Harris v. Provident Life & Accident Insurance

776 F. Supp. 1450, 1991 U.S. Dist. LEXIS 21178, 1991 WL 223126
CourtDistrict Court, D. Oregon
DecidedOctober 4, 1991
DocketCiv. 91-575-FR
StatusPublished
Cited by5 cases

This text of 776 F. Supp. 1450 (Harris v. Provident Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harris v. Provident Life & Accident Insurance, 776 F. Supp. 1450, 1991 U.S. Dist. LEXIS 21178, 1991 WL 223126 (D. Or. 1991).

Opinion

OPINION

FRYE, Judge:

The matter before the court is defendants’ motion for summary judgment (# 5).

Plaintiffs, Lawrence C. Harris, Jr. and Mary Harris (respectively, Harris and M. Harris), bring this action 1) for breach of fiduciary duty and breach of contract against the defendants, Provident Life & Accident Insurance Company (Provident), Service Corporation International (SCI), Lincoln Memorial Park, Inc. (Lincoln), and Carl Chadowski; 2) for misrepresentation against Lincoln and Chadowski; and 3) for misrepresentation against Provident. 1

UNDISPUTED FACTS

Harris and M. Harris are husband and wife. Harris is a former employee of Lincoln. Employees of Lincoln are covered under the SCI Health Plan (the Plan), a self-insured, group health plan sponsored by Lincoln’s parent corporation, SCI. SCI contracts with Provident to perform certain administrative functions of the Plan. SCI is required to assist Provident in determining the eligibility of an employee to receive benefits. Employees of Lincoln are covered under the Plan on the first day of the month following the completion of one full month of service.

*1452 On September 25, 1989, Harris became employed by Lincoln as a salesman of funeral service programs. On October 9, 1989, Harris made his first sale of a funeral services program for Lincoln. On several occasions thereafter, Chadowski, Lincoln’s manager and sales director, told Harris and M. Harris that Harris and his dependents were covered under the Plan as of the date of the first sale that Harris made. Chadowski made these representations 1) with the knowledge that they were false or with reckless or negligent disregard for the truth; and 2) with the intent that Harris and M. Harris would rely upon them. Provident told M. Harris that Plan benefits were available if the employer of Harris confirmed this coverage. In reliance on the representations of Chadowski and Provident, Harris and M. Harris enrolled their son, Kenneth Harris, in an inpatient alcoholism treatment center, thereby incurring $9,208.65 in medical expenses. Thereafter, Provident refused to reimburse Harris and M. Harris for these expenses because, under the Plan document, their coverage did not become effective until the first day of the month after Harris had been employed by Lincoln for one full month.

CONTENTIONS OF THE PARTIES

Defendants move for summary judgment on all claims for relief. Defendants contend that the Employee Retirement Income Security Act of 1974 (ERISA) preempts the state law claims of Harris and M. Harris; and Harris and M. Harris have failed to state a cause of action under ERISA because ERISA does not allow the recovery of monetary damages against a nonfiduci-ary on the basis of a claim arising out of the administration of an employee benefit plan, and Harris and M. Harris have failed to show that any defendant is an ERISA fiduciary.

Harris and M. Harris contend that, at worst, they have an action for either 1) common law claims of misrepresentation or breach of contract; or 2) breach of fiduciary duty under ERISA. Harris and M. Harris contend that their state law claims are not preempted. They also argue that Chadowski and Provident are ERISA fiduciaries and that they breached their fiduciary duties.

APPLICABLE STANDARD

Summary judgment is appropriate where “there is no genuine issue as to any material fact and ... the moving party is entitled to a judgment as a matter of law.” Fed. R.Civ.P. 56(c). The initial burden is on the moving party to point out the absence of any genuine issue of material fact. Once the initial burden is satisfied, the burden shifts to the opponent to demonstrate through the production of probative evidence that there remains an issue of fact to be tried. Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 2552, 91 L.Ed.2d 265 (1986). On a motion for summary judgment, all reasonable doubt as to the existence of a genuine issue of fact should be resolved against the moving party. Hector v. Wiens, 533 F.2d 429, 432 (9th Cir.1976).

ANALYSIS

The intent of Congress in passing ERISA was “ ‘to promote the interests of employees and their beneficiaries in employee benefit plans.’ ” Ingersoll-Rand Co. v. McClendon, — U.S.-,-, 111 S.Ct. 478, 482, 112 L.Ed.2d 474 (1990) (quoting Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 90, 103 S.Ct. 2890, 2896, 77 L.Ed.2d 490 (1983)). ERISA includes a number of safeguards designed both to protect the rights of employees and to prevent abuses by employees. The safeguards designed to protect the rights of employees include the preemption provision of ERISA, 29 U.S.C. § 1144; the civil enforcement provision of ERISA, 29 U.S.C. § 1132(a); and the provision of ERISA which sets forth liability for breach of fiduciary duty, 29 U.S.C. § 1109. See Ingersoll-Rand, 111 S.Ct. at 482.

1. Preemption

The preemption clause of ERISA provides:

Except as provided in subsection (b) of this section, the provisions of this sub- *1453 chapter and subchapter III of this chapter shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in section 1003(a) of this title and not exempt under section 1003(b) of this title.

29 U.S.C. § 1144(a). In formulating this “ ‘deliberately expansive’ language,” Congress rejected “more limited pre-emption language that would have made the clause ‘applicable only to state laws relating to the specific subjects covered by ERISA.’ ” Ingersoll-Rand, — U.S. at-, 111 S.Ct. at 482 (quoting Shaw, 463 U.S. at 98, 103 S.Ct. at 2900). The Supreme Court has, in a series of opinions, directed courts to apply the preemption clause of ERISA expansively. Id.; FMC Corp. v. Holliday, — U.S.-, 111 S.Ct. 403, 112 L.Ed.2d 356 (1990); Metropolitan Life Ins. Co. v. Taylor, 481 U.S. 58, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987); Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 107 S.Ct. 1549, 95 L.Ed.2d 39 (1987).

Underlying the state law claims of Harris and M.

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776 F. Supp. 1450, 1991 U.S. Dist. LEXIS 21178, 1991 WL 223126, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harris-v-provident-life-accident-insurance-ord-1991.