Rhorer v. Raytheon Engineers & Constructors, Inc.

181 F.3d 634, 1999 U.S. App. LEXIS 15948, 1999 WL 499567
CourtCourt of Appeals for the Fifth Circuit
DecidedJuly 15, 1999
Docket98-20347
StatusPublished
Cited by85 cases

This text of 181 F.3d 634 (Rhorer v. Raytheon Engineers & Constructors, Inc.) 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
Rhorer v. Raytheon Engineers & Constructors, Inc., 181 F.3d 634, 1999 U.S. App. LEXIS 15948, 1999 WL 499567 (5th Cir. 1999).

Opinion

DeMOSS, Circuit Judge:

The plaintiff-appellant, Susan Rhorer (“Rhorer”), appeals the summary judgment dismissal of her suit to recover life insurance benefits under an employee benefits plan governed by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. Rhorer initially filed a claim for benefits with the plan administrator, defendant-ap-pellee, Raytheon Engineers & Constructors (“Raytheon”). Raytheon denied the claim on the ground that her deceased husband had not satisfied a requirement in the policy that required Mr. Rhorer to be actively at work on a full time basis (“the active work requirement”). The main issue in this appeal is whether the district court properly found that there was no triable issue of fact on the question of whether Raytheon abused its discretion in denying her claim. For the following reasons we affirm the district court in part, reverse in part, and remand for further proceedings.

I.

Rhorer’s late husband, James E. Rhorer (“Mr. Rhorer”), was the president of Lit-win Corporation, an engineering firm, from 1978 until 1995. In May 1995 he was diagnosed with high grade lymphoma and in early July began to work from his home and hospital room. 1 On July 26, Raytheon purchased Litwin and agreed to retain Mr. Rhorer as a full-time employee at the same title and salary. At the time of the purchase, Raytheon knew of Mr. Rhorer’s illness and was aware that he was no longer working from his office.

After purchasing Litwin, Raytheon sent its employees enrollment materials for participation in Raytheon’s employee benefits plan. Those materials contained a summary plan description, called Blueprints, but did not include a copy of the plan’s group life insurance policy. In August 1995, Mr. Rhorer reviewed those materials, elected $990,000 in optional life insurance coverage, to take effect on September 1, 1995, and began paying the required premiums. 2 On November 21, 1995, Raytheon notified Mr. Rhorer by letter that his optional life insurance election would not take effect until he actively returned to work. By that time, Mr. Rhorer was physically unable to return to work. He died on December 1, 1995.

After the death of her husband, Rhorer filed a claim for $990,000 in benefits based on the optional life insurance policy Mr. Rhorer had elected under the plan. Ray-theon denied her claim on the ground that Mr. Rhorer had not complied with the active work requirement contained in the insurance policy. That condition of coverage required that participating employees “be actively at work on full time at the business establishment of the Employer or at other locations to which the Employer’s business requires the Employee to travel.” Rhorer then filed an administrative appeal, which was denied.

On February 4, 1997, Rhorer, as executrix of her husband’s estate, sued Ray-theon in federal district court seeking to recover the proceeds from her husband’s optional life insurance policy. Rhorer, on *638 behalf of the plan, also asserted a claim against Raytheon for breach of its fiduciary duty under ERISA. See 29 U.S.C. §§ 1132(a)(2) & 1109. 3 Both claims rested on the contention that the summary plan description failed to adequately disclose the active work requirement, in violation of ERISA and the applicable administrative regulations. Rhorer subsequently moved for partial summary judgment on her benefits claim. Raytheon responded and filed a cross-motion for summary judgment against all of Rhorer’s claims. In a memorandum opinion the district court denied Rhorer’s partial summary judgment motion, granted Raytheon’s motion, and dismissed Rhorer’s suit in its entirety. Rhorer appeals. 4

II.

We review a district court’s grant of summary judgment de novo. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986); Todd v. AIG Life Ins. Co., 47 F.3d 1448, 1451 (5th Cir.1995). Summary judgment is appropriate if the record discloses “that there is no' genuine issue as to any material fact and the moving party is entitled to a judgment as a matter of law.” Fed.R.Civ.P. 56(c). In making this determination we must evaluate the facts in the light most favorable to the non-moving party. Matsushita, 475 U.S. at 587, 106 S.Ct. 1348; Todd, 47 F.3d at 1451.

III.

A.

The first issue we must consider is the applicable standard for reviewing Ray-theon’s ■ denial of Rhorer’s claim for life insurance benefits. Rhorer asserts that de novo review is the proper standard because this action presents the legal question of whether the summary plan description was sufficiently accurate under ERISA. See Penn v. Howe-Baker Eng’rs, Inc., 898 F.2d 1096, 1100 & n. 3 (5th Cir.1990). When presented with this argument, the district court found that Rhorer’s suit was more properly viewed as a challenge to Raytheon’s interpretation of the plan’s terms. The district court thus held that under Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989), Raytheon’s decision was governed instead by the abuse of discretion standard.

Rhorer’s first amended complaint alleges two separate causes of action under the ERISA statute. In count one Rhorer sues under § 1132(a)(1)(B) of ERISA to recover the insurance benefits allegedly owed to her under the plan. 5 See 29 U.S.C. § 1132(a)(1)(B). In count two she asserts a claim under § 1132(a)(2), alleging that Raytheon violated its fiduciary duty as plan administrator by publishing a misleading and incomplete summary plan description. 6 See 29 U.S.C. § 1132(a)(2). *639 We note the distinction between these two claims because each claim, as alleged, requires a different standard of review. Rhorer’s claim to recover plan benefits under § 1132(a)(1)(B) is a direct challenge to Raytheon’s interpretation of the plan’s terms. Accordingly, since1 the plan expressly vests Raytheon with the discretionary authority to construe its terms, under Firestone

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Bluebook (online)
181 F.3d 634, 1999 U.S. App. LEXIS 15948, 1999 WL 499567, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rhorer-v-raytheon-engineers-constructors-inc-ca5-1999.