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Barbarino v. Aetna Life Insurance Co.

United States District Court, N.D. California, San Jose Division

March 16, 2015

LAURA BARBARINO, Plaintiff,
v.
AETNA LIFE INSURANCE COMPANY; BOEING SHORT TERM DISABILITY PLAN; BOEING LONG TERM DISABILITY PLAN, Defendants

For Laura Barbarino, Plaintiff: Christopher George Wilhelmi, Joel P Waelty, LEAD ATTORNEYS, Hinkle, Jachimowicz, Pointer & Emanuel, San Jose, CA.

For Aetna Life Insurance Company, Boeing Short Term Disability Plan, Boeing Long Term Disability Plan, Defendants: Jordan S. Altura, LEAD ATTORNEY, Dawn Noel Valentine, Gordon & Rees LLP, San Francisco, CA.

ORDER DENYING DEFENDANTS' MOTION TO DISMISS Re: Dkt. No. 10

EDWARD J. DAVILA, United States District Judge.

Presently before the Court is Defendants Aetna Life Insurance Company (" Aetna" ), Boeing Short Term Disability Plan, and Boeing Long Term Disability Plan's (collectively, " Defendants" ) Motion to Dismiss Plaintiff Laura Barbarino's (" Plaintiff" ) Second Cause of Action. The Court found this matter suitable for decision without oral argument pursuant to Civil Local Rule 7--1 (b) and previously vacated the hearing. Having reviewed the parties' briefing, the Court DENIES Defendant's Motion to Dismiss Plaintiff's Second Cause of Action.

I. BACKGROUND

Plaintiff alleges that in 2008, she was hired by Jeppesen/Boeing as an International Trip Planner 3. Dkt. No. 1-1 (" Compl." ) at ¶ 14. Through her employment, Plaintiff enrolled in the Boeing Short Term Disability Plan and the Boeing Long Term Disability Plan (collectively, the " Plan" ). Id. at ¶ ¶ 3, 15.

On February 12, 2013, Plaintiff alleges that she stopped working at Jeppesen/Boeing because of fibromyalgia and chronic fatigue. Id. at ¶ 18. Her related symptoms and conditions included: physical impairments, severe and uncontrolled sensitivity in/on her body, cognitive disorder, and anxiety. Id. Due to Plaintiff's inability to perform mentally and physically in the workplace, her treating physician removed her from the workplace. Id. Since then, she has been permanently disabled. Id.

On February 26, 2013, Plaintiff alleges that she submitted a claim for Short Term Disability benefits and produced sufficient proof of her permanent disability. Id. at ¶ 19. In March 2013, Aetna allegedly denied Plaintiff's claim, basing their decision by their clinical consultants, claims analysts, and disability professionals, and stating that a Short Term Disability claim from a psychological perspective was not supported. Id. at ¶ 21. In April 2013, Plaintiff appealed Aetna's denial of her claim and produced additional proof of her permanent disability. Id. at ¶ 22. In May 2013, Aetna allegedly denied Plaintiff's appeal claiming that that the information did not support her disability as of February 2013. Id. at ¶ 23. Moreover, Aetna also allegedly denied Plaintiff's claim for Long Term Disability benefits stating that Plaintiff had not met the required waiting period. Id.

In March 2014, Plaintiff alleges that she sent a letter to Aetna expressing her intent to file a claim for Long Term Disability benefits, requesting a copy of Aetna's claim form, and requesting any other documentation necessary to file a claim. Id. at ¶ 26. In April 2014, Aetna allegedly sent a letter to Plaintiff denying her claim to Long Term Disability benefits, and setting forth the conditions for considering a claimant disabled. Id. at ¶ 27. The letter further stated that Plaintiff had not satisfied the required waiting period. Id. at ¶ 29.

Plaintiff alleges that despite multiple claims for Long Term Disability benefits, at no time did Aetna perform an actual or meaningful review of her claims as required by the Plan. Id. at ¶ 30. She alleges that she has exhausted all administrative remedies under the Plan for both Short Term Disability and Long Term Disability benefits. Id. at ¶ 31.

Plaintiff commenced the instant action in Superior Court, County of Santa Clara, and in August 2014, Defendants removed the case to this court. See Dkt. No. 1. Defendants, thereafter, filed the instant motion. See Dkt. No. 10 (" Mot.). Plaintiff filed an opposition brief, and Defendants filed a reply brief. See Dkt. Nos. 18 (" Opp." ), 19 (" Reply" ).

II. LEGAL STANDARD

Federal Rule of Civil Procedure 8(a) requires a plaintiff to plead each claim in the complaint with sufficient specificity to " give the defendant fair notice of what the . . . claim is and the grounds upon which it rests." Bell A. Corp. v. Twombly,550 U.S. 544, 555, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007) (internal quotations omitted). A complaint which falls short of the Rule 8(a) standard may be dismissed if it fails to state a claim upon which relief can be granted. Fed.R.Civ.P. 12(b)(6). Dismissal under Rule 12(b)(6) for failure to state a claim is " proper only where there is no cognizable legal theory or an absence of sufficient facts alleged to support a cognizable legal theory." Shroyer v. New Cingular Wireless Servs., Inc.,606 F.3d 658, 664 (9th Cir. 2010) (quoting Navarro v. Block,250 F.3d 729, 732 (9th Cir. 2001)). In considering whether the complaint is sufficient to state a claim, the court must accept as true all of the factual allegations contained in the complaint. Ashcroft v. Iqbal,556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). While a complaint need not contain detailed factual allegations, it " must contain sufficient factual matter, accepted as true, to 'state ...


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