Arora v. Buckhead Family Dentistry, Inc.

Citation: Not availableDocket: Civil Action No. 2016-1806

Court: District Court, District of Columbia; January 7, 2018; Federal District Court

Original Court Document: View Document

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Cigna Health and Life Insurance Company's renewed motion to dismiss has been granted by the Court, which also ordered the transfer of the remainder of the case to the U.S. District Court for the Northern District of Georgia under 28 U.S.C. § 1631. The background of the case involves Sanjay Arora, who, while living in Atlanta in 2013, sought dental treatment from Dr. Travis Paige at Buckhead Family Dentistry for a cracked tooth. After receiving a crown that was supposed to be a “high noble metal crown” covered by Cigna, Arora experienced pain due to receiving a lower quality crown instead. He demanded a refund from Cigna for his co-payment but was denied, despite Cigna acknowledging a quality of care concern. Following this, Arora switched dentists and later moved to Washington, D.C., initiating a diversity action against Dr. Paige, Buckhead, Global Dental Solutions LLC, and Cigna, asserting claims including breach of fiduciary duty and negligent misrepresentation. The Court previously determined that it lacked personal jurisdiction over Buckhead and Global, prompting consideration of transferring the case to Georgia, where the relevant events occurred.

Arora did not demonstrate proper service of process on Cigna, leading the Court to refrain from addressing Cigna’s arguments regarding the merits of Arora's complaint. Consequently, the Court allowed Arora another chance to serve Cigna. Each defendant argued against transferring the case, asserting that Arora's claims lacked merit, which would render any transfer futile. Arora, fearing statute of limitations issues, sought the transfer and submitted a proof of service claiming he had served Cigna’s Legal Department and Attorney of Record. In response to Cigna's earlier request for the Court to consider its motion to dismiss upon proof of service, the Court asked Cigna to clarify its stance on service. Cigna waived its objection to service and renewed its motion to dismiss for failure to state a claim. 

To withstand a motion to dismiss under Rule 12(b)(6), a complaint must present sufficient factual matter to establish a plausible claim for relief. A claim is plausible if it allows the court to reasonably infer the defendant's liability based on the alleged misconduct. While detailed factual allegations are not mandatory, the complaint must surpass mere labels or formulaic recitations of legal elements. The Court must accept the truth of well-pleaded factual allegations and grant the plaintiff all reasonable inferences from those facts, but does not need to accept legal conclusions disguised as factual claims.

Cigna’s motion to dismiss is analyzed under the choice-of-law rules applicable to diversity actions in the District of Columbia. The court applies a modified governmental interests analysis to determine which jurisdiction has the most significant relationship to the dispute, referencing the Restatement (Second) of Conflict of Laws, § 145, which outlines four relevant factors: location of the injury, location of the conduct causing the injury, the parties' ties (domicile, residence, etc.), and where the relationship is centered. Cigna asserts that Georgia law should apply, as the injury, conduct, and parties' relationship all occurred in Georgia. Arora does not challenge this assertion. The court concurs, identifying Georgia as having the most significant relationship to the case, especially considering that both Buckhead and Global are based in Atlanta, Georgia. The only potential justification for applying D.C. law is Arora’s subsequent move to the District of Columbia, which the court deems insufficient to alter the dominant ties to Georgia.

Cigna is accused of breaching its fiduciary duty to Arora by (1) knowingly charging him for a more expensive dental crown, (2) failing to investigate Buckhead despite awareness of fraudulent billing, and (3) retaining Buckhead in its approved network. Cigna argues that, under Georgia law, no fiduciary relationship exists between an insurer and its insured. Arora contends that a fiduciary duty arises when an insurer administers an employer-sponsored plan under ERISA, but the complaint does not establish that his plan was ERISA-governed. If it were, his state law claim could be preempted. Additionally, Arora claims Cigna made a self-imposed fiduciary duty through statements on its website, but the court finds this insufficient to establish such a duty and notes that these arguments were not included in the amended complaint, thus not properly before the court. Consequently, the court will dismiss Arora's claim for breach of fiduciary duty against Cigna.

