McDermott v. Sentry Life Insurance Co.

2000 OK CIV APP 115, 15 P.3d 508, 71 O.B.A.J. 3035, 2000 Okla. Civ. App. LEXIS 81, 2000 WL 1693490
CourtCourt of Civil Appeals of Oklahoma
DecidedMay 16, 2000
DocketNo. 89,707
StatusPublished
Cited by7 cases

This text of 2000 OK CIV APP 115 (McDermott v. Sentry Life Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Civil Appeals of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McDermott v. Sentry Life Insurance Co., 2000 OK CIV APP 115, 15 P.3d 508, 71 O.B.A.J. 3035, 2000 Okla. Civ. App. LEXIS 81, 2000 WL 1693490 (Okla. Ct. App. 2000).

Opinion

OPINION ON REMAND

TAYLOR, J.

1 1 We review this matter on reassignment from the Oklahoma Supreme Court pursuant to its order of April 12, 1999, vacating our opinion issued June 9, 1998, and directing us to reconsider this cause based upon the full trial court record and additional briefs submitted since the date of our opinion. Based on reconsideration of the record, the parties' briefs, the amicus brief submitted by the United States Department of Labor, and the applicable law, we now reverse the decision of the trial court on the issue of preemption and remand for further proceedings.

STANDARD OF REVIEW

12 Plaintiff, David Bruce McDermott, filed this appeal seeking review of the trial court's order granting summary judgment in favor of Defendants, Sentry Life Insurance Company (Sentry) and Steven A. Marzett, based on preemption by the Employee Retirement Income Security Act, 29 U.S.C.A. §§ 1001 through 1461 (West 1999) (ERISA). The issue presented is whether ERISA preempts an independent contractor's state-law claims against an insurance company and its sales agent, based on deceptive practices in the sale of a group insurance policy to an employer, where the employer purchased the policy in reliance on the alleged representation that the independent contractor would be covered under the policy and the insurer later denies coverage based on the contractor's status as a non-employee. The question of ERISA preemption involves a question of law, and we review the trial court's ruling on the issue de novo, ie., without deference to the trial court's decision. See Airparts Co. v. Custom Benefit Serv. of Austin, 28 F.3d 1062, 1064 (10th Cir.1994). We find that preemption does not bar Plaintiffs claim.

DISCUSSION

Plaintiff's State-Law Causes of Action Are Not Preempted by ERISA

$3 ERISA has been described as a comprehensive statute "designed to promote the interests of employees and their benefi-claries in employee benefit plans." Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 90, 103 S.Ct. 2890, 2896, 77 L.Ed.2d 490 (1983). The preemption clause-included by Congress to implement ERISA's goal and purpose-is recognized as "deliberately expansive" and "conspicuous for its breadth" See FMC Corp. v. Holliday, 498 U.S. 52, 58, 111 S.Ct. 403, 407, 112 L.Ed.2d 356 (1990); Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 46, 107 S.Ct. 1549, 1552, 95 L.Ed.2d 39 (1987). The clause provides that, with certain limited exceptions, the provisions of ERISA "shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan...." 29 U.S.CA. § 1144(a). State-law based claims developed under the common law are among those "state laws" potentially subject to preemption. 29 U.S.C.A. § 1144(c)(1); UNUM Life Ins. Co. of Am. v. Ward, 526 U.S. 358, 365 n. 1, 119 S.Ct. 1380, 1886 n. 1, 143 L.Ed.2d 462 (1999).

T 4 As noted in our previous opinion, Plaintiff was an outside salesman for Eversharp Tool & Cutter Company (Eversharp), and was paid on a commission basis. From 1983 or 1984 through February 1988, as part of Plaintiff's compensation for his services, Ev-ersharp paid the premiums to cover Plaintiff on a group health insurance policy with Mutual Benefit Life Insurance Company.

T5 In March 1988, Eversharp changed insurance carriers to Defendant Sentry. It is undisputed that Eversharp intended, when it purchased the Sentry policy, to "replace the previous employee group coverage that was in place" and to obtain from Sentry coverage that would include Plaintiff.1 Testi[511]*511mony indicated it was a condition of Ever-sharp's decision to change insurance carriers that all of the individuals who had been covered by Eversharp's policy with Mutual Benefit also would be covered by the Sentry policy, and that Plaintiff was one of the individuals for whom Eversharp wanted coverage.2

T6 Defendant Marzett, Sentry's agent, sold Eversharp the Sentry group health insurance policy. Douglas Turner, Ever-sharp's president, testified that Marzett approached Eversharp about changing its life and health policies to Sentry, and that Mar-zett was aware Eversharp already had workers' compensation insurance with Sentry.3 Plaintiff's evidence further suggested that, after Marzett was advised by Plaintiffs father (because Plaintiff was not in the office at the same time Marzett was there) of Plaintiffs working hours and job description, Mar-zett filled out Plaintiff's insurance application. Marzett indicated on the application that Plaintiff was a full-time employee who worked at least 30 hours a week in the office.4 Marzett then allegedly either assured Eversharp that Plaintiff was eligible, or stated he would check with Sentry to be sure that Plaintiff was covered and get back to Eversharp if there was a problem. Ultimately, Sentry issued the policy listing Plaintiff as an insured. Plaintiff received an insurance card, and, believing he was covered by Sentry, did not obtain other individual coverage for himself or his family.

T7 On May 16, 1988, Sentry paid a loss under the policy on behalf of Plaintiff. Then, on May 19, 1988, Plaintiff was seriously injured in an automobile accident, resulting in extensive medical expenses. According to Marzett's deposition testimony, Sentry initiated an investigation of Plaintiff's employment status after Plaintiff made the latter, larger claim for these expenses. Sentry's investi_ ation led it to conclude Plaintiff was not a full-time employee within the coverage of the group policy. The company declined to pay his claim, and attempted to return the premiums for Plaintiff's policy to Eversharp.

18 Plaintiff brought this action, initially alleging he was an "employee" who had been wrongfully denied coverage by Sentry. Defendants moved for summary judgment, asserting Plaintiff was not an employee covered by the Eversharp policy, that the policy was an employee benefits plan under ERISA, and that Plaintiff's claims were preempted. The trial court found in an interlocutory order that the group health policy underwritten by Sentry was an ERISA plan. It further held that Plaintiff was not an insured under the policy nor was he insured under the Eiver-sharp plan. The interlocutory order found Plaintiff's breach of contract claim was preempted by ERISA. However, it denied Defendants' motion for summary judgment on Plaintiff's claims of negligence and fraud, except to the extent they were based on "representations or omissions" as to how the Eversharp plan would be administered, "because such allegations are preempted."

9 Plaintiff filed a "Second Amended Petition," alleging he was a self-employed independent contractor and not an employee. He asserted claims sounding in breach of contract/promissory - estoppel, - negligence, constructive fraud, and deceit, based on Sentry and Marzett's allegedly deceptive practices designed to induce Eversharp to purchase Sentry insurance.

" 10 Eventually, Defendants filed motions for summary judgment that again raised ERISA preemption. The trial court found that "the duties and breaches alleged by Plaintiff concern representations about the [512]

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2000 OK CIV APP 115, 15 P.3d 508, 71 O.B.A.J. 3035, 2000 Okla. Civ. App. LEXIS 81, 2000 WL 1693490, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mcdermott-v-sentry-life-insurance-co-oklacivapp-2000.