Continental Casualty Co. v. York (In Re York)

205 B.R. 759, 1997 U.S. Dist. LEXIS 2777, 1997 WL 109480
CourtDistrict Court, E.D. North Carolina
DecidedMarch 5, 1997
Docket5:96-cv-00879
StatusPublished
Cited by12 cases

This text of 205 B.R. 759 (Continental Casualty Co. v. York (In Re York)) is published on Counsel Stack Legal Research, covering District Court, E.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Continental Casualty Co. v. York (In Re York), 205 B.R. 759, 1997 U.S. Dist. LEXIS 2777, 1997 WL 109480 (E.D.N.C. 1997).

Opinion

ORDER

MALCOLM J. HOWARD, District Judge.

This matter is before the court on appeal from an order of the United States Bankruptcy Court for the Eastern District of North Carolina (“Bankruptcy Court”) denying appellants’ motion for summary judgment and granting sua sponte summary judgment for the appellee on two issues. A hearing was conducted on August 15, 1996, by Bankruptcy Judge J. Rich Leonard, and the order was entered on September 17, 1996. The parties have thoroughly briefed the appeal to this court, and the matter is now ripe for adjudication.

STATEMENT OF THE CASE

On January 26, 1970, Susan York (‘Work”) was hired by Knoll International, Inc. (“Knoll”), where she remained employed for 20 years until she became disabled on March 17, 1990. Although originally labeled a “major affective disorder,” York’s illness is defined in her affidavit as chronic fatigue syndrome, involving depression. When York became disabled, she worked in the position of Senior Buyer, and was earning approximately $34,000 per year.

On January 1, 1989, Knoll established the Knoll International, Inc. Long Term Disability Plan (the “Plan”), to provide disability benefits to its employees. As an employee, *761 York was a beneficiary under the Plan, and she became entitled to receive benefits under the Plan on September 15, 1990. Benefits under the Plan were provided pursuant to a group policy written by Continental Casualty Company (“Continental”). Under the Plan, the maximum monthly benefit is 60% of the beneficiary’s salary, which is reduced by the amount of any disability benefits paid or payable under the Social Security Act.

During the period that the Plan covered York for her disability, York also filed for Social Security disability benefits. Continental claims that it offered York the choice between two benefit options while York waited for her Social Security payments. Under one option, York would receive the entire 60% of her salary without any reduction for Social Security benefits she would receive. Under this option, York would be required to reimburse Continental for any overpayment in a lump sum taken from any Social Security money she received. Under the other option, York would receive 60% of her salary less the disability amount to which she was entitled under the Social Security Act.

Affidavits of three Continental employees support Continental’s proposition that York was fully aware of the consequence of selecting the first of these options when she made her election. A Senior Claims Representative, Darla Chamberalin, testified by affidavit that York’s options were fully explained to her by letter dated September 3,1991, which stated:

If you request us ... to advance full benefits while you go through the Social Security application and appeal process, it is very possible that an overpayment will occur. It is important that you notify us immediately upon receipt of the award so that we can recalculate your benefits and determine the amount of overpayment. Any monies you receive from Social Security should be set aside until we notify you of the amount of the overpayment. When we have notified you of the full amount of the overpayment, full reimbursement of same should be made within three weeks.

Aff. of Darla Chamberlain at 2; Order, Continental Casualty Co. v. York, Sept. 17, 1996, at 3.

Continental paid York her maximum benefit of $1,721.65 per month, or $41,310.60 total, while her Social Security claim was pending. In February 1993, York received a lump sum Social Security award in the amount of $1,040 per month retroactive to 1990. This Social Security payment resulted in an overpayment of disability benefits paid to York in the amount of $22,325.33. A letter dated March 8 from Claim Specialist Laura Wheeley informed York that any retroactive benefits received from Social Security should be utilized to reimburse Continental for the advanced benefits extended to York during the pendency of her Social Security claim. PI. Br. on Appeal to Dist. Ct. at 8-9. Neither party disputes that York has never reimbursed Continental for the overpayment; indeed, York admitted that she used the money to pay living expenses and to buy a fishing boat to enable her fiance to supplement their income.

York claims that she enrolled in a disability plan in 1985 which was written by Confederation Life Insurance Company, and she was never given notice of any change to the Continental plan which took effect in 1989. York claims that despite her repeated requests for evidence documenting that she was given notice of the 1989 change, Continental and Knoll have failed to produce such evidence. In essence, York urges that her understanding of her disability coverage under the Plan explains her failure to reimburse Continental.

Continental’s plan limits coverage for disabilities caused by mental or emotional disorders to 24 months. York alleges she was unaware of the 24-month limitation on benefits for mental disorders until she was given notice in August 1992 that her benefits would be terminated. York’s affidavit states, in part:

At the time I began receiving the Knoll disability benefit payments in September, 1990 it was my understanding that these benefits would continue until age sixty-five (65) or my complete recovery. There was no mention of any limitation for the nature of my disability at the time I began to receive benefits or of the possibility of an integration clause requiring reimburse *762 ment to Knoll for any Social Security proceeds I might later receive. Up until my benefits were cancelled in 1992 I was never advised of any possible exclusion based on the nature of my illness.

Aff. of Susan York, ¶ 5.

York claims that she was first made aware of aware of her obligation to reimburse Continental when

[i]n early September, 1991 I received a letter ... requesting that I apply for Social Security disability benefits.... I was advised at that time that should the Social Security award exceed the benefits received under the Knoll plan I would be responsible for reimbursing Knoll for the excess out of those benefits. Based on my understanding that my disability benefits would be ongoing I agreed to the reimbursement arrangement.

Id. ¶ 6. York also avers that since she had been receiving disability benefits under the Plan for roughly a year, her financial situation required her to continue to receive the maximum possible benefits at that time. Due to York’s understanding that her disability benefits would be ongoing until age 65, she agreed to reimburse Continental. Id.

Continental and the Plan filed suit in the United States District Court for the Eastern District of North Carolina to recover the overpayment to the defendant. However, the action was stayed as a result of York filing a petition in bankruptcy. York eventually conceded liability on this debt in the amount sought by Continental, and on March 11, 1996, the stay was lifted to allow the District Court to enter judgment. Therefore, the only issues before the Bankruptcy Court concerned the nondischargeability of the debt pursuant to § 523(a) of the Bankruptcy Code.

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Bluebook (online)
205 B.R. 759, 1997 U.S. Dist. LEXIS 2777, 1997 WL 109480, Counsel Stack Legal Research, https://law.counselstack.com/opinion/continental-casualty-co-v-york-in-re-york-nced-1997.