Kaufman v. Unum Life Insurance Co. of America

834 F. Supp. 2d 1186, 52 Employee Benefits Cas. (BNA) 1631, 2011 WL 2923698, 2011 U.S. Dist. LEXIS 78481
CourtDistrict Court, D. Nevada
DecidedJuly 18, 2011
DocketNo. 2:06-CV-00621-ECR-LRL
StatusPublished

This text of 834 F. Supp. 2d 1186 (Kaufman v. Unum Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, D. Nevada primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kaufman v. Unum Life Insurance Co. of America, 834 F. Supp. 2d 1186, 52 Employee Benefits Cas. (BNA) 1631, 2011 WL 2923698, 2011 U.S. Dist. LEXIS 78481 (D. Nev. 2011).

Opinion

[1189]*1189 Order

EDWARD C. REED, JR., District Judge.

This action arises out of a dispute over an ERISA plan providing long-term disability benefits. Now pending are a motion for summary judgment (# 55) filed by Defendant, and a cross-motion for summary judgment (# 64) filed by Plaintiff. The motions are ripe, and we now rule on them.

I. Factual and Procedural Background

Plaintiff Joseph A. Kaufman, M.D. (“Kaufman”) worked as a cardiologist until 1998, when he suffered orthopedic and neurological injuries which have prevented him from working as a cardiologist. (Second Am. Compl. ¶ 9(# 18).) Since the injuries, Kaufman has worked in an administrative position. (Id.) Kaufman was insured under a long-term disability benefits plan (“the Plan”) issued by Defendant Unum Life Insurance Company of America (“Unum”). (Id. ¶6-8.) The Plan is an employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 (“ERISA”). (D’s Mot. for Summary Judgment at 2(# 55).) Kaufman submitted a claim to Unum for long-term disability benefits. (Second Am. Compl. ¶ 10(# 18).) Unum determined that Kaufman was eligible for benefits, with certain reductions pertaining to his current earnings. (D’s Mot. for Summary Judgment at 2(# 55).) Unum terminated all benefit payments when Kaufman’s income reached eighty percent of Kaufman’s pre-disability income. (Id.) Unum also determined that there had been an overpayment of benefits due to errors in Kaufman’s reported income. (Id.) Kaufman disputes that there was any overpayment, and claims that his benefits should never have been reduced by his post-disability income under the terms of the long-term disability plan issued by Unum. (Second Am. Compl. ¶ 11(# 18).)

On April 13, 2006, Kaufman sued Unum in Clark County, Nevada. On May 18, 2006, Unum removed (# 1) the action from the Clark County Nevada District Court to the United States District Court for the District of Nevada. On May 11, 2007, Kaufman filed an amended complaint (# 11), along with the Cardiovascular Center of Southern Nevada Long Term Disability Plan as an additional plaintiff. On May 25, 2007, Unum filed its answer (# 12) to the amended complaint (# 11), with counterclaims for equitable restitution and unjust enrichment for the amount of the allegedly overpaid benefits. On September 14, 2007, Kaufman filed his second amended complaint (# 18), along with a stipulation that all claims of the Cardiovascular Center of Southern Nevada Long Term Disability Plan were being dismissed with prejudice. On October 4, 2007, Unum filed its answer (# 21) to the second amended complaint (# 18).

On September 10, 2010, Unum filed its motion for summary judgment (# 55). On November 5, 2010, Kaufman filed his response and cross-motion for summary judgment (## 63, 64) to Unum’s motion for summary judgment (# 55). On December 3, 2010, Unum filed its reply (# 67) in support of its motion for summary judgment (# 55) and response (# 68) to the cross-motion for summary judgment (# 64). On December 17, 2010, Kaufman filed a reply (# 69) in support of his cross-motion for summary judgment (# 64). On January 31, 2011, Unum filed a notice of supplemental authority (# 70) relating to its motion for summary judgment (# 55). On February 3, 2011, Kaufman filed his response (# 71) to Unum’s notice of supplemental authority (# 70). On July 5, 2011, Kaufman filed a notice of supplemental authority (#74). On July 7, 2011, a [1190]*1190hearing was held on the motion for summary judgment (# 55) and the cross-motion for summary judgment (# 64).

