Ford v. Unum Life Insurance Co. of America

465 F. Supp. 2d 324, 2006 U.S. Dist. LEXIS 88341, 2006 WL 3512146
CourtDistrict Court, D. Delaware
DecidedDecember 6, 2006
DocketCA. 05-118(KAJ)
StatusPublished
Cited by1 cases

This text of 465 F. Supp. 2d 324 (Ford v. Unum Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, D. Delaware primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ford v. Unum Life Insurance Co. of America, 465 F. Supp. 2d 324, 2006 U.S. Dist. LEXIS 88341, 2006 WL 3512146 (D. Del. 2006).

Opinion

MEMORANDUM OPINION

JORDAN, District Judge.

I. INTRODUCTION

This case involves claims of discrimination and breach of contract brought by Stephanie Lynn Ford, a pro se plaintiff, against Unum Life Insurance Company of America (“Unum”). She has filed two actions relating to Unum’s denial of her claim for benefits. Ms. Ford first filed a complaint in the Court of Common Pleas for the State of Delaware, seeking damages for lost wages, pain and suffering, mortgage payments, a lost life insurance policy, and lost “eligibility To [sic] be re-, hired for employment after 17 years of service,” all allegedly resulting from Unum’s denial of requested benefits. (Docket Item [“D.I.”] 2 at 5.) Unum removed that case to this court. (Civ.A. No. 05-cv-105, D.I. 1.) Ms. Ford filed a second complaint in this court, seeking recovery of long-term disability benefits and alleging discrimination on an unspecified basis. (D.I. 2 at 1-3.) Those cases were consolidated. (Civ.A. No. 05-105, D.I. 13.) On March 9, 2006, I granted Unum’s Motion to Dismiss the claims originally filed in the Court of Common Pleas (Civ. A. No. 05-105, D.I. 2), finding that Ms. Ford’s state law claims for breach of contract, negligence, and intentional infliction of emotional distress were preempted under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq., and that the damages she requested were not available under ERISA. (Civ.A. No. 05-105, D.I. 18.)

Ms. Ford now asserts that she was wrongly denied disability benefits under a Long-Term Disability Plan (the “Plan”) 1 , a plan administered by Unum and regulated by ERISA, which denial amounted to discrimination under Title VII or Section 1981 2 and breach of contract. 3 (D.I. 45 at 9.) She also alleges that Unum wrongly terminated a $75,000 life insurance policy on which she has paid premiums. (D.I. 2 at 3, 5; D.I. 45 -at 2, 7.) Unum contends it did not violate Title VII, because it did not employ Ms. Ford, nor did it violate Section 1981. (D.I. 36 at 9-10.) Unum also argues that' Ms. Ford’s breach of contract claim for denial of benefits is preempted by ERISA (id. at 10), and that the appropriate standard for me to employ in re *328 viewing Unum’s decision is an “abuse of discretion” standard. (Id. at 13-18.) Unum further argues that it did not abuse its discretion when rendering its decision against Ford. (Id. at 18-21.) Before me now is a Motion for Summary Judgment filed by Ms. Ford (“Ms. Ford’s Motion”) (D.I. 45), and a Motion for Summary Judgment filed by Unum. (D.I. 36.) Unum’s Motion does not address Ms. Ford’s $75,000 life insurance policy claim. 4 Accordingly, I construe Unum’s Motion for Summary Judgment as a Motion for Partial Summary Judgment (“Defendant’s Motion”). For the reasons that follow, Defendant’s Motion will be granted, and Plaintiffs Motion will be denied.

II. BACKGROUND 5

Ms. Ford is a former employee of Chris-tiana Care Health System, Inc. (“Christia-na”), where she worked as a radiology clerk for seventeen years. (D.I. 45 at 3.) Ms. Ford was a participant of Christiana’s Long-Term Disability Plan, effective January 1, 1999. (Civ. A. No. 05-CV-105, D.I. 4 [“App’x”], Ex. A at 4.) Christiana declared itself “the Plan Administrator and named fiduciary of the Plan, with authority to delegate its duties.” (Id. at 31.) The Plan indicates that it was “funded as an insured plan..., issued by Unum Life Insurance Company of America.” (Id. at 32.) The Plan also states that Unum was its “designee” as a “claims fiduciary.” (Id. at 36.) The Plan gave “the broadest discretion permissible under ERISA and any other applicable laws” to the Plan Administrator and its designee and stated that the Plan Administrator or its designee’s decisions would “constitute final review of [the participant’s] claim by the Plan.” (Id.)

On October 28, 2003, Ms. Ford was involved in a hit-and-run automobile accident. (D.I. 2 at 2.) Her treating physician, Dr. Ross M. Ufberg, examined her on October 30, 2003 (App’x, Ex. B at 122-126), November 10, 2003 (id. at 119-21), December 4, 2003 (id. at 116-18), December 22, 2003 (id. at 113-15), January 20, 2004 (id. at 110-12), and February 23, 2004. (Id. at 107-09.) On each of these occasions, Dr. Ufberg diagnosed that Ms. Ford sustained rib trauma; cervical, thoracic, and lumbosacral strain; bilateral hamstring strain; and right shoulder, arm, and forearm strain. (Id. at 108, 110-11, 113-14, 116-17, 120, 124.) After each examination, he opined that Ms. Ford was “totally incapacitated.” (Id. at 109, 112, 115,118,121,126.) After his last examination, he indicated that Ms. Ford would be incapacitated until March 29, 2004. (Id. at 109.) His recommendations from those visits included participating in outpatient therapy to reduce pain symptoms, taking Motrin for pain and Flexeril for muscle spasms, participating in a home program of stretching exercises, and using a cervical pillow. (Id. at 108, 111, 114, 117, 120, 124-25.)

On February 17, 2004, Ms. Ford filed a long-term disability claim with Unum. (Id. *329 at 16-45.) On March 23, 2004, Sheila Weiss, a registered nurse, reviewed Ms. Ford’s medical records. (Id. at 155-57.) Ms. Weiss observed that Ms. Ford sustained soft tissue injuries from the automobile accident in the form of sprain and strain injuries and had received conservative medical treatment consisting of therapeutic exercises, modalities, and mild medications. (Id. at 157.) She concluded that “[mjedical necessity of activity restrictions beyond 2-4 weeks following the acute soft tissue injury are not supported by the available medical information.” (Id.) She also opined that “[i]n the presence of incapacitating pain one would expect a more aggressive work up including additional diagnostic testing and possible chronic pain management referral.... Pain has been managed with mild medications.” (Id.)

On March 25, 2004, Dr. Aliene Scott, an MD and board certified in occupational medicine, reviewed the medical summary by Sheila Weiss and the records from Dr. Ufberg. (Id. at 158.) Dr. Scott opined that the records were consistent with a strain/sprain injury, and no physical findings or diagnostic test results indicated that she sustained other injuries. (Id.) Dr. Scott was “in agreement with the analysis and conclusions of Sheila Weiss” and found “no basis in the records for the ongoing ‘totally incapacitated’ restrictions.... The non-aggressive treatment and infrequent doctor visit schedule do not support this.” (Id.)

On March 29, 2004, Unum informed Ms.

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Bluebook (online)
465 F. Supp. 2d 324, 2006 U.S. Dist. LEXIS 88341, 2006 WL 3512146, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ford-v-unum-life-insurance-co-of-america-ded-2006.