DeBold v. Liberty Life Assurance Company of Boston

CourtDistrict Court, D. Massachusetts
DecidedJune 28, 2021
Docket1:20-cv-11802
StatusUnknown

This text of DeBold v. Liberty Life Assurance Company of Boston (DeBold v. Liberty Life Assurance Company of Boston) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
DeBold v. Liberty Life Assurance Company of Boston, (D. Mass. 2021).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS

* JAMI DEBOLD, * * Plaintiff, * * v. * Civil Action No. 20-cv-11802-ADB * LIBERTY LIFE ASSURANCE COMPANY * OF BOSTON, et al., * * Defendants. * *

MEMORANDUM AND ORDER

BURROUGHS, D.J.

Plaintiff Jami DeBold brings this action against Defendants Liberty Life Assurance Company of Boston (“Liberty Life”), Liberty Mutual Insurance Company (“Liberty Mutual”), the Wachovia Corporation Long Term Disability Plan (the “Wachovia Plan”), Lincoln Financial Group (“Lincoln”), and Wells Fargo & Company (“Wells Fargo,” and together with Liberty Life, Liberty Mutual, the Wachovia Plan, and Lincoln, “Defendants”), alleging a violation of the Employee Retirement Income Security Act of 1974 (“ERISA”).1 [ECF No. 10 (“SAC”)].2 Currently before the Court are Defendants’ motion to dismiss, [ECF No. 14], Defendants’ motion to strike, [ECF No. 25], and Ms. DeBold’s motion for leave to file another amended

1 Liberty Life is the current claims administrator for the Wachovia Plan. See [SAC ¶ 13]. Liberty Life and Liberty Mutual were both part of the Liberty Mutual Group until Liberty Life was sold to Lincoln in 2018. [Id. ¶¶ 4–5]. Seemingly, Liberty Mutual’s only connection to this suit is that it used to be Liberty Life’s sister corporation, and Lincoln’s only connection to this suit is that it is Liberty Life’s parent corporation. 2 Although the operative complaint is titled “Second Amended Complaint,” it is, in fact, Ms. DeBold’s first amended complaint. Nevertheless, for ease of reference, the Court will refer to it as the Second Amended Complaint (“SAC”). complaint, [ECF No. 30-1]. For the reasons set forth below, Defendants’ motions are GRANTED, and Ms. DeBold’s motion is DENIED. I. BACKGROUND A. Factual Background

For purposes of this Order, the facts are drawn from the SAC and interpreted in the light most favorable to Ms. DeBold. See Ocasio-Hernández v. Fortuño-Burset, 640 F.3d 1, 7 (1st Cir. 2011). As it must, the Court “accept[s] the truth of all well-pleaded facts and draw[s] all reasonable inferences therefrom.” Grajales v. P.R. Ports Auth., 682 F.3d 40, 44 (1st Cir. 2012). Additionally, the Court may consider “documents the authenticity of which are not disputed by the parties; . . . official public records; . . . documents central to [Ms. DeBold’s] claim; [and/or ] documents sufficiently referred to in the [SAC].” Watterson v. Page, 987 F.2d 1, 3 (1st Cir. 1993). Ms. DeBold is a participant in the Wachovia Plan. The plan was originally established by First Union Corporation (“First Union”) and called the First Union Long Term Disability Plan

(the “First Union Plan”). [SAC ¶ 14]. In September 2001, First Union merged with Wachovia Corporation (“Wachovia”), and the post-merger entity used the name Wachovia. See [ECF No. 16-3 at 50]. On January 1, 2002, in light of the merger, the First Union Plan was renamed the Wachovia Plan. See [id.]. Pursuant to the Wachovia Plan, the “Plan Administrator” shall have the exclusive right and the sole discretionary authority to interpret the terms and provisions of the Plan and to resolve all questions arising thereunder, including, without limitation, the authority to determine eligibility for Benefits and the right to resolve and remedy ambiguities, inconsistencies or omissions in the Plan, and, subject to [the “Denial of Claim” procedures outlined in] Section 4.7, such action shall be conclusive. [Id. at 29]. “Plan Administrator” is defined as “the person or committee appointed by the Employer to administer the Plan, or in the absence of such appointment, the Employer.” [Id. at 17]. “Employer,” in turn, means “First Union Company . . . and any successor thereto that adopts the Plan.” [Id. at 16]. Because First Union merged with Wachovia, which was eventually acquired by Wells Fargo, see [SAC ¶¶ 16, 18–19], Wells Fargo is the current Plan Administrator, and therefore has exclusive discretionary authority with respect to the Wachovia Plan. The

