“[T]he trigger for bringing a[n] MSP[A] claim is not the pendency of a disputed tort claim, but the established obligation to pay medical costs... .” (internal quotation marks omitted)
How later courts described this case
- “[T]he trigger for bringing a[n] MSP[A] claim is not the pendency of a disputed tort claim, but the established obligation to pay medical costs... .” (internal quotation marks omitted)
- “[I]n the usual case in which all federal-law claims are eliminated before trial, the balance of factors to be considered . . — Judicial economy, convenience, fairness, and comity — will point toward declining to exercise jurisdiction over the remaining state-law claims.”
Written by the judges who cited it.
The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA
BRANDON RULUND AKINS, )
)
Plaintiff, )
)
v. ) 1:25cv712
)
TASHI LATWON RATLIFF, et al., )
)
Defendants. )
MEMORANDUM OPINION, ORDER, AND RECOMMENDATION
OF UNITED STATES MAGISTRATE JUDGE
This matter comes before the undersigned United States
Magistrate Judge on an Application to Proceed in District Court
Without Prepaying Fees or Costs (Docket Entry 1) (the
“Application”) filed by Brandon Rulund Akins (the “Plaintiff”) in
conjunction with Plaintiff’s pro se complaint (Docket Entry 2) (the
“Complaint”) against, as relevant here, GEICO Indemnity Company
(the “Defendant”) (see id. at 1).1 For the reasons that follow,
the undersigned will (i) grant the Application for the limited
purpose of recommending dismissal of Plaintiff’s lone federal
claim, under 28 U.S.C. § 1915(e)(2)(B), for failure to state a
claim, as well as dismissal without prejudice of any state claim(s)
under 28 U.S.C. § 1367(c)(3), and (ii) resolve ancillary motions
relevant to the Application and Complaint (see Docket Entries 7,
13, 21, 23, 26).
1 Docket Entry page citations utilize the CM/ECF footer’s
pagination.
LEGAL STANDARD
“The federal in forma pauperis statute, enacted in 1892 and
presently codified as 28 U.S.C. § 1915, is designed to ensure that
indigent litigants have meaningful access to the federal courts.”
Neitzke v. Williams, 490 U.S. 319, 324 (1989). To balance this
public interest with the potential administrative burden on the
courts, the statute provides, in relevant part, that “the court
shall dismiss the case at any time if the court determines that the
action . . . fails to state a claim on which relief may be
granted,” 28 U.S.C. § 1915(e)(2)(B)(ii).
A complaint falls short of that requirement when it does not
“contain sufficient factual matter, accepted as true, to ‘state a
claim to relief that is plausible on its face.’” Ashcroft v.
Iqbal, 556 U.S. 662, 678 (2009) (internal citations omitted)
(quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). “A
claim has facial plausibility when the plaintiff pleads factual
content that allows the court to draw the reasonable inference that
the defendant is liable for the misconduct alleged.” Id. Further,
“the tenet that a court must accept as true all of the allegations
contained in a complaint is inapplicable to legal conclusions.
Threadbare recitals of the elements of a cause of action, supported
by mere conclusory statements, do not suffice.” Id.2
2 Although “[a] document filed pro se is to be liberally
construed, and a pro se complaint, however inartfully pleaded, must
(continued...)
2
BACKGROUND
The Complaint seeks relief against Defendant (see Docket Entry
2 at 14-15) for its alleged “failure to comply with its obligations
under the Medicare Secondary Payer Act (‘MSPA’)” (id. at 2), see 42
U.S.C. § 1395y, its “breach of [the] common law duty of good faith
and fair dealing” (Docket Entry 2 at 2), and its “repeated
violations of the North Carolina Unfair Claims Settlement Practices
Act, N.C. Gen. Stat. § 58-63-15(11), and the Unfair and Deceptive
Trade Practices Act, N.C. Gen. Stat. § 75-1.1” (Docket Entry 2 at
2).°
2(...continued)
be held to less stringent standards than formal pleadings drafted
by lawyers,” Erickson v. Pardus, 551 U.S. 89, 94 (2007) (internal
citation and quotation marks omitted), the United States Court of
Appeals for the Fourth Circuit has “not read Erickson to undermine
Twombly’s requirement that a pleading contain more than labels and
conclusions,” Giarratano v. Johnson, 521 F.3d 298, 304 n.5 (4th
Cir. 2008) (internal quotation marks omitted) (dismissing pro se
complaint); accord Atherton v. District of Columbia Off. of Mayor,
567 F.3d 672, 681-82 (D.C. Cir. 2009) (“A pro se complaint .. □
‘must be held to less stringent standards than formal pleadings
drafted by lawyers.’ But even a pro se complainant must plead
‘factual matter’ that permits the court to infer ‘more than the
mere possibility of misconduct.’” (first quoting Erickson, 551 U.S.
at 94; then quoting Igbal, 556 U.S. at 679)).
