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Morjaria v. Harvard Vanguard Medical Associates, Inc.

United States District Court, D. Massachusetts

March 20, 2015

GIRJA

OPINION AND ORDER

GEORGE A. O'TOOLE, Jr., District Judge.

I. Background

On January 17, 2014 the plaintiff initiated this action against Aetna Life Insurance Company and Aetna, Inc. (collectively "the Aetna defendants") and her employer Harvard Vanguard Medical Associates ("Harvard Vanguard"). Summonses were issued but never served. On the last day of the 120-day period for service of process under Federal Rule of Civil Procedure 4(m), the plaintiff filed an amended complaint adding as a defendant Harvard Vanguard Medical Associates Health and Welfare Benefit Plan ("the Plan"). She served all four defendants with the amended complaint that same day. Against each defendant, the plaintiff alleges breach of fiduciary duty under the Employment Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq., and six "additional and alternative" counts sounding in negligence, contract, and Mass. Gen. Laws chapters 93A and 176D.

The amended complaint alleges the following relevant facts. The plaintiff is employed by Harvard Vanguard and is entitled to employee benefits under the Plan, including a spousal group life insurance policy which is fully insured by Aetna. Both the Plan and the policy are ERISAgoverned. The plaintiff insured her husband's life under the policy in the amount of $100, 000 and began paying premiums for coverage. Relying on representations by "one or more defendants" and her continued contributions, the plaintiff did not seek coverage elsewhere. Her husband died on January 18, 2011. At first, she was told by agents of Harvard Vanguard and/or the Plan (collectively "the HVMA defendants") that she was entitled to payment and was asked to provide them certain information for submission to Aetna. Subsequently, HVMA informed the plaintiff that, after contacting Aetna, they found that she was not entitled to benefits because they had enrolled her in the policy insuring her husband's life in error. A February 16, 2011 letter from the benefits specialist reads: "We regret to inform you that you do not qualify for any death benefits... The system inadvertently processed your enrollment without the insurance company's approval." (Amended Compl. ¶ 34 (dkt. no. 4).) A letter from HVMA's general counsel to the plaintiff's prior attorney similarly states: "Because of an administrative error, we began deducting premiums for spousal life insurance coverage even though those premiums should not have been deducted until we received approval from Aetna. We discovered our administrative error after your client submitted a claim for benefits under the life insurance policy." (Id. ¶ 36.) HVMA offered to reimburse the plaintiff for her contributions. When the plaintiff contacted Aetna directly, she was told that Aetna had not received the claim from HVMA and could not process the claim unless it was received from her employer.

The Aetna defendants moved to dismiss on the grounds that the ERISA claim contains no allegation of wrongdoing by Aetna and that the state law claims against Aetna are preempted. The HVMA defendants also moved to dismiss, arguing inter alia that the original and amended complaints suffer from procedural defects warranting dismissal. The plaintiff opposed both motions and, with the Court's leave, the HVMA defendants filed a reply addressing the service of process issue only.

II. Discussion

A. Validity of the Amended Complaint

i. Federal Rule of Civil Procedure 15(a)

The HVMA defendants argue that the amended complaint is a legal nullity because the original complaint was never served. Their argument is based on a hyper-literal, and incorrect, reading of Federal Rule of Civil Procedure 15(a), which provides:

(a) Amendments Before Trial.
(1) Amending as a Matter of Course. A party may amend its pleading once as a matter of course within:
(A) 21 days after serving it, or
(B) if the pleading is one to which a responsive pleading is required, 21 days after service of a responsive pleading or 21 days after service of a motion under Rule 12(b), (e), or (f), whichever is earlier.
(2) Other Amendments. In all other cases, a party may amend its pleading only with the opposing party's written consent or the court's leave. The court should ...

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