Long Term Disability Plan of Hoffman-La Roche, Inc. v. Hiler (In Re Hiler)

99 B.R. 238, 1989 Bankr. LEXIS 575, 1989 WL 40105
CourtUnited States Bankruptcy Court, D. New Jersey
DecidedApril 10, 1989
Docket19-12124
StatusPublished
Cited by33 cases

This text of 99 B.R. 238 (Long Term Disability Plan of Hoffman-La Roche, Inc. v. Hiler (In Re Hiler)) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Long Term Disability Plan of Hoffman-La Roche, Inc. v. Hiler (In Re Hiler), 99 B.R. 238, 1989 Bankr. LEXIS 575, 1989 WL 40105 (N.J. 1989).

Opinion

OPINION

VINCENT J. COMMISA, Chief Judge.

This matter comes before the Court in the context of an adversary proceeding brought by the Long Term Disability Plan of Hoffman-LaRoche (“the Plan” or “the Plaintiff”) seeking, inter alia, a determination that the Plan has a valid right of recoupment against the Debtor, not subject to the automatic stay, and that the indebtedness of the Debtor to the Plan be declared nondischargeable. The Court now considers the Plaintiff’s Motion for Summary Judgment on these issues. 1 This Opinion shall constitute the Court’s Findings of Fact and Conclusions of Law pursuant to Bankruptcy Rule 7052.

The Debtor, George Hiler, (“Hiler”), is a beneficiary under the Plan, an employee benefit plan created pursuant to the Em *240 ployee Retirement Income Security Act of 1974 (“ERISA”). On or about February 2, 1981, Hiler became “totally disabled,” as that term is defined in the Plan, and thus became entitled to disability benefits from the Plan.

According to the provisions of the Plan, covered members are entitled to receive sixty per cent (60%) of their basic monthly income (“Gross Disability Income”) for the duration of qualified periods of disability. However, the Plan does not provide that the Plan itself is solely responsible for the obligation to pay the Gross Disability Income; rather, the Plan is designed to ensure that the beneficiary receives an amount equal to the Gross Disability Income, with contributions from all possible sources being considered. The other sources include, inter alia, Social Security disability benefits. Thus, the Gross Disability Income is reduced by the sum of the other benefits received to arrive at the “Net Benefits” payable.

Until a covered member’s entitlement to Social Security disability benefits is finally determined, an estimated amount is used for the calculation of Net Benefits payable under the Plan. Upon receipt of a final determination, the amount paid as Net Benefits up to that point is adjusted to reflect the difference between the estimated amount of Social Security disability benefits and the actual amount of the award. Hiler’s Gross Disability Income, in the amount of $1225.50, was effective February 2, 1982. The estimated amount of Social Security disability benefits attributed to Hiler was $593.00 per month. Thus, after deduction of this amount, the Plan paid the debtor monthly Net Benefits in the amount of $632.50.

On May 10, 1982, before he had received a final determination from Social Security, and before he began receiving any Social Security Disability payments, Hiler requested that the Plan stop deducting the amount of the estimated Social Security disability benefits from his Gross Disability Income. Although the Plan granted this request, it was stipulated that there would be no change with regard to the effect of a favorable decision from Social Security. Therefore, if Hiler were to receive Social Security disability benefits in the future, the entire amount of the award would be deducted from his Gross Disability Income. In return, Hiler agreed to repay the Plan any and all benefits he would receive from Social Security in the event of a favorable decision, and agreed to notify the Plan of any subsequent Social Security determinations. Hiler and the Plan administrators memorialized the same in reimbursement agreements dated September 21, 1982 and April 29, 1983.

Hiler proceeded to collect the Gross Disability Income, in the monthly amount of $1225.50, without deductions. The Plan Administration, on several occasions, reminded the debtor of his agreement to repay, and demanded that he submit Social Security status reports. Hiler made a third application to Social Security in March of 1984. In May of that same year, the Debt- or received a notice from Social Security advising him that he had met half of the requirements for eligibility and that a favorable decision was contingent upon his meeting the second half of the requirements. Hiler forwarded a copy of said notice to the Plan Administration to inform them that he was waiting for yet a second notice in July of 1984. Hiler met the second half of the requirements and received a favorable decision which was effective in December, 1986. The award was for $636.00 per month retroactive to March, 1983. Hiler never notified the Plan of this award. Since the Plan was never notified, it continued to pay Hiler his Gross Disability Income of $1225.50 without deductions, and he continued to accept and cash the checks.

The Plan learned of Hiler’s award in September of 1987, when it received notice of the same directly from the Social Security Administration. An immediate recalculation of Hiler’s monthly payments was performed by the Plan to adjust Hiler’s Gross Disability Income payment to reflect his monthly Social Security Disability award of $636.00. The Plan then advised Hiler of the adjustment and requested repayment of $34,980.00, the sum of all the *241 amounts Hiler had received from Social Security which had not been deducted by the Plan.

Upon Hiler’s failure to repay the Elan any part of the amount owed, in October of 1987, the Plan began to recoup the overpayment balance due out of Hiler’s monthly Net Benefits at the rate of $589.50 per month. In effect, the Plan was no longer sending Hiler a check, but rather was applying the Net Benefits towards Hiler’s debt. These actions, taken in an effort to recoup the amount due, were expressly allowed under the terms of the Plan.

On April 28, 1988 (“Filing Date”) Hiler filed a voluntary petition in bankruptcy under Chapter 7 of the Bankruptcy Code. Since the filing date, the Plan has continued to deduct the overpayment balance due from the Net Benefits which would otherwise be payable to Hiler under the Plan. The Plan, the plaintiff herein, contends that it has a valid right of recoupment not subject to the automatic stay provisions of 11 U.S.C. § 362. The plaintiff, in its motion for summary judgment, seeks declaratory relief affirming the validity of its position since it is continuing in the exercise of its express right of recoupment under the Plan. The debtor, in his responding papers, contends that the plaintiff should be estopped from exercising that right, based on his allegation that Hoffman-LaRoche, Inc.’s conduct in compelling the debtor to return to work when he was still in poor health, caused him to suffer further emotional distress.

In deciding a motion for summary judgment, the moving parly must demonstrate that there is no genuine issue of material fact. Fed.R.Civ.P. 56(c), made applicable by rule 7056 of the Bankruptcy Rules. In re Heafitz, 85 B.R. 274, 278 (Bkrtcy.S.D.N.Y.1988). In making such determination, the Court must look to “the pleadings, depositions, answers to interrogatories and admissions on file, together with affidavits, if any_” Fed.R.Civ.P. 56(c). If, after such examination, there is no genuine issue as to any material fact the moving party will be entitled to judgment as a matter of law. Id. Fed.R.Civ.P.

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Cite This Page — Counsel Stack

Bluebook (online)
99 B.R. 238, 1989 Bankr. LEXIS 575, 1989 WL 40105, Counsel Stack Legal Research, https://law.counselstack.com/opinion/long-term-disability-plan-of-hoffman-la-roche-inc-v-hiler-in-re-hiler-njb-1989.