O'LEARY v. Provident Life and Accident Ins. Co.

456 F. Supp. 2d 285, 40 Employee Benefits Cas. (BNA) 1436, 2006 U.S. Dist. LEXIS 76438, 2006 WL 2989016
CourtDistrict Court, D. Massachusetts
DecidedOctober 20, 2006
DocketCivil Action 03-40245-FDS
StatusPublished
Cited by3 cases

This text of 456 F. Supp. 2d 285 (O'LEARY v. Provident Life and Accident Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
O'LEARY v. Provident Life and Accident Ins. Co., 456 F. Supp. 2d 285, 40 Employee Benefits Cas. (BNA) 1436, 2006 U.S. Dist. LEXIS 76438, 2006 WL 2989016 (D. Mass. 2006).

Opinion

MEMORANDUM AND ORDER

SAYLOR, District Judge.

This is an action concerning an employee disability policy. Plaintiff James R. O’Leary seeks to recover benefits under a disability policy issued by defendant Provident Life and Accident Insurance Company. O’Leary alleges that he became disabled on December 23, 1998, and has remained so since that time. Provident paid disability benefits for about a year and a half, but then determined that O’Leary was not totally disabled and discontinued paying benefits.

The complaint, which alleges only state law claims, was filed in the Worcester Superior Court. Defendant removed the action to federal court, contending that the case is governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq (“ERISA”), and that plaintiffs state law claims are accordingly preempted. Plaintiff contends, however, that Massachusetts state law governs the action in all respects. Pursuant to an order of this Court, the parties conducted limited discovery and submitted memoran-da as to whether the claims are governed by federal or state law. While neither party has formally moved for summary judgment, defendant’s memorandum requests that the Court dismiss plaintiffs state law claims on the ground that they are preempted by ERISA. Because both memoranda make reference to evidence outside the pleadings, the Court will treat defendant’s memorandum as a motion for *287 summary judgment, arising under Federal Rule of Civil Procedure 56. 1

For the reasons stated below, summary judgment will be granted. Plaintiff, however, will be given thirty days to seek reconsideration or move for other relief.

I. Factual Background

The facts, which are largely undisputed, are set forth in the light most favorable to the plaintiff.

A. O’Leary’s Employment

The New England Carpenters Training Fund (the “Fund”) is a trust, whose Board of Trustees consists of representatives of both labor unions and employers. 2 The Fund’s purpose is to train apprentice carpenters. It is a stand-alone entity with a training facility located in Millbury, Massachusetts. While the number of Fund employees has varied, it presently has an administrator, seven instructors, three secretaries, and four kitchen workers.

O’Leary was hired as the Fund’s administrator in 1988. As administrator, his duties were to oversee training, develop curriculum, supervise office staff and instructors, attend various apprenticeship training committee meetings throughout the country, and administer the school. O’Leary reported directly to the Fund’s Board of Trustees.

The Board of Trustees decided to hire O’Leary at a meeting held on August 25, 1988. The minutes of that meeting indicate that the Fund would provide him with health benefits, pension benefits, and a deferred compensation plan. There is no mention in the minutes of a disability policy. Subsequently, O’Leary received several documents from the fund, including: (1) a personnel policy for salaried employees; (2) a James O’Leary Employee Benefit Plan for deferred compensation; (3) a Pension Fund summary plan description; (4) an Annuity Fund summary plan description; and (5) a Health Benefits summary plan description. None of these documents make reference to a disability policy or disability insurance benefits.

B. Disability Coverage

A few weeks after O’Leary began working for the Fund, it decided to provide him with disability insurance coverage. Apparently, a number of business agents of local unions had received disability coverage, and the Board of Trustees had decided to provide the same benefit to the Fund’s administrator. It is undisputed that the decision to provide disability insurance was made by the Board of Trustees. It is further undisputed that O’Leary was the only Fund employee to receive this coverage.

Following the Board’s decision to provide coverage, O’Leary applied for a disability policy with Provident. On his application, O’Leary stated that his employer would “pay for all disability coverage to be carried by [me] with no portion of the premium to be included in [my] taxable income.” (Harrington Dep., Ex. 9).

The disability policy took effect at some point in 1988. The policy included a “Sala *288 ry Allotment Premium Payment” rider, which provides:

In consideration of the Salary Allotment Agreement between your employer and us, we agree to accept Policy Premiums as billed to your employer.

The conditions of this rider are:

1. The policy will not continue in force beyond the time for which the premium is paid, subject to the grace period.
2. If your employer fails to pay premiums when due because of clerical error or negligence, your insurance under the policy will not be prejudiced.
3. This rider will be void if:
a. your employment with your employer ends;
b. the Salary Allotment Agreement is terminated; or
c. for any reason, your employer fails to pay premiums.
4. If this rider is voided, premiums will be due and payable as required in the policy.

(Harrington Dep., Ex. 9)

O’Leary issued payments for the premium amount on Massachusetts Carpenters Training Fund checks, which he was authorized to sign. There is no dispute that the Fund paid 100% of the premium amount. The policy provided annual opportunities to increase the amount of the disability benefit. In order to accept such increases, O’Leary had to obtain the Board’s approval. The Board gave its approval on a number of occasions, and at least once disapproved an increase in the benefit.

Although the Board of Trustees had discretion to terminate O’Leary’s disability coverage at any time, it kept the policy in place during the entirety of his employment with the Fund. O’Leary never received a summary plan description or any other such documentation in connection with the disability policy. The Fund kept a physical copy of the disability policy.

C. Denial of Disability Benefits

O’Leary contends that he became disabled under the terms of the disability policy on December 23, 1998. The nature of the disability is unclear. He subsequently applied for benefits, and on April 23, 1999, Provident began making payments to him — informing him nonetheless that the company reserved the right to make a different formal determination regarding benefits after its investigation into his alleged disability.

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Bluebook (online)
456 F. Supp. 2d 285, 40 Employee Benefits Cas. (BNA) 1436, 2006 U.S. Dist. LEXIS 76438, 2006 WL 2989016, Counsel Stack Legal Research, https://law.counselstack.com/opinion/oleary-v-provident-life-and-accident-ins-co-mad-2006.