3 In addition to Defendant and its insured, the Complaint
named “Government Employees Insurance Company (GEICO)” and “Geico
Insurance Company, LLC” as defendants upon its filing. (Docket
Entry 2 at 1.) Plaintiff thereafter moved twice to amend the
caption and clarify his claims against Defendant, rather than the
other entities named in the Complaint. (See Docket Entries 13,
26.) Defendant “consent[ed] to Plaintiff’s [first] request”
(Docket Entry 17 at 1) to “remov[e ] other named entities [aside
from Defendant]” (Docket Entry 13 at 2) and did not respond to the
second, substantially similar motion (see Docket Entry 26; Docket
(continued...)
According to the Complaint:
On or about the evening of July 25, 2024, at
approximately 9:00 p.m., Plaintiff [ ] operated his
vehicle lawfully and responsibly when he was violently
rear-ended by a vehicle operated by Defendant[’s insured]
. . . [who] was at the time insured by Defendant [ ].
The force of the collision caused immediate and serious
physical injuries to [ ] Plaintiff, necessitating
emergency medical attention and transport via ambulance
to Hoke Hospital.
Plaintiff was diagnosed and treated for multiple
injuries, including:
• Acute cervical and lumbar strains
• Paraspinal tenderness
• Persistent migraines
• Concussion-like symptoms including
dizziness, lethargy, confusion, and vision
disturbances
• Psychological trauma
These injuries required, and continue to require, ongoing
treatment including physical therapy and psychological
counseling.
On or about date [sic], [Defendant] offered Plaintiff a
settlement of $3,000 without requiring any Medicare or
TRICARE lien documentation. However, this directly
contradicts [Defendant’s] current position and
demonstrates an inconsistent and unreasonable delay
tactic.
3(...continued)
Entries dated Nov. 17, 2025, to present). The undersigned will
therefore grant the first of those motions (Docket Entry 13) as to
the termination of “Government Employees Insurance Company (GEICO)”
and “Geico Insurance Company, LLC” (id. at 1-2) as defendants and
will terminate the second motion (Docket Entry 26) as moot. See
Fed. R. Civ. P. 15(a)(2). Additionally, Plaintiff pursued a
negligence claim against Defendant’s insured (see Docket Entry 2 at
4) before settling with that individual (see Docket Entry 25 at 1-2
(noticing voluntary dismissal of Defendant’s insured); id. at 4-5
(providing copy of written release)).
4
(Id. at 3-4 (paragraph numbering, parenthetical, internal brackets,
and stray quotation mark omitted); see also Docket Entry 2-1 at 1;
Docket Entry 2 at 10 (alleging that “Plaintiff declined to accept
[Defendant’s] inadequate offer”).)
The Complaint further alleges that “Defendant . . . has
acknowledged liability and issued partial [p]ayments to [ ]
Plaintiff in the amount of: $18,846.37 for the total loss of
[ P]laintiff’s vehicle [and] $788.72 for rental car reimbursement”
(id. at 4 (bullet points omitted)) and that “the remaining dispute
pertains solely to damages, not liability” (id. at 5).
Continuing, the Complaint alleges:
Plaintiff provided [Defendant] with clear, undeniable,
and thoroughly documented evidence of medical expenses,
physical injuries, and legal liability stemming from the
July 25, 2024 collision caused by Defendant[’s insured].
These irrefutable facts were supported by hospital
records, diagnostic imaging, therapy notes, and incident
reports which left no reasonable doubt regarding the
extent of the damages or [ ] Defendant’s responsibility.
[Defendant’s] refusal to engage fairly, despite this
overwhelming documentation, constitutes a severe and
deliberate breach of its duty to act in good faith.
Over the course of several months, Plaintiff consistently
communicated with [Defendant], submitting multiple
requests for resolution via phone calls, emails, portal
messages, and formal written notices for a settlement
instead of litigation. At each turn, [Defendant] either
ignored or misrepresented the law about legal
requirements, intentionally delaying a response, [and]
refusing to enter into good-faith negotiations.
(Id.; see also id. at 5-6 (alleging that Defendant’s
“representative made false and obstructive statements approximately
20 times” and listing allegedly false and obstructive statements).)
5
Additionally, the Complaint alleges that “Plaintiff is
enrolled in both Medicare and TRICARE and, as a result of injuries
sustained in the [ ] collision, incurred substantial medical
expenses related to treatment, therapy, and diagnostic care.” (Id.
at 8; see also id. at 11 (alleging that “Plaintiff is a Medicare
recipient with TRICARE as secondary insurance”).) According to the
Complaint, Defendant “[f]alse[ly s]tate[d]” that it “is legally
required to obtain a summary of verification of Medicare and
TRICARE lien payments prior to making a settlement offer or
discussing settlement numbers with [ ] Plaintiff.” (Id. at 6
(internal quotation marks omitted).) That statement, the Complaint
alleges, “is entirely inaccurate and serves as a delay tactic” (id.
at 10).
