Caprio v. Bell Atl Sickness

Court of Appeals for the Third Circuit·Decided July 8, 2004·No. 03-2253·Published

Opinion

Opinions of the United

2004 Decisions States Court of Appeals for the Third Circuit

7-8-2004

Caprio v. Bell Atl Sickness Precedential or Non-Precedential: Precedential

Docket No. 03-2253

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Recommended Citation "Caprio v. Bell Atl Sickness" (2004). 2004 Decisions. Paper 442. http://digitalcommons.law.villanova.edu/thirdcircuit_2004/442

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PRECEDENTIAL Attorney for Appellant

UNITED STATES COURT OF APPEALS Steven D. Spencer FOR THE THIRD CIRCUIT Kay Kyungsun Yu Morgan, Lewis & Bockius 1701 Market Street

No. 03-2253 Philadelphia, Pa. 19103

Attorneys for Appellees

FRANK J. CAPRIO, Verizon Communications Inc. and Bell Atlantic Sickness Appellant and Accident Disability v. Benefit Plan

BELL ATLANTIC SICKNESS Douglas E. Ress AND ACCIDENT PLAN; CORE, INC.; Kaufman, Coren, Ress & Weidman VERIZON, INC. 1525 Locust Street 17th Floor Philadelphia, Pa. 19102

On Appeal from the United States District Court James T. Finnigan for the Eastern District of Pennsylvania Rich May (D.C. Civ. No. 00-cv-06155) 176 Federal Street Honorable R. Barclay Surrick, Boston, MA 02110 District Judge

Attorneys for Appellee CORE, Inc.

Submitted under Third Circuit LAR 34.1(a) June 28, 2004 OPINION OF THE COURT

BEFORE: AMBRO, BECKER, and GREENBERG, Circuit Judges GREENBERG, Circuit Judge.

(Filed: July 8, 2004)

I. INTRODUCTION

William T. Wilson This matter comes on before this MacElree Harvey Ltd court on an appeal brought by Frank J. 17 West Miner Street Caprio from orders entered in the district P.O. Box 660 court on April 1, 2003, granting a motion West Chester, PA 19381 for summary judgment made by

defendants Bell Atlantic Sickness and includes administrative appeal Accident Plan (“Plan”), Verizon, Inc. procedures. Inasmuch as Caprio was (“Verizon”) and CORE, Inc. (“CORE”) awarded benefits based on sickness but (“appellees”), denying Caprio’s motion denied more generous accident benefits, for summary judgment, and entering he seeks in this action to recover accident judgment in favor of the appellees. We benefits. will vacate the orders and will remand the case to the district court for further After certain proceedings in the proceedings. district court that we need not describe, appellees moved for summary judgment, The background of the case is as but the court denied their motion without follows. Caprio, who claimed to be prejudice in a memorandum opinion on disabled and who had been employed by May 31, 2002. The court, largely Bell Atlantic Company of Pennsylvania concerning its opinion with determining and later by its successor, Verizon, its standard of review under Firestone brought this action against appellees Tire & Rubber Co. v. Bruch, 489 U.S. under ERISA, 29 U.S.C. § 1001 et seq., 101, 109 S.Ct. 948 (1989), concluded seeking benefits under a Sickness and that it would examine the denial of Accident Disability Benefit Plan that benefits under an arbitrary and capricious Bell Atlantic and Verizon provided.1 standard of review. The district court Caprio made CORE a defendant because then considered our opinion in Pinto v. it had administrative and fiduciary Reliance Standard Life Insurance Co., responsibilities under the Plan and made 214 F.3d 377, 387 (3d Cir. 2000), determinations regarding claimants’ quoting it for the point that “heightened eligibility for payments, including scrutiny is required when an insurance determinations with respect to Caprio. company is both plan administrator and The Plan makes a distinction between funder.” The district court later in its disabilities attributable to sickness and opinion cited Goldstein v. Johnson & those attributable to accidents and Johnson, 251 F.3d 433, 442 (3d Cir.

2001), concluding from that case that Pinto “does not appear to be limited to 1 plans involving insurance companies.” Even though Caprio sued Verizon, Inc. appellees indicate that there is no The district court noted that such entity and that Verizon appellees had submitted an affidavit Pennsylvania, Inc., a subsidiary of stating that CORE’s compensation was Verizon Communications Inc., was “not tied in any way to the results of the Caprio’s employer. Appellees indicate disability cases that it manages for Bell that Caprio also misnamed the defendant Atlantic.” This representation led the Plan. These mistakes may be rectified on court to observe that, according to the remand by appropriate amendments.

affidavit, “CORE has no conflict of disability benefits. The interest in administering claims under the District Court’s decision Plan.” Nevertheless, inasmuch as the that CORE did not abuse court believed that Caprio was entitled to its discretion in denying answers to interrogatories he had served Caprio’s appeals before it definitively settled on its concerning the standard of review, it denied appellees’ classification of his [short motion without prejudice and ordered term disability] benefits them to answer Caprio’s interrogatories was also correct. “for the limited purpose of determining the appropriate standard of review in this Id. at 11. case.” Not inappropriately, the court did not indicate what its result would be on In fact, notwithstanding the the merits depending on the standard of foregoing statement, the court did not review it selected. indicate, following the appellees’

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