Furleigh v. Allied Group Inc.

281 F. Supp. 2d 952, 31 Employee Benefits Cas. (BNA) 2477, 2003 U.S. Dist. LEXIS 15837, 2003 WL 22080735
CourtDistrict Court, N.D. Iowa
DecidedSeptember 8, 2003
DocketC02-3069-MWB
StatusPublished
Cited by6 cases

This text of 281 F. Supp. 2d 952 (Furleigh v. Allied Group Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Furleigh v. Allied Group Inc., 281 F. Supp. 2d 952, 31 Employee Benefits Cas. (BNA) 2477, 2003 U.S. Dist. LEXIS 15837, 2003 WL 22080735 (N.D. Iowa 2003).

Opinion

MEMORANDUM OPINION AND ORDER REGARDING DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT

BENNETT, Chief Judge.

TABLE OF CONTENTS

I. INTRODUCTION. tO ui Ü1

A. Procedural Background. to cr Ü1

B. Findings of Fact. to oi OÍ

1. Allied’s long term disability plan. tO cn 05

2. Plaintiff Furleigh’s retirement. tO or <1

3. Medical records. ZO oi OO

II. LEGAL ANALYSIS. 9 62

A. Standards For Summary Judgment. 9 62

B. Timeliness of the Action. 9 63

1. Most analogous statute of limitations-963

а. Generally. 964

б. Where the applicable plan contains a contractual period of limitations . ZO 05

i. Where the contractual period of limitations is expressly authorized by state statute. ZO 05 CJI

ii. Where the contractual limitations period in the plan is not expressly authorized by state statute. to 05 <1

2. Accrual of plaintiff Furleigh’s cause of action. to 05 to

C. Timeliness Of Written Proof Of Loss. to -d to

D. Was Plaintiff Totally Disabled At The Time Of His Retirement? ... to ^

1. Standard of Review . to <3 ^

2. Total disability as defined by the Plan. to <! ^

3. Evidence of total disability . zo -d cn

a. Continuously unable to perform substantial and material duties of his occupation. io O 05

i. Incidents occurring during plaintiff Furleigh’s employment . to £r-05

ii. Medical records. CO t> 05

b. Under the regular care of a licensed physician. CO 05

c. Not employed in any occupation. CO £- 05

III. CONCLUSION.979

I. INTRODUCTION

A. Procedural Background

On August 9, 2002, plaintiff John P. Furleigh (“Furleigh”) filed a petition in the Iowa District Court for Cerro Gordo County against defendants Allied Group, Inc. (“Allied”) and Continental Casualty Company (“CNA”) to recover long term disabil *956 ity (“LTD”) benefits under AHied’s long term disability plan (“Plan”), which was funded by a group term disability policy issued by CNA (“Policy”). Specifically, plaintiff Furleigh asserts Iowa common law claims for breach of contract and a declaratory judgment that Allied and CNA are in breach of contract. Defendants Allied and CNA removed the case to this court on September 10, 2002, pursuant to 28 U.S.C. § 1441, correctly asserting that Furleigh’s claim was governed exclusively by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (“ERISA”). (Doc. No. 1). On November 12, 2002, Defendants Allied and CNA filed their answer. (Doc. No. 5). Defendants Allied and CNA filed a motion for summary judgment on June 27, 2003, asserting that there is no genuine issue of any material fact that Furleigh’s claim is barred as untimely under the terms of the Policy, and that plaintiff was not disabled at any time during his employment with Allied. (Doc. No. 15). Furleigh filed a timely resistance to defendants’ motion for summary judgment on July 22, 2008 (Doc. No. 16). On July 23, 2003, this court granted the defendants’ motion for extended time to reply to the plaintiffs resistance, and according to the terms of that order defendants Allied and CNA timely filed a reply on August 5, 2003 (Doc. No. 22). The court turns first to a discussion of the undisputed facts as shown by the record and the parties’ submissions, then to consideration of whether the defendants are entitled to summary judgment.

B. Findings of Fact
1. Allied’s long term disabilitg plan

Plaintiff John P. Furleigh 1 was employed by Allied Group, Inc. as a full-time claims supervisor from June 2, 1975 until July 7, 1995. 2 At the time of his retirement, Furleigh was sixty years old. As an employee of Allied, Furleigh participated in Allied’s long term disability plan (“Plan”), an employee welfare benefit plan as defined by ERISA. This Plan was funded by a group term disability policy issued by CNA (“Policy”), which became effective on March 1, 1992. Defendants’ Appendix in Support of Summary Judgment (“Defendants’ Appendix”), Doc. No. 15 at 0087. 3 The Policy was effective through June 30, 1998. Furleigh was furnished with a copy of the summary plan description (“SPD”) on September 12, 1992, which described, among other things, eligibility requirements for long term disability (“LTD”) benefits under the Plan. Defendants’ Appendix, Doc. No. 15 at 0026. The SPD’s definition of “total disability” is as follows:

“Total Disability” means that, during the Elimination Period and Your Occupation Period, You, because of Injury or Sickness, are:
1. continuously unable to perform the substantial and material duties of Your regular occupation;
2. under the regular care of a licensed physician other than Yourself; and
*957 3. not gainfully employed in any occupation for which You are or become qualified by education, training, or experience.

Defendants’ Appendix, Doc. No. 15 at 0015. “Elimination Period” is defined further as “the length of time you must be disabled before you are eligible to begin receiving [benefits].” Defendants’ Appendix, Doc. No. 15 at 0008. The SPD provides for an Elimination Period of 180 days, and an Occupation Period of 24 months. Defendants’ Appendix, Doc. No. 15 at 0011. Under the terms of the SPD, benefits under the Plan terminate on the earliest of the following dates:

1. the date the policy is terminated;
2. the premium due date if ALLIED fails to pay the required premium for you, except for an inadvertent error; or
3. the date You
a.

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281 F. Supp. 2d 952, 31 Employee Benefits Cas. (BNA) 2477, 2003 U.S. Dist. LEXIS 15837, 2003 WL 22080735, Counsel Stack Legal Research, https://law.counselstack.com/opinion/furleigh-v-allied-group-inc-iand-2003.