Moreover, the Complaint alleges that “Plaintiff provid[ed
Defendant with] all medical notes, bills and billing statements
from Tricare” (id. at 6; see also id. at 11 (alleging that
“Plaintiff submitted all required documentation to Defendant [ ],
including proof of significant injuries and medical expenses
exceeding $25,000”)). The Complaint further alleges that
Defendant’s “continued refusal to make an offer [of settlement]
under the pretext of needing lien information” (id. at 12) caused
“Plaintiff [to] suffer[] financial losses, worsening physical
conditions due to delayed treatment, prolonged emotional distress,
and interference with his federally protected rights” (id.), all of
6
which “should be compensated accordingly” (id. at 8; see also id.
at 14-15 (requesting, among other forms of relief, “compensatory
damages in the amount of $500,000” and “punitive damages in the
amount of $500,000%)).
DISCUSSION
I. Failure to State a Claim
Plaintiff seeks relief against Defendant for its alleged
“failure to comply with its obligations under the Medicare
Secondary Payer Act” (id. at 2).
“During the initial years of the Medicare program after its
enactment in 1965, Medicare acted as the first payer for many
medical services ... . In 1980 and 1981, in part due to rising
Medicare costs, Congress enacted and amended the Medicare Secondary
Payer statute.” Marietta Mem’l Hosp. Emp. Health Benefit Plan v.
DaVita Inc., 596 U.S. 880, 882 (2022). “That statute as amended
makes Medicare a ‘secondary’ payer,” id. at 882-83, “in certain
circumstances when both Medicare and a non-Medicare entity have
independent duties to pay for a covered person’s healthcare costs,”
DaVita Inc. v. Virginia Mason Mem’1l Hosp., 981 F.3d 679, 684 (9th
Cir. 2020). The MSPA “creates a federal coordination of benefits
between primary and secondary payers. Worker’s compensation plans,
liability insurance plans, and no fault insurance plans act as
primary payers, and Medicare benefits act as secondary payers.”
Humana Ins. Co. v. Paris Blank LLP, 187 F. Supp. 3d 676, 677-78
(E.D. Va. 2016) (internal citations omitted). “When a primary plan
is responsible for payment for medical services, a secondary payer
may make a conditional payment on behalf of the beneficiary and
then seek recovery for such conditional payment from the primary
plan.” Id. at 678.
“The MSP[A ] provides two mechanisms for enforcing a primary
plan’s recoupment obligation. First, the United States may sue to
recover the amount from the primary plan or from the individual or
entity to whom the primary plan has paid the funds.” Penegar v.
Liberty Mut. Ins. Co., 115 F.4th 294, 297 (4th Cir. 2024) (citing
42 U.S.C. § 1395y(b)(2)(B)(iii)). “Second, and pertinent to [this]
case, private parties may sue to recover double damages from a
primary plan that has failed to provide for primary payment in
accordance with the MSP[A ].” Id. (citing 42 U.S.C.
§ 1395y(b)(3)(A)). “The ostensible purpose of [the private cause
of action] . . . is ‘to help the government recover conditional
payments from insurers or other primary payers.’” Id. at 298
(quoting Netro v. Greater Balt. Med. Ctr., Inc., 891 F.3d 522, 524
(4th Cir. 2018)).
Turning to the text of the statute, the MSPA “establishe[s] a
private cause of action for damages (which shall be in an amount
double the amount otherwise provided) in the case of a primary plan
which fails to provide for primary payment (or appropriate
reimbursement) in accordance with paragraphs (1) and (2)(A)” of
8
subsection (b) of the statute. 42 U.S.C. § 1395y(b)(3)(A).4
“Paragraph (2)(A) . . . forbids Medicare from paying for services
when a primary plan is responsible, ‘except as provided in
subparagraph (B).’” MSPA Claims 1, LLC v. Kingsway Amigo Ins. Co.,
950 F.3d 764, 771 (11th Cir. 2020) (quoting 42 U.S.C.
§ 1395y(b)(2)(A)). In turn, “subparagraph (B) states that a
primary plan must reimburse Medicare ‘if it is demonstrated that
such primary plan has or had a responsibility to make payment with
respect to such item or service.’” Id. (quoting
§ 1395y(b)(2)(B)(ii)). “A primary plan’s responsibility for such
payment,” according to the MSPA, “may be demonstrated by a
judgment, a payment conditioned upon the recipient’s compromise,
waiver, or release (whether or not there is a determination or
admission of liability) of payment for items or services included
in a claim against the primary plan or the primary plan’s insured,
or by other means.” 42 U.S.C. § 1395y(b)(2)(B)(ii).5
4 Paragraph (1) sets forth “[r]equirements of group health
plans,” 42 U.S.C. § 1395y(b)(1), not implicated here.
