Mefford v. Prudential Insurance

99 F. Supp. 3d 551, 2015 U.S. Dist. LEXIS 39065, 2015 WL 1400784
CourtDistrict Court, E.D. Pennsylvania
DecidedMarch 26, 2015
DocketCivil Action No. 14-CV-1006
StatusPublished
Cited by1 cases

This text of 99 F. Supp. 3d 551 (Mefford v. Prudential Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mefford v. Prudential Insurance, 99 F. Supp. 3d 551, 2015 U.S. Dist. LEXIS 39065, 2015 WL 1400784 (E.D. Pa. 2015).

Opinion

MEMORANDUM AND ORDER

JOYNER, District Judge.

This civil action, seeking relief under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq., is before this Court now on Motions of both defendants for Summary Judgment as well as the Plaintiffs Cross-Motion for Summary Judgment. For the reasons which follow, the Plaintiffs Cross-Motion for Summary Judgment shall be granted and the motions of both Defendants denied.

History of the Case

Plaintiff Michael Mefford commenced this lawsuit in February, 2014 to recover a $100,000 benefit under a Dependent Life Insurance Policy which he elected for his wife, Kimberly Mefford, through his employer, Defendant Tyco International Management Company (“TYCO”) during Tyco’s annual benefits open enrollment period in October, 2012. This dependent insurance, along with the life insurance on his own life which Plaintiff elected at the same time, was to become effective on January 1, 2013 and was part of the group plan offered by Defendant Tyco and made available to its employees through Defendant Prudential Insurance Company. (First Amended Complaint [“FAC”], ¶ s 20, 21).

On November 19, 2012 as the result of a stomach disorder, Plaintiff went out on short-term disability from his regular employment with Tyco and he remained out on short-term disability through January 7, 2013, the date of Kimberly Meffórd’s apparently sudden death. (FAC, ¶ 23). [554]*554Despite having deducted Plaintiffs portion of the premium payment for his spouse’s life insurance from his paycheck for January 1, 2013, Defendants nevertheless denied Plaintiffs claim for the $100,000 benefit on the grounds that recovery was barred due to his failure to satisfy the “Active At Work Requirement” contained within the policy. (FAC, ¶ s 23, 24, 25).

By this action, Plaintiff asserts that the Active Work Requirement is ambiguous in that it is nowhere defined to include an absence from work specifically based upon a disability and is nowhere utilized in policy provisions dealing with coverages for a spouse or domestic partner.' (FAC, ¶ 31). Hence Plaintiff claims, the denial of the benefit sought in this case is violative of ERISA.

Summary Judgment Standards

In determining a motion for summary judgment, we are guided by the standards outlined in Fed.R.Civ.P. 56. Under subsection(a) of that rule,

A party may move for summary judgment, identifying each claim or defense — or the part of each claim or defense — on which summary judgment is sought. The court shall grant summary judgment if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law...

In reviewing the record before it for purposes of assessing the propriety of entering summary judgment, the court should view the facts in the light most favorable to the non-moving party and draw all reasonable inferences in that party’s favor. Ma v. Westinghouse Electric Co., 559 Fed.Appx. 165, 168 (3d Cir.2014); Burton v. Teleflex, Inc., 707 F.3d 417, 425 (3d Cir.2013). The initial burden is on the party seeking summary judgment to point to the evidence “which it believes demonstrate the absence of a genuine issue of material fact.” United States v. Donovan, 661 F.3d 174, 185 (3d Cir.2011) (quoting Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986)). An issue is genuine only if there is a sufficient evidentiary basis on which a reasonable jury could find for the non-moving party, and a factual dispute is material only if it might affect the outcome of the suit under governing law. Kaucher v. County of Bucks, 455 F.3d 418, 423 (3d Cir.2006) (citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986)).

However, to survive summary judgment, the non-moving party must present more than a mere scintilla of evidence; there must be evidence on which the jury could reasonably find for the non-movant. Jakimas v. Hoffmann-LaRoche, Inc., 485 F.3d 770, 777 (3d Cir.2007). And, “if there is a chance that a reasonable juror would not accept a moving party’s necessary propositions of fact, summary judgment is inappropriate.” Burton, supra, (quoting El v. SEPTA, 479 F.3d 232, 238 (3d Cir.2007)).

The rule is no different where there are cross-motions for summary judgment. “Cross-motions are no more than a claim by each side that it alone is entitled to summary judgment, and the making of such inherently contradictory claims does not constitute an agreement that if one is rejected the other is necessarily justified or that the losing party waives judicial consideration and determination whether genuine issues of material fact exist.” Lawrence v. City of Philadelphia, 527 F.3d 299, 310 (3d Cir.2008) (quoting Rains v. Cascade Industries, Inc., 402 F.2d 241, 245 (3d Cir.1968)). The mere fact that “both parties seek summary judgment does not constitute a waiver of a full trial or the right to have the case presented to a jury.” Facenda v. N.F.L. Films, Inc., 542 F.3d 1007, 1023 (3d Cir.2008) (quoting 10A [555]*555Charles Alan Wright, Arthur R. Miller & Mary Kay Kane, Federal Practice and Procedure § 2720 (3d ed.1998), at 330-331).

Discussion

“ERISA was enacted ‘to promote the interests of employees and their beneficiaries in employee benefit plans’ and ‘to protect contractually defined benefits.’ ” Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 113, 109 S.Ct. 948, 956, 103 L.Ed.2d 80 (1989) (quoting Massachusetts Mutual Life Ins. Co. v. Russell, 473 U.S. 134, 148, 105 S.Ct. 3085, 3093, 87 L.Ed.2d 96 (1985) and Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 90, 103 S.Ct. 2890, 2896, 77 L.Ed.2d 490 (1983)). To this end, “ERISA provides ‘a panoply of remedial devices’ for participants and beneficiaries of benefit plans.” Firestone, 489 U.S. at 109, 109 S.Ct. at 948 (quoting Massachusetts Mutual, 473 U.S. at 146, 105 S.Ct. at 3092).

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99 F. Supp. 3d 551, 2015 U.S. Dist. LEXIS 39065, 2015 WL 1400784, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mefford-v-prudential-insurance-paed-2015.