Harris v. Hartford Life & Accident Insurance

533 F. Supp. 2d 1202, 2008 WL 401359, 2008 U.S. Dist. LEXIS 10320
CourtDistrict Court, M.D. Alabama
DecidedFebruary 12, 2008
DocketCivil Action 2:07cv508-WHA
StatusPublished

This text of 533 F. Supp. 2d 1202 (Harris v. Hartford Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, M.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harris v. Hartford Life & Accident Insurance, 533 F. Supp. 2d 1202, 2008 WL 401359, 2008 U.S. Dist. LEXIS 10320 (M.D. Ala. 2008).

Opinion

MEMORANDUM OPINION AND ORDER

W. HAROLD ALBRITTON, Senior District Judge.

I. INTRODUCTION

This case is before the court on Hartford Life & Accident Insurance Company’s (“Hartford”) Motion for Summary Judgment (Doc. # 19), filed on November 28, 2007.

The Plaintiff, James Larry Harris (“Harris”), originally filed a Complaint in the Circuit Court of Montgomery County, alleging state law claims. Hartford removed the case to this court on the basis of federal question jurisdiction, stating that Harris’s state law claims were completely preempted by the Employment Retirement Income Security Act (“ERISA”). No motion to remand was filed.

Hartford filed a Motion to Dismiss the state law claims. Harris filed no objection to the Motion after being given an opportunity to do so, and the Motion was granted by this court. The court gave Harris time in which to file an Amended Complaint and Harris timely filed an Amended Complaint bringing an ERISA claim. Hartford now moves for summary judgment as to that claim on the basis of Harris’s failure to exhaust administrative remedies.

II. SUMMARY JUDGMENT STANDARD

Under Rule 56(c) of the Federal Rules of Civil Procedure, summary judgment is proper “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986).

The party asking for summary judgment “always bears the initial responsibility of informing the district court of the basis for its motion, and identifying those portions of the ‘pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any,’ which it believes demonstrate the absence of a genuine issue of material fact.” Id. at 323, 106 S.Ct. 2548. The movant can meet this burden by presenting evidence showing there is no dispute of material fact, or by showing, or pointing out to, the district court that the nonmoving party has failed *1204 to present evidence in support of some element of its case on which it bears the ultimate burden of proof. Id. at 322-324, 106 S.Ct. 2548.

Once the moving party has met its burden, Rule 56(e) “requires the nonmoving party to go beyond the pleadings and by [its] own affidavits, or by the ‘depositions, answers to interrogatories, and admissions on file,’ designate ‘specific facts showing that there is a genuine issue for trial.’ ” Id. at 324, 106 S.Ct. 2548. To avoid summary judgment, the nonmoving party “must do more than show that there is some metaphysical doubt as to the material facts.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986). On the other hand, the evidence of the nonmovant must be believed and all justifiable inferences must be drawn in its favor. See Anderson v. Liberty Lobby, 477 U.S. 242, 255, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).

After the nonmoving party has responded to the motion for summary judgment, the court must grant summary judgment if there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c).

III. FACTS

The submissions of the parties establish the following facts, viewed in a light most favorable to the non-movant:

The Plaintiff, James Larry Harris, suffers from a condition diagnosed as cho-roidal neovascularization which causes blindness. Harris filed for worker’s compensation benefits with his employer and the benefits were denied. According to Harris’s brief, at his employer’s suggestion, Harris filed for disability benefits through insurance coverage with his employer.

Defendant Hartford Life and Accident Company denied disability benefits, stating that the disability was work-related, based on Harris’s representation that his disability related to his occupation as a welder. Hartford advised Harris by letter that he could submit additional information, including a letter of denial of worker’s compensation, and a signed/dated worker’s compensation reimbursement agreement. Defendant’s Exhibit B. Hartford also advised him that he had a right to appeal Hartford’s determination, and that he could do so even if he did not have new information to submit. Id. Hartford further informed him that after his appeal, if Hartford again denied his claim, then he would have a right to bring a civil action under ERISA. Id. Despite being so-advised, it is apparently undisputed that Harris submitted no additional information and did not appeal Hartford’s denial of benefits.

A worker’s compensation case has been filed in state court, that case has been tried, and parties to the action are waiting for a ruling from the court.

IV. DISCUSSION

Hartford has argued that it is entitled to summary judgment because Harris was afforded, and notified of, but did not exhaust, administrative remedies upon the denial of his claim for benefits.

It is clear under Eleventh Circuit law that a plaintiff must exhaust a plan’s administrative remedies before bringing an ERISA suit. Counts v. American General Life and Acc. Ins. Co., 111 F.3d 105, 108 (11th Cir.1997). A district court has the discretion “to excuse the exhaustion requirement when resort to administrative remedies would be futile or the remedy inadequate,” Counts, 111 F.3d at 108, or where a claimant is denied “meaningful access” to the administrative review scheme in place. Perrio v. Southern Bell Tel. & Tel. Co. 209 F.3d 1309, 1315 (11th *1205 Cir.2000). The test for “futility” is not whether the “claims would succeed, but whether the employees could have availed themselves of the grievance procedure.” Mason v. Continental Group, Inc., 763 F.2d 1219, 1224 (11th Cir.1985), cert. denied, 474 U.S. 1087, 106 S.Ct. 863, 88 L.Ed.2d 902 (1986).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Rosemary R. Richards v. Hartford Life & Accident
153 F. App'x 694 (Eleventh Circuit, 2005)
Perrino v. Southern Bell Telephone & Telegraph Co.
209 F.3d 1309 (Eleventh Circuit, 2000)
John Mason v. Continental Group, Inc.
474 U.S. 1087 (Supreme Court, 1986)
Anderson v. Liberty Lobby, Inc.
477 U.S. 242 (Supreme Court, 1986)
John Mason, III v. Continental Group, Inc.
763 F.2d 1219 (Eleventh Circuit, 1985)
Kevin L. Lee v. Blue Cross/blue Shield of Alabama
10 F.3d 1547 (Eleventh Circuit, 1994)

Cite This Page — Counsel Stack

Bluebook (online)
533 F. Supp. 2d 1202, 2008 WL 401359, 2008 U.S. Dist. LEXIS 10320, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harris-v-hartford-life-accident-insurance-almd-2008.