Marita L. Curcio the Estate of Frederick Curcio, III v. John Hancock Mutual Life Insurance Company Capital Health Systems John Hancock Mutual Life Insurance Company ("John Hancock"), in No. 93-7545, Marita L. Curcio the Estate of Frederick Curcio, III v. John Hancock Mutual Life Insurance Company Capital Health Systems Marita L. Curcio, Individually and as of the Estate of Frederick Curcio, Iii, in No. 93-7556

33 F.3d 226, 18 Employee Benefits Cas. (BNA) 1822, 1994 U.S. App. LEXIS 21935
CourtCourt of Appeals for the Third Circuit
DecidedAugust 17, 1994
Docket93-7545
StatusPublished
Cited by180 cases

This text of 33 F.3d 226 (Marita L. Curcio the Estate of Frederick Curcio, III v. John Hancock Mutual Life Insurance Company Capital Health Systems John Hancock Mutual Life Insurance Company ("John Hancock"), in No. 93-7545, Marita L. Curcio the Estate of Frederick Curcio, III v. John Hancock Mutual Life Insurance Company Capital Health Systems Marita L. Curcio, Individually and as of the Estate of Frederick Curcio, Iii, in No. 93-7556) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Marita L. Curcio the Estate of Frederick Curcio, III v. John Hancock Mutual Life Insurance Company Capital Health Systems John Hancock Mutual Life Insurance Company ("John Hancock"), in No. 93-7545, Marita L. Curcio the Estate of Frederick Curcio, III v. John Hancock Mutual Life Insurance Company Capital Health Systems Marita L. Curcio, Individually and as of the Estate of Frederick Curcio, Iii, in No. 93-7556, 33 F.3d 226, 18 Employee Benefits Cas. (BNA) 1822, 1994 U.S. App. LEXIS 21935 (3d Cir. 1994).

Opinion

33 F.3d 226

18 Employee Benefits Cas. 1822

Marita L. CURCIO; The Estate of Frederick Curcio, III
v.
JOHN HANCOCK MUTUAL LIFE INSURANCE COMPANY; Capital Health Systems
John Hancock Mutual Life Insurance Company ("John Hancock"),
Appellant in No. 93-7545,
Marita L. CURCIO; The Estate of Frederick Curcio, III
v.
JOHN HANCOCK MUTUAL LIFE INSURANCE COMPANY; Capital Health Systems
Marita L. Curcio, Individually and as Executrix of the
Estate of Frederick Curcio, III, Appellant in No. 93-7556.

Nos. 93-7545, 93-7556.

United States Court of Appeals,
Third Circuit.

Argued March 10, 1994.
Decided Aug. 17, 1994.

Michael D. Fishbein (argued), Levin, Fishbein, Sedran & Berman, Philadelphia, PA, for appellee/cross appellant Marita L. Curcio.

James K. Thomas, II, Richard C. Seneca (argued), Thomas, Thomas & Hafer, Harrisburg, PA, for appellee CAP Health Systems.

Alan R. Boynton, Jr., (argued), McNees, Wallace & Nurick, Harrisburg, PA, for appellant.

Before: MANSMANN and LEWIS, Circuit Judges and McKELVIE, District Judge.*

OPINION OF THE COURT

MANSMANN, Circuit Judge.

Frederick Curcio, III, M.D., died in an automobile accident while employed as a full time physician at Harrisburg Hospital, which is owned by Capital Health Systems. Capital Health sought to provide to its employees basic life insurance coverage and basic accidental death and dismemberment coverage through John Hancock Mutual Life Insurance Company. Marita L. Curcio, Frederick's widow, collected $200,000 in life insurance proceeds and $50,000 from the accidental death coverage. Claiming entitlement to an additional $150,000 in accidental death benefits because of representations made by Capital Health in its plan summary document, she brought an action, individually and as executor of Frederick's estate, against Capital Health and John Hancock under the Employee Retirement Income Security Act of 1974, 29 U.S.C. Secs. 1001-1461 (1988). The district court granted summary judgment in favor of Mrs. Curcio and Capital Health and against John Hancock. John Hancock appeals and Mrs. Curcio cross-appeals to preserve her rights against Capital Health. We hold that John Hancock is not responsible either for Capital Health's inaccurate representations made to its employees or for any additional recovery under John Hancock's clearly stated policy. We further hold that Capital Health is liable under the alternative theories of breach of fiduciary duty and equitable estoppel.

I.

The historical facts of this case are not in dispute. Since October of 1989,1 John Hancock has provided life insurance and accidental death and dismemberment insurance for all full-time Capital Health employees in an amount equal to the employee's base annual salary to a maximum of $50,000. John Hancock also offered twenty-one senior employees, who had the same basic coverage as the other employees, the opportunity to purchase supplemental coverage, for both life and AD & D, up to the amount they were currently receiving. Because no one could be added to this group of employees, it became known as the frozen group. Dr. Curcio was not a member of this group.2

One year later Capital Health wanted to extend to all employees the opportunity to purchase the same supplemental coverage from John Hancock as offered to the frozen group. Capital Health held group meetings for its employees where it introduced the supplemental coverage through an audio-visual presentation, explaining that supplemental insurance could be purchased in amounts equaling one, two or three times the amount of an employee's base annual salary, not to exceed $150,000. This coverage amount would be in addition to the coverage amount provided by the basic plan. The presentations clearly represented to the employees that this option was available "to increase your life and AD & D insurances significantly." The audiotape, which was accompanied by slides, stated in pertinent part:

Finally, let's look at other important elections you have available under choice plus.

