Mealey's (August 12, 2016, 12:14 PM EDT) -- LYNCHBURG, Va. — A Virginia federal judge on Aug. 10 granted a health insurer’s motion to dismiss a lawsuit alleging that it unlawfully ignored requests to provide plan documents and breached co-fiduciary duties owed under the Employee Retirement Income Security Act because it is barred by res judicata (W.A. Griffin v. Areva Inc., No. 6:16-cv-00029, W.D. Va.; 2016 U.S. Dist. LEXIS 105887).
(Opinion available. Document #54-160914-007Z.)
U.S. Judge Norman K. Moon of the Western District of Virginia granted the motion by Areva Inc., which argued that plaintiff W.A. Griffin lacked statutory standing and that her case attempted to relitigate an identical dispute resolved by a Georgia federal court earlier this year.
Areva is a health insurance corporation that administers plans through agent companies, one of which is Blue Cross Blue Shield Healthcare Plan of Georgia. Griffin, whom the judge described as a “serial litigant in federal court,” is a resident of Fulton County, Ga., and operates a small dermatology practice in the area.
Billing Dispute
On April 30, 2013, A.H., one of Griffin’s patients, reported to Griffin’s office for surgery and signed a document assigning to Griffin all of the rights and benefits arising under his health insurance policy with Blue Cross. Griffin contacted Blue Cross to verify A.H.’s insurance coverage and subsequently performed the surgery.
Griffin consulted a national database called Fair Health Inc. to determine that the proper billing amount for the surgery she performed on A.H. was $2,148.02. She submitted a claim for this amount to Blue Cross. Instead of paying the full amount, Blue Cross only covered $997 of the charge. Griffin was directly compensated $287.72. She claimed that Blue Cross owes her an additional $1,414.39 on the claim.
Griffin later sent two requests to appeal to Blue Cross, on May 17, 2013, and July 6, 2013, respectively. The second request included a demand for policy documents. Each of these requests was ignored by Blue Cross, the judge wrote.
Griffin brought three ERISA claims against Areva. She alleged that Areva violated 29 U.S. Code Section 1132(a)(1)(B) by declining to fully compensate her for A.H.’s surgery, violated 29 U.S. Code Sections 1024(b), 1104 and 1133(2) by failing to turn over requested plan documents and violated 29 U.S. Code Section 1105(a)(2) for its alleged breach of co-fiduciary duties that include the duty to monitor its agents such as Blue Cross and instruct other plan fiduciaries to forward requested documents.
Res Judicata
Areva argued that Griffin’s action was barred by res judicata, saying that it is identical to one Griffin brought against Areva earlier this year in the U.S. District Court for the Northern District of Georgia that was dismissed with prejudice on May 26.
“The complaint in Griffin’s prior case alleged claims that are identical in all respects to those she alleges in her present suit,” Judge Moon wrote. “Each of Griffin’s prior three claims cites the same statutory provisions and pleads the same facts as in her present action.
“Furthermore, these claims arose out of the identical treatment of the same patient and the same appeal letter that are currently at issue. To put it succinctly, Griffin has largely copy-and-pasted the allegations from her Georgia lawsuit into her complaint in this action. Accordingly, the present case concerns the same parties and arises out of the same causes of action that were at issue in Griffin’s prior case.”
Areva also requested that the judge issue a prefiling injunction against Griffin, saying relief is necessary because Griffin’s “repetitive and unmeritorious lawsuits are burdensome to the federal court system, and her repeated filings serve no purpose but to harass defendants and impose on them the cost and time of repeatedly defending themselves in federal court.”
Injunction Denied
Judge Moon said Areva has identified more than 20 cases against similarly situated defendants filed by Griffin in the Northern District of Georgia. Judge Moon said this is Griffin’s first filing in the Western District of Virginia and only the second case against Areva.
“Griffin has a history of filing numerous duplicative claims in other courts and against similarly-situated defendants,” Judge Moon wrote. “But the Court is hesitant to issue a prefling injunction at this juncture, although it will revisit the issue if Griffin continues to proliferate similar filings.”
Areva is represented by David E. Constine III of Troutman Sanders in Richmond, Va. Griffin, of Atlanta, is pro se.
(Additional documents available: Complaint. Document #54-160914-008C. Areva motion to dismiss. Document #54-160914-009M. Response to motion. Document #54-160914-010W.)...