Hulbert v. Hartford Life and Accident Insurance Company

CourtDistrict Court, N.D. California
DecidedAugust 2, 2021
Docket5:20-cv-03687
StatusUnknown

This text of Hulbert v. Hartford Life and Accident Insurance Company (Hulbert v. Hartford Life and Accident Insurance Company) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hulbert v. Hartford Life and Accident Insurance Company, (N.D. Cal. 2021).

Opinion

1 2 3 UNITED STATES DISTRICT COURT 4 NORTHERN DISTRICT OF CALIFORNIA 5 SAN JOSE DIVISION 6 7 CHRISTIAN HULBERT, Case No. 20-cv-03687-BLF

8 Plaintiff, ORDER GRANTING DEFENDANT’S 9 v. MOTION UNDER RULE 52 AND DENYING PLAINTIFF’S MOTION 10 HARTFORD LIFE AND ACCIDENT UNDER RULE 52 INSURANCE COMPANY, 11 Defendant. 12 13 I. INTRODUCTION 14 Plaintiff Christian Hulbert (“Hulbert”) filed this ERISA1 action against Defendant Hartford 15 Life and Accident Insurance Company (“Hartford”) following Hartford’s denial of his claim for 16 long term disability benefits under a group insurance policy that Hartford issued to Hulbert’s 17 former employer, Infinera Corporation (“Infinera”). See Compl., ECF 1. The policy in question is 18 Group Long Term Disability Policy No. GLT681103 (“Disability Policy”), which is one 19 component of Infinera Corporation Employee Health and Welfare Benefits Plan (“the Plan”). AR 20 1376, ECF 28. Infinera is the plan administrator, and Hartford is the insurer. AR 1376, 1442. 21 The Disability Policy outlines what employees must show in order to be deemed “Totally 22 Disabled.” AR 1441. A worker is Totally Disabled when he is “unable to perform with reasonable 23 continuity the Essential Duties necessary to pursue [his Own] Occupation in the usual or 24 customary way” for a period of two years. Id. To continue to receive benefits beyond 24 months, 25 the worker must show that he cannot perform with reasonable continuity in “Any Occupation.” Id. 26 Hulbert left his job on August 15, 2018, after tripping down three stairs and hitting his head, 27 1 resulting in a concussion. AR 1160, 1375. Hartford granted Hulbert short-term disability benefits. 2 AR 175, ECF 27. Hulbert then applied for long-term benefits under the Disability Policy. AR 79. 3 In April 2019, Hartford rejected Hulbert’s long-term disability application, finding that Hulbert 4 did not show he was disabled under the Plan. AR 114. Hulbert appealed this decision the 5 following October, supported by new medical evidence. AR 12. Hartford rejected the appeal in 6 December 2019. AR 84. 7 The parties filed cross motions for judgment pursuant to Federal Rule of Civil Procedure 8 52. See Pl.’s Mot., ECF 30; Def.’s Mot., ECF 32. The Court heard oral arguments on April 22, 9 2021. See Min. Entry, ECF 36. For the reasons discussed below, the Court issues the following 10 findings of fact and conclusions of law and GRANTS Hartford’s Rule 52 motion. The Court 11 DENIES Mr. Hulbert’s Rule 52 motion. 12 II. LEGAL STANDARD 13 Federal Rule of Civil Procedure 52 provides that “[i]n an action tried on the facts without a 14 jury ... the court must find the facts specially and state its conclusions of law separately.” Fed. R. 15 Civ. P. 52(a)(1). “In a Rule 52 motion, as opposed to a Rule 56 motion for summary judgment, the 16 court does not determine whether there is an issue of material fact, but actually decides whether 17 the plaintiff is [entitled to benefits] under the policy.” Prado v. Allied Domecq Spirits and Wine 18 Group Disability Income Policy, 800 F. Supp. 2d 1077, 1094 (N.D. Cal. 2011) (citing Kearney v. 19 Standard Ins. Co., 175 F.3d 1084, 1095 (9th Cir. 1999)). In making that determination, the court 20 must “evaluate the persuasiveness of conflicting testimony and decide which is more likely true” 21 in order to make findings of fact that will be subject to review under a clearly erroneous standard 22 if appealed. Kearney, 175 F.3d at 1095. 23 The parties agree that California Insurance Code § 10110.6 applies to this case. Pl.’s Mot. 24 15. The Court thus must determine, based on the evidence in the administrative record, whether 25 Hulbert carries the burden of showing, by a preponderance of the evidence, that he was disabled 26 under the terms of the Plan, without according deference to Hartford’s denial of claim. Kearney, 27 175 F.3d at 1087-90; Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 963 (9th Cir. 2006); 1 Oster v. Standard Ins. Co., 759 F. Supp. 2d 1172, 1185 (N.D. Cal. 2011). To prevail, Hulbert 2 needs to prove it is “more likely than not” that he was disabled under the terms of the Plan. 3 Armani v. Nw. Mut. Life Ins. Co., 840 F.3d 1159, 1163 (9th Cir. 2016) (standard of proof in de 4 novo ERISA disability claim is preponderance of the evidence); Sanchez v. Monumental Life Ins. 5 Co., 102 F.3d 398, 404 (9th Cir. 1996) (defining “preponderance of the evidence” as “more likely 6 than not”). 7 III. FINDINGS OF FACT 8 9 A. Mr. Hulbert’s Occupation 10 Mr. Hulbert was employed as a Senior Support Technician (DOT No. 032.262-010, 11 Sedentary, SVP - 7) with Infinera from 2013 until 2018. AR 257. This “sedentary” work is not 12 physically demanding. AR 259. Hulbert spent most of the workday sitting, and he was not 13 generally called upon to lift, carry, push, or pull objects. Id. However, this work had some mental 14 rigor. AR 261. The work “require[d] that [Hulbert] be able to correctly analyze, troubleshoot, and 15 evaluate computer network problems in order to quickly resolve problems [sic] issues.” Id. 16 B. The Long-Term Disability Plan 17 While working for Infinera, Mr. Hulbert was enrolled in the Infinera Corporation 18 Employee Health and Welfare Benefits Plan, which is an ERISA employee welfare benefits plan. 19 AR 1442. Infinera is the Plan Administrator of the Plan. Id. Disability benefits under the Plan are 20 insured by Hartford under Group Long Term Disability Policy No. GLT681103 issued by 21 Hartford to Infinera. AR 1376. 22 In order to qualify for long-term benefits, a policyholder must show that he/she is “Totally 23 Disabled” under the language of the Policy. The Disability Policy defines “Total Disability” as: 24