5 “Other means” of demonstrating responsibility to pay “must
involve an enforceable obligation such as a judgment or
settlement,” Caldera v. Ins. Co. of the State of Pa., Civ. Action
No. 11-321, 2012 WL 360183, at *4 (S.D. Tex. Feb. 2, 2012), aff’d
on other grounds, 716 F.3d 861 (5th Cir. 2013); see also Sullivan
v. Farm Bureau Mut. Ins. Co. of Mich., No. 1:10cv909, 2011 WL
1231264, at *3 (W.D. Mich. Apr. 1, 2011) (requiring a showing of
“something akin to judicial determination or settlement”).
9
Accordingly, “[t]he private cause of action under the MSPA
requires three elements: (1) a primary plan, (2) that is
responsible to pay for an item or service, and (3) that failed to
make the appropriate payment to Medicare for the item or service.”
Sims v. PMA Ins. Co., No. 1:20cv249, 2021 WL 369675, at *7 n.8
(M.D.N.C. Feb. 3, 2021).
As to the first element, the term “primary plan” includes, as
relevant here, “an automobile or liability insurance policy or
plan,” 42 U.S.C. § 1395y(b)(2)(A)(ii). The second and third
elements of an MSPA claim represent “two important conditions
precedent that must be satisfied prior to invoking this cause of
action. First, Medicare must have actually made payments on
Plaintiff’s behalf.” Sullivan v. Farm Bureau Mut. Ins. Co. of
Mich., No. 1:10cv909, 2011 WL 1231264, at *3 (W.D. Mich. Apr. 1,
2011) (internal quotation marks and citation omitted). See also,
e.g., Leggette v. B.V. Hedrick Gravel & Sand Co., No. 3:04cv530,
2006 WL 6809606, at *11 (W.D.N.C. May 24, 2006) (“[An] MSP[A]
‘double damages’ claim may be maintained only where Medicare has,
in fact, paid claims that a primary insurer should have, but
refused, to pay.”). “The second condition precedent is that the
insurer must be ‘responsible’ for making the payments.” Sullivan,
2011 WL 1231264, at *3. “Until [a d]efendant[’s] responsibility to
pay for a Medicare beneficiary’s expenses has been demonstrated
(for example, by a judgment), [a d]efendant[’s] obligation to
10
reimburse Medicare does not exist under the relevant provisions.”
Glover v. Liggett Grp., Inc., 459 F.3d 1304, 1309 (11th Cir. 2006).
Here, the Complaint fails to allege the existence of any
payments made on Plaintiff’s behalf by Medicare; instead, it merely
alleges that “Plaintiff is a Medicare recipient” (Docket Entry 2 at
11) who “incurred substantial medical expenses” (id. at 8), and
that the “total cost of [those] medical expenses exceeds $25,000”
(id. at 4). Even liberally construed, these allegations fall short
of “[t]he requirement of actual payment by Medicare as a
prerequisite to maintaining a[n MSPA] action,” Leggette, 2006 WL
6809606, at *11, as nothing in the Complaint indicates that
Medicare or its affiliates “incurred costs covering [Plaintiff’s]
medical expenses,” MSP Recovery Claims, Series LLC v. Grange Ins.
Co., No. 5:19cv219, 2019 WL 6770729, at *17 (N.D. Ohio Dec. 12,
2019), which a primary payer (such as Defendant) should have born,
or for which Plaintiff may properly seek “reimbursement,” 42 U.S.C.
§ 1395y(b) (3) (A), under the MSPA.® “Moreover, absent [allegations
6 The Complaint’s allegations that “Plaintiff provid[ed
Defendant with] all medical notes, bills and billing statements
from Tricare” (Docket Entry 2 at 6 (emphasis added)) — “a federal
health insurance program administered by [the Department of
Defense] to provide medical care to current and retired service
members and their families,” County Bd. of Arlington Cnty. v.
Express Scripts Pharmacy, Inc., 996 F.3d 243, 248-49 (Ath Cir.
2021) (internal quotation marks and brackets omitted) — also prove
insufficient, because only “the United States [or its authorized
representative] may institute and prosecute legal proceedings
against a third party payer to enforce a right of the United States
under [TRICARE],” 32 C.F.R. § 220.7(a)-(b); see also 10 U.S.C.
(continued...)
11
concerning Plaintiff’s] submission of [his medical] claims to and
payment of at least some portion of them by Medicare, it [would be]
impossible to calculate the amount of damages subject to doubling,”
Leggette, 2006 WL 6809606, at *11, further rendering the
Complaint’s allegations insufficient. See id. (explaining that
“the baseline for double damages is not the amount billed by the
provider, but the damages Medicare actually incurred as a result of
the primary plan’s failure to pay” (citing 42 U.S.C.
§ 1395y(b)(3)(A))).
The Complaint also fails to allege facts “demonstrat[ing] that
[a] primary plan has or had a responsibility to make a payment with
respect to” Plaintiff’s medical expenses. 42 U.S.C.
§ 1395y(b)(2)(B)(ii). As noted above, “[o]ne way to demonstrate
such a responsibility is by showing that the primary plan had a
contractual obligation to pay.” MSP Recovery Claims, Series LLC v.
