Minutello v. Hartford Life & Accident Insurance

964 F. Supp. 2d 491, 2013 WL 4053144, 2013 U.S. Dist. LEXIS 112942
CourtDistrict Court, W.D. Pennsylvania
DecidedAugust 12, 2013
DocketNo. 2:12-cv-01240
StatusPublished
Cited by2 cases

This text of 964 F. Supp. 2d 491 (Minutello v. Hartford Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Minutello v. Hartford Life & Accident Insurance, 964 F. Supp. 2d 491, 2013 WL 4053144, 2013 U.S. Dist. LEXIS 112942 (W.D. Pa. 2013).

Opinion

MEMORANDUM OPINION

TERRENCE F. McYERRY, District Judge.

The instant action involves a plan administrator’s termination of long-term disability benefits previously paid to a plan participant over the course of ten years. Before the Court for disposition are the Defendant’s MOTION FOR SUMMARY JUDGMENT (ECF No. 18), the Defendant’s Brief in Support of Motion for Summary Judgment (ECF No. 19), the Defendant’s Concise Statement of Material Facts (ECF No. 20), the Plaintiffs MOTION FOR SUMMARY JUDGMENT (ECF No. 23), the Plaintiffs Brief in Support of Motion for Summary Judgment (ECF No. 22), the Plaintiffs Concise Statement of Material Facts (ECF No. 2k), the Defendant’s Response in Opposition to the Plaintiffs Motion for Summary Judgment (ECF No. 27), the Defendant’s Response to the Plaintiffs Concise Statement of Material Facts (ECF No. 28), and the Plaintiffs Response to the Defendant’s Motion for Summary Judgment (ECF No. 32). For the reasons that follow, the Defendant’s Motion for Summary Judgment will be granted, and the Plaintiffs Motion for Summary Judgment will be denied.

I.Background

Plaintiff Theresa R. Minutello (“Minutello”) was born on February 13, 1960. ECF No. 17 at 1. In 1979, at the age of nineteen, she started to work as an Assistant Manager for the Holiday Inn. ECF Nos. 24 & 28 at ¶ 1. On December 22, 1986, Starwood Hotels & Resorts Worldwide, Inc. (“Star-wood”), hired Minutello to work as an Assistant Banquet Manager. ECF Nos. 20 & 32 at ¶ 1.

Defendant Hartford Life and Accident Insurance Company (“Hartford”) administers a Group Benefit Plan (“Plan”) available to Starwood employees. ECF No. 17-2. The Plan provides long-term disability benefits to eligible employees pursuant to the terms of Group Insurance Policy GLT-673050 (“Policy”). Id. at 5. The language of the Policy that define the terms “disability” and “disabled” provides as follows:

Disability or Disabled means that during the Elimination Period and for the next 18 months you are prevented by:
1. accidental bodily injury;
2. sickness;
3. Mental Illness;
4. Substance Abuse; or
5. pregnancy,
From performing one or more of the Essential Duties of Your Occupation, and as a result your Current Monthly [496]*496Earnings are no more than 80% of your Pre-disability Earnings.
After that, you must be so prevented from performing one or more of the Essential Duties of Any Occupation.
Your failure to pass a physical examination required to maintain a license to perform the duties of Your Occupation does not alone mean that you are Disabled.

Id. at 25. The term “Your Occupation” is defined as a particular individual’s “occupation as it is recognized in the general workplace,” and “does not mean the specific job [that he or she is] performing for a specific employer or at a specific location.” Id. at 28. The Policy defines the term “Any Occupation” as “an occupation for which [an individual is] qualified by education, training or experience,” and . that has an “earnings potential” exceeding an amount calculated in accordance with specified terms. Id. at 24. Hartford has “full discretion and authority to determine eligibility for benefits and to construe and interpret all terms and provisions of the Group Insurance Policy.” Id. at 17. As an employee of Starwood, Minutello participated in the Plan. ECF Nos. 20 & 32 at ¶ 2.

In June 2001, Minutello was examined by her family physician, Dr. Gurmit Singh, and her rheumatologist, Dr. Angela M. Stupi. ECF Nos. 20 & 32 at ¶7. She complained of fatigue, joint pain, myalgia, night sweats, exhaustion, and fevers. Id. Dr. Singh determined that Minutello was suffering from Mixed Connective Tissue Disease, Systematic Lupus Erythematosis (“SLE”), and Raynaud’s Disease. Id. Minutello applied for long-term disability benefits on December 18, 2001, contending that she was “disabled” within the meaning of the Policy. Id. at ¶ 9. Her application was supported by a statement, provided by Dr. Singh. Id.

Hartford approved Minutello’s application for benefits. ECF Nos. 20 & 32 at ¶ 10. Maryann Iannettone (“Iannettone”), an Examiner for Hartford, communicated the approval to Minutello in a letter dated February 1, 2002. ECF No. 17-1 at 862-863. Although Minutello was deemed to be disabled because of her inability to perform the essential duties of her own occupation, Iannettone’s letter explained that the more demanding “Any Occupation” standard would apply as of June 2, 2003. Id. at 863. Minutello was informed that, regardless of her condition, no benefits would be payable beyond February 12, 2027. Id. The amount of her monthly payment was set at $2,400.76. Id. at 864.

A participant seeking benefits under the Plan must apply for benefits under the Social Security Act [42 U.S.C. §§ 401-433, 1381 — 1383f] when the duration of his or her disability “meets the minimum duration required to apply for such benefits.” 1 ECF No. 17-2 at 16. Minutello was instructed to apply for Social Security disability benefits if she had not already done so. ECF No. 17-1 at 863. In a decision rendered on February 17, 2002, the Social Security Administration (“SSA”) determined that Miniitello had become statutorily “disabled” on June 1, 2001. Id. at 1093. She was advised that benefits under the Social Security Act would be forthcoming. Id.

After investigating Minutello’s condition further, Hartford determined that she was “disabled” under the “Any Occupation” [497]*497standard. ECF Nos. 20 & 32 at ¶ 12. Consequently, Minutello’s benefits under the Plan continued beyond June 2, 2003. ECF No. 17-1 at 1061. On June 7, 2005, Minutello verified that nobody in her family had an alternative source of income or an interest in a business. Id. at 42. Between 2007 and 2009, Dr. Singh submitted annual statements to Hartford supporting Minutello’s continued eligibility for benefits. ECF Nos. 20 & 32 at ¶ 14. Minutello periodically detailed her abilities and limitations in response to inquiries made by Hartford. Id. at ¶ 15.

At some point, Minutello complained of progressive memory problems. ECF Nos. 20 & 32 at ¶ 17. On October 21, 2009, Dr. Hassan Hassouri performed a neurological examination of Minutello to determine whether she was suffering from a memory impairment. Id. at ¶ 16. He recommended that neuropsychometric testing be conducted to ascertain any deficits that she may have had in specific areas. Id. An outpatient neuropsychological assessment was performed by Dr. Tad Gorske on March 2, 2010. Id. at ¶ 17. In most respects, the assessment yielded normal results. Id. at ¶ 18. Although Minutello’s cognitive scores were consistent with those of patients suffering from autoimmune disorders, Dr. Gorske suggested that such cognitive difficulties were attributable to anxiety and depression. Id. at ¶ 19. A magnetic resonance imaging (“MRI”) scan was recommended to rule out intracranial pathology.

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Bluebook (online)
964 F. Supp. 2d 491, 2013 WL 4053144, 2013 U.S. Dist. LEXIS 112942, Counsel Stack Legal Research, https://law.counselstack.com/opinion/minutello-v-hartford-life-accident-insurance-pawd-2013.