JULIE PARKE, — v. FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY, — JULIE PARKE, — v. FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY, —

368 F.3d 999, 32 Employee Benefits Cas. (BNA) 2681, 2004 U.S. App. LEXIS 10148
CourtCourt of Appeals for the First Circuit
DecidedMay 24, 2004
Docket03-1294, 03-1437
StatusPublished
Cited by91 cases

This text of 368 F.3d 999 (JULIE PARKE, — v. FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY, — JULIE PARKE, — v. FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY, —) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
JULIE PARKE, — v. FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY, — JULIE PARKE, — v. FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY, —, 368 F.3d 999, 32 Employee Benefits Cas. (BNA) 2681, 2004 U.S. App. LEXIS 10148 (1st Cir. 2004).

Opinion

JOHN R. GIBSON, Circuit Judge.

The district court held that First Reliance Standard Life Insurance Company was liable to Julie Parke under the Employment Retirement Income Security Act of 1974, or ERISA, for prejudgment interest during the period in which Parke’s benefits were wrongfully delayed. The district court denied Parke’s request for certification of a class but awarded her attorney’s fees. 1 Both parties appeal portions of the district court’s order and judgment. First Reliance argues: 1) the district court erred in awarding prejudgment interest to Parke based on First Reliance’s delay in starting payments; 2) the district court erred in awarding Parke the attorney’s fees she incurred during administrative review proceedings related to her claim; and 3) the district court erred in awarding Parke approximately $96,000 in attorney’s fees. For her part, Parke appeals two issues 2 : 1) the district court’s *1003 denial of class certification; and 2) the district court’s decision to allow First Reliance to offset the gross, rather than net, social security benefits Parke received in calculating her benefits. We affirm the district court in all respects except its award of attorney’s fees incurred during Parke’s administrative review proceedings, which we reverse.

FACTS

Julie Parke suffers from insulin-dependent diabetes and a variety of severe diabetic complications. In 1998, these ailments forced her to resign from her position as an account executive with Petry Media Corporation. She subsequently applied for long-term disability benefits from First Reliance Standard Life Insurance Company, which provided such benefits to Petry employees under a group policy. First Reliance denied her claim on November 6, 1998, because it concluded that her job was “sedentary” and could be performed despite her health problems. Parke, with the help of counsel, requested administrative review of this denial on February 3, 1999.

First Reliance reversed its decision on June 4, 1999, and retroactively awarded Parke long-term disability benefits through January 30,1999. However, First Reliance suspended ongoing benefits to Parke because it contended that Parke had not submitted adequate medical records to demonstrate the permanent nature of her disability. Parke filed this action on July 7, 1999, seeking in part to force First Reliance to reinstate her benefits. On October 14, 1999, First Reliance voluntarily reinstated Parke’s benefits, effective retroactively to February 1,1999.

The reinstatement of benefits did not completely resolve the dispute. Parke asserted that she was entitled to interest and attorney’s fees in connection with her efforts to have her benefits resumed. She also claimed that First Reliance had incorrectly calculated an offset under the policy for Parke’s social security benefits. She moved for certification of her complaint as a class action, and both parties filed cross motions for summary judgment. The district court denied all three motions.

Parke’s claims ultimately were tried to the district court. The district court determined that: Parke is entitled to interest during the time her benefits were denied and suspended in violation of First Reliance’s fiduciary duty; First Reliance correctly calculated the social security offset; and Parke is entitled to attorney’s fees and costs. The district court awarded more than $96,000 in attorney’s fees, which included fees incurred by Parke during the administrative proceedings. The parties *1004 appeal most aspects of the district court’s order.

I.

Parke argues that the district court erred by denying her motion for class certification insofar as it sought injunctive relief for other members of the putative class. Parke sought an order enjoining First Reliance from suspending or terminating long-term disability benefits of a claimant until after it receives evidence that the claimant is no longer disabled or until after the claimant unreasonably refuses to provide current evidence of disability. In essence, Parke’s claim is that First Reliance engages in a practice of awarding long-term disability benefits to a claimant, then terminating or suspending those benefits without asking for or receiving evidence that the claimant’s condition has changed.

Parke may sue on behalf of a class only if she meets four threshold requirements: 1) the class is so numerous that joinder of all members is impracticable; 2) there are questions of law or fact common to the class; 3) the claims or defenses of the representative parties are typical of the claims or defenses of the class; and 4) the representative parties will fairly and adequately protect the interests of the class. Fed.R.Civ.P. 23(a) (2003). If these four requirements are met, Parke still must satisfy at least one of the requirements contained in Fed.R.Civ.P. 23(b). The district court denied the motion for class certification because it concluded that Parke could not meet the threshold requirement of typicality. The district court determined that the-Petry Media disability plan permits First Reliance to terminate benefits prior to receiving proof that the claimant’s disability status has changed. Thus, even if First Reliance had breached its duties under the plan in the particular context of Parke’s claim, the propriety of terminating any other claimant’s benefits remains dependent on the facts of the individual case and the terms of any other disability plans under which First Reliance may review claims. 3

We review a district court’s denial of class certification for abuse of discretion. . Owner-Operator Indep. Drivers Ass’n, Inc. v. New Prime, Inc., 339 F.3d 1001, 1011 (8th Cir.2003), cert. denied, — U.S. —, 124 S.Ct. 1878, — L.Ed.2d — (2004). The record shows that the district court did not abuse its discretion by refusing to certify a class for injunctive relief. The Petry Media plan states that “monthly benefits are terminated on the earliest of ... 2) the date the Insured ceases to meet the Eligibility Requirements.” To be eligible for benefits, a claimant must provide medical documentation showing that the claimant is totally disabled. However, the evidence of total disability is not always sufficient to show that the disability is permanent or long-term. Thus, while Parke may be correct in her argument that First Reliance’s termination of benefits before asking for or receiving updated medical records would *1005 often constitute a breach of First Reliance’s obligations, the question of whether a breach occurred remains a case-by-case determination. See Holmes v. Pension Plan of Bethlehem Steel Corp., 213 F.3d 124, 137-38 (3d Cir.2000) (affirming district court’s denial of class certification for class of beneficiaries whose benefits were wrongfully delayed because “the issue of liability itself requires an individualized inquiry into the equities of each claim.”).

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368 F.3d 999, 32 Employee Benefits Cas. (BNA) 2681, 2004 U.S. App. LEXIS 10148, Counsel Stack Legal Research, https://law.counselstack.com/opinion/julie-parke-v-first-reliance-standard-life-insurance-company-julie-ca1-2004.