American Fam. Connect Prop. & Cas. Ins. Co., No. 23cv20105, 2023 WL
2536444, at *3 (S.D. Fla. Mar. 16, 2023) (brackets and internal
6(...continued)
§ 1095(e)(1) (“The United States may institute and prosecute legal
proceedings against a third-party payer to enforce a right of the
United States under this section.”). However, even if the
Complaint’s allegations that (A) “Plaintiff is a Medicare recipient
with TRICARE as secondary insurance” (Docket Entry 2 at 11) and (B)
TRICARE produced “bills and billing statements” to Plaintiff (id.
at 6) combined to support the inference that (C) Medicare incurred
expenses, too, given TRICARE’s status “as secondary” to Medicare
(id. at 11 (emphasis added)), the Complaint nonetheless fails to
allege Defendant’s demonstrated responsibility to reimburse
Medicare’s expenses, as explained in the discussion that follows
above.
12
quotation marks omitted). Despite alleging that Defendant
“acknowledged liability and issued partial [p]ayments .. . for the
total loss of [ P]laintiff’s vehicle . . . [and his] rental car
[expenses]” (Docket Entry 2 at 4), the Complaint does not allege
the existence of a settlement agreement that could “demonstrate □□
. . [Defendant’s] responsibility,” 42 U.S.C.
§ 1395y(b) (2) (B) (11), to reimburse Medicare for Plaintiff’s medical
expenses.’ On the contrary, the Complaint attempts to hold
Defendant liable for its “refusal to make a settlement offer”
(Docket Entry 2 at 12 (emphasis added); see also id. at 2 (alleging
“delay and obstruction of settlement”), 5 (alleging that Plaintiff
“submitt[led]” and Defendant “ignored” multiple “written notices for
a settlement instead of litigation”), 6 (alleging existence of
7 The Complaint’s contention that, because Defendant
“acknowledged liability and issued partial payments” for
Plaintiff’s vehicle and rental car expenses (Docket Entry 2 at 4),
“the [instant] dispute pertains solely to damages, not liability”
(id. at 5) represents a legal conclusion which the Court need not
accept at this stage of the proceedings, see Igbal, 556 U.S. at
678. Moreover, aS a general matter, “[Defendant’s] payment of
property damages cannot create an acknowledg[]ment of its liability
for [Plaintiff’s] personal injuries,” Denis v. Liberty Mut. Ins.
Co., 791 F.2d 846, 849 (llth Cir. 1986), nor can it
“demonstrate[ Defendant’s] . . . responsibility,” 42 U.S.C.
§ 1395y(b) (2) (B) (11), to reimburse Medicare for the cost of those
injuries. Likewise, Defendant’s “offer[ of] a settlement of
$3,000” (Docket Entry 2 at 4) cannot suffice “to prove the validity
of the claim [against Defendant] that the [ ] offer was meant to
settle,” Macsherry v. Sparrows Point, LLC, 973 F.3d 212, 224 (4th
Cir. 2020); see also Sharp v. City of Elizabeth City, No. 2:23cv52,
2023 WL 9051270, at *3 (E.D.N.C. Dec. 29, 2023) (refusing to
“consider [a] settlement demand for purposes of determining whether
[the] plaintiff has stated a valid claim”).
13
promises to “provide a settlement offer” which “[Defendant] failed
to honor” (internal quotation marks omitted)), 14 (alleging that
Defendant “withh[eld] settlement”)). That attempt falls short,
however, as “[t]he MSP[A] itself does not impose a duty to pay on
[Defendant but] . . . [i]nstead[ ] presupposes an existing
obligation,” Virginia Mason Mem’l Hosp., 981 F.3d at 684 (internal
quotation marks omitted), which the Complaint does not plead. See
also Fresenius Med. Care Holdings, Inc. v. Brooks Food Grp., Inc.,
Civ. Action No. 3:07cv14, 2007 WL 2480251, at *7-8 (W.D.N.C. Aug.
28, 2007) (explaining that “[t]he MSPA makes it a condition
precedent to reimbursement that there be a ‘demonstrated
responsibility’ to pay for items or services” and that “[t]o hold
otherwise would open a primary insurer to double damages each time
it contests a claim, rather than only when it fails to pay after
responsibility has been established”).
In sum, the Complaint fails to allege payments made by
Medicare and “Defendant[’s demonstrated] responsibility for th[ose]
payments. If and when such a [settlement or] determination is made
. . . [and] Defendant[] fail[s] to reimburse [Medicare for] the
appropriate funds, then the MSPA allows for a private cause of
action for double damages.” Fresenius, 2007 WL 2480251, at *8.
Absent such facts, the Complaint fails to state a claim.8
8 Alternatively, because “[Plaintiff’s] suit remains
contingent upon Defendant[’s] failing to [reimburse Medicare] after
(continued...)
14
II. State-Law Claims
The Complaint pursues claims against Defendant for breach of
the “duty of good faith and fair dealing” (Docket Entry 2 at 5;
accord id. at 12) and “violat[ions of] North Carolina’s Unfair
Claims Settlement Practices Act .. . and the Unfair and Deceptive
Trade Practices Act” (id. at 12; accord id. at 9, 13, 14-15).
