§Why CasetextPricing

Peacock Medical Lab, LLC et al v. United Health Group, Inc. et al

MOTION TO DISMISS 26 Amended Complaint, FOR FAILURE TO STATE A CLAIM and Incorporated Memorandum of Law

29 Cited authorities

  1. Varity Corp. v. Howe

    516 U.S. 489 (1996)   Cited 2,389 times   33 Legal Analyses
    Holding that ERISA fiduciaries may have duties to disclose information about plan prospects that they have no duty, or even power, to change

  2. Davis v. Coca-Cola Bottling

    516 F.3d 955 (11th Cir. 2008)   Cited 955 times   2 Legal Analyses
    Holding that hiring decisions were "discrete acts of discrimination" that could not go forward under the continuing-violation doctrine

  3. Spinedex Physical Therapy USA Inc. v. United Healthcare of Ariz., Inc.

    770 F.3d 1282 (9th Cir. 2014)   Cited 164 times   3 Legal Analyses
    Holding that a valid assignment of rights allows a third party to bring the beneficiary's claim

  4. Cagle v. Bruner

    112 F.3d 1510 (11th Cir. 1997)   Cited 202 times
    Holding that district court erred in construing ambiguities against drafter under arbitrary and capricious review

  5. Jones v. Am. General Life and Acc. Ins. Co.

    370 F.3d 1065 (11th Cir. 2004)   Cited 138 times   1 Legal Analyses
    Holding courts must analyze allegations supporting § 1132 claims to determine if also sufficient to state a claim under § 1132(B) regardless of relief sought and irrespective of allegations supporting other claims

  6. Perrino v. Southern Bell Tel. Tel. Co.

    209 F.3d 1309 (11th Cir. 2000)   Cited 140 times
    Holding "therefore, if a reasonable administrative scheme is available to a plaintiff and offers the potential for an adequate legal remedy, then a plaintiff must first exhaust the administrative scheme before filing a federal suit."

  7. W.R. Townsend Contracting, Inc. v. Jensen Civil Construction, Inc.

    728 So. 2d 297 (Fla. Dist. Ct. App. 1999)   Cited 134 times   2 Legal Analyses
    Reversing order dismissing promissory estoppel claim and remanding with instructions for a jury trial

  8. Springer v. Wal-Mart Assoc. Group Health Plan

    908 F.2d 897 (11th Cir. 1990)   Cited 157 times   1 Legal Analyses
    Holding that showing of futility was insufficient where the Plaintiff failed to pursue administrative review following the administrator's denial of her claim

  9. In re Managed Care Litigation

    298 F. Supp. 2d 1259 (S.D. Fla. 2003)   Cited 90 times
    Holding that medical associations suffered injury caused by “systematic practices regarding payments directly affect[ed] medical associations who must deal with the fallout of such behavior.”

  10. Clair v. Harris Trust and Sav. Bank

    190 F.3d 495 (7th Cir. 1999)   Cited 87 times
    Holding that plaintiff was barred from collecting accrued interest when employer disbursed benefits according to the procedure and the time period outlined in the employee-benefit plan

  11. Rule 12 - Defenses and Objections: When and How Presented; Motion for Judgment on the Pleadings; Consolidating Motions; Waiving Defenses; Pretrial Hearing

    Fed. R. Civ. P. 12   Cited 348,416 times   930 Legal Analyses
    Granting the court discretion to exclude matters outside the pleadings presented to the court in defense of a motion to dismiss

  12. Rule 8 - General Rules of Pleading

    Fed. R. Civ. P. 8   Cited 157,557 times   196 Legal Analyses
    Holding that "[e]very defense to a claim for relief in any pleading must be asserted in the responsive pleading. . . ."

  13. Section 1132 - Civil enforcement

    29 U.S.C. § 1132   Cited 26,363 times   171 Legal Analyses
    Holding liable "[a]ny administrator" who fails to provide documents in a timely manner

  14. Section 1024 - Filing with Secretary and furnishing information to participants and certain employers

    29 U.S.C. § 1024   Cited 1,319 times   8 Legal Analyses
    Striking "plan description"

  15. Section 627.6131 - [Effective 1/1/2025] Payment of claims

    Fla. Stat. § 627.6131   Cited 10 times

    (1) The contract shall include the following provision: "Time of Payment of Claims: After receiving written proof of loss, the insurer will pay monthly all benefits then due for (type of benefit) . Benefits for any other loss covered by this policy will be paid as soon as the insurer receives proper written proof." (2) As used in this section, the term "claim" for a noninstitutional provider means a paper or electronic billing instrument submitted to the insurer's designated location that consists