ee, e.g., Thomas v. Oregon Fruit Prods. Co., 228 F.3d 991, 996-97 (9th Cir. 2000) (no right to a jury trial under ERISA because in enacting ERISA Congress “‘created a right that is essentially equitable in nature’”); Hampers v. W. R. Grace & Co., 202 F.3d 44, 54 (1st Cir. 2000) (affirming denial demand for a jury trial under ERISA); Langlie v. Onan Corp., 192 F.3d 1137, 1141 (8th Cir. 1999) (“there is no right to a jury trial under ERISA”); Adams v. Cyprus Amax Minerals Co., 149 F.3d 1156, 1162 (10th Cir. 1998) (same); Broaddus v. Fla. Power Corp., 145 F.3d 1283, 1287 n.** (11th Cir. 1998) (same); DeFelice v. Am. Int’l Life Assurance Co. of N.Y., 112 F.3d 61, 64 (2d Cir. 1997) (no right to a jury trial under ERISA); Borst v. Chevron Corp., 36 F.3d 1308, 1324 (5th Cir. 1994) (same); Biggers v. Wittek Indus., Inc., 4 F.3d 291, 298 (4th Cir. 1993) (same); Spinelli v. Gaughan, 12 F.3d 853, 855-58 (9th Cir. 1993) (no right to jury trial on a retaliatory discharge claim under ERISA, Section 502(a)(3)); Reese v. CNH Am., Inc., 574 F.3d 315, 327 (6th Cir. 2009)

As set forth in §29 C.F.R. 2560.503-1(1), in the case of the failure of a plan to follow claims procedure consistent with the requirements of this section, a claimant shall be deemed to have exhausted the administrative remedies under the plan and shall be entitled to pursue any available remedies under §502(a) of ERISA on the basis that the plan has failed to provide a reasonable claims procedure that would yield a decision on the merits of the claim. h. Cecelia Giles and Sean Childers sought to recover AD&D benefits due to them under the terms of the plan pursuant to 29 U.S.C. §502(a)(1), in addition to costs and attorney’s fees. I. Alternatively, Cecelia Giles and Sean Childers would show unto this Honorable Court that according to Guardian, Plaintiff herein, the administrative claims procedure as to the AD&D benefits is currently tolled, pending receipt of further information regarding the insured’s death (and that is, the toxicology report or the medical examiner’s report).

Thus, this fundamental disagreement is what gives rise to the Co-Defendants’ claim for interest and attorneys’ fees. B. Attorneys’ Fees and Interest are in the Discretion of the Court In the Co-Defendants’ respective counterclaims, each sought AD&D benefits due under the terms of the Plan pursuant to 29 U.S.C. § 502(a)(1), in addition to any costs and reasonable attorney’s fees, interest, and any other relief deemed just and proper. See Ans.

v. BCBS of Ks., Inc., 49 F.3d 1460 (10th Cir. 1995) .............................................................................. 5 Tirgan v. Mega Life & Health Ins., 700 A.2d 1239 (N.J. Super. Ct. Law Div. 1997) .................................................. 2 UNUM Life Ins. Co. v. Zaun, 2014 U.S. Dist. LEXIS 1004525 (D. Minn. May 29, 2014) ................................ 9 Wallach v. Eaton Corp., 837 F.3d 356 (3d Cir. 2016) ................................................................................. 3 Zarrilli v. John Hancock Life Ins. Co., 231 F. App’x 122 (3d Cir. 2007) ........................................................................ 14 Statutes 29 U.S.C. § 502 .................................................................................................. 3, 5, 6 29 U.S.C. § 1144(a) ................................................................................................. 13 Case 2:16-cv-08637-CCC-MF Document 36 Filed 06/23/17 Page 4 of 21 PageID: 1481 iv N.J.S.A. § 26:2S-6.1(c) .............................................................................................. 4 Other Authorities 29 C.F.R. § 2560.503-1(m)(4)(i) ........................................................................... 7, 8 Lena H. Sun, 50 Hospitals Charge Uninsured More Than 10 Times Cost of Care, Study Finds, Wash. Post (June 8, 2015) ....................................... 10 Case 2:16-cv-08637-CCC-MF Document 36 Filed 06/23/17 Page 5 of 21 PageID: 1482 1 INTRODUCTION CarePoint’s case has fatal flaws that undermine its claims pleaded under a dozen federal and state legal theories. CarePoint complains that United d

