Reber v. Provident Life & Accident Insurance

93 F. Supp. 2d 995, 2000 U.S. Dist. LEXIS 6409, 2000 WL 427073
CourtDistrict Court, S.D. Indiana
DecidedMarch 29, 2000
DocketIP99-0099-C-T/G
StatusPublished
Cited by7 cases

This text of 93 F. Supp. 2d 995 (Reber v. Provident Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reber v. Provident Life & Accident Insurance, 93 F. Supp. 2d 995, 2000 U.S. Dist. LEXIS 6409, 2000 WL 427073 (S.D. Ind. 2000).

Opinion

ENTRY DISCUSSING PENDING MOTIONS

TINDER, District Judge.

This matter comes before the court on the following motions: Defendant Provident Life & Accident Insurance Company’s (“Provident”) Motion to Dismiss and Motion to Strike, seeking dismissal of the Complaint, or alternatively, seeking to strike the demand for extracontractual damages and a jury trial, on the grounds that the state law theories in the Complaint are preempted by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001, et seq.; and, Plaintiff Deborah J. Reber’s Petition to Remand and alternative Motion for Leave to Amend Complaint, seeking a remand of this action on the grounds that the disability insurance contract at issue is not governed by ERISA and this court lacks federal question jurisdiction. After considering the motions and the submissions of the parties, the court finds as follows.

I. Facts 1

In 1986, Ms. Reber was employed by the California law firm or Haasis, Pope & Cor- *997 rell (“Law Firm”). 2 The Law Firm provided her with disability coverage under a group insurance policy (“Group Policy”), issued by Paul Revere Insurance Company (“Paul Revere”). On April 1, 1986, Ms. Reber also became covered by the policy at issue in this case, an individual policy of disability insurance from Provident (“Provident Policy” or “Policy”).

The Policy contains a “Salary 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 the 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.

(Compl., Ex. A at 14.) The “Salary Allotment Agreement” between the Law Firm and Provident provides that:

“[t]he Employer agrees as respects policies issued by the Insurance Company to certain individuals ... [t]o pay a portion of the required premiums and to make salary deductions of the remainder of the required premiums for such policies, and to remit such premiums to the Insurance Company when due.... ”

(Thompson Aff., Ex. A.) As a part of the agreement between the Law Firm and Provident, Provident discounted the premiums on the Policy by ten percent. (Thompson Aff. ¶ 3.) This discount was only available to eligible employees of the Law Firm by virtue of their employment. (Id. ¶¶ 2-3.) Also, because the Law Firm agreed to pay at least a portion of the premiums, Ms. Reber was provided with a higher level of coverage than would have been available absent her employment with the Law Firm. (Id.)

Between 1984 and 1989, Provident covered as few as four and as many as twenty of the employees of the Law Firm with various disability policies (including Ms. Reber). (Supplemental Aff. of Terry Thompson ¶ 2.) The premiums of each policy were billed to the Law Firm on a group billing statement. (Id.) When an individual’s coverage was canceled, any premium refund was issued to the Law Firm. (Id.)

A Provident agent met with Ms. Reber, explained the Policy, took her application, and handled the entire application process. (Reber Aff. ¶¶ 2-4.) On her application, Ms. Reber stated that her 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.” (Notice of Removal, Ex. A.) Ms. Reber never received a summary plan description, annual reports, or any other such documentation in connection with the Policy. (Reber Aff. ¶ 5.)

*998 Later in 1986, Ms. Reber experienced the onset of a severe bladder dysfunction. Provident investigated her claim on the Policy and determined that she was totally disabled. Paul Revere also determined that she was totally disabled pursuant to the Group Policy. Likewise, Ms. Reber applied for, and received, Social Security disability benefits.

At that point, Ms. Reber had no further involvement with the Law Firm, and Provident paid disability benefits on the Policy directly to her. Pursuant to the Policy terms, Provident waived any premiums on the Policy while Ms. Reber was disabled.

In 1989, the Law Firm terminated its Salary Allotment Agreement with Provident. The Law Firm instructed Provident to cancel every policy listed on Provident’s billing statement, including Ms. Reber’s Policy (which had continued to be listed on the Law Firm’s billing statement with a premium amount of “$0”, pursuant to the waiver of premium provision contained in the Policy). The Law Firm went defunct in 1989, and had no further involvement with Provident or Ms. Reber.

Despite the termination of the Salary Allotment Agreement between the Law Firm and Provident, Provident continued to pay Ms. Reber benefits and continued to waive the Policy premiums.

Provident reviewed Ms. Reber’s claim on a periodic basis. In June 1998, Provident terminated Ms. Reber’s disability benefits.

On January 8, 1999, Ms. Reber filed the Complaint in Hamilton (Indiana) Superior Court, seeking damages for Provident’s alleged breach of contract and bad faith termination of benefits. Provident removed the ease to this court, alleging federal question jurisdiction under ERISA, on the grounds that the Policy is an ERISA employee welfare benefit plan. Provident then filed its Motion to Dismiss and Motion to Strike on the basis of ERISA preemption. Ms. Reber filed her Petition to Remand on the grounds that the Policy is not an ERISA plan. Ms. Reber also filed a Motion for Leave to Amend Complaint, in the event the court finds that the Policy is governed by ERISA.

II. Discussion

The burden of showing that removal was appropriate rests upon Provident, as the party seeking the removal. See Jones v. General Tire & Rubber Co., 541 F.2d 660, 664 (7th Cir.1976). The central issue in determining whether removal was appropriate is whether the Policy is part of an employee benefit plan that is subject to ERISA. ERISA generally applies only to employee benefit plans. See 29 U.S.C.

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Bluebook (online)
93 F. Supp. 2d 995, 2000 U.S. Dist. LEXIS 6409, 2000 WL 427073, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reber-v-provident-life-accident-insurance-insd-2000.