Reliable Home Health v. Union Central Ins C

CourtCourt of Appeals for the Fifth Circuit
DecidedJuly 10, 2002
Docket01-30331
StatusPublished

This text of Reliable Home Health v. Union Central Ins C (Reliable Home Health v. Union Central Ins C) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reliable Home Health v. Union Central Ins C, (5th Cir. 2002).

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 __________________________

Plaintiffs-Appellants,

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,

2 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

3 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.

4 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.

5 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.

Reliable filed suit against Glapion and Union Central, but

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