Reliable Home Health v. Union Central Ins C

Court of Appeals for the Fifth Circuit·Decided July 10, 2002·No. 01-30331·Published

Opinion

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT

No. 01-30174

RELIABLE HOME HEALTH CARE, Inc.; LOUIS T. AGE, Jr., Plaintiffs-Appellants-Cross Appellees, versus UNION CENTRAL INSURANCE COMPANY; Et Al, Defendants,

GLAPION GROUP, Inc.; ROBERT JODY SANDERSON; WALTER A. GLAPION, Jr.; AMERICAN AUTOMOBILE INSURANCE COMPANY,

Defendants-Appellees-Cross-Appellants.

No. 01-30331

RELIABLE HOME HEALTH CARE, Inc.; LOUIS T. AGE, Jr., Plaintiffs-Appellants,

versus UNION CENTRAL INSURANCE COMPANY; Et Al, Defendants,

GLAPION GROUP, Inc.; ROBERT JODY SANDERSON; WALTER A. GLAPION, Jr.; AMERICAN AUTOMOBILE INSURANCE COMPANY,

Defendants-Appellees.

Appeals from the United States District Court for the Eastern District of Louisiana

July 10, 2002

Before DUHÉ, DeMOSS, and CLEMENT, Circuit Judges. CLEMENT, Circuit Judge:

Reliable Home Health Care, Inc. (“Reliable”) filed suit against the Glapion Group, Inc. (“Glapion”) for breach of its fiduciary duties arising out of a deferred compensation plan created by Glapion for Reliable. This case involves a claim of breach of fiduciary duty under ERISA. Prior to trial, Reliable settled with Union Central Insurance Co. (“Union Central”) for $165,000. Following a bench trial, the district court found that Glapion breached its fiduciary duty to Reliable by failing to advise Reliable it would lose the cash surrender value in its insurance policies if it stopped paying premiums or by failing to recover the money after it was lost. The court found Glapion liable for $58,075.87, the cash surrender value of the policies. However, no damages were awarded because the court held that Reliable was made whole by its settlement with Union Central. The court also held that each party was to bear its own costs but did award Glapion costs and attorneys’ fees in the amount of $8,264.75 for an unsuccessful attempt to take trial testimony via video conference due to plaintiff’s lack of cooperation. Both parties timely appealed the court’s decision. For the following reasons,

we AFFIRM in part and REVERSE in part.

I. Facts and Proceedings Louis Age (“Age”) is the CEO for Reliable, a Medicare certified home health care agency doing business in and around New Orleans. Reliable’s services include in-home nursing, nursing aid, and rehabilitation services. Age was a licensed insurance broker formerly employed by Union Central. Glapion, owned and operated by Walter A. Glapion, Jr. and Robert J. Sanderson (“Sanderson”), was an agent for Union Central. Mr. Glapion was the general manager for Union Central and wrote insurance for it in addition to other insurance companies.

In 1992, Age contacted Mr. Glapion, a former colleague, concerning having Glapion create deferred compensation plans for Age and other executive employees of Reliable. Age forwarded a copy of a deferred plan seeking one similar to it. He also sent copies of the Medicare regulations for such plans which preclude the use of whole life policies as funding mechanisms. Age informed Glapion that he wanted a deferred compensation plan containing group insurance in addition to a cash product, preferably an annuity.

As a Medicare provider, Reliable was entitled to reimbursement for necessary and reasonable costs which included premiums for payment of policies, including the policies which provided the funding mechanism for the deferred compensation plan. Pursuant to the Medicare cost reimbursement system, Medicare reimburses its

providers, such as Reliable, through interim payments throughout the course of the provider’s fiscal year. At the end of each fiscal year, the provider prepares and submits a cost report and trial balance to an intermediary, an organization under contract to the Department of Health and Human Services, for approval. Blue Cross/Blue Shield of New Mexico was designed by the Health Care Financing Administration (“HCFA”) as its intermediary for Louisiana. David Fiedler was the intermediary who audited and approved Reliable’s cost reports.

Glapion wrote a pension plan for Reliable which was rejected in February 1993 by Fiedler because it included a whole life insurance policy. As a result, Glapion employed an attorney to create an adequate deferred compensation plan for Reliable. The attorney created a prototype for Glapion in September 1993. In March 1994, Fiedler approved the prototype. Glapion used the prototype to make the plan for Reliable and used Selectex as a funding mechanism. The prototype, completed in 1993, was backdated and signed to reflect a November 1992 date, the date on which the Plan was initially created for Reliable. The Plan was signed by Sanderson on behalf of Age.1 Despite assertions that he did not sign nor ever see the

1 Age argues that Sanderson was not authorized to sign any documents on his behalf. However, testimony elicited at trial indicated that Age did give other people authority to sign his name.

deferred compensation plan, Age paid the premiums from 1992 until April 1994. Additionally, from 1992 to 1997, Reliable submitted cost reports detailing costs for which it sought reimbursement. The cost reports were submitted to Fiedler who issued a Notice of Program Reimbursement (“NPR”) and reimbursed Reliable for costs incurred through the payment of premiums for these years. Age signed the reports certifying that all costs claimed on the reports were permissible under Medicare regulations.

Sanderson was told by Union Central that Reliable’s policy was paid up to date with a credit of $39,858.29 on February 22, 1996. A check from Union Central was received in the amount of $15,490.93, made payable to Liberty Bank and Trust, the custodian of Reliable’s plan on October 7, 1996.2 Sanderson advised Age to discontinue payments until a determination could be made as to the whereabouts of approximately $24,000, the difference between the credit Reliable was told it had and the $15,000 check it received.3 On December 31, 1996, Age was informed by Union Central that he owed $135,418.78 and would be terminated retroactive to April 1, 1994, the date of the last payment, unless the Plan was made

2 While Liberty was the designated custodian and owner of the policies by the Plan, no money was ever deposited with Liberty on behalf of Reliable. No escrow account was ever opened. Dividend checks sent from Union Central to Liberty on behalf of the Reliable participants were endorsed by Liberty and then delivered to the participants.

3 Unbeknownst to Sanderson, Age had stopped paying premiums to Union Central in April 1994.

current by June 1, 1997. Once Union Central conducted the accounting, Glapion advised Age to resume paying the premiums in order to make the Plan current. Age did not resume payment of the premiums. When the policy was terminated, its cash surrender value was severely depleted because Union Central had instituted the automatic loan provisions of the policies to pay for the delinquent premiums. Age claims he was unaware of the existence of this provision.

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