Douglas v. Evans Industries, Inc.

184 F. Supp. 2d 636, 2001 U.S. Dist. LEXIS 22668, 2001 WL 1752501
District Court, E.D. Michigan·Decided December 28, 2001·No. 2:00-cv-75525·Published·Cited by 2 cases

Opinion

OPINION

DUGGAN, District Judge.

Following the denial of her claim for life insurance benefits under her late husband’s life insurance policy, Plaintiff brought this ERISA action against Defendants challenging that denial of benefits. *637 At a hearing held on August 9, 2001, Defendant Union Central Life Insurance Company, the plan administrator, acknowledged that in light of a recent Sixth Circuit case its previous decision denying life insurance benefits to Plaintiff must be reversed. However, the parties disputed the amount of life insurance benefits to which Plaintiff was entitled. The parties agreed to have the Court make a determination on the amount of life insurance benefits owed to Plaintiff, rather than have that issue referred back to the plan administrator. After reviewing supplemental briefs addressing the issue, the Court concluded that based upon the evidence presented, Plaintiff was entitled to life insurance benefits in the amount of $10,000.

On November 16, 2001, Plaintiff filed a motion for attorneys’ fees and interest. For the reasons that follow, the Court concludes that Plaintiff is entitled to an award of attorney fees in the amount of $5,234.50. The Court also concludes that Plaintiff is entitled to interest on her $10,000 Judgment from the date of the denial of Plaintiffs claim, September 30, 1999.

Background

Plaintiff Judith Douglas is the surviving spouse of Charles Douglas (“Mr.Douglas”). For over forty years Mr. Douglas was employed by Robin Products Company (“Robin Products”), currently known as Great Lakes Plastics, which is a division of Defendant Evans Industries, Incorporated (the Court will refer to Defendants Great Lakes Plastics and Evans Industries collectively as “Evans Industries”). As of September 1, 1996, Mr. Douglas was covered by a group term life insurance policy issued to Robins Products by Royal Maccabees Life Insurance Company. Defendant Union Central Life Insurance Company (“Union Central”) is the successor carrier to Royal Maccabees Life Insurance Company. Mr. Douglas designated Plaintiff as his sole beneficiary under the policy.

On May 13, 1998, Mr. Douglas left work after suffering a seizure. Mr. Douglas, who was diagnosed with cancer and began receiving medical treatment, never returned to work. His condition continued to deteriorate and he died on July 14,1999.

On or about September 16, 1999, Plaintiff submitted a written claim for life insurance benefits to both Evans Industries and Union Central. (ComplV 18). On September 30, 1999, Union Central denied Plaintiffs claim for life insurance benefits, finding that no life insurance benefits were available under the policy. (Pl.’s Mot. for Summ. J., Ex. J).

After exhausting her administrative remedies, Plaintiff filed suit against Defendants in Wayne County Circuit Court on December 5, 2000. Defendants removed the action to this Court on December 22, 2000, asserting federal question jurisdiction.

On August 9, 2001, the Court held a hearing regarding a motion for summary judgment 1 filed by Plaintiff and a motion for partial summary judgment filed by Union Central. At that hearing, Union Central continued to deny liability, asserting that it was not the plan administrator. However, after the Court stated that it found Union Central to be the plan administrator, 2 Union Central conceded that its *638 decision denying benefits to Plaintiff must be reversed in light of a recent Sixth Circuit case, Stafford v. First Tennessee Nat’l Bank & Union Central Life Ins. Co., 230 F.3d 1360, 2000 WL 1359631 (6th Cir.2000).

However, that conclusion did not end the matter. While the parties agreed that Plaintiff was entitled to life insurance benefits under her late husband’s policy, the amount of benefits that Plaintiff was entitled to remained in dispute. The Schedule of Benefits for the group term life insurance policy at issue indicated that eligible salaried employees (“class 01”) are entitled to a life insurance benefit of $50,000, while eligible hourly employees (“class 02”) are entitled to a life insurance benefit of only $10,000. {See Schedule of Benefits). Union Central and Evans Industries took the position that Mr. Douglas was an hourly employee, and Plaintiff was therefore entitled to a maximum benefit of $10,000. Plaintiff, on the other hand, asserted that Mr., Douglas was a salaried employee, and that she was therefore entitled to $50,000 in life insurance benefits.

At the hearing, the Court explained that as the plan administrator had determined that no life insurance benefits were available under the policy, the administrator never had occasion to determine the amount of benefits to which Plaintiff would be entitled. See Schadler v. Anthem Life Ins. Co., 147 F.3d 388, 398 (5th Cir.1998). As such, the record before the Court did not contain a determination by the administrator as to the amount of benefits Plaintiff would be entitled to under the policy.

Under the circumstances, the Court initially believed the case should be remanded to the plan administrator for a determination of the amount of benefits to which Plaintiff was entitled and for the development of a full factual record on that issue. 3 See Donnelly, 1999 WL 313896 at *2 (vacating district court’s grant of summary judgment and instructing district court to remand action for eligibility determination by administrator); Cate v. CNA Ins. Co., 965 F.Supp. 1039, 1046 (M.D.Tenn.1997) (remanding action to plan administrator for reconsideration and further development of the record); Schadler, 147 F.3d 388, 398 (vacating judgment of district court and instructing district court to remand case to plan administrator). However, at the hearing Union Central and Plaintiff agreed that such course of action would only delay an ultimate determination of the issue by this Court, as upon remand Union Central would undoubtedly determine that Mr. Douglas was an hourly employee, and Plaintiff would then be back before this Court challenging that determination.

Accordingly, rather than have the benefit amount issue referred back to Union Central for a determination, “the parties agreed to allow the Court to make a factual determination on the issue.” (Pl.’s Supp. Br. at 1). In stipulating to having this Court render a decision on the issue, the parties agreed that evidence outside the administrative record would be presented to the Court in order to enable the Court to make a determination. After viewing all of the evidence presented on the issue, the Court determined that Mr. Douglas was an hourly employee, and Plaintiff was therefore entitled to a benefit of $10,000. (See 11/2/01 Opinion). Accordingly, Plaintiff obtained a Judgment in the amount of $10,000. (See 11/2/01 Judgment).

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Douglas v. Evans Industries, Inc., 184 F. Supp. 2d 636, 2001 U.S. Dist. LEXIS 22668, 2001 WL 1752501 (E.D. Mich. 2001).

184 F. Supp. 2d 636 (Douglas v. Evans Industries, Inc.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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