Richards v. Hartford Life and Accident Ins. Co.

356 F. Supp. 2d 1278, 2004 U.S. Dist. LEXIS 27045, 2004 WL 3167317
CourtDistrict Court, S.D. Florida
DecidedDecember 1, 2004
Docket03-81066-CIV-RYSKAMP, 03-81066-CIV-VITUNAC
StatusPublished
Cited by14 cases

This text of 356 F. Supp. 2d 1278 (Richards v. Hartford Life and Accident Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, S.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Richards v. Hartford Life and Accident Ins. Co., 356 F. Supp. 2d 1278, 2004 U.S. Dist. LEXIS 27045, 2004 WL 3167317 (S.D. Fla. 2004).

Opinion

ORDER GRANTING DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT AND DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT

RYSKAMP, District Judge.

THIS CAUSE comes before the Court pursuant to the parties’ cross-motions for summary judgment. Hartford Life and Accident Insurance Company and Fidelity National Financial, Inc. (“Hartford” and “Fidelity”; collectively “Defendants”) moved for summary judgment on September 16, 2004 [DE 33]. Rosemary Richards (“Plaintiff’) moved for summary judgment on September 28, 2004 [DE 38]. The Court heard oral argument on these motions on November 17, 2004. These motions are ripe for adjudication.

I.BACKGROUND

Plaintiff brings this action pursuant to the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 based on Hartford’s denial of her claim for long term disability benefits under policyholder Fidelity’s ERISA welfare benefit plan. (Compl.lffl 6, 9.) Fidelity employed Plaintiff as a title examiner from April 9, 1999 through October 8, 2002. (Administrative Record, “A.R.” 373.) According to the Policy,

Disability or Disabled means that during the Elimination Period and for the next 24 months you are prevented by:
1. accidental body injury;
2. sickness;
3. Mental Illness;
4. Substance Abuse; or
5. pregnancy,
from performing one or more of the Essential Duties of Your Occupation. .. .After that, you must be so prevented from performing one or more of the Essential Duties of Any Occupation.

*1280 (Ex. A. at 15.) The Policy defines “Your Occupation” as “your occupation as it is recognized in the general workplace. Your Occupation does not mean the specific job you are performing for a specific employer or at a specific location.” (Ex. A. at 17.) Hartford based its decision to deny benefits on the following definition of the position of title examiner:

The job description and key responsibilities of the Title Examiner position are to proofread and ensure accuracy of all work processing work including but not limited to correct book and page information. Review of all title orders over your authorized level with an underwriter. Assist customers, agents and employees with various title problems and/or concerns as they arise in a courteous and friendly manner. Search, examine and review all title work to ensure compliance with customers instructions applicable state, company guidelines and/or the transactions structure and intent. Prepare policies and endorsements for direct non-escrow orders. Review of new files within 24 hours of receiving to ascertain if any information is needed from customer in order to examine the property. Call customer as soon as possible if order cannot be completed by the time it is needed, cost will exceed our normal charge or any other serious issues. Search and examine complex titles, often without help of pri- or title evidence, in such a manner that claims are minimized.

(A.R.220-21.) The Department of Labor rates the level of physical exertion an occupation requires according to five categories: sedentary, light, medium, heavy and very heavy. (A.R.113.) Hartford classified the position of “title examiner” as sedentary. See A.R. 79 (“[Plaintiff] was working in a sedentary exertion-level occupation as a Title Examiner”); A.R. 113 (classifying Plaintiffs job as “sedentary” according to Department of Labor categorization scheme). The Department of Labor’s Dictionary of Occupational Titles defines sedentary work as requiring exertion of “up to 10 pounds of force occasionally ... and/or a negligible amount of force frequently ... to lift, carry, push, pull, or otherwise move objects.” Lopes v. Metropolitan Life Ins. Co., 332 F.3d 1, 3 (1st Cir.2003). The Policy gave Hartford “full discretion and authority to determine eligibility for benefits and to construe and interpret all terms” of the Policy. (Ex. A. at 14.)

