Opinion
3:20-CV-01181-AR
04-28-2022
ANTONINA REUTOV, Plaintiff, v. TATANCA HEALTH CARE PLAN, TATANCA HEALTH CARE PLAN BOARD OF TRUSTEES, dba Omnis Benefit Administrator, Defendant.
FINDINGS AND RECOMMENDATION
JEFFREY ARMISTEAD UNITED STATES MAGISTRATE JUDGE
Introduction
Plaintiff Antonina Reutov brings this action against defendants Tatanca Health Care Plan and Tatanca Health Care Plan Board of Trustees, dba Omnis Benefit Administrator (collectively “Tatanca”), for improper denial of benefits under Reutov's health care plan in violation of the Employee Retirement Income Security Act of 1974 (“ERISA”). Before the court is Reutov's motion for an order of default judgment, or in the alternative, for a hearing on damages. Motion for Order of Default Judgment (“Mot. for Default”), ECF No. 48. The court recommends that Reutov's motion be DENIED without prejudice.
Background
Tatanca purport to be a self-funded health and welfare plan and a plan administrator overseeing the processing of claims and payment of benefits. Compl. ¶¶ 2-3, ECF No. 1. Reutov is an individual domiciled in Oregon. Id. ¶ 1.
From March 2019 through December 2019, Reutov received medical services and incurred related expenses in an unspecified amount at Legacy Silverton Hospital. Id. ¶ 9. Before receiving those services, Reutov had purchased a “LBP Gold 4 Prenatal” health insurance plan (the “Plan”) from Tatanca. See ¶¶ 8-9. After enrolling in the Plan, Reutov visited the online patient portal provided by Tatanca to review her options for in-network and out-of-network providers. See id. ¶ 10. Tatanca's patient portal represented Legacy Silverton Hospital to be an in-network provider. Id.
Relying on that representation, Reutov received medical services at Legacy Silverton Hospital. However, when she applied to Tatanca for medical benefits under the Plan, Tatanca stated that the hospital was an out-of-network provider and refused to pay $38,420.86 in benefits. Id. ¶ 12. After attempting to resolve that coverage dispute directly with Tatanca, Reutov brought this civil action in July 2020, asserting alternative claims for payment benefits or equitable reliefunder ERISA provisions, 29 U.S.C. §§ 1132(a)(1)(B) and 1132(a)(3). Compl. ¶¶ 7-18; 24-30.
Reutov also alleged a statutory-damages claim, but she releases that claim for the purpose of default judgment. Mot. for Default, 5.
In November 2020, Tatanca appeared and moved to dismiss or transfer venue based on a forum selection clause in the Plan policy. Mot. to Dismiss, ECF No. 15. Magistrate Judge John V. Acosta considered the parties' arguments and recommended denial of Tatanca's motions. Findings and Recommendations (“F&R”), ECF No. 25. Following that recommendation, the court granted Tatanca three extensions of time to file an objection. Order, ECF Nos. 28, 30, 32. Tatanca never filed an objection. On September 11, 2021, Judge Michael H. Mosman adopted the F&R in full. Opinion & Order, ECF No. 33. Two weeks later, Tatanca's counsel moved to withdraw from representation, for which the court granted leave. Motion to Withdraw, ECF No. 37; Order, ECF No. 42. The court also granted Tatanca an extension of time to Answer the Complaint. Order, ECF No. 36. Tatanca never filed an Answer and have since failed to appear in this action.
On October 29, 2021, Reutov moved for leave to file an amended complaint. Mot. to Amend, ECF No. 40. One month later, the court held a telephonic status conference to clarify a matter in that pending motion. Minutes of Proceeding, ECF No. 44. Tatanca did not appear at the status conference, and Judge Acosta directed Reutov to “advise the court as to which course of action [she] wish[ed] to pursue.” Id. Reutov moved for entry of default, which the court granted.Motion for Entry of Default, ECF No. 45; Order, ECF No. 46. On January 14, 2022, Reutov filed the motion here for an order of default judgment. Mot. for Default, 13.
