Jason Rappaport v. Guardian Life Insurance Company of America

CourtDistrict Court, S.D. New York
DecidedSeptember 22, 2025
Docket1:22-cv-08100
StatusUnknown

This text of Jason Rappaport v. Guardian Life Insurance Company of America (Jason Rappaport v. Guardian Life Insurance Company of America) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jason Rappaport v. Guardian Life Insurance Company of America, (S.D.N.Y. 2025).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK JASON RAPPAPORT, Plaintiff, Case No. 1:22-cv-08100 (JLR) -against- OPINION AND ORDER GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, Defendant. JENNIFER L. ROCHON, United States District Judge: This litigation arises from a dispute between Plaintiff Jason Rappaport (“Rappaport”), the beneficiary of a long-term disability (“LTD”) benefits plan (the “Plan”), and Defendant Guardian Life Insurance Company of America (“Guardian”) about whether Rappaport’s LTD benefits were improperly terminated in January 2021, when Guardian informed Rappaport he no longer qualified for benefits because he was capable of earning more than the maximum permitted under the Plan. Following the denial of his administrative appeal to Guardian, Rappaport brought this suit seeking recovery of unpaid LTD benefits under section 502(a)(1)(B) of the Employment Retirement Income Security Act (ERISA) of 1974, 29 U.S.C. § 1132(a)(1)(B); reformation of the plan so that “insured earnings” would include his K-1 earnings under section 502(a)(3), id. § 1132(a)(3); and attorneys’ fees and costs under section 502(g)(1), id. § 1132(g)(1). Dkt. 1 (“Compl.”) ¶¶ 114-141; see also Dkt. 31 (“AC”). Guardian asserted counterclaims for recovery of overpayment and set off. Dkt. 99. Following summary judgment, Rappaport’s claims and Guardian’s counterclaim for set off remained. See Rappaport v. Guardian Life Ins. Co. of Am., No. 22-cv-08100 (JLR), 2024 WL 4872736, at *17 (S.D.N.Y. Nov. 22, 2024) (Rappaport I). The Court held a first bench trial on a stipulated record on April 1, 2025, and found that the Plan’s insured-earnings definition included Rappaport’s K-1 earnings and that, in the alternative, Rappaport was entitled to reformation of the plan to include K-1 earnings in the insured-earnings definition. See generally Rappaport v. Guardian Life Ins. Co. of Am., 782 F. Supp. 3d 109 (S.D.N.Y. 2025) (Rappaport II). The parties asked the Court to remand to Guardian so that it could determine Rappaport’s LTD benefits in accordance with the Court’s

finding and determine if any set off was appropriate. Id. at 130. Following the remand, the parties informed the Court that they could not reach an agreement as to whether there had been an overpayment (or underpayment) of LTD benefits. Dkts. 161, 162. Guardian claimed that it was entitled to a set off in the amount of $100,297.72 in benefits as of January 22, 2021, while Rappaport argued that set off was inappropriate and instead claimed that he was owed $17,000 in unpaid benefits up until January 22, 2021. Dkt. 170 (“Pl. Br.”) at 2; Dkt. 161 at 1. The parties identified three outstanding areas of disagreement: (1) how Guardian should have calculated Rappaport’s insured earnings as of his date of disability in 2015; (2) whether Guardian properly indexed Rappaport’s insured earnings each year; and (3) whether Guardian made errors calculating

benefits in specific months. Dkt. 162 at 1. The Court permitted briefing and additional submissions with respect to these issues and held a second bench trial on September 3, 2025. Dkt. 165. No witnesses were presented, and the parties again asked the Court to decide the matter on a stipulated administrative record and oral argument. Tr. at 42:18-25. In the meantime, Rappaport moved for attorneys’ fees and costs based on the first bench trial, Dkt. 150, and to strike a report submitted by Guardian in connection with the second bench trial, Dkt. 176. Those motions are fully briefed. For the following reasons, the Court concludes that Guardian’s calculations on remand were largely correct, and that there was an overpayment of $97,297.72 prior to January 22, 2021, the date on which Guardian terminated Rappaport’s LTD benefits. Therefore, the Court finds that Guardian is entitled to a set off in the amount of $97,297.72 against any future LTD benefits paid to Rappaport. In addition, the Court DENIES Rappaport’s motion to strike and GRANTS in PART his motion for attorneys’ fees and costs.