To establish a claim for negligent misrepresentation in Georgia, Arora must demonstrate that Cigna (1) provided false information negligently; (2) he reasonably relied on that information; and (3) he suffered economic harm as a result of that reliance. Arora claims Cigna misrepresented that Dr. Paige and Buckhead Family Dentistry were “qualified, honest and ethical” by including them in a list of recommended dentists. He alleges that Cigna continued to include them even after being aware of their fraudulent practices, which constituted ongoing negligent misrepresentation. Arora asserts that he justifiably relied on these misrepresentations to his detriment.

Cigna counters that Arora's claims lack substantiation, arguing he fails to explain why his reliance was justified and that any actions taken by Cigna post-injury could not have contributed to his harm. The Court finds the amended complaint insufficient, lacking specific facts to suggest Cigna was aware that Dr. Paige or Buckhead Family Dentistry were not as represented before Arora's treatment. Furthermore, it concludes that Arora does not provide adequate facts to link Cigna's failure to act after his complaints to the injuries he claims. Consequently, Arora’s claim for negligent misrepresentation will be dismissed for failing to sufficiently state a claim.

Arora alleges a conspiracy among Cigna, Dr. Paige, and Buckhead Family Dentistry to commit fraud, defined as a combination of two or more persons pursuing an unlawful goal. In civil cases, a conspiracy alone does not provide grounds for action; the underlying tort must be demonstrated, along with resulting damages. To establish fraud, Arora must prove five elements: a false representation, scienter, intent to induce action, justifiable reliance, and damages. He claims that the defendants conspired to hide the fraudulent substitution of a promised higher-quality crown with a lower-quality one. Specifically, Cigna is accused of documenting receipt of a higher-quality crown and continuing to endorse Dr. Paige and Buckhead as qualified professionals despite knowledge of the substitution.

However, Arora fails to provide specific facts that would enable the court to infer intentional or negligent misrepresentations by Cigna, or that Cigna conspired with the other parties. He does not allege that Cigna had reason to suspect the provision of an inferior crown or that it misled him about any wrongdoing. Furthermore, he does not meet the heightened pleading standards of Rule 9(b), which requires detailed allegations of fraud. Consequently, the court will dismiss Arora’s conspiracy claim against Cigna under Rules 12(b)(6) and 9(b).

The Court has determined it lacks personal jurisdiction over defendants Global, Abramson, Buckhead, and Dr. Paige, prompting a consideration of transferring the case to the U.S. District Court for the Northern District of Georgia under 28 U.S.C. § 1631. This statute allows for transfer when a court lacks jurisdiction, the transferee court has jurisdiction, and transfer serves the interests of justice. The Court recognizes that the Georgia district would have personal jurisdiction as all defendants are located in Atlanta, and this is not disputed. 

While defendants argue that both the current and transferee courts lack subject matter jurisdiction due to the amount in controversy not exceeding $75,000, the Court finds this assertion unpersuasive. Under federal law, a plaintiff’s good faith allegation of the amount in controversy is accepted unless it can be shown with legal certainty that the claim is for less than the jurisdictional amount. Arora has claimed damages exceeding $75,000 and also seeks punitive damages under Georgia law. Despite concerns regarding the likelihood of recovering such an amount, the Court concludes that Arora has sufficiently pled to establish diversity jurisdiction.

The Court determines that transferring the case to the Northern District of Georgia aligns with the interest of justice, particularly for pro se plaintiff Arora, whom Congress intended to support through § 1631. Courts have recognized that transfer is appropriate when a pro se plaintiff misfiles their action. Dismissing the case could significantly prejudice Arora, especially given potential limitations on his ability to pursue claims if the case is dismissed. The only detriment to the defendants from a transfer would be the time and cost of litigation. The Court emphasizes that penalizing a pro se litigant for venue errors contradicts the interest of justice, as established in precedent cases. Consequently, Cigna’s renewed motion to dismiss is granted, Cigna is dismissed as a defendant, its motion regarding the dismissal is denied as moot, and the case is ordered to be transferred to the U.S. District Court for the Northern District of Georgia under 28 U.S.C. § 1631. 

SO ORDERED.

s/ Randolph D. Moss  
RANDOLPH D. MOSS  
United States District Judge  
Date: January 8, 2018