II. Standard of Review

A. Legal Standard for Summary Judgment

Summary judgment allows courts to avoid unnecessary trials where no material factual dispute exists. N.W. Motorcycle Ass’n v. U.S. Dep’t of Agric., 18 F.3d 1468, 1471 (9th Cir.1994). The court must view the evidence and the inferences arising therefrom in the light most favorable to the nonmoving party, Bagdadi v. Nazar, 84 F.3d 1194, 1197 (9th Cir.1996), and should award summary judgment where no genuine issues of material fact remain in dispute and the moving party is entitled to judgment as a matter of law. Fed. R.Civ.P. 56(c). Judgment as a matter of law is appropriate where there is no legally sufficient evidentiary basis for a reasonable jury to find for the nonmoving party. Fed.R.CivP. 50(a). Where reasonable minds could differ on the material facts at issue, however, summary judgment should not be granted. Warren v. City of Carlsbad, 58 F.3d 439, 441 (9th Cir.1995), cert. denied, 516 U.S. 1171, 116 S.Ct. 1261, 134 L.Ed.2d 209 (1996).

The moving party bears the burden of informing the court of the basis for its motion, together with evidence demonstrating the absence of any genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). Once the moving party has met its burden, the party opposing the motion may not rest upon mere allegations or denials in the pleadings, but must set forth specific facts showing that there exists a genuine issue for trial. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). Although the parties may submit evidence in an inadmissible form — namely, depositions, admissions, interrogatory answers, and affidavits — only evidence which might be admissible at trial may be considered by a trial court in ruling on a motion for summary judgment. Fed.R.Civ.P. 56(c); Beyene v. Coleman Sec. Servs., Inc., 854 F.2d 1179, 1181 (9th Cir.1988).

In deciding whether to grant summary judgment, a court must take three necessary steps: (1) it must determine whether a fact is material; (2) it must determine whether there exists a genuine issue for the trier of fact, as determined by the documents submitted to the court; and (3) it must consider that evidence in light of the appropriate standard of proof. Anderson, 477 U.S. at 248, 106 S.Ct. 2505. Summary judgment is not proper if material factual issues exist for trial. B.C. v. Plumas Unified Sch. Dist., 192 F.3d 1260, 1264 (9th Cir.1999). “As to materiality, only disputes over facts that might affect the outcome of the suit under the governing law will properly preclude the entry of summary judgment.” Anderson, 477 U.S. at 248, 106 S.Ct. 2505. Disputes over irrelevant or unnecessary facts should not be considered. Id. Where there is a complete failure of proof on an essential element of the nonmoving party’s case, all other facts become immaterial, and the moving party is entitled to judgment as a matter of law. Celotex, 477 U.S. at 323, 106 S.Ct. 2548. Summary judgment is not a disfavored procedural shortcut, but rather an integral part of the federal rules as a whole. Id.

B. Standard of Review for Cases Arising Under ERISA

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Conkright v. Frommert
559 U.S. 506 (Supreme Court, 2010)
Cooperative Benefit Administrators, Inc. v. Ogden
367 F.3d 323 (Fifth Circuit, 2004)
Anderson v. Liberty Lobby, Inc.
477 U.S. 242 (Supreme Court, 1986)
Firestone Tire & Rubber Co. v. Bruch
489 U.S. 101 (Supreme Court, 1989)
Great-West Life & Annuity Insurance v. Knudson
534 U.S. 204 (Supreme Court, 2002)
Sereboff v. Mid Atlantic Medical Services, Inc.
547 U.S. 356 (Supreme Court, 2006)
Metropolitan Life Insurance v. Glenn
554 U.S. 105 (Supreme Court, 2008)
Randle v. Crawford
604 F.3d 1047 (Ninth Circuit, 2010)
Salomaa v. Honda Long Term Disability Plan
642 F.3d 666 (Ninth Circuit, 2011)
Jennifer Venters v. City of Delphi and Larry Ives
123 F.3d 956 (Seventh Circuit, 1997)
Abatie v. Alta Health & Life Ins. Co.
458 F.3d 955 (Ninth Circuit, 2006)
Blankenship v. Liberty Life Assur. Co. of Boston
486 F.3d 620 (Ninth Circuit, 2007)

Cite This Page — Counsel Stack

Bluebook (online)
834 F. Supp. 2d 1186, 52 Employee Benefits Cas. (BNA) 1631, 2011 WL 2923698, 2011 U.S. Dist. LEXIS 78481, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kaufman-v-unum-life-insurance-co-of-america-nvd-2011.