Facts supporting jurisdiction must appear in the complaint,
see Pinkley, Inc. v. City of Frederick, 191 F.3d 394, 399 (4th Cir.
1999), and the party asserting federal jurisdiction bears the
burden of “show[ing] that jurisdiction does, in fact, exist,” Davis
v. Pak, 856 F.2d 648, 650 (4th Cir. 1988) (internal quotation marks
omitted). Here, the Complaint invokes (A) the Court’s “original
jurisdiction under 28 U.S.C. § 1331” (Docket Entry 2 at 3),
alleging that “Plaintiff’s [MPSA] claims arise under the laws the
United States” (id.), and (B) the Court’s “supplemental
jurisdiction over Plaintiff’s state law claims” (id.).
8(...continued)
[a demonstration of its responsibility to pay] occurs .. .
[Plaintiff’s] claim is not currently fit for judicial decision
. . . [and] should be dismissed as premature.” Sims, 2021 WL
369675, at *7; see also id. at *5-7, *7 n.8 (dismissing MSPA for
failure to plead both responsibility to pay and failure to
pay/reimburse and noting that a “merits analysis would turn on the
same factors affecting the jurisdictional analysis”); Sullivan,
2011 WL 1231264, at *3 (“[The pllaintiff’s original [c]omplaint
attempts to simultaneously litigate his MSP[A] claim with the
underlying claim. The MSP[A] claim is accordingly premature
. . .”); Mason v. American Tobacco Co., 346 F.3d 36, 43 (2d Cir.
2003) (“[T]he trigger for bringing a[n] MSP[A] claim is not the
pendency of a disputed tort claim, but the established obligation
to pay medical costs... .” (internal quotation marks omitted)).
15
Federal courts possess “original jurisdiction of all civil
actions arising under the Constitution[ and] laws . . . of the
United States,” 28 U.S.C. § 1331. When a court possesses federal
question jurisdiction over a federal claim, “[a] claim that neither
arises from a federal question nor satisfies the requirements for
diversity jurisdiction may nevertheless be entertained in federal
court [via] supplemental jurisdiction under 28 U.S.C. § 1367.”
Mebane v. GKN Driveline N. Am., Inc., 499 F. Supp. 3d 220, 231
(M.D.N.C. 2020). “Under supplemental jurisdiction, ‘[t]he state
and federal claims must derive from a common nucleus of operative
fact’ where a plaintiff ‘would ordinarily be expected to try them
all in one judicial proceeding.’” Id. (quoting United Mine Workers
of Am. v. Gibbs, 383 U.S. 715, 725 (1966)).
Importantly, supplemental jurisdiction constitutes “a doctrine
of discretion,” United Mine Workers, 383 U.S. at 726, in regards to
which “[n]eedless decisions of state law should be avoided,” id.
As such, if “federal claims are dismissed before trial, . . . the
state claims should be dismissed as well.” Id.; see also 28 U.S.C.
§ 1367(c)(3) (“The district courts may decline to exercise
supplemental jurisdiction over a claim . . . [if] the district
court has dismissed all claims over which it has original
jurisdiction[.]”).
Although Plaintiff’s MSPA claim raises a federal question, the
Complaint pursues state-law claims which arise under North Carolina
16
law? and thus do not satisfy federal question jurisdiction.
Therefore, given the foregoing recommendation of dismissal of
Plaintiff’s federal claim, the Court should decline to exercise
supplemental jurisdiction over Plaintiff’s state-law claims. See
Carnegie-Mellon Univ. v. Cohill, 484 U.S. 343, 350 n.7 (1988)
(“[I]n the usual case in which all federal-law claims are
eliminated before trial, the balance of factors to be considered
. . — Judicial economy, convenience, fairness, and comity — will
point toward declining to exercise jurisdiction over the remaining
state-law claims.”).*°
III. Ancillary Motions
In addition to the Application, Complaint, and the motions to
amend resolved in footnote 3 above, this case comes before the
undersigned on Defendant’s Motion to Dismiss (Docket Entry 7)
(“Dismissal Motion”), Defendant’s Motion to Strike Plaintiff’s
9 “North Carolina [law, rather than federal law,] recognizes
a cause of action for a breach of the implied covenant of good
faith and fair dealing,” Nadendla v. WakeMed, 24 F.4th 299, 307
(4th Cir. 2022) (emphasis added), and Plaintiff’s claims for
“[s]tatutory violations under North Carolina law” (Docket Entry 2
at 14) plainly arise under state law.
10 Additionally, diversity of citizenship jurisdiction —
which the Complaint does not invoke (see Docket Entry 2 at 3) —
does not exist for Plaintiff’s state-law claims because the
Complaint fails to allege Defendant’s citizenship (see id. at 2
(alleging only Plaintiff’s status as a “resident of .. . North
Carolina”)). See also MicroPicture Int’l, Inc. v. Kickartz, No.