Capital Health provides free group life and accidental death and dismemberment--or AD & D--insurance for all full-time and part-time employees scheduled to work at least 16 hours a week. Each of the coverages is equal to:

. One Times Basic Average Earnings up to a Maximum of $50,000 for full-time employees and,

. One Times Basic Average Earnings up to a Maximum of $25,000 for part-time employees.

You also have an opportunity of purchasing additional coverages up to three times basic average earnings subject to the maximums shown on the chart. (Chart on Screen)

The contributions you pay for these coverages are at low group rates and depend on your amount of coverage and your age. An important point: unless you take advantage of increasing your insurance coverages now, you will only be able to "step up" one additional level of coverage per year--until you reach your coverage limit--if you want higher levels of coverage in the future. In short, this is a one time offer. You can either take advantage of the current enrollment period to increase your life and AD & D insurances significantly or wait until future years to increase coverages on a slower year to year basis. (Emphasis added.)

The dispute is whether the supplemental insurance offered to all the employees was the same as the coverage offered to the frozen group; specifically, did the supplemental coverage include life and AD & D? John Hancock claims the supplemental coverage only included life insurance, and it points to the differing language in each group's policies to support its position.3

Dr. Curcio's salary made him eligible to purchase the maximum amount of coverage, which he did. Capital Health charged him bi-weekly premiums of $6.00 for this coverage. The record indicates, and the district court so found, that Dr. Curcio believed his coverage to include both life and AD & D insurance. On August 5, 1991, Dr. Curcio died in an automobile accident.

A representative from Capital Health, James Henry, made an inquiry by telephone to John Hancock regarding a determination of benefits due Mrs. Curcio. Then Assistant Sales Manager, Richard Lintner, responded that Dr. Curcio had $400,000 in coverage ($50,000 basic life, $50,000 basic AD & D, $150,000 supplemental life, and $150,000 supplemental AD & D).

Shortly thereafter John Hancock recanted its oral representation of coverage and expressed, before a claim was filed, that its preliminary determination was incorrect and that Dr. Curcio had $150,000 in supplemental life coverage only, giving his beneficiary a total benefits package of $250,000. John Hancock claimed that employees in Dr. Curcio's position never had the opportunity to purchase supplemental AD & D coverage, and even if they did, Dr.

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

Related

Haisley v. Sedgwick Claims Management Services, Inc.
776 F. Supp. 2d 33 (W.D. Pennsylvania, 2011)
Sanborn-Alder v. Cigna Group Insurance
771 F. Supp. 2d 713 (S.D. Texas, 2011)
Belmonte v. EXAMINATION MANAGEMENT SERVICES, INC.
730 F. Supp. 2d 603 (N.D. Texas, 2010)
Miller v. Mellon Long Term Disability Plan
721 F. Supp. 2d 415 (W.D. Pennsylvania, 2010)
Hirsh v. Boeing Health and Welfare Benefit Plan
719 F. Supp. 2d 508 (E.D. Pennsylvania, 2010)
Johnson v. Nanticoke Memorial Hospital, Inc.
700 F. Supp. 2d 670 (D. Delaware, 2010)
WE Aubuchon Co., Inc. v. BENEFIRST, LLC
661 F. Supp. 2d 37 (D. Massachusetts, 2009)
Pell v. EI DuPont De Nemours & Co. Inc.
539 F.3d 292 (Third Circuit, 2008)
Hill v. Aetna Life Insurance
546 F. Supp. 2d 343 (S.D. Mississippi, 2008)
Olick v. Kearney
451 F. Supp. 2d 665 (E.D. Pennsylvania, 2006)
Mulder v. PCS HEALTH SYSTEMS. INC.
432 F. Supp. 2d 450 (D. New Jersey, 2006)
Engers v. AT & T
428 F. Supp. 2d 213 (D. New Jersey, 2006)
Tilton v. Radiation Oncologists, P.A.
409 F. Supp. 2d 560 (D. Delaware, 2006)
Delcastillo v. Odyssey Resource Management, Inc.
320 F. Supp. 2d 889 (D. Nebraska, 2004)
Laborers Combined Funds of Western Pennsylvania v. Cioppa
346 F. Supp. 2d 765 (W.D. Pennsylvania, 2004)
McRae v. Rogosin Converters, Inc.
301 F. Supp. 2d 471 (M.D. North Carolina, 2004)
Wallin v. Severance Plan of Electronic Data Systems
84 F. App'x 193 (Third Circuit, 2003)
Leuthner v. BLUE CROSS AND BLUE SHIELD OF NE PA
270 F. Supp. 2d 584 (M.D. Pennsylvania, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
33 F.3d 226, 18 Employee Benefits Cas. (BNA) 1822, 1994 U.S. App. LEXIS 21935, Counsel Stack Legal Research, https://law.counselstack.com/opinion/marita-l-curcio-the-estate-of-frederick-curcio-iii-v-john-hancock-mutual-ca3-1994.