Epolito v. Prudential Insurance Co. of America

737 F. Supp. 2d 1364, 2010 U.S. Dist. LEXIS 91010
CourtDistrict Court, M.D. Florida
DecidedSeptember 2, 2010
Docket6:09-cv-00334
StatusPublished
Cited by14 cases

This text of 737 F. Supp. 2d 1364 (Epolito v. Prudential Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Epolito v. Prudential Insurance Co. of America, 737 F. Supp. 2d 1364, 2010 U.S. Dist. LEXIS 91010 (M.D. Fla. 2010).

Opinion

ORDER

MARCIA MORALES HOWARD, District Judge.

THIS CAUSE is before the Court on Plaintiffs Dispositive Motion for Summary Judgment with Incorporated Statement of Undisputed Facts and Memorandum of Law in Support (Doc. No. 25; Epolito’s Motion) filed on December 11, 2009. On February 8, 2010, Defendant The Prudential Insurance Company of America (Prudential) filed a response in opposition to Epolito’s Motion. See Defendant’s Response in Opposition to Plaintiffs Dispositive Motion for Summary Judgment (Doc. No. 36; Prudential’s Response). In addi *1366 tion, Prudential filed a cross-motion for summary judgment on December 11, 2009, see Defendant/Counterclaimant’s Motion for Summary Judgment and Memorandum of Law in Support (Doc. No. 26; Prudential’s Motion), and Plaintiff Patricia Epolito (Epolito) filed her response in opposition to Prudential’s Motion on February 8, 2010, see Plaintiffs Memorandum of Law in Opposition to Defendant’s Motion for Summary Judgment (Doc. No. 37; Epolito’s Response). With Court permission, Prudential filed a reply to Epolito’s Response on March 8, 2010. See Defendant’s Reply Brief in Further Support of Its Motion for Summary Judgment (Doc. No. 40; Prudential’s Reply). Accordingly, the Motions before the Court are ripe for review.

I. Background Facts

Kemper Auto & Home, the personal lines property and casualty insurance business of the Kemper Insurance Companies, an affiliate of Lumbermens Mutual Casualty Company (Lumbermens), hired Patricia Epolito on February 7, 1977. See Prudential’s Motion, Ex 1: Administrative Record (A.R.) at 179-81; 347, 492, 574. As an employee, Epolito was eligible for and enrolled in a pension plan named the Kemper Retirement Plan. See Affidavit of Patricia Epolito 1 (Doc. No. 24; Epolito Affidavit) ¶ 3. On June 28, 2002, Unitrin, Inc. (Unitrin) acquired Kemper Auto & Home through an asset purchase agreement. A.R. at 492, 574. As a result, Epolito received a copy of Unitrin’s new employee manual on December 13, 2002, which included a letter stating: “[wjelcome to Unitrin’s Kemper Auto and Home Group.

Employees of Unitrin’s Kemper Auto and Home Group are employed by Kemper Independence Insurance Company, which is a wholly owned subsidiary of Unitrin, Inc.” Epolito Affidavit ¶ 10; Id., Ex. C. Epolito also received a letter from Unitrin, dated December 18, 2002, offering her a position with Kemper Independence Insurance Company, a Unitrin Company (Kemper Independence/Unitrin). Id. ¶ 19; Id., Ex. D. In addition, the letter requested that Epolito sign an Agreement and Release form consenting to the transfer of her employment record to her “new employer.” Id., Ex. D. Upon acceptance of this offer, the letter informed Epolito that her effective date of employment would be January 1, 2003. Id.

Thereafter, Epolito enrolled in an employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001-1381, and funded through an insurance policy issued by Prudential. Unitrin, Inc. is the Plan’s Contract Holder and “all full-time non-commissioned employees of Kemper Auto and Home Insurance Company” constitute the Covered Class. A.R. at 4. On February 3, 2003, Epolito stopped working due to health complications caused by Graves’ Disease. Id. at 76, 347. She filed a claim for long term disability (LTD) benefits under the Plan and was initially approved to receive benefits in the amount of $3,891.87 per month, effective August 2, 2003. Id. at 62. Near the end of December 2003, Epolito decided to begin withdrawing her pension benefits from the Kemper Retirement Plan as well. See Epolito Affidavit ¶22. 2 Thus, on Febru *1367 ary 1, 2004, Epolito started receiving pension benefits in the amount of $1,864.42 per month. Id., Ex. F. In addition, on December 11, 2003, Epolito filed an application with the Social Security Administration (SSA) for social security disability (SSD) benefits in connection with the disabling effects of her Graves’ Disease and depression. A.R. at 513. Pursuant to Prudential’s request, Epolito signed a Reimbursement Agreement in which she acknowledged that Prudential was entitled to reduce her LTD benefits by the amount she received for her disability under the Social Security Act. See id. at 65, 227. As part of that Agreement, Prudential agreed to “postpone making the reduction of benefits” described above, in return for Epolito’s promise to reimburse Prudential for the payments made to her in excess of the amount to which she would have been entitled under the terms of the Plan, “if any benefits under the Social Security Act are awarded retroactively.” Id. at 227. Although her SSD benefits claim was denied initially and upon reconsideration, ultimately, an Administrative Law Judge approved her claim on November 7, 2006. Id. at 510-19. As a result, Epolito began receiving SSD benefits, including a retroactive award of benefits dating back to July 2003. Id. at 562; 565. The initial amount of her monthly benefit payment was $1,687.20. Id.

On July 26, 2005, Prudential advised Epolito that her LTD benefits would be terminated as of August 1, 2005, because she no longer met the definition of “Total Disability” under the Plan. 3 Id. at 66. After unsuccessfully administratively appealing this determination, Epolito brought a lawsuit challenging Prudential’s decision on July 10, 2006. See generally Epolito v. Prudential Ins. Co. of Am. (Epolito I), 523 F.Supp.2d 1329 (M.D.Fla.2007). In Epolito I, the Court determined that Prudential’s “decision to deny [Epolito] LTD benefits was both wrong and unreasonable,” and directed that Epolito be awarded past due benefits from the benefit termination date. Id. at 1344. The case was then remanded to Prudential for a calculation of Epolito’s LTD benefits. Id.

On remand, Prudential determined that under the terms of the Plan it was entitled to offset the amount of Epolito’s LTD benefits by the amount she was receiving in pension and SSD benefits. 4 A.R. at 467-68. In reaching this conclusion, Prudential relied on a provision in the Plan which provides: “Prudential will deduct from your gross disability payment the following deductible sources of income: ... The amount that you: ... (b) voluntarily elect to receive as retirement or early retirement payments under your Employer’s retirement plan.” Id. at 17-18. The Plan defines the term “Employer” to mean “the Contract Holder, and includes any division, subsidiary or affiliate who is reported to Prudential in writing for inclusion under the Group Contract, provided that Prudential has approved such a request.” Id. at 34.

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Bluebook (online)
737 F. Supp. 2d 1364, 2010 U.S. Dist. LEXIS 91010, Counsel Stack Legal Research, https://law.counselstack.com/opinion/epolito-v-prudential-insurance-co-of-america-flmd-2010.