Plaintiff began experiencing severe shoulder pain and tingling in her left arm in 1985. (A.R.416.) These symptoms dissipated, but Plaintiff continued to have periodic bouts of shoulder, hand and arm pain. Id. Plaintiff was involved in a car accident in December of 1995, after which she noticed tingling in her right upper thigh. (A.R.87, 416.) In 1997, while bending over, Plaintiff heard a “pop” and felt pain in her neck. (A.R.416.) Plaintiff had a C4-5 cervical fusion in 1998. In 1999, Plaintiff slipped and fell in a restaurant. In May of 2000, Plaintiff began experiencing a tingling sensation in the right side of her face. Id. In May of 2001, Plaintiff walked into a sliding glass door, lacerated her nose and fell backwards onto a pool table, hitting her head. (A.R.393). In July of 2001,’ Plaintiff sought the care of neurologist Paul Elliott, D.O. (“Dr.Elliott”), complaining of headaches and “all sorts of pain-type conditions.” Id. Dr. Elliott noted that Plaintiff may be suffering from Multiple Sclerosis (“MS”), but that previous physicians Plaintiff had consulted believed that Plaintiffs problems related to her cervical spine. Id. In April of 2002, Plaintiff experienced pain and foggy vision in her right eye. (A.R.416.) Plaintiff experienced pain in both eyes in May of 2002. In June of 2002, Plaintiff again experienced pain and foggy vision in her right eye. Id. In July of 2002. Plaintiff *1281 experienced left arm pain and began to feel fatigued. Id.

Plaintiff ceased work on July 12, 2002. complaining of neck and back arthritis, herniated discs and possible MS. Plaintiff claimed to have difficulty concentrating, writing and keyboarding. (A.R.79.) Plaintiff applied for and received short term disability benefits. (A.R.308.) In support of her application for short term benefits, Plaintiff enclosed an August 9, 2002 statement from Dr. Elliott showing that Plaintiffs subjective symptoms consisted of chronic pain, intermittent blurred vision, confusion and depression. (A.R. 434.) Dr. Elliott made a primary diagnosis of MS and secondary diagnoses of cervical herniated nucleus pulposis, hypertension and fibromyalgia. (A.R.373, 454, 368, 434-35.) Dr. Elliott’s statement also indicated that two MRIs of Plaintiffs brain showed that Plaintiff suffered from demye-linating disease. (A.R.434.) As to physical restrictions, Dr. Elliott believed that Plaintiff could stand for two hours with a 15 minute break, walk for two hours with a 15 minute break, lift or push 10 pounds and sit for indefinite periods of time. Dr. Elliott believed that Plaintiff could drive as long as she was not experiencing blurred vision. Nevertheless, he cautioned that Plaintiff should avoid reaching over her head and should avoid activities involving repetitive motion. (A.R.434-35.)

Plaintiffs short term benefits expired on September 15, 2002. (A.R. 308.) On December 30, 2002. Plaintiff applied for long term disability benefits based on the same reported conditions. (A.R.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Ness v. Aetna Life Insurance Co.
257 F. Supp. 3d 1280 (M.D. Florida, 2017)
Vivas v. Hartford Life & Accident Insurance
49 F. Supp. 3d 1124 (S.D. Florida, 2014)
Howard v. Hartford Life & Accident Insurance
929 F. Supp. 2d 1264 (M.D. Florida, 2013)
Bloom v. Hartford Life & Accident Insurance
917 F. Supp. 2d 1269 (S.D. Florida, 2013)
Richey v. Hartford Life & Accident Insurance
608 F. Supp. 2d 1306 (M.D. Florida, 2009)
Pylant v. Hartford Life & Accident Insurance
497 F.3d 536 (Fifth Circuit, 2007)
Massengill v. Shenandoah Life Insurance
459 F. Supp. 2d 656 (W.D. Tennessee, 2006)
Pylant v. Hartford Life & Accident Insurance
429 F. Supp. 2d 816 (N.D. Texas, 2006)
Anderson v. Unum Life Ins. Co. of America
414 F. Supp. 2d 1079 (M.D. Alabama, 2006)
Rosemary R. Richards v. Hartford Life & Accident
153 F. App'x 694 (Eleventh Circuit, 2005)
Tsoulas v. Liberty Life Assur. Co. of Boston
397 F. Supp. 2d 79 (D. Maine, 2005)
Ecklund v. Continental Casualty Co.
415 F. Supp. 2d 1353 (N.D. Alabama, 2005)
Normil v. Colonial Life & Accident Insurance
403 F. Supp. 2d 1159 (S.D. Florida, 2005)
Panther v. Synthes (U.S.A.)
371 F. Supp. 2d 1267 (D. Kansas, 2005)

Cite This Page — Counsel Stack

Bluebook (online)
356 F. Supp. 2d 1278, 2004 U.S. Dist. LEXIS 27045, 2004 WL 3167317, Counsel Stack Legal Research, https://law.counselstack.com/opinion/richards-v-hartford-life-and-accident-ins-co-flsd-2004.