Karen Briggs v. Nat'l Union Fire Ins. Co.

Court of Appeals for the Sixth Circuit·Decided May 23, 2019·No. 18-1828·Unpublished

Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 19a0265n.06

No. 18-1828

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

KAREN BRIGGS, individually and as personal ) FILED representative of the Estate of Christopher A. ) May 23, 2019 Neumann, ) DEBORAH S. HUNT, Clerk )

Plaintiff-Appellant, )

)

v. )

ON APPEAL FROM THE

)

UNITED STATES DISTRICT

NATIONAL UNION FIRE INSURANCE )

COURT FOR THE WESTERN

COMPANY OF PITTSBURGH, PA; )

DISTRICT OF MICHIGAN

INTERPUBLIC GROUP OF COMPANIES, INC. )

WELFARE BENEFIT PLAN; INTERPUBLIC )

GROUP OF COMPANIES, INC., )

)

Defendants-Appellees. )

)

BEFORE: SUHRHEINRICH, BUSH, and READLER, Circuit Judges.

SUHRHEINRICH, Circuit Judge. After Christopher A. Neumann died in a private plane crash, Neumann’s mother and beneficiary, Plaintiff Karen Briggs, claimed benefits under Neumann’s accidental death and dismemberment policy (“AD&D Policy”), issued by Defendant National Union Fire Insurance Company (“NUFIC”). Neumann, an employee of Defendant Interpublic Group of Companies, Inc. (“IPG”), purchased the optional AD&D benefits as part of Defendant IPG’s ERISA Welfare Benefit Plan (“Plan”) (collectively “IPG Defendants”). NUFIC denied Briggs’s claim under an aerial navigation exclusion in the Policy for insureds who die in a private plane crash. She then sued NUFIC and the IPG Defendants under ERISA. 1 The district

1 The Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq.

court dismissed all of Briggs’s claims and entered judgment in favor of all defendants. For the following reasons, we affirm the judgment of the district court.

I. BACKGROUND

A. Facts

IPG offers its employees various voluntary benefits under its Plan, as outlined in the Plan Document. The Plan Document incorporates by reference third-party insurance policies, including NUFIC’s AD&D Policy.

The Plan and AD&D Policy make NUFIC the Claims Administrator of the AD&D Policy.

The Plan also makes NUFIC the named fiduciary for the AD&D Policy. The AD&D Policy requires that notice of claims and proof of loss be furnished to NUFIC, and both documents state that any benefits will be paid by NUFIC.

IPG provided employees with an “overview” of “choices available” in a booklet entitled “Your Benefits Guide 2011.” Choices include AD&D insurance. The Benefits Guide explains that if an employee chooses “coverage under the [AD&D Policy] and [he] or a family member suffers injury or dies as a result of an accident, the Plan will pay” 100% coverage for “Loss of . . . Life.” However, on the bottom of the last page of the Benefits Guide, (and the last of several blank pages), in somewhat fine print, it states:

This Benefits Guide provides a general description of the various benefit plans offered by The Interpublic Group of Companies, Inc. (“the Company”) to its employees and employees of participating units in 2011. This Benefits Guide is provided to assist you in making elections during enrollment for the 2011 plan year.

The information in this Benefits Guide is subject to and qualified by the terms and conditions contained in the official plan documents, including summary plan descriptions, for the plans that provide the benefits listed in this Benefits Guide.

This Benefits Guide is not an official plan document or summary plan description for the benefit plans. Although the Company intends to continue the benefit plans indefinitely, the Company reserves the right to change, amend or terminate any of the benefit plans at any time. For more information about the benefit plans, please contact your local Benefits Administrator.

The Benefits Guide does not address enrollment information, premiums, the claims process, or coverage exclusions under the AD&D Policy The Benefits Guide was the only document distributed to employees about the AD&D Plan.

Neumann was an employee of Weber Shandwick, a division of IPG. He enrolled in NUFIC’s AD&D Policy on October 6, 2011. He selected $1,000,000 in coverage for himself and an additional $600,000 in coverage payable to his dependent, Todd Glenn Lloyd, in the event of an accidental death. His premiums were approximately $19.60/month ($235.20/year). Lloyd was automatically designated as Neumann’s beneficiary under the Policy, and Neumann made his mother, Briggs, the contingent beneficiary.

On January 6, 2014, Neumann and Lloyd died in a private plane crash near Boyne City, Michigan. Lloyd was flying the plane; Neumann was the sole passenger. There is no dispute that Neumann was not a ticketed passenger. Shortly thereafter, Briggs submitted a claim for AD&D benefits to all three defendants through NUFIC’s Claims Administrator, AIG Claims Services of Shawness, Kansas (“AIG”).2 AIG denied Briggs’s claim under the aerial navigation exclusion of the policy and notified Briggs of her right to appeal. The AD&D Policy excludes from coverage any loss caused by “flight in . . . any vehicle used for aerial navigation, other than as a fare-paying passenger on a scheduled or charter flight operated by a scheduled airline whether as a passenger, pilot, operator or crew member” (“aerial navigation exclusion”). Briggs’s administrative appeal was also denied.

2 AIG also assisted Briggs in submitting a claim under a voluntary life insurance policy. Briggs received $1.12 million dollars under that policy as the beneficiary of Neumann and Lloyd.

B. Procedural History

Briggs sued under ERISA. Count I sought benefits from NUFIC under the AD&D Policy pursuant to § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B).3 Count II sought benefits from the Plan pursuant to § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B). Count III requested reformation of the Plan pursuant to § 502(a)(3). Count IV sought equitable relief against NUFIC for breach of fiduciary duty under § 502(a)(3). Count V asked for the same relief against IPG. Count VI requested civil penalties against IPG pursuant to § 502(c)(1)(B) for IPG’s failure to produce a summary plan description when Briggs asked for it on July 23, 2014. The Interpublic Defendants and NUFIC each moved to dismiss the complaint under Fed. R. Civ. P. 12(b)(6).

On August 8, 2017, the district court dismissed Count II against IPG (but not the Plan), holding that IPG was not a proper defendant for Briggs’s § 502(a)(1)(B) benefits claim. The court also dismissed Briggs’s § 502(a)(3) claims for equitable relief against IPG and the Plan (Counts III and V), and NUFIC (Count IV), because Briggs could not show that the IPG Defendants or NUFIC misrepresented the terms of the insurance plan. The court rejected Briggs’s argument that the Benefits Guide, the only document Neumann received, was a misrepresentation because it failed to disclose terms that defeat coverage. The court rejected this argument because explicit This left Briggs’s § 502(a)(1)(B) claim for benefits against the NUFIC and the Plan (Counts I and II).4 On July 6, 2018, the district court issued a final order and judgment on the parties’ cross-motions for summary judgment on the administrative record, holding that the AD&D Policy expressly excluded benefits. The court stated that NUFIC’s and the Plan’s “alleged failure to disclose the full policy provisions d[id] not entitle Briggs to a substantive award for benefits.” The

3 All references are to the First Amended Complaint, referred to simply as the “complaint.”

4 Briggs’s does not appeal this ruling however.

court again rejected Briggs’s argument that she was entitled to equitable relief under § 502(a)(3), explaining that under ERISA, the written terms of the plan documents, here the AD&D Policy, governed any entitlement to benefits. The court also rejected Briggs’s argument that the Benefits Guide qualified as a summary plan description under ERISA. Finally, the court denied civil penalties under § 502(c)(1)(B), 29 U.S.C. § 1132(c)(1)(B).

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Karen Briggs v. Nat'l Union Fire Ins. Co., (6th Cir. 2019).

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