Loo v. Cajun Operating Co.

130 F. Supp. 3d 1097, 2015 WL 5460693
CourtDistrict Court, E.D. Michigan
DecidedSeptember 17, 2015
DocketCase No. 14-cv-10604
StatusPublished
Cited by2 cases

This text of 130 F. Supp. 3d 1097 (Loo v. Cajun Operating Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Loo v. Cajun Operating Co., 130 F. Supp. 3d 1097, 2015 WL 5460693 (E.D. Mich. 2015).

Opinion

OPINION AND ORDER GRANTING CROSS-DEFENDANT RELIANCE’S MOTION TO DISMISS DEFENDANT . CHURCH’S’ CROSS-COMPLAINT [41], DENYING CROSS-DEFENDANT CHURCH’S’ MOTION TO AMEND THE CROSS-COMPLAINT [50], AND DENYING AS MOOT CROSS-DEFENDANT RELIANCE’S MOTION TO STAY DISCOVERY [62]

LAURIE J. MICHELSON, District Judge

Donna Van Loo was an employee, of Cross-Plaintiff Cajun Operating Company [1100]*1100d/b/a Church’s Chicken (“Church’s”). Church’s provided life insurance to Van Loo and its other employees through Cross-Defendant Reliance Standard Life Insurance Company. The Policy required that insureds submit an evidence of insurability form (“EIF”) in order for certain amounts of insurance to be effective. But Van Loo never submitted an EIF, and so when her parents, Plaintiffs Donald and Harriet Van Lob, submitted a claim after her death, Reliance denied benefits in excess' of the guaranteed-issue amount.

Alleging that their daughter was never informed that to qualify for supplemental coverage over $300,000, she had to submit an EIF certifying the state of her health at the time her coverage crossed the $300,000 threshold,- Plaintiff’s sued Church’s and Reliance, asserting various causes of action under the Employee Retirement Income Security Act (“ERISA”). After initial motion practice, the Court dismissed all but a denial-of-benefits claim against Reliance and a fiduciary-breach claim against Church’s. See Van Loo v. Cajun Operating Co., 64 F.Supp.3d 1007 (E.D.Mich.2014). Shortly thereafter, Church’s filed a cross-claim against Reliance, asserting that Reliance caused Van Loo’s failure to submit the EIF and, in turn, the underlying suit againsj; Church’s. Now before the Court are Reliance’s Motions to Dismiss the Cross Claim and to Stay Discovery, and Church’s’ Motion to Amend the Cross Claim. After careful consideration of the briefs and thorough review of the pleadings, the Court finds that oral argument will not aid in resolving the pending' motions. See E.D. Mich. LR Ll(f)(2). ¡

For the reasons set forth below, the motion to amend will be denied, the motion to dismiss will be granted, and the motion to stay will.be denied as'moot.

I. PROCEDURAL HISTORY AND ALLEGATIONS OF THE CROSS-COMPLAINT

The Court first describes the procedural posture of the case and then recites the allegations of the proposed amended cross-complaint, taking the allegations as true and drawing reasonable inferences in favor of Church’s.

A.

The Van Loos’ breach-of-fiduciary-duty claim against Church’s is that .Church’s “misrepresented] Ms. Van Loo’s eligibility for Supplemental Life Insurance Benefits under the Group Life Policy____’■’ Id. at 1016. In essence, that Church’s communications and dealings -with Ms. Van Loo led her to reasonably believe she was covered for supplemental life insurance despite the lack of an EIF. Id. at 1019.

Following the ruling on the Van Loos’ Complaint, in December 2014, Church’s filed a cross-claim against Reliance, on behalf of itself and the “Church’s Chicken Welfare Benefits Plan [the “Plan”].” (Dkt.38, Cross-Compl.) Church’s alleges that “[b]y way of a delegation - of responsibility from' CHURCH’S[,] expressly accepted by RELIANCE in 2010, RELIANCE became responsible for the Evidence of Insurability Forms (“EIF”) requirement for many PLAN' participants, including Donna Van Loo.” (Cross-Compl. at ¶7.) The EIF itself “directed PLAN participants to return the form to RELIANCE.” (Id. at ¶9.) Church’s says that once Reliance accepted responsibility for EIFs, Reliance should have known that Church’s .would rely “on RELIANCE to track the return of those forms and would rely on RELIANCE to communicate to CHURCH’S any changes in benefits required under the PLAN as a result of the EIF.” (Id. at ■ ¶ 9.-) Church’s says [1101]*1101that only after Reliance denied Plaintiffs’ claim did it realize that Van Loo needed an EIF for her coverage level to become effective, (Id. at ¶ 15.)

