Murray v. Hartford Life & Accident Insurance

623 F. Supp. 2d 1341, 2009 U.S. Dist. LEXIS 52192
CourtDistrict Court, M.D. Florida
DecidedJune 11, 2009
Docket8:08-cv-00150
StatusPublished
Cited by3 cases

This text of 623 F. Supp. 2d 1341 (Murray v. Hartford Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Murray v. Hartford Life & Accident Insurance, 623 F. Supp. 2d 1341, 2009 U.S. Dist. LEXIS 52192 (M.D. Fla. 2009).

Opinion

Order

ANNE C. CONWAY, District Judge.

This cause comes before the Court for consideration of Defendant Hartford Life & Accident Insurance Company’s (“Hartford Life”) Dispositive Motion for Summary Judgment (Doc. No. 19), filed on January 9, 2009. Plaintiff David Murray (“Murray”) filed a response in opposition (Doc. No. 21) to Hartford Life’s Motion for Summary Judgment on January 22, 2009. Hartford Life filed a reply in support of its motion for summary judgment (Doc. No. 24) on March 2, 2009. 1 Based on the parties’ submissions and a review of the administrative record and relevant case law, the Court concludes that Hartford Life is entitled to judgment as a matter of law on Murray’s claims.

I. BACKGROUND

Murray was employed at Publix Super Markets, Inc. (“Publix”) as an assistant store manager. (Doc. No. 20 Ex. 3 p. 56.) According to Publix’s job description, an assistant store manager’s main function is to “assist in leading the management team in operating a quality store” and to be “[rjesponsible for [the] total store in the absence of the Store Manager.” (Id. at 58.) Murray’s duties included the following:

*1343 1. working with the store manager and department managers to improve operations;
2. assisting in setting goals, developing plans, overseeing inventory-control and merchandising of product;
3. ensuring all associates are treated with dignity and respect;
4. supervising and assisting in evaluation and training of associates and participating in hiring and disciplinary actions when appropriate;
5. assisting in projecting sales and controlling costs;
6. reinforcing all company policies, and all local, state and federal regulations;
7. reinforcing sanitation, security and safety guidelines;
8. utilizing excellent interpersonal skills;
9. maintaining good public relations, including following up on customer and associate issues;
10. assisting in monitoring competition;
11. assisting customers; and
12. completing other duties as may arise.

(Id.) As to “Working Conditions,” the Pub-lix job description stated:

An Assistant Store Manager’s duties are performed primarily throughout the store and involve accepting responsibility for leading others. An Assistant Store Manager may be exposed to various temperature changes, work environments and types of tasks performed. Work includes frequent walking, standing and interaction with customers, associates, district staff and vendors.

(Id. at 59.) Murray participated in Pub-lix’s employee welfare benefit plan and was issued a long-term disability (“LTD”) policy (the “Policy”). (Doc. No. 1 ¶ 6.)

LTD benefits were payable to a participant who became totally disabled, as defined in the Policy, and remained continuously totally disabled through and beyond the Policy’s elimination period (the “Elimination Period”). (Doc. 1 Ex. A p. 18, 25.) The Policy defined “totally disabled” as follows:

Totally Disabled means that:
(1) during the Elimination Period; and
(2) for the next 24 months, you are prevented by Disability from doing all the material and substantial duties of your own occupation on a full-time basis.
After that, and for as long as you remain Totally Disabled, you are prevented by Disability from doing any occupation or work for which you are, or could become, qualified by:
(1) training;
(2) education; or
(3) experience.

(Id. at 25.) The Policy defined the Elimination Period as follows:

Elimination Period means the period of time you must be Totally Disabled before benefits become payable. The Elimination Period for this Plan is the first 90 days of any one period of Total Disability. If you cease to be Totally Disabled and return to work for a total of 14 days or less during an Elimination Period, the Elimination Period will not be interrupted or extended.
Except for the 14 days or less you work, you must be Totally Disabled by the same condition for the total Elimination Period.

(Id. at 18.) Thus, for the Elimination Period and the following twenty-four months, the question is whether a claimant is disabled from performing the material and substantial duties of his own occupation on a full-time basis. After twenty-four months of benefits, the question is whether *1344 a claimant is disabled from performing the duties of any occupation for which the claimant is, or could become, qualified by training, education, or experience.

On December 26, 2006, Murray fell from a four foot stepladder while changing a light bulb in his kitchen, landing on his heels. (Doc. No. 20 Ex. 3 p. 100.) He was barefoot at the time. (Id.) Immediately after the accident, he was seen at Winter Park Memorial Hospital’s emergency room for back and bilateral heel pain. (Id.; Doc. No. 20 Ex. 4 pp. 3, 52.) On December 28, 2006, Murray, using crutches, was seen at the Jewett Orthopaedic Clinic (“Jewett Clinic”) in Winter Park, Florida. (Doc. No. 20 Ex. 4 p. 3.) Hugo Quevedo, PA-C 2 (“Quevedo”) examined Murray and reported that Murray rated his pain as 5 out of 10 and worse with motion. (Id.) Quevedo further noted that Murray stated he was having increased difficulty ambulating and was unable to put any pressure on his heels. (Id.) Additionally, Quevedo stated that Murray will “remain off work for the next 4 weeks.” (Id. at 1.) The diagnostic impression of the right knee revealed an incidental finding of patellofemoral arthritis. (Id. at 2.) No fractures, dislocations, or obvious subluxations were found in the left knee. (Id.) The diagnostic impression of the left foot revealed “what appeared] to be a fracture of the neck of the calcaneus, with an undetermined fracture of the calcaneal spur.” (Id. at 1-2.) “Radio-graphs of the right foot reveal[ed] what appear[ed] to be an acute fracture of the calcaneal spur.” (Id. at 1.)

On December 29, 2006, Ivan Repass, PA-C (“Repass”) examined Murray at the Jewett Clinic in connection with mid-thoracic back pain. (Doc. No. 20 Ex. 3 p. 100.) Repass noted that Murray’s “pain is somewhat improved, and now is pretty much a dull pain. When he rotates at the waist, he has the acute onset of sharp pain. He has pain if he lies fiat on his back.” (Id.)

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Bluebook (online)
623 F. Supp. 2d 1341, 2009 U.S. Dist. LEXIS 52192, Counsel Stack Legal Research, https://law.counselstack.com/opinion/murray-v-hartford-life-accident-insurance-flmd-2009.