25 Total Disability or Totally Disabled means during the Elimination Period and for the next 2 years, as a result of injury or sickness, you are unable to perform with reasonable 26 continuity the Essential Duties necessary to pursue Your Occupation in the usual or 27 customary way. After that, as a result of injury or sickness you are unable to engage with reasonable continuity in Any Occupation. 1 AR 1441. 2 “Your Occupation” means any job that shares the same “Essential Duties” as the job the 3 policyholder worked when he/she became disabled. AR 1441. “Any Occupation” is any job that 4 the policyholder is qualified for, so long as it has an earning potential greater than either (1) the 5 product of the Indexed Pre-disability Earnings and the Benefit Percentage, or (2) the Maximum 6 Monthly Benefit. AR 1438. 7 The Policy includes a provision for “Mental Illness and Substance Abuse.” AR 1431. If a 8 disability is caused by “Mental Illness” or “Substance Abuse,” benefits are limited, and only 9 payable for 24 months, unless the policyholder is confined to a hospital at the end of the 24-month 10 period. Id. The policy defines “Mental Illness” narrowly, only recognizing illnesses listed in the 11 Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric 12 Association. AR 1439. 13 C. Mr. Hulbert’s Medical Treatment History 14 Mr. Hulbert has reported various symptoms since at least 2014.

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Bluebook (online)
Hulbert v. Hartford Life and Accident Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hulbert-v-hartford-life-and-accident-insurance-company-cand-2021.