judgment Standard
Under Rule 56(c) of the Federal Rules of Civil Procedure, summary judgment is appropriate when the pleadings and record evidence show that no genuine issue of material fact exists and that, as a matter of law, the movant is entitled to judgment. Little v. Liquid Air Corp., 37 F.3d 1069, 1075 (5th Cir. 1994). A material fact is one that "might affect the outcome of the suit under the governing law" and a "dispute about a material fact is `genuine' . . ., if the evidence is such that a reasonable jury could return a verdict for the nonmoving party." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986).
In a motion for summary judgment, the burden is on the movant to prove that no genuine issue of material fact exists, and if the movant fails to meet its burden, the motion must be denied, regardless of the nonmovant's response. Little, 37 F.3d at 1075. If, however, the movant does meet its burden, then the nonmovant must go beyond the pleadings and "designate specific facts showing that there is a genuine issue for trial." Id. The record before the court must be considered in the light most favorable to the nonmovant. Harrison v. Byrd, 765 F.2d 501, 504 (5th Cir. 1985).
III. Aetna's Motion for Summary Judgment
Aetna offers summary judgment evidence that the SBC Plan is an Employee Retirement Income Security Act ("ERISA") Plan. Thomas does not dispute that the SBC Plan is an ERISA Plan, nor does she offer any evidence to prove otherwise. As such, no genuine dispute exists on the issue of whether the SBC Plan falls within the ambit of ERISA, and, as a matter of law, Thomas's claim that Aetna breached its duty of good faith and fair dealing is preempted by ERISA. See Hogan v. Kraft Foods, 969 F.2d 142, 144-45 (5th Cir. 1992) (finding plaintiffs' claim of breach of duty of good faith and fair dealing relating to the denial of pension benefits preempted by ERISA). Thus, Aetna's summary judgment motion is GRANTED on Thomas's claim that Aetna breached its duty of good faith and fair dealing.
ERISA's civil enforcement provision, found at 29 U.S.C. § 1132(a)(1)(B), does not allow for the recovery of extra-contractual and punitive damages. Medina v. Anthem Life Ins. Co., 983 F.2d 29, 31-32 (5th Cir.), cert. denied, 510 U.S. 816, and cert. denied, 510 U.S. 819 (1993). In other words, under ERISA, Thomas can sue only for the recovery of benefits under the SBC Plan. Id.; 29 U.S.C. § 1132(a)(1)(B). Thus, to the extent that Thomas's claim for failure to fully investigate is an extra-contractual claim, asserted under the Deceptive Trade Practices Act ("DTPA"), TEX. BUS. COM. CODE ANN. § 17.50(a)(4) and/or TEX. INS. CODE ANN. art. 21.21 § 4(10)(a)(viii), summary judgment is likewise GRANTED on that claim. However, to the extent that it is a claim for the recovery of benefits under ERISA, 29 U.S.C. § 1132(a)(1)(B), the Court now turns its attention to that claim.
TEX. BUS. COM. CODE ANN. § 17.50(a)(4) provides: (a) A consumer may maintain an action where any of the following constitute a producing cause of economic damages for mental anguish:
(4) the use or employment by any person of an act or practice in violation of Article 21.21, Insurance Code.
TEX. INS. CODE ANN. art. 21.21 § 4(10)(a)(viii) defines "[an] unfair method of competition and unfair and deceptive acts or practices in the business of insurance" to include:
(10) Unfair Settlement Practices. (a) Engaging in any of the following unfair settlement practices with respect to a claim by an insured or beneficiary:
(viii) refusing to pay a claim without conducting a reasonable investigation with respect to the claim.
By affidavit of Gregory Boardman, Aetna's Regional Director of Group Insurance Underwriting during the time the SBC Plan was in effect, Aetna provides summary judgment evidence that:
SBC terminated [Aetna's contract], at issue in this lawsuit, effective April 1, 1999. Other than completing reviews of claims incurred on or after October 1, 1996 and before April 1, 1999, Aetna no longer provides any claims administrative services for the SBC Plan under which Ms. Thomas seeks to recover benefits.
