Bassel v. Aetna Health Insurance Company of New York
- Jesse Furman
- 1:20-cv-09019
- U.S. District Court · Southern District of New York
- 4
In Bassel v. Aetna, Judge Furman granted the motion as to several claims and reserved the remaining issues for telephone argument.
The ruling affected Jamie H. Bassel DC PC d/b/a New York City Chiropractic, Aetna Health Insurance Company of New York, and the other defendants named in the amended complaint. It granted the dismissal motion as to specified claims and defendants but left the remainder of the motion unresolved.
What happened
In Bassel v. Aetna Health Insurance Company of New York, the defendants asked the court to dismiss the plaintiff’s amended complaint. The court addressed only part of that request in this opinion.
The court granted the motion on three groups of arguments because the plaintiff did not respond to them: claims involving plans not governed by the Employee Retirement Income Security Act, a request for an injunction under that law, and state-law claims involving plans governed by that law. The court also granted the motion as to the remaining fraud claims because the complaint did not provide enough detail, and as to claims against defendants other than Aetna because it did not allege facts supporting their liability.
Judge Jesse M. Furman reserved judgment on the rest of the motion. The court scheduled telephone argument about exhaustion of administrative remedies, the assignment of claims, and possible sanctions involving the plaintiff’s counsel.
The detailed version
- Bassel v. Aetna Health Insurance Company of New York · No. 1:20-cv-09019
- Jesse Furman
- Jan. 6, 2022
Background
The defendants moved to dismiss the plaintiff’s amended complaint. The opinion rules on several parts of that motion but expressly reserves judgment on the remainder.
Rulings on abandoned arguments
The court granted the motion on three arguments that the plaintiff did not address in its opposition:
- The plaintiff’s claims under the Employee Retirement Income Security Act (ERISA) concerning members covered by plans that the defendants said were not governed by ERISA, specifically plans identified as State of New Jersey Health Benefits, Fashion Institute of Technology, and Metropolitan Transportation Authority New York City Transit.
- Count III, which sought injunctive relief under 29 U.S.C. § 1132(a)(3).
- The plaintiff’s state-law claims concerning ERISA plans, which the defendants argued were displaced by federal law.
The court treated the claims involved in those arguments as abandoned because the plaintiff did not respond to the defendants’ request to dismiss them.
Fraud claims
The court also granted the motion as to the plaintiff’s remaining fraud claims. Rule 9(b) requires fraud to be pleaded with particularity, including details about who allegedly committed the fraud, what happened, when and where it happened, and how it was carried out. The court concluded that the amended complaint contained virtually no fraud-related allegations and did not come close to meeting that standard.
Claims against non-Aetna defendants
The court further granted the motion as to the plaintiff’s claims against all defendants other than Aetna. It concluded that the amended complaint alleged no facts or factual content that could plausibly support liability by those defendants, whether under a theory that one party was responsible for another’s conduct or otherwise. The court also noted that the complaint’s requested relief sought recovery only from Aetna.
Issues reserved for oral argument
The court reserved judgment on the remainder of the defendants’ motion and scheduled telephone oral argument for January 13, 2022. The identified issues included whether the amended complaint showed on its face that the plaintiff failed to exhaust administrative remedies; whether, if exhaustion was not clear from the complaint, the motion should be converted to a motion for summary judgment or denied without prejudice to an early, limited summary-judgment motion; and whether an exception to exhaustion applied.
The court also directed the parties to address whether the validity of assignments to the plaintiff concerned standing or instead should be considered under Rule 17 of the Federal Rules of Civil Procedure. If Rule 17 applied, the court would consider whether the defendants’ motion should be denied without prejudice to renewal under that rule. Finally, the court asked counsel to be prepared to address whether the plaintiff’s counsel should be ordered to explain why sanctions should not be imposed based on alleged legal misstatements and copied, largely inapplicable arguments in the opposition papers.
Disposition
Judge Jesse M. Furman granted the defendants’ motion as to the abandoned claims, the remaining fraud claims, and the claims against all non-Aetna defendants. The court reserved judgment on the remainder of the motion pending oral argument.
Read the full 4-page opinion on CourtListener, the free public archive maintained by the Free Law Project.