HOTOP v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA

CourtDistrict Court, D. New Jersey
DecidedJuly 30, 2020
Docket2:18-cv-15312
StatusUnknown

This text of HOTOP v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA (HOTOP v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
HOTOP v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, (D.N.J. 2020).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

ROBERT JOHN HOTOP,

Plaintiff, Civil Action No. 18-15312 v. OPINION THE PRUDENTIAL INSURANCE COMPANY OF AMERICA,

Defendant.

ARLEO, UNITED STATES DISTRICT JUDGE THIS MATTER comes before the Court by way of Defendant Prudential Insurance Company of America’s (“Prudential” or “Defendant”) Motion for Summary Judgment against Plaintiff Robert John Hotop (“Plaintiff” or “Hotop”) under Federal Rule of Civil Procedure 56(c). ECF No. 59. Plaintiff opposes the Motion. ECF No. 64. For the reasons set forth herein, Defendant’s Motion is GRANTED. I. BACKGROUND1 This action arises from a dispute over whether Plaintiff is entitled to $100,000 or $1,000,000 from Prudential due under a life insurance policy. A. Plaintiff’s Life Insurance Policy During His Employment Plaintiff is a former employee of United Parcel Service (“UPS”). Def. SOMF ¶ 23. During his tenure at UPS, Plaintiff received welfare benefits and coverage for his spouse, Patricia Hotop (“Patricia”), through “The UPS Flexible Benefits Plan” (the “Plan”). Id. ¶¶ 1, 24. The Plan 1 Unless otherwise indicated, the Court draws the following facts from Defendant’s Statement of Material Facts (“Def. SOMF”), ECF No. 59.12, Plaintiff’s Supplemental Statement of Material Facts (“Pl. Supp. SOMF”), ECF No. 64.2, that are not in dispute, and the parties’ responses to those submissions, see ECF No. 64.1 (“Pl. Response to Def. SOMF”); ECF No. 65.1 (Def. Response to Pl. Supp. SOMF”). provided life insurance benefits to employees through a group insurance contract between UPS and Prudential, which designated Prudential as the Plan’s claims administrator (the “Group Contract”).2 Id. ¶ 8. The Plan permitted employees to obtain up to $500,000 in supplemental dependents term life insurance (“SDTLI Coverage”) for their spouses. Id. ¶¶ 11-12. While

employed at UPS, Plaintiff received $360,000 in supplemental term life insurance coverage for himself and $100,000 in SDTLI Coverage for Patricia. Id. ¶ 25. B. Plaintiff’s Election to Port His Life Insurance Policy After Retirement On October 1, 2017, Plaintiff retired from UPS. Id. ¶ 26. Upon his retirement, Plaintiff received a notice from UPS that he could continue the insurance coverage he had during his employment by electing one of two options. See id. ¶ 27. The first option—conversion—would allow Plaintiff to convert his supplemental coverage to an individual whole life policy. Id. ¶ 15. The second option—portability—would allow him to continue his coverage at group rates. See id.3 Plaintiff called Prudential on October 30, 2017 to inquire about the difference between [ deleted word] porting and converting his coverage and spoke with a Prudential representative. Id.

¶¶ 29-30. During that call, Plaintiff expressed that he wished to “stick with the portability” option. Id. ¶ 31. On November 13, 2017, Prudential sent Plaintiff a letter, notifying him that he could continue “the same amount of coverage that was in force on the last day of [his] active service” under the portability provision, and that he would move to a Prudential standard portability rate after the first full year of ported coverage. See id. ¶¶ 34-35; see also Declaration of Angle (“Angle

