Hunley v. Hartford Life and Accident Ins. Co.

712 F. Supp. 2d 1271, 2010 U.S. Dist. LEXIS 40701, 2010 WL 1708718
CourtDistrict Court, M.D. Florida
DecidedApril 26, 2010
Docket6:08-cv-02008
StatusPublished

This text of 712 F. Supp. 2d 1271 (Hunley v. Hartford Life and Accident Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hunley v. Hartford Life and Accident Ins. Co., 712 F. Supp. 2d 1271, 2010 U.S. Dist. LEXIS 40701, 2010 WL 1708718 (M.D. Fla. 2010).

Opinion

*1274 ORDER ON DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT

ELIZABETH A. KOVACHEVICH, District Judge.

This cause comes before the Court on Defendant’s Motion for Final Summary Judgment and Plaintiffs Response thereto (Doc. 21 and 27). For the reasons set forth below, Defendant’s Motion for Final Summary Judgment is GRANTED.

PROCEDURAL HISTORY

This action is a claim for relief under the Employee Retirement Income Security Act (hereinafter “ERISA”), 29 U.S.C. § 1001 et. seq. This dispute arises from an employee benefit plan (hereinafter “the Plan”) sponsored by Sara Lee Corporation (hereinafter “Sara Lee”). On October 7, 2008, Plaintiff, Deborah Hunley (hereinafter “Hunley”), filed a Complaint against the Defendant, Hartford Life and Accident Insurance Company (hereinafter “Hartford”), alleging failure and refusal to pay Long-Term Disability (hereinafter “LTD”) benefits under her employee benefit plan. (Dkt. 1). In the Complaint, Hunley contends that she qualifies for LTD benefits, and that Hartford has failed to pay these benefits since May 11, 2007. (Dkt. 1). The Complaint also argues that CNAGLA Group Life Assurance Company (hereinafter “CNAGLA”) is the previous owner of the Plan, and following Hartford’s purchase of CNAGLA, there was no amendment to the Plan granting Hartford discretionary authority to administer claims under the Plan. (Dkt. 1). Hunley’s Complaint requested this court grant LTD benefits from May 11, 2007 through the filing of this lawsuit. (Dkt. 1).

In response to the Complaint, Hartford filed its Answer and Affirmative Defenses on December 1, 2008. (Dkt. 8). Hartford asserts it had discretionary authority to administer the Plan. (Dkt. 8). Hartford also admits that Hunley was approved for benefits and was paid benefits until May 11, 2007. (Dkt. 8). However, Hartford contends Hunley is not entitled to LTD benefits under the plan because she is not “Disabled” as defined in the plan. (Dkt. 8). Hartford argues that Hunley is able to perform the essential duties of “any occupation” as defined in the Plan, and therefore, she is not entitled to LTD under the Plan. (Dkt. 8).

Hartford then petitioned the Court to Amend its Answer and Affirmative Defenses and for Leave to Assert Counterclaim. (Dkt. 14). The Court granted this motion. (Dkt. 15). In its Amended Answer and Affirmative Defenses, Hartford again renewed its claim that it had discretionary authority to administer the Plan. (Dkt. 16). It also renewed its assertion that Hunley is not disabled as defined in the plan, and she is not entitled to LTD since she is able to perform essential duties of “any occupation” for which she was qualified. (Dkt. 16). Furthermore, Hartford filed a Counterclaim alleging recovery for overpayment of benefits. (Dkt. 16). Hartford argued that Hunley received Social Security benefits while also receiving benefits under her Hartford plan. (Dkt. 16). However, Hunley never responded to Hartford’s counterclaim, and this Court entered a default judgment against Hunley on March 25, 2010. (Dkt. 84).

On November 10, 2009, Hartford filed its Motion for Final Summary Judgment. (Dkt. 21). In the motion, Hartford argues that there ai~e no genuine issues of material fact in the Administrative Record, and it is entitled to Summary Judgment as a matter of law because Hunley is not disabled under the Plan since she can perform “any occupation.” (Dkt. 21). In addition, Hartford asserts its determination under the Plan is subject to a deferential *1275 arbitrary and capricious standard of review because it had discretionary authority to administer the Plan. (Dkt. 21) Although Hunley’s plan was originally with CNAGLA, Hartford contends that it purchased 100% of CNAGLA stock and the purchase included all rights and obligations of CNAGLA policies, including the Hunley policy. (Dkt. 21, Exhibit B). Thus, Hartford argues it acquired discretionary authority to administer the Plan. (Dkt. 21, Exhibit B). Alternatively, Hartford argues that even if this Court were to hold it did not have discretionary authority to administer the Plan, it acted as a “plan fiduciary” and, therefore, the discretionary authority to determine Hunley’s benefits under the Plan flowed from its fiduciary capacity. (Dkt. 21). In applying the arbitrary and capricious standard of review, Hartford asserts that there was a reasonable basis for its determination to deny Hunley LTD benefits under the “Occupational Qualifier” definition of the Plan. Hartford asserts that the evidence in the Administrative Record shows Hunley was capable of performing “any occupation” as defined by the Plan because she qualified for several jobs that accommodated her medical restrictions. (Dkt. 21). Hartford also argues that its decision to deny Hunley benefits was not tainted by self-interest since it promptly approved Hunley for benefits under the “Occupational Qualifier” definition of the Plan; it continued to pay benefits until its review was complete; and it granted Hunley’s counsel numerous extensions to submit evidence in support of her appeal. (Dkt. 21) Hartford also renewed its motion for judgment on the overpayment of benefits; however, as stated supra, a default judgment was entered on this issue, and therefore, it will not be addressed any further. (Dkt. 34). In sum, Hartford’s Motion for Final Summary Judgement requests this court apply the arbitrary and capricious standard of review and affirm Hartford’s decision to deny Hunley LTD benefits. (Dkt. 21).

Hunley filed a response to Hartford’s Motion for Final Summary Judgment on December 15, 2009. (Dkt. 27). In her Memorandum in Opposition to Defendant’s Motion for Final Summary Judgment, Hunley argues that Hartford is not entitled to Final Summary Judgment because Hartford’s rejection of her LTD benefits was “wrong” and unreasonable in light of the fact that her medical condition prevents her from performing “any type of work.” (Dkt. 27). Additionally, Hunley contends that Hartford did not have discretionary authority to administer the plan, and therefore, a de novo standard of review applies. (Dkt. 27). Hunley argues that Hartford’s purchase of CNAGLA only proves that they were a successor-in-interest of the Plan not that it has express discretionary authority to administer the Plan. (Dkt. 27). Hunley asserts that under a de novo standard Hartford’s decision to deny Hunley LTD benefits was “wrong.” (Dkt. 27). Hunley argues that the Administrative Record is replete with evidence showing her medical condition impairs her presently and on a permanent basis. (Dkt. 27). Alternatively, Hunley argues that even if this Court finds Hartford had discretionary authority to determine LTD benefits under the Plan, its decision to deny Hunley LTD benefits was arbitrary and capricious because no reasonable basis existed for denying the decision. (Dkt. 27). Hunley asserts there are several doctors’ reports in the Administrative Record showing that her medical condition prevents her from performing “any occupation.” (Dkt. 27). Furthermore, Hunley contends this Court should consider Hartford’s conflict of interest as a factor in making its decision. (Dkt. 27). Hunley argues that Hartford’s position as a professional insurance company offers it incentive to deny claims and, therefore, pres *1276

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Bluebook (online)
712 F. Supp. 2d 1271, 2010 U.S. Dist. LEXIS 40701, 2010 WL 1708718, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hunley-v-hartford-life-and-accident-ins-co-flmd-2010.