3:05cv34, 2005 WL 8174556, at *1 (W.D. Va. July 25, 2005) (“[A]
party alleging jurisdiction based on diversity of citizenship
clearly must state the citizenship of all parties involved in the
action.”).
17
Surreply to the Dismissal Motion (Docket Entry 23) (“Motion to
Strike”), and Plaintiff’s Motion for “In Camera Inspection of
Exhibit A” (Docket Entry 21) (“Inspection Motion”), which Plaintiff
attached to his response in opposition the Dismissal Motion (see
Docket Entry 15-1). (See also Docket Entry dated Dec. 10, 2025
(referring Inspection Motion); Docket Entry dated Feb. 19, 2026
(referring Dismissal Motion and Motion to Strike).)
In light of the foregoing recommendation that the Court
dismiss this action, the undersigned (A) will terminate the Motion
to Strike as moot and (B) will recommend that the Court terminate
the Dismissal Motion as moot. Likewise, the Inspection Motion asks
the “Court to conduct an in-camera inspection of [ ] transcribed
audio recordings” (Docket Entry 21 at 1 (emphasis omitted))
submitted with Plaintiff’s response to the Dismissal Motion (see
Docket Entry 15; Docket Entry 15-1). The undersigned has reviewed,
and thus “inspected,” those materials (which appear on the public
docket and generally amount to verified pleadings (see, e.g.,
Docket Entry 15-1 at 2)) in the course of addressing the Dismissal
Motion, Application, and Complaint, and will therefore terminate
the Inspection Motion as moot.
IV. Plaintiff’s Inaccurate Pleadings
Lastly, in recommending dismissal of the instant action, the
undersigned also admonishes Plaintiff for failing to confirm the
accuracy of his pleadings, as required under Federal Rule of Civil
18
Procedure (the “Rules”) 11, and warns Plaintiff that any future
filings containing errant or fabricated citations may result in
sanctions, including orders to pay an opposing party’s reasonable
attorney’s fees. See Fed. R. Civ. P. 1il(c).
Rule 11(b6) provides, in relevant part, that:
By representing to the court a pleading, written motion,
or other paper .. . [an] unrepresented party certifies
that to the best of the persons’s knowledge, information,
and belief, formed after an inquiry reasonable under the
circumstances... the claims, defenses, and other legal
contentions are warranted by existing law or by a
nonfrivolous argument for extending, modifying, or
reversing existing law or for establishing new law.
Fed. R. Civ. P. 11(b) (emphasis added).
“Rule 11 applies to pro se parties as well as parties
represented by counsel.” Walker v. Tillerson, No. 1:17cv732, 2018
WL 1187599, at *9 (M.D.N.C. Mar. 7, 2018), aff’d sub nom. Walker v.
Pompeo, 735 F. App’x 69 (4th Cir. 2018). “All litigants, pro se
and practitioners [alike], must ensure that the legal authority
they cite actually exists and is properly characterized in all
filings.” United States v. Boice, No. 1:20crl167, 2025 WL 2076452,
at *4 n.4 (E.D. Va. June 23, 2025).
Here, the Complaint alone contains at least 11 citations to
cases that either do not exist or do not stand for the legal
propositions that Plaintiff invoked. (See, e.g., Docket Entry 2 at
7, 9, 10, 11, 13 (citing Alford v. Motors Ins. Corp., 104 N.C. App.
537 (1991), Barber v. Perry, 61 N.C. App. 134, 300 S.E.2d 387
(1983), Estate of Harvey v. Kore-Kut, Inc., 364 N.c. 394, 700
19
S.E.2d 231 (2010), Estate of McCall v. United States, 206 F. Supp.
3d 1304 (N.D. Fla. 2016), and Calderon v. GEICO Gen. Ins. Co., No.
1:19cv362 (M.D.N.C. Jan. 26, 2021) — none of which exist at those
citations); id. at 14 (citing “Kusulas v. GEICO” without further
identifying information), 15 (citing “In re. COVIDrelated coverage,
[as a] 2024 NC Supreme Court decision affirming insurer liability
for wrongful denial,” despite a cursory search revealing that the
only potentially relevant North Carolina Supreme Court decision
from that year affirmed dismissal of a plaintiff’s insurance-
related claims, see Cato Corp. v. Zurich Am. Ins. Co., 386 N.C.
667, 676, 909 S.E.2d 144, 151 (2024)).
Similarly, Plaintiff’s subsequent filings contain over a dozen
dubious citations. (See, e.g., Docket Entry 4 at 1, 5, 6, 8
(citing Calderon three times and Estate of McCall five times at
non-existent citations); Docket Entry 5 at 3 (citing United States
v. Harris, No. 1:19cr44, 2021 WL 1089411, at *2 (M.D.N.C. Mar. 22,
2021), and Robinson v. Bowser, No. 1:15cv596, 2015 WL 11571094, at
*1 (M.D.N.C. Mar. 22, 2021), neither of which exists as cited);
Docket Entry 8 at 3 (again citing Harris and Bowser at non-existent
citations); Docket Entry 13 at 2 (citing R.S. v. Board of Dirs. of
Woods Charter Sch. Co., No. 1:16cv119 (M.D.N.C. Apr. 19, 2016), and
stating that “[t]his Court granted a pro se plaintiff’s motion to
amend to add and correct parties early in litigation” in that case,
despite (A) the absence of any docket entry or decision rendered in
20
R.S. v. Board on the date cited, compare id., Docket Entry 5 (Mar.