Plaintiff does not dispute UPS and Prudential had a group contract or that the group contract designated Prudential 2as claims administrator. He claims, however, that the Plan provided life insurance benefits through that contract to a ctive employees only. See Pl. Response to Def. SOMF ¶ 8. 3 The parties dispute whether the portability option allowed p a rticipants like Plaintiff to continue coverage under the Plan. See Def SOMF ¶ 15; Pl. Response to Def. SOMF ¶ 15. A fulsome description of this dispute is later described herein. Decl.”) Ex. B at Pru1000, 59.11. The letter also directed Plaintiff to sign and return a “Portability Election form” to Prudential if he wished to continue his coverage “on a portable basis.” Angle Decl. Ex. B at Pru1000. On November 20, 2017, Plaintiff called Prudential again, and he told a Prudential representative, among other things, that he wished to “continue [Patricia’s coverage] which was roughly $100,000.” Def. SOMF 36, 39. Plaintiff executed the Portability Election form, electing to continue his supplemental term life insurance and Patricia’s SDTLI coverage “as a portable participant,” and faxed it to Prudential on December 11, 2017. Id. {| 43-47. On December 19, 2017, Prudential sent Plaintiff an automatically generated billing notice for $2,359.80 in premiums for the period of October 1, 2017 to March 31, 2018. Id. 4] 73; see also Angle Decl. Ex. D (the “Billing Notice’). The Billing Notice also reflected a summary of Plaintiff’ s coverage as follows: The Below Plan Description Reflects Your Coverage(s) as of: January 1, 2018 Plan Description Insurance Amount Optional Life (11) $368,000 ODL-Spouse (10) $1,000,000 On January 2, 2018, after receiving the Billing Notice, which indicated $1,000,000—rather than $100,000—in SDTLI Coverage for Patricia, Plaintiff called Prudential to “make sure what [his] coverage is and what [his] costs are.” See Def. SOMF 4 80. Plaintiff asked the responding Prudential representative, Kyle, to “break down what [his] insurance is and what [his] wife’s insurance is and the costs for the two[.]” Id. When Plaintiff asked specifically about his wife’s coverage, Kyle stated, “it does look like that is set [at] a million dollars. That is $345.00 monthly.” Id. 481. After that phone call, Plaintiff paid the premium amount listed on the Billing Notice. Id. {| 86; see also Pl. Supp. SOMF §] 39. On January 30, 2018, Plaintiff called Prudential and again spoke with Kyle, who confirmed that Plaintiff's coverage “was approved” and was “effective as

of 11/1/2017.” Id. ¶ 88. Prudential later electronically drafted a premium payment from Plaintiff’s bank account for the period of January 2018 to March 2018. Pl. Supp. SOMF ¶ 40. One day before Plaintiff first called Prudential to discuss the rates reflected on the Billing Notice, on January 1, 2018, the Group Contract terminated for active UPS employees. Id. ¶ 20. The parties dispute the effect of this termination on Plaintiff as a UPS retiree.4 See Def. SOMF

¶¶ 21-22; Pl. Response to Def. SOMF ¶¶ 21-22. Prudential claims that despite the Group Contract’s termination, certain retirees like Plaintiff continued coverage under the Plan. See id. Prudential calls these individuals “UPS Continuees.” Id. Plaintiff, however, claims that he and other retirees with ported coverage under the Plain were “transferred to the Prudential Standard Port Plan and separated entirely from the UPS ERISA Plan.” Pl. Response to Def. SOMF ¶¶ 21- 22; see also Pl. Supp. SOMF ¶¶ 7-9. According to Plaintiff, after his policy was transferred to the Prudential Standard Port Plan, “UPS had no involvement, or administrative or financial obligation or burden relating to life insurance Prudential provided to Hotop” and it “made no contributions” to Plaintiff’s policy. Pl. Supp. SOMF ¶¶ 10-12.

C. Plaintiff’s Claim for SDTLI Benefits Patricia Hotop passed away on February 4, 2018. Def. SOMF ¶ 92. On March 6, 2018, Plaintiff called Prudential to make a claim for SDTLI benefits. Id. ¶ 93. During the call, Plaintiff requested to verify the amount of Patricia’s SDTLI coverage, but the Prudential representative to whom he spoke told Plaintiff he could not provide that information. Id. ¶ 95. Plaintiff called Prudential again the next day and made the same request. See id. ¶ 96. Prudential advised him

4 The parties do not dispute that the Plan in effect before the Group Contract’s termination was an ERISA plan. See Def. SOMF ¶ 7. that it could provide “the value amount of the policy” upon its receipt of Plaintiff’s claim form. Id.

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HOTOP v. THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hotop-v-the-prudential-insurance-company-of-america-njd-2020.