Debra Rogers appeals from the judgment of the district court dismissing her action against Jefferson-Pilot Life Insurance Company pursuant to rule 12(b)(6) of the Federal Rules of Civil Procedure. Her complaint, based on both state and federal grounds, demanded hospitalization benefits under an employee group health care policy. We reverse the court’s dismissal of Rogers’ federal claim.
Rogers alleges in her amended complaint that, when she contacted Jefferson-Pilot in the summer of 1987 to determine if her
The district court dismissed all four counts of the complaint. It held that ERISA preempted the three state law pendent claims and that the ERISA count was erroneously grounded on 29 U.S.C. § 1140. Section 1140 applies only to actions against an employer, not against insurers or other third parties administering insurance benefits. Rogers appeals only the dismissal of her ERISA count. We reverse.
In the ERISA count of her complaint, Rogers stated:
19. This action is brought for relief arising from Defendant’s interference with Plaintiff’s rights under the Employee Retirement Income Securities Act, 29 USC Section 1001 et. seq., in violation of 29 USC Section 1140.
20. Jurisdiction is conferred upon this Court by the Employee Retirement Income Security Act, 29 USC Section 1001 et. seq.
21. Plaintiff is an employee of Recco Tape and Label, Inc., and was provided with health insurance by her employer which afforded coverage of herself and her minor children by a group policy with Defendant. This policy is an employee benefit plan governed by the Employment Retirement Income Security Act, 29 USC Section 1001, et. seq.
She concluded by stating:
25. Defendant’s refusal to pay the aforementioned medical bills was for the purpose of interfering with the attainment of a right to which a participant or beneficiary may become entitled under the plan and was therefore unlawful under 29 USC Section 1140.
Rogers’ complaint, to say the least, was inartfully drafted and her attorney compounded that problem by failing to respond to Jefferson-Pilot’s rule 12(b)(6) motion for dismissal. In our view, however, a rule 12(b)(6) motion should be granted only in very limited circumstances. The Supreme Court has explained that “[t]he Federal Rules reject the approach that pleading is a game of skill in which one misstep by counsel may be decisive to the outcome and accept the principle that the purpose of pleading is to facilitate a proper decision on the merits.”
Conley v. Gibson,
In
Robertson v. Johnston,
Although the district court points out that [Robertson’s] suit was based upon Sections 2000a-2000a-6 of the Act, Section 2000a-l was not specifically relied upon by [Robertson], nor was it mentioned in the Court’s opinion. However, [w]e see no reason why we should make what we think would be an erroneous decision, because the applicable law was not insisted upon by one of the parties.
Id.
at 44 (citations and quotation marks omitted);
see also Bramlet v. Wilson,
While we agree with Jefferson-Pilot and the district court that section 1140 relief is only available to an employee against his employer, section 1132(a)(1)(B) authorizes a suit by an employee against an insurance carrier responsible for administering and paying claims under a covered insurance plan:
A civil action may be brought—
(1) by a participant or beneficiary—
(B) to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan....
Although the complaint does not specifically identify section 1132(a)(1) as the authority for Rogers’ complaint, read in its entirety and viewed in a light most favorable to Rogers, the ERISA count states a valid claim for relief.
That part of the judgment of the district court dismissing the first three counts of Rogers’ complaint is affirmed. The part of the judgment denying count four is reversed and the case is remanded for a trial on the merits of Rogers’ ERISA allegations.
AFFIRMED IN PART; REVERSED IN PART.