Wachovia Plan permits Wells Fargo to appoint a third-party “Claims Administrator” to provide “third party administrative services under the Plan.” [ECF No. 16-3 at 14]. Liberty Life is the appointed “Claims Administrator.” [SAC ¶ 20]. The Wachovia Plan establishes a three-step internal claim review process. First, the Claims Administrator reviews the claim and makes an initial determination. [ECF No. 16-3 at 29 (“The Claims Administrator shall review claims for benefits, including claims resulting after the termination of the Participant’s benefits, and respond thereto within a reasonable time after receiving the claim.”)]. Next, assuming the claim is denied, the claimant may request a “full and fair review of the claim by the Claims Administrator.” [Id.]. Finally, assuming the Claims Administrator upholds the denial upon review, the claimant may request that the Plan

Administrator, or its designee, review the claim denial. [Id. at 30]. Only after exhausting these internal appeals may a claimant initiate a civil action. [Id.]. On or about December 30, 2001, an accident rendered Ms. DeBold a quadriplegic. [SAC ¶ 15]. At some point following her injury, Ms. DeBold submitted a claim for long term disability benefits.3 See [SAC ¶ 16; ECF No. 16-1 at 2]. On July 9, 2002, her claim was

3 It is unclear when exactly Ms. DeBold made her claim. Although she alleges that “First Union’s long term disability plan paid [her] $4,782.24 in monthly benefits until First Union’s merger with Wachovia in 2001,” the merger, which occurred in September 2001, pre-dated her December 2001 injury. Further, according to the letter approving her long term disability claim, which explicitly references the Wachovia Plan (as opposed to the First Union Plan), she did not begin receiving benefits until June 2002. [ECF No. 16-1 at 3 (noting an effective date of June 29, 2002)]. approved, see [ECF No. 16-1 at 2], and she began receiving monthly long term disability payments.4 In or about October 2018, her monthly payment decreased by $797.04. [SAC ¶ 24]. The decrease in benefits resulted from her decision to “roll over” a lump sum of roughly $106,000 from her Wells Fargo Cash Balance Fund pension account to her individual retirement account (“IRA”).5 [Id. ¶¶ 25–26; ECF No. 16-2 at 2–3 (October 18, 2018 letter from Liberty

Life to Ms. DeBold informing her of the reduction in benefits); ECF No. 16-3 at 86–91]. Liberty Life took the position that the “rollover” transaction constituted income from another source (in this case, benefits from a retirement account), which required a decrease in Ms. DeBold’s disability benefits under the terms of the plan.6 [See ECF No. 16-2 at 2–3]. In November 2018, Ms. DeBold, believing this change to be improper under the plan’s provisions, appealed the reduction, arguing that a direct rollover into her IRA should not have resulted in any change to her benefits because she did not directly receive any money as a result of the transfer. [SAC ¶¶ 27–28]. Liberty Life denied her appeal in December 2018. [Id. ¶ 29;

4 In the SAC, Ms. DeBold alleges that she initially received $4,782.24 per month. [SAC ¶ 16]. The claim approval letter, however, lists her gross monthly benefits as $3,957.47. [ECF No. 16-1 at 3]. 5 Ms. DeBold alleges that Liberty Mutual, as opposed to Liberty Life, initiated the reduction. [SAC ¶ 25]. The letter concerning the decrease in benefits, [ECF No. 16-2], is written on Lincoln letterhead but the body of the letter states that Liberty Life is responsible for managing benefits.

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