Based on these allegations, Church’s has asserted against Reliance claims for breach of fiduciary duty, misrepresentation, and indemnification. (See CrossCompl.) Reliance filed a motion to dismiss the cross-complaint. (Dkt. 41, Mot. to Dismiss.) Shortly thereafter, Church’s filed a motion to amend the cross-complaint. (Dkt. 50, Mot. to Amend.) Church’s seeks to amend the cross-complaint to add allegations regarding a “Plan Administrator’s Guide” issued by Reliance and relevant omissions regarding the EIF therein, and also seeks to assert a new interpretation of the EIF requirement as stated in the Policy. (Id. at 3.) As noted above, Reliance opposes the motion .to supplement the allegations as untimely and futile. So the Court will consider whether the allegations of the amended cross-complaint are sufficient to withstand a motion to dismiss.

B.

The Policy’s guaranteed-issue amount is the crux of this dispute. In the proposed amended cross-complaint, Church’s asserts that “the POLICY states that elections of ‘[a]mounts of Supplemental Life insurance ‘over $300,000 are subject to [RELIANCE’S] approval of a person’s proof of good health.’ ” (Dkt. 50-2, Proposed Am. Cross-Compl. at ¶ 14.) Moreover, the Policy states that if a proposed election “would result in an increase in the amount of Supplemental insurance of- 10% or more,” proof of good health would be required. (Id. at 1Í16.) Reliance issued a “Plan Administrator’s Guide” to Church’s, but the Guide' “does not address who is responsible for administering any EIF required under the POLICY.” (Id. at ¶¶ 22-23.)

Employees were to select their own level of coverage under the Policy. “Subject to its terms, the PLAN allowed eligible CHURCH’S employees, including Van Loo, to elect basic life and accidental death and dismemberment insurance (“Basic Life”) as well as supplemental life insurance benefits (“Supplemental Life”).” (Id. at ¶ 8.) In 2007, with an annual salary of $100,000, Van Loo elected Basic benefits and Supplemental benefits in an amount equal to two times her salary. (Id. at ¶ 9.) In 2008, with an annual salary of- $100,000; Van Loo elected Basic and Supplemental benefits in an amount equal to three times her salary. (Id. set ¶ 10.) Church’s asserts that ‘[b]ecause Van Loo’s elections for 2007 thrdugh 2010 neither sought Supplemental Life insurance benefits greater than $300,000, nor resulted in those benefits increasing by 10% or more than the preceding year, none of the POLICY’S EIF provisions were triggered.” (Id. at ¶ 17.)

The crux of the proposed amended cross-complaint is Van Loo’s 2011 election. That year, Van Loo increased her Supplemental .election to “4x salary.” (Id. at ¶ 18.) Church’s contends that it recognized at this time-that Van Loo may have triggered the EIF requirement. (Id. at ¶ 20.) Thus, Church’s “ask[ed] [Reliance] to administer any EIF requirement for Van Loo and other PLAN participants.” (Id.) Church’s also says that it wanted Reliance to take on this task because there had been “unclear communication” regarding the EIF requirement. (Id. at ¶21.) Specifically, the Guide did not address who would be responsible for administering the EIF requirement, how it should be administered, or what effect the lack of an EIF would have. (Id. at ¶¶ 24-25.)

Church’s alleges that Reliance “expressly accepted responsibility for administering the EIF requirement for Van Loo and [1102]

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

Related

Van Loo v. Cajun Operating Co.
190 F. Supp. 3d 704 (E.D. Michigan, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
130 F. Supp. 3d 1097, 2015 WL 5460693, Counsel Stack Legal Research, https://law.counselstack.com/opinion/loo-v-cajun-operating-co-mied-2015.