Thus, the court treats Reutov's pending motion to amend (ECF No. 40) as abandoned.
Legal Standard
On a motion for default judgment, the court presumes all well-pleaded factual allegations are true, except those related to damages. TeleVideo Sys., Inc. v. Heidenthal, 826 F.2d 915, 917 18 (9th Cir. 1987). Where those facts establish a defendant's liability, the court has discretion- though not an obligation-to enter a default judgment. Aldabe v. Aldabe, 616 F.2d 1089, 1092 (9th Cir. 1980). In exercising this discretion, courts in this circuit consider the factors articulated in Eitel v. McCool, 782 F.2d 1470 (9th Cir. 1986). DIRECTV, Inc. v. Hoa Huynh, 503 F.3d 847, 852 (9th Cir. 2007). The Eitel factors are:
(1) the possibility of prejudice to the plaintiff; (2) the merits of plaintiff's substantive claims; (3) the sufficiency of the complaint; (4) the sum of money at stake in the action; (5) the possibility of a dispute concerning material facts; (6) whether the default was due to excusable neglect; and (7) the strong policy underlying the Federal Rules of Civil Procedure favoring decisions on the merits.Eitel, 782 F.2d at 1471-72. The “starting point” of the court's analysis, however, “is the general rule that default judgments are ordinarily disfavored.” Id. at 1472 (citation omitted).
Discussion
In her motion for default judgment, Reutov requests the court order “entry of judgment jointly and severally against [Tatanca] in the amount of $48,107.50.” Motion for Default, 1. Specifically, she requests a damages award of $8,492 for herself and a reasonable attorney's fee award of $39,615.50. Id. The court recommends denying this request, for three reasons.
First, the court cannot determine whether the supplied documentation correctly and consistently supports Reutov's requested damages and attorney's fees. Reutov submitted ten exhibits with her motion for default judgment. See id., Exs. 1-10. In the declaration accompanying those documents, Reutov's counsel indicates only that “the exhibits are true and accurate copies of what they purport to be.” Decl. of Clinton Tapper in support of Application for Order of Default Judgment, (“Tapper Decl.”) ¶ 5, ECF No. 51. This statement fails to meaningfully identify or explain the purpose of the accompanying exhibits, and the court declines to devote any more judicial resources to making sense of these documents. Thus, Reutov's motion does not support her requested damages and attorney's fee award. See Carpenters Health and Sec. Trust of W. Wash. v. GHL Architectural Millwork, LLC, Case No. 19-cv-01030-RAJ, 2020 WL 2333784 (W.D. Wash. May 11, 2020) (“To the extent Plaintiffs which to recover damages from [defendant], they must clearly and consistently establish their entitlement to a specific amount in the motion for default judgment and directly and clearly support that request with the accompanying exhibits and declarations.” (Underscore in original)).
Second, the court is confused about the amount Reutov claims as damages and her support for that amount. In a single paragraph, Reutov explains that, during litigation, she applied for patient forgiveness and Legacy Health forgave all but $8,492-the amount she now requests as damages. Id. at 4. However, elsewhere in the motion, Reutov dedicates nearly two pages to a chart containing estimated amounts of payments and nonpayments made by Tatanca. Id. at 2-4. Given the limited sum that Reutov actually requests, the purpose of this chart is unclear. Moreover, Reutov's motion does not explain how a hearing would clarify her damages request.
Finally, Reutov's motion does not address the Eitel factors. See generally id. The court would appreciate from Reutov a discussion of the factors to support a recommendation for entry of default judgment. Accordingly, the court is not persuaded that entering a default judgment is appropriate at this time.
Conclusion
For the foregoing reasons, the court recommends that Reutov's motion for default judgment (ECF No. 48) be DENIED without prejudice to refiling with the corrections identified in this Findings and Recommendation.
Scheduling Order
The Findings and Recommendation will be referred to a district judge. Objections, if any, are due within fourteen days. If no objections are filed, the Findings and Recommendation will go under advisement on that date. If objections are filed, a response is due within fourteen days. When the response is due or filed, whichever date is earlier, the Findings and Recommendation will go under advisement.