BENEFITS CALCULATIONS PRIOR TO JANUARY 22, 2021 I. BACKGROUND1 Rappaport receives LTD coverage from a Guardian insurance policy obtained through his previous employer, Industrial Credit of Canada d/b/a/ ICC Mortgage Services (“ICC”). Stip. ¶¶ 1, 5-7, 10-11. When ICC applied for the LTD policy in 2005, it reported the earnings of its employees through a census report. App’x 5590, 5598. ICC’s 2005 submission for Rappaport included both his W-2 wages and K-1 income from the previous calendar year. See Rappaport II, 782 F. Supp. 3d at 123 & n.4; App’x 5598. On July 14, 2015, Rappaport began working part time due to severe symptoms from polycythemia vera, a debilitating form of leukemia. Rappaport II, 782 F. Supp. 3d at 115; see also Stip. ¶ 27; App’x 298. On August 17, 2015, Rappaport informed Guardian that he was

unable to work full time and had reduced his work hours. Stip. ¶ 27. Rappaport applied for LTD benefits on September 15, 2015. Stip. ¶ 28. On September 21, 2016, Guardian informed Rappaport that it had determined that LTD benefits were payable and calculated his insured earnings, as defined by the Plan, as $18,333.33 per month. Stip. ¶¶ 29-30; see App’x 1066.

1 Where necessary, the Court cites to the administrative record and joint stipulation of facts submitted in connection with the April 2025 bench trial. Citations to “App’x” refer to the administrative record, Dkts. 118 to 123; “Stip.” to the parties’ stipulated facts, Dkt. 112-1; and “Tr.” to the bench trial transcript from September 3, 2025. Guardian began paying Rappaport the maximum LTD benefit of $10,000 per month, effective October 13, 2015, and paid that maximum monthly benefit through August 2020. Stip. ¶¶ 31- 32; see App’x 1066. On August 11, 2020, Guardian informed Rappaport that it was terminating his LTD benefits because it had not received ongoing proof of claim, namely, forms from his medical provider. Stip. ¶ 61; App’x 2662-66. After Rappaport submitted medical forms and his 2020

earnings, Stip. ¶¶ 64-69, Guardian informed Rappaport on January 22, 2021, that it had determined he no longer qualified for disability payments because, as of January 1, 2019, he was “capable of earning more than the maximum allowed while disabled,” that is, “greater than 80% of [his] indexed insured earnings.” Stip. ¶ 72; App’x 2854-55. Guardian also stated that it determined that it had overpaid Rappaport by $326,889.05 based on its recalculation of his earnings while disabled and requested reimbursement of that amount. App’x 2855. The parties then proceeded through the administrative appeals process, and Rappaport ultimately filed this ERISA action against Guardian on September 22, 2022. See generally Compl. He sought recovery of unpaid LTD benefits under section 502(a)(1)(B) of ERISA, 29 U.S.C. § 1132(a)(1)(B); reformation of the Plan under section 502(a)(3) so that “insured

earnings” would include bonuses and commissions, id. § 1132(a)(3); and attorneys’ fees and costs under section 502(g)(1), id. § 1132(g)(1). Compl. ¶¶ 114-141. Following a remand for Guardian to engage in further review of underwriting documentation, and after discovery, the parties cross-moved for partial summary judgment on January 5, 2024. Dkts. 74, 75, 76, 81. The Court denied Guardian’s motion for partial summary judgment, and granted Rappaport’s cross-motion for partial summary judgment in part and denied it in part. See generally Rappaport I, 2024 WL 4872736. As relevant here, the Court held that a de novo standard applied and that Rappaport’s reformation claim in Count II was not time barred. See id. at *5-6, *13-14.

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Jason Rappaport v. Guardian Life Insurance Company of America, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jason-rappaport-v-guardian-life-insurance-company-of-america-nysd-2025.