Aetna Life & Casualty Co. v. LaPierre (In Re LaPierre)

180 B.R. 95, 1994 Bankr. LEXIS 2203, 1994 WL 780886
United States Bankruptcy Court, D. South Carolina·Decided December 30, 1994·No. 19-01151·Published·Cited by 3 cases

Opinion

ORDER

JOHN E. WAITES, Bankruptcy Judge.

THIS MATTER comes before the Court upon an adversarial proceeding filed by Aet-na Life & Casualty Company (“Aetna”) seeking a determination as to whether it is entitled to a recoupment of pre-petition over-payments under a disability insurance policy from post-petition payments to one of the joint debtors, Cecilia E. LaPierre (“La-Pierre”), and if so, what is the amount subject to that recoupment.

In this proceeding, Aetna takes the position that according to the disability insurance policy and related Reimbursement Agreement, it is entitled to reduce the payments made to the defendant because of an award of the Social Security Administration in favor of the defendant on August 28, 1983. Aetna asserts that it did not know of the award until September of 1991, due to the defendant’s failure to disclose the existence of the award.

LaPierre disputes that Aetna was unaware of the award of the Social Security Administration and takes the position that Aetna’s action against her is a set-off rather than a recoupment of the debt and further that any indebtedness she may owe Aetna was previously discharged in her bankruptcy case. Alternatively, LaPierre takes the position that if the debt has not been discharged, that the amount owed to Aetna is in a lesser amount than that claimed by Aetna. La-Pierre also takes the position that the actions of Aetna in reducing post-petition payments are in violation of the stays or injunctions imposed by 11 U.S.C. § 362(a), 524(a) and 727 1 and she is therefore entitled to appropriate damages.

After careful consideration of the evidence; consisting of various letters and memoranda, the Reimbursement Agreement of July 2, 1982, the Social Security Disability Award Certificates, the Aetna Group Disability Policy of February 2, 1978 (“the LTD Policy”), the joint Chapter 7 Petition, Schedules and Statements and the testimony of the witnesses, Cecilia La Pierre and Kathryn Bullock (“Bullock”), an employee of Aetna, the Court makes the following Statement of Facts and Conclusions of Law.

STATEMENT OF FACTS

1. LaPierre was an employee of Polaroid Corporation and was covered by a Group Long Term Disability Insurance Policy (“the LTD Policy”) issued by Aetna for the benefit of the employees of Polaroid Corporation (“Polaroid”).

2. The LTD Policy provides certain set monthly benefits payable to employees in the event of disability. The amount of benefits could be reduced in the event an employee became eligible for Social Security benefits or increased in the event Polaroid funded a higher level of benefits.

3. Section 2 of Article II of the LTD Policy provides in part that “The amount of monthly benefit payable under this policy for a given monthly period of total disability shall be 65% of the employee’s monthly rate of basic earnings if no other income benefits are payable for the given monthly period. If other income benefits are payable for a given monthly period, the amount of monthly benefit payable under this policy for the given monthly period shall be an amount equal to the excess, if any, of (i) 65% of the employee’s monthly rate of basic earnings over (ii) the amount of other income benefits payable for the given monthly period; provided, however, that the amount of any payments under the Federal Social Security Act, or any Canadian Act or Acts of similar purpose, to which the employee’s spouse, children, and dependents are entitled on account of the em *98 ployee’s retirement or disability, shall be considered an ‘other income benefit’ only to the extent that the total of such payments in the given monthly period exceeds 10% of the employee’s monthly rate of basic earnings”.

4. Section 6 of Article VI of the LTD Policy provides in part that “[t]he Insurance Company shall have the right to require as part of the proof of claim satisfaction evidence (1) that the employee, spouse, child, or dependant has made application (and has, within a reasonable length of time following denial of such benefits, made reapplication) for all other income benefits referred to in Section of 2 of Article II, (2) that he has furnished all required proofs of such benefits, (3) that he has not subsequently waived such benefits, and (4) of the amount of all such benefits payable.”

5. Section 8 of Article VI of the LTD Policy provides that “[i]n the event that an employee receives a monthly benefit payment under this policy which is in excess of the monthly benefit payment which should have been made, the Insurance Company shall have the right to recover the amount of such excess from the employee. The Insurance Company may, however, at its option, deduct the amount of such excess from any subsequent monthly benefits payable to the employee”.

6. As contemplated in the LTD Policy, La-Pierre entered into an individual Reimbursement Agreement with Aetna on July 2, 1982, which also provided for reimbursement by the employee if overpaid under the terms of the LTD Policy.

7. LaPierre became disabled and left her employment at Polaroid on or about June 24, 1981, making her eligible for disability payments under the LTD Policy. On May 27, 1982, Aetna advised LaPierre of the approval of her long term disability benefits and informed her of the need to apply for Social Security and if denied, to appeal the denial. Except for the initial letter of June 23, 1982 from Polaroid informing LaPierre that her claim was approved and form letters to the “Long Term Disability Members or Recipients” advising the members that Polaroid had funded a higher level of benefits, all other correspondence submitted to the Court concerning the benefits and payments was between LaPierre, Aetna and their attorneys or representatives.

8. LaPierre began receiving payments under the LTD Policy from Aetna on June 25, 1982. Between June 25, 1982 and December 31, 1986, LaPierre received $39,081.45 representing monthly payments of $721.06. LaPierre received an additional $45,204.42 in payments between January 1, 1987 and September 30, 1991 representing payments of $793.06 per month. Polaroid funded a higher level of benefits effective January 1, 1994 which would result in an approximate payment to LaPierre of $888.23 per month.

9. Aetna reduced the disability payment to LaPierre on April 24, 1992, effective retroactively to October 1, 1991.

10. LaPierre was notified by the Social Security Administration on August 28, 1983 that she was eligible for Social Security benefits retroactive to December of 1981.

11. Aetna was informed by LaPierre in September of 1991 that she was receiving Social Security benefits.

12. Aetna sent correspondence to LaPierre requesting information about her Social Security Award, if any, on July 25,1990, February 6, 1991, June 19, 1991, September 19, 1991, October 4, 1991, January 10, 1992, April 24, 1992 and February 17, 1993.

13. LaPierre filed a joint Chapter 7 petition with her husband Peter D. LaPierre on April 20, 1990. LaPierre was granted a discharge on June 30, 1990.

14. On May 6, 1992, pursuant to Order of this Court, the debtor’s joint Chapter 7 was reopened to add Aetna as an unsecured creditor.

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Aetna Life & Casualty Co. v. LaPierre (In Re LaPierre), 180 B.R. 95, 1994 Bankr. LEXIS 2203, 1994 WL 780886 (S.C. 1994).

180 B.R. 95 (Aetna Life & Casualty Co. v. LaPierre (In Re LaPierre)) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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