Aetna's App., Ex. A. Thomas offers no evidence to the contrary, only stating summarily in her response to Aetna's Motion for Summary Judgment that she "disagrees" with Aetna that its responsibilities under the SBC Plan terminated on April 1, 1999. Further, there is no evidence to indicate that Aetna has not "completed the review" of Thomas's claim. In fact, all parties seem to agree that Aetna completed its review of Thomas's claim and certified the claim only through March 14, 1997. The Eighth Circuit addressed similar facts in Hall v. LHACO. Inc., 140 F.3d 1190, 1195-97 (8th Cir. 1998) and concluded that the plaintiff did not have standing to pursue his ERISA claims against LHACO, Inc., the former plan administrator, because his claim pursuant to 29 U.S.C. § 1132(a)(1)(B) was not "redressable" against LHACO. Standing to pursue a lawsuit requires, among other things, that it is "`likely,' as opposed to merely `speculative,' that the [party's] injury will be `redressed by a favorable decision.'" Lujan v. Defenders of Wildlife, 504 U.S. 555, 561 (1992) (quoting Simon v. Eastern Ky. Welfare Rights Org., 426 U.S. 26, 38, 43 (1976)). The court in Hall reasoned that LHACO, as the former plan administrator, was in no position to pay out benefits to the plaintiff, to enforce the plaintiffs rights under the Plan, or to clarify the plaintiffs rights to future benefits under the terms of the Plan. Hall, 140 F.3d at 1196. As such, Hall's claims under 29 U.S.C. § 1132(a)(1)(B) were not "redressable" against LHACO, and the plaintiff thus had no standing to pursue his claims against LHACO. Id. In the instant case, Thomas provides no evidence to dispute Aetna's assertion that it no longer provides any claims administrative services for the SBC Plan. Thomas, like the plaintiff in Hall, has no standing to pursue her claims against Aetna because those claims are not "redressable" against Aetna. This Court therefore GRANTS Aetna's summary judgment motion on Thomas's claim to recover disability benefits from Aetna.
IV. SWBTC's Motion for Summary Judgment.
In her response to SWBTC's Motion for Summary Judgment, Thomas seems to be asserting ERISA claims against SWBTC that she heretofore has not claimed. The Court will not consider any such claims, as they were not asserted in Thomas's Complaint, which is the subject of the Motion.
To establish her cause of action for wrongful termination, Thomas must prove, among other things, that she and her employer have a contract that specifically limits SWBTC's right to terminate her employment at will. See Webber v. M W. Kellogg Co., 720 S.W.2d 124, 127 (Tex.App.-Houston [14th Dist.] 1986, writ ref'd n.r.e.). This element of proof derives from Texas's long time status as an "employment-at-will" state, allowing for the termination of employment "at any time by either party, with or without cause, absent an express agreement to the contrary." Federal Express Corp. v. Dutschmann, 846 S.W.2d 282, 283 (Tex. 1993).
By the affidavit of Nora Creed, who was Thomas's supervisor at SWBTC during the time period immediately preceding her termination, SWBTC has provided summary judgment evidence that Thomas was an at-will employee. Thomas has produced no evidence to controvert this assertion. Further, she has offered no evidence that would indicate that she and SWBTC had a contract that specifically limits SWBTC's rights to terminate her employment. See Webber, 720 S.W.2d at 127. Finally, she has produced no evidence that she falls into any of the narrow public policy and statutory exceptions to the general at-will rule. See, e.g., Winters v. Houston Chronicle Publ'g. Co., 795 S.W.2d 723, 724 (Tex. 1990). There is, therefore, no genuine dispute as to Thomas's status as an at-will employee. As such, SWBTC's summary judgment motion is GRANTED as a matter of law.
V. Conclusion
For the reasons stated above, Plaintiff's claims are DISMISSED WITH PREJUDICE, with costs taxed in favor of Aetna and SWBTC.
SO ORDERED.