Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Ibson v. United Healthcare Services, Inc.

United States Court of Appeals, Eighth Circuit

December 6, 2017

CeCelia Catherine Ibson Plaintiff- Appellant
v.
United Healthcare Services, Inc. Defendant-Appellee

          Submitted: October 18, 2017

         Appeal from United States District Court for the Southern District of Iowa - Des Moines

          Before WOLLMAN, BEAM, and SHEPHERD, Circuit Judges.

          SHEPHERD, Circuit Judge.

         A thorny dispute between CeCelia Ibson and United HealthCare Services, Inc. ("UHS") has returned once more to this court. After we decided ERISA preempted her state-law claims, Ibson filed claims under ERISA against UHS. The district court dismissed her complaint, while noting that-if her allegations were true-UHS treated her "horribly." The question before us, then, is whether Ibson has pled a viable claim against UHS under ERISA. We largely agree with the district court's dismissal of her claims, but remand for further inquiry into her equitable claim for premiums she paid to UHS.

         I.

         Ibson was at one time a shareholder in an Iowa law firm that contracted with UHS to provide health insurance for its employees. On Ibson's prior appeal, we noted that the "law firm remitted payment to the insurance company and distributed information from UHS . . . but performed no other administration relating to the insurance." Ibson v. United Healthcare Servs., Inc., 776 F.3d 941, 943 (8th Cir. 2014). UHS, however, expressly disavowed the "plan administrator" role in the policy document, and no other entity was named to fill that role. J.A. 112.

         Ibson enrolled herself and her family, including her late husband, Jay Wagner, in her employer-sponsored UHS healthcare plan in March 2004. In early 2008, UHS began denying claims and started instituting recoupment actions for claims already paid.[1] This was at a time of great hardship for Ibson's family: Wagner was battling metastatic melanoma. In April 2008, UHS sent an email promising to return Ibson's policy and coverage to normalcy.[2] Ibson's law firm cancelled the policy in June 2008, but UHS continued recoupment actions-despite its earlier email-into 2010. UHS eventually paid $36, 417.29 for outstanding claims. Ibson maintains in this action, however, that they still owe $190, 579.91 in relation to care Wagner received.

         Ibson filed suit initially in September 2012, alleging state-law claims against UHS. As noted above, on appeal, we held that Ibson's claims were preempted by ERISA. Id. at 946. She re-filed a complaint against UHS in July 2015 and subsequently amended it in November 2015.[3] The first three counts of the amended complaint were ERISA based, and the last count was again a state-law claim. The complaint sought the value of alleged unpaid benefits and of premiums paid by Ibson to UHS (Count I), statutory damages for UHS's failure to dutifully carry out the task of "plan administrator" (Count II), attorney fees (Count III), and damages arising from a breach of contract in relation to the April 2008 email (Count IV). On a partial motion to dismiss, the district court dismissed Count IV as preempted by ERISA, and later, on summary judgment, it dismissed Counts I, II, and III. Ibson now appeals.[4]

         II.

         We review the district court's dismissal on summary judgment of Counts I and II, and dismissal of Count IV for failure to state a claim, de novo. See Odom v. Kaizer, 864 F.3d 920, 921 (8th Cir. 2017) (summary judgment); K.T. v. Culver-Stockton Coll., 865 F.3d 1054, 1057 (8th Cir. 2017) (failure to state a claim).

         A.

         Viewed in a light most favorable to Ibson, Kaizer, 864 F.3d at 921, Count I of her amended complaint seeks relief under two different, interrelated ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.