Michael J. Hughes v. K Mart Corporation and Aetna Life Insurance Company

983 F.2d 1066, 1993 U.S. App. LEXIS 5149, 1993 WL 11830
CourtCourt of Appeals for the Sixth Circuit
DecidedJanuary 20, 1993
Docket92-1396
StatusUnpublished
Cited by3 cases

This text of 983 F.2d 1066 (Michael J. Hughes v. K Mart Corporation and Aetna Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Michael J. Hughes v. K Mart Corporation and Aetna Life Insurance Company, 983 F.2d 1066, 1993 U.S. App. LEXIS 5149, 1993 WL 11830 (6th Cir. 1993).

Opinion

983 F.2d 1066

NOTICE: Sixth Circuit Rule 24(c) states that citation of unpublished dispositions is disfavored except for establishing res judicata, estoppel, or the law of the case and requires service of copies of cited unpublished dispositions of the Sixth Circuit.
Michael J. HUGHES, Plaintiff-Appellant,
v.
K MART CORPORATION and Aetna Life Insurance Company,
Defendants-Appellees.

No. 92-1396.

United States Court of Appeals, Sixth Circuit.

Jan. 20, 1993.

Before KENNEDY and BATCHELDER, Circuit Judges, and ENGEL, Senior Circuit Judge.

PER CURIAM.

Plaintiff-appellant, Michael J. Hughes ("appellant"), appeals the district court's award of summary judgment to defendants-appellees, K Mart Corporation ("K Mart") and Aetna Life Insurance Company ("Aetna"), in this action for the recovery of life insurance benefits under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §§ 1001, et seq., and under state statutory and common-law claims. We affirm.

I.

A.

Plaintiff's decedent, Elizabeth Hughes ("Hughes"), began employment with K Mart in September of 1978. In December of 1978, after completing three months of full-time employment, she became eligible for life insurance benefits under K Mart's benefit plan ("Plan").1 Life insurance, in the amount of one times her annual salary, was provided on a non-contributory basis, that is, with no contribution required from the employee, through a group insurance policy with Aetna ("Policy"). In December of 1978, Hughes also elected to receive optional, contributory life insurance in the amount of one times her annual salary.

B.

The Policy provided, in pertinent part, as follows:

Section 3. Employees to be Insured (Continued)

(I) Employee Coverage (Continued)

B. Effective Dates of Insurance:

(1) As to contributory insurance, each employee who makes written request to his Participant Employer for Employee Coverage ... is to be insured for Employee Coverage on the date he becomes eligible for Employee Coverage or on the date he makes such request, whichever is later; provided, however, that

* * *

(b) any employee who is both disabled (i.e., ill or injured) and away from work on the date Employee Coverage is to become effective shall not be insured until he actually returns to work on a full-time regular basis.

In 1984, K Mart issued to employees a booklet entitled "Group Term Life Insurance Plan" ("1984 booklet"). In November of 1988, K Mart mailed to employees, via intraoffice mail, a booklet entitled "Partners for Quality Health Care" ("1988 booklet"). The 1988 booklet informed employees that "[e]ffective April 1, 1989, your new Optional Life Insurance Plan provides you with the opportunity to purchase additional coverage." This booklet also informed employees that "the new Optional Life Insurance Plan doesn't become effective until April 1, 1989...."

In a letter accompanying this booklet ("1988 letter"), K Mart stated that "[e]ffective April 1, 1989, you'll be able to purchase an increased amount of Optional Life Insurance. You can purchase an amount equal to one, two or three times your pay." Appellant maintains that to his knowledge, his wife never received a copy of the 1984 booklet, the 1988 booklet, or the 1988 letter. Although K Mart has no written records that show Hughes was mailed copies of these documents, K Mart's summary judgment motion was supported by three affidavits of K Mart employees that indicate the 1988 booklet and 1988 letter were sent to all "centrally-paid" K Mart employees, one of whom was Hughes. The three affiants, who are centrally-paid K Mart employees, all received copies of the 1988 booklet and 1988 letter via intraoffice mail.

In February of 1989, K Mart employees received a booklet entitled "Employees' Group Life Insurance Plan" ("1989 booklet") and an accompanying letter ("1989 letter"). Appellant concedes that Hughes received copies of these two documents. The 1989 letter states, in part, that "[a]n employee on Leave of Absence cannot enroll for an increased amount of optional life insurance until they [sic] return to active employment." The 1989 booklet, in a section entitled "When Coverage Begins," states, in part:

WHEN COVERAGE BEGINS

Your basic, Company-paid life insurance and AD & D coverage begin automatically on the first day of the month following completion of three months of continuous active full-time service.

If you choose optional life insurance, coverage begins at the same time as your basic life and AD & D coverage, provided you have completed the necessary enrollment form.

If you are not actively at work on the date coverage is to begin, coverage begins the date you return to active employment.

The 1989 booklet also makes reference to "April 1, 1989." However, it does not expressly state that an employee is ineligible for optional life insurance coverage unless actively employed on April 1, 1989.

On March 1, 1989, Hughes completed and signed an enrollment form indicating that she was electing to increase her optional life insurance coverage from one times to three times her annual salary. This enrollment form contained the following provision:

I hereby elect to enroll in the optional Contributory Life Insurance Policy provided by the Company and authorize the Company to make the proper reductions to my earnings to pay the cost of this insurance and understand my pre-tax payment election is irrevocable for the next calendar year unless there is a change in my family status.

On the enrollment form, Hughes designated appellant as the beneficiary.

C.

On March 17, 1989, Hughes took a medical leave of absence from K Mart. She never returned.2 As of April 1, 1989, K Mart began deducting amounts from Hughes's paycheck to cover the cost of the additional life insurance. In July of 1989, Hughes received from K Mart a summary of her benefits entitled "Your Personal Benefits Statement." This statement indicated that as of April 1, 1989, Hughes was covered for the additional life insurance for which she had filled out an enrollment form on March 1, 1989. However, the following month, by letter dated August 29, 1989, K Mart notified Hughes for the first time that she was ineligible for this additional life insurance because "an employee on Leave of Absence cannot enroll for an increased amount of optional life insurance until they [sic] return to active employment." K Mart also sent Hughes a refund check for $64.60, which represented the amount of Hughes's payments attributable to the additional life insurance coverage.3

On September 1, 1989, Hughes died. By check dated October 14, 1989, Aetna paid $72,000 to appellant. This payment was made pursuant to the contributory and non-contributory life insurance coverage that Hughes had had since 1978. Aetna denied appellant's claim for $72,000 in additional life insurance.

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983 F.2d 1066, 1993 U.S. App. LEXIS 5149, 1993 WL 11830, Counsel Stack Legal Research, https://law.counselstack.com/opinion/michael-j-hughes-v-k-mart-corporation-and-aetna-li-ca6-1993.