Rose Moss v. Unum Life Insurance Company

495 F. App'x 583
CourtCourt of Appeals for the Sixth Circuit
DecidedAugust 17, 2012
Docket11-6017
StatusUnpublished
Cited by17 cases

This text of 495 F. App'x 583 (Rose Moss v. Unum Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rose Moss v. Unum Life Insurance Company, 495 F. App'x 583 (6th Cir. 2012).

Opinion

SARGUS, District Judge.

Plaintiff Rose Moss (“Mrs. Moss”), individually and as administratrix of the estate of her husband, Gary L. Moss (“Mr. Moss”), appeals the district court’s judgment denying relief in this ERISA action for supplemental life insurance benefits against Defendants Unum Life Insurance Company of America (“Unum”), Service-Master Company, Inc. (“ServiceMaster”), and The ServiceMaster Health and Welfare Benefit Plan (the “Plan”).

Mrs. Moss raises the following issues on appeal: (1) whether the district court erred in granting summary judgment in favor of ServiceMaster on the basis that Mrs. Moss could not pursue a breach of fiduciary duty claim against ServiceMaster under 29 U.S.C. § 1132(a)(3); (2) whether the district court erred in affirming Unum’s denial of Mrs. Moss’s claim for supplemental life insurance benefits; (3) whether the district court erred in denying Mrs. Moss’s motion to compel production of documents withheld from the administrative claim file on the basis of the attorney-client privilege; and (4) whether the district court abused its discretion in granting ServiceMaster’s and the Plan’s motion for protective order on the basis that Mrs. Moss’s discovery sought information concerning a substantive, rather than procedural, challenge, and not considering evidence outside of the administrative record.

For the following reasons, we AFFIRM the judgment of the district court.

I. BACKGROUND

Gary Moss was an employee of Service-Master until his termination on August 5, 2008. As part of his employment, Mr. Moss participated in ServiceMaster’s life insurance plan, through which Mr. Moss paid monthly premiums to Unum for supplemental life insurance. ServiceMaster paid approximately $14.04 per month for basic life insurance for Mr. Moss in the amount of $110,000. In addition, Mr. Moss paid $117.20 per month for supplemental life insurance in the amount of $293,000.

Suffering from lung cancer, Mr. Moss stopped working at ServiceMaster on Jan *586 uary 6, 2008. He was declared disabled and became entitled to receive long-term disability benefits on April 15, 2008. On April 25, 2008, ServiceMaster sent Mr. Moss a statement of benefits, which detailed those benefits that would continue as a result of his long-term disability. This included his supplemental life insurance policy at a monthly premium of $117.20, and stated “[c]overage will continue at the costs listed below for the remainder of the plan year.” (R. 24-5, at 1.) Mr. Moss continued to pay $117.20 each month after he began receiving disability benefits. Combined with his costs for these and other benefits, Mr. Moss regularly paid $450.90 to ServiceMaster each month.

On August 7, 2008, following Mr. Moss’s termination, ServiceMaster sent a eonversion/portability notice to Mr. Moss regarding conversion of his benefits into personal insurance policies obtained directly through the insurance companies, including Unum. The notice stated as follows:

This notice provides the necessary plan information you will need if you wish to convert or port your benefit coverage to a personal policy directly with the insurance company. Included is a form that you can submit to your insurance company in order to convert or port your benefits.
Please note: If you choose to continue coverage, you must return this notice with the application and the first premium payment within 31 days of the date your coverage ends. If this letter is not attached, coverage will be denied.

(Conversion/Portability Notice, R. 35-5.) This notice included information regarding Mr. Moss’s basic and supplemental life insurance. Mr. Moss acknowledged his right to convert his insurance policies, and that he must do so within thirty-one days, by signing and dating a “Notification of Conversion Privilege” form on August 29, 2008. (Notification of Conversion Privilege, R. 24-18.)

On September 2, 2008, Mr. Moss applied for conversion of his basic life insurance in the amount of $110,000 for himself and $50,000 for his wife. (Application for Conversion of Group Life Insurance to an Individual Life Insurance Policy, R. 33-6.) On September 10, 2008, Unum contacted Mr. Moss via letter to request completion