11, 2016), with id., Docket Entry 6 (May 9, 2016), and (B) the
plaintiff in that case proceeding exclusively with counsel, not pro
se, see id., Docket Entry 2 at 1 (noticing appearance of counsel on
action’s commencement); Docket Entry 26 at 3 (again citing R.S. v.
Board for same unfounded proposition) .)
“The [undersigned] understands that Plaintiff is proceeding
pro se, but that does not allow [him] to flaunt the [ R]Jules and
haphazardly file pleadings without completing any due diligence.”
Lucas v. Scharf, No. 3:25cvl1015, 2026 WL 642917, at *2 (W.D.N.C.
Feb. 25, 2026); see also id. (“Even a cursory Google search would
[have] reveal[ed] that these cases do not exist [as cited].”).
More pointedly, Plaintiff’s submissions foreground an issue that
“[c]lourts across the country are grappling with,” In re Nwaubani,
No. 25-9517, 2026 WL 687194, at *3 (4th Cir. Mar. 11, 2026), in
that citations such as Plaintiff’s to “nonexistent cases .. . are
the frequent posterchild” for “the use of generative [artificial
intelligence] in materials submitted to the court,” id.; see also
Kruglyak v. Home Depot U.S.A., Inc., 774 F. Supp. 3d 767, 770 (W.D.
Va. 2025) (“Tt has become widely known that [artificial
intelligence] platforms sometimes ‘hallucinate,’ meaning they
provide inaccurate responses. In the legal research context, these
hallucinations can include the generation of fictitious case cites
and misrepresentations of case summaries or holdings[.]”).
21
At this juncture, the undersigned need not determine “whether
[Plaintiff] drafted [the foregoing pleadings] with the assistance
of artificial intelligence or not,” Kideckel v. Foreign Nation of
Can., No. 1:24cv2907, 2026 WL 125208, at *3 (D.D.C. Jan. 16, 2026)
(internal quotation marks omitted), appeal filed, 2026 WL 125208
(Jan. 23, 2026), and need only advise that Plaintiff’s citations to
non-existent or wholly inapplicable authorities almost certainly
contravene his obligations under Rule 11. See, e.g., Suiter v. Gm
- Gen. Motors, LLC, No. 5:24cv54, 2026 WL 701683, at *8 (W.D. Va.
Mar. 12, 2026) (“Regardless of whether [the plaintiff] used these
tools, submitting a filing containing fabricated authority . . . is
unacceptable and . . . could also constitute a violation of [Rule]
11, for which the court may impose sanctions.” (internal quotation
marks omitted)). The undersigned therefore warns Plaintiff that
subsequent filings containing such blatant fabrications may result
in sanctions.
CONCLUSION
The Complaint fails to state a claim on which relief may be
granted, and the Court should decline to exercise supplemental
jurisdiction over Plaintiff’s state-law claims. Consistent with
that recommendation, the undersigned has resolved or recommended
resolution of ancillary motions and has warned Plaintiff that
filings containing citations to inaccurate or non-existent
authorities may subject him to sanctions under Rule 11.
22
IT IS THEREFORE ORDERED (A) that the Application (Docket Entry
1) is GRANTED for the sole purpose of entering this Recommendation
and (B) that Plaintiff is WARNED that the Court may impose
sanctions for future failures to confirm the accuracy of his
pleadings and other filings.
IT IS FURTHER ORDERED (A) that Plaintiff’s first Motion to
Amend Caption and Clarify Defendants (Docket Entry 13) is GRANTED
as to the termination of “Government Employees Insurance Company
(GEICO)” and “Geico Insurance Company, LLC” as defendants and (B)
that the Inspection Motion (Docket Entry 21), the Motion to Strike
(Docket Entry 23), and Plaintiff’s second Motion to Amend Caption
and Clarify Defendants (Docket Entry 26) are TERMINATED AS MOOT.
IT IS RECOMMENDED (A) that Plaintiff’s lone federal claim be
dismissed pursuant to 28 U.S.C. § 1915(e)(2)(B)(ii) for failure to
state a claim, as well as that the Court decline to exercise
supplemental jurisdiction over Plaintiff’s state claim(s) under 28
U.S.C. § 1367(c)(3), and (B) that the Dismissal Motion (Docket
Entry 7) be TERMINATED AS MOOT.
This 28th day of April, 2026.
/s/ L. Patrick Auld
L. Patrick Auld
United States Magistrate Judge
23