Carroll v. United of Omaha Life Insurance

378 F. Supp. 2d 741, 2005 U.S. Dist. LEXIS 19145, 2005 WL 1667659
CourtDistrict Court, E.D. Louisiana
DecidedJune 17, 2005
DocketCIV.A. 03-0569
StatusPublished
Cited by3 cases

This text of 378 F. Supp. 2d 741 (Carroll v. United of Omaha Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carroll v. United of Omaha Life Insurance, 378 F. Supp. 2d 741, 2005 U.S. Dist. LEXIS 19145, 2005 WL 1667659 (E.D. La. 2005).

Opinion

ORDER AND REASONS

LEMMON, District Judge.

IT IS ORDERED that defendant ConA-gra Foods, Inc.’s motion for summary judgment (Document 34) is GRANTED.

Defendant United of Omaha Life Insurance Company’s motion in limine and motion for summary judgment (Documents 38 and 43) are DENIED.

Plaintiff Isabele J. Carroll’s motion for summary judgment (Document 45) is GRANTED.

The court finds that United of Omaha abused its discretion in calculating the benefits due to Jimmy A. Carroll’s beneficiary under ConAgra’s ERISA basic benefits coverage, and the policy is ambiguous on the calculation of supplemental benefits. The benefits due are $117,000.00 in basic benefits, and $175,000.00 in supplemental benefits, plus interest, less a credit to United of Omaha for $142,000.00 previously paid. Additionally, plaintiffs request for attorney’s fees is GRANTED, and this case is referred to the magistrate judge for a determination of the appropriate amount of fees to be awarded.

A. Background.

Effective January 1, 2000, defendant ConAgra established an ERISA benefits plan for its employees, which plan was insured by United of Omaha. The Summary Plan Description (SPD), in a section entitled “Highlights of Plan Details,” states the following with regard to the plan’s life insurance benefits:

Basie Life Insurance Benefit Death benefit equal to two times your annual base salary (rounded up to the next $1,000) paid to your beneficiary; minimum $50,0000 up to a maximum of $1,000,000
Supplemental Life Insurance Benefit Death benefit equal to *744 one, two or three times your annual salary plus prior year’s commissions and incentives (rounded up to the next $1,000) paid to your beneficiary, up to a maximum of $1,000,000. The guaranteed issue amount is $500,000. 1

These benefits were also explained later in the SPD:

Life Insurance For You
The company provides you with Basic Life Insurance equal to two times your annual base salary at no cost to you, up to a maximum benefit of $1,000,000. To determine the benefit amount, multiply your base salary by two and round that amount up to the next higher $1,000. Regardless of the amount of your salary, the minimum benefit amount is $50,000. See the Glossary of Terms for the definition of base salary. Your benefit adjusts automatically as your salary changes.
For additional term life insurance protection, you may purchase Supplemental Life Insurance equal to one, two or three times your salary (which includes your current base salary plus the prior calendar year’s commissions and incentives, if any) up to the guarantee issue limit of $500,000. You must provide proof of good health to purchase life insurance under the circumstances listed below.
A Your Supplemental Life benefit amount exceeds $500,000
A You increase your coverage amount more than one level during the annual enrollment period.
Your maximum supplemental life insurance cannot exceed $1,000,000. To determine the benefit amount, multiply your base salary (and the prior year’s commissions and incentives) by one, two or three depending on the level you select and round that amount up to the next higher $1,000. The premiums you pay are based on your age and are deducted from your pay on an after-tax basis. As with Basic Life Insurance, your Supplemental Life benefit adjusts automatically as your salary changes. 2

Additionally, the SPD’s “Glossary of Terms” provides:

Base salary is your annual pay. For commissioned employees, salary equals base salary plus commissions and incentives for the previous calendar year. For commissioned employees with less than one year of service, the life insurance benefit is $50,000. For hourly employees, base salary equals the hourly rate times the number of hours per week worked, or 2,080 hours per year. When determining Basic Life and Basic AD & D benefits, base salary equals your annual pay. When determining Supplemental Life and Supplemental AD & D benefits, base salary equals your annual pay plus commissions and incentives for the prior year. 3

Decedent Jimmy A. Carroll was a ConA-gra employee since 1989. Prior to October 2001, Carroll’s compensation from ConA-gra consisted of a $58,000.00 annual salary. Beginning on October 1, 2001, ConAgra changed the manner in which certain of its employees were compensated, and Carroll began to receive an annual salary of $19,278.00, plus a 13% commission on his sales. During the 2001 calendar year, *745 Carroll received $11,292.86 in bonuses and commissions-, and $46,833.20 in salary, or a total of $58,126.06. 4

Carroll died on March 6, 2002. On May 1, 2002, Toni Fetter at United of Omaha initially calculated the amount of Carroll’s basic life insurance benefits as $39,000.00 by multiplying Carroll’s “annual salary on last date at work” by two ($19,278.00 X 2 = $38,556.00, rounded up to $39,000.00). Fetter calculated the amount of supplemental benefits as $92,000.00, reaching this figure by multiplying Carroll’s salary at date of death, plus his 2001 commissions, by three ($19,278.00 + 11,292.86 = $30,577.86; $30,577.86 x 3 = $91,712.58, rounded up to $92,000.00). Later that day, Shirley Blaney, a ConAgra employee, instructed Fetter that “the Basic Minimum amount is $50,000.00. That is the difference of $11,000.00 that you are stating for the difference.” United of Omaha therefore calculated Carroll’s total benefit to be $142,000.00, representing $50,000.00 due as the basic benefit and $92,000.00 due as the supplemental benefit. On May 3, 2002, United of Omaha issued two drafts totaling $142,000.00 to Mrs. Carroll.

Plaintiff argues that the amount of basic benefits should have been $116,252.12 (Carroll’s total 2001 salary plus commissions and incentives X 2), and the amount of supplemental benefits should have been $174,378.18 (Carroll’s 2001 salary plus commissions and incentives X 3), rounded up to a total of $292,000.00.

B. Analysis.

1. United of Omaha’s Motion in Li-mine (Document 38).

Relying on Vega v. National Life Ins. Serv., Inc., 188 F.3d 287 (5th Cir.1999) (en banc), United of Omaha argues that the court’s analysis of whether the plan administrator acted properly is limited to consideration of the administrative record before the administrator, and that the court may not consider evidence outside of that record such as depositions. Vega explained:

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378 F. Supp. 2d 741, 2005 U.S. Dist. LEXIS 19145, 2005 WL 1667659, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carroll-v-united-of-omaha-life-insurance-laed-2005.