of Allegheny, 515 F.3d 224, 233 (3d Cir.2008)…………………………………………………………..2 Tannenbaum v. UNUM Life Ins. Co. of Am., 2004 WL 1084658 (E.D. Pa. Feb. 27, 2004)………………………………………….9, 10 Varity Corp. v. Howe, 516 U.S. 489 (1996)…………………………………………………………………...9, 10 Wehr Constructors, Inc. v. Assurance Co. of Am., 384 S.W.3d 680, 685 (Ky. 2012)………………………………………………………….5 Statutes 29 U.S.C. § 1132(a)(1)…………………………………………………………………….1, 9, 10 Case 1:17-cv-00700-JBS-KMW Document 18 Filed 03/20/17 Page 4 of 16 PageID: 360 iv 29 U.S.C. § 1132(a)(1)(B)………………………………………………………….......................9 29 U.S.C. § 1132(a)(3)…………………………………………………………………................9 29 U.S.C. § 1132(a)(3)(B)………………………………………………………………………...9 29 U.S.C. § 1133 ....................................................................................................................... 2, 10 29 U.S.C. § 502(a)(1)(B)……………………………………………………………………….....9 29 C.F.R. 2560.503-1 ................................................................................................................ 2, 10 Rules Fed R. Civ. P. 12(b)(6)………………………………………………………………………….2, 3 Case 1:17-cv-00700-JBS-KMW Document 18 Filed 03/20/17 Page 5 of 16 PageID: 361 1 PRELIMINARY STATEMENT Plaintiff, Rahul Shah, MD (“Plaintiff”), by and through his attorneys, Callagy Law, P.C., respectfully submits this Brief in Opposition to Defendant Blue Cross Blue Shield of Alabama’s (“Defendant) Motion to Dismiss pursuant to Fed. R. Civ. P. 12(b)(6) (“Motion”). This action arose from Defendant’s failure to fully reimburse Plaintiff for medically necessary services provided to patient Christopher H. (“Patient”), who duly assigned his benefits to Plaintiff.

...........................................................................................9 Varity Corp. v. Howe, 516 U.S. 489 (1996) .......................................................................................................9, 10 Vaughn v. Bay Environmental Management, Inc., 567 F.3d 1021, 1024 (9th Cir. 2009) ...................................................................................3 Statutes 29 U.S.C. § 1002 ............................................................................................................................. 1 29 U.S.C. § 1132(a)(1)(B) .......................................................................................................... 8, 9 29 U.S.C. § 1132(a)(3) .................................................................................................................... 9 29 U.S.C. § 1132(a)(3)(B) ............................................................................................................. 9. 29 U.S.C. § 502(a)(1)(B) ................................................................................................................ 9 29 U.S.C. § 503(a)(3) ...................................................................................................................... 9 29 U.S.C. § 1002 ............................................................................................................................. 1 29 C.F.R. 2560.503-1(g)(1)(iv).................................................................................................... 7,8 29 C.F.R. 2560.503-1 ................................................................................................................. 2,10 29 U.S.C § 1132(a)(1) .................................................................................................................. 1,9 29 U.S.C § 1133 ........................................................................................................................ 2, 10 Rules Fed. R. Civ. P. 12(b)

582 F.3d 1083 (9th Cir. 2009) ................................................................................................... 2 Segovia v. Schoenmann 408 F. App’x 61 ......................................................................................................................... 9 Vincenzo v. Hewlett-Packard Co. 2012 WL 4838442 (N.D. Cal. Oct. 10, 2012) ............................................................. 5, 6, 7, 11 STATUTES 28 U.S.C. § 1441(a) ......................................................................................................................... 2 28 U.S.C. § 1447(c) ......................................................................................................................... 1 29 U.S.C. § 502(a) ................................................................................................................. 1, 4, 15 29 U.S.C. §§ 1002(2)(B)(3) and 1002(2)(A) ................................................................................... 5 29 U.S.C. § 1101(a) ....................................................................................................................... 12 California Business & Professions Code § 16600 ....................................................................... 3, 1 California Civil Code § 52.1 ............................................................................................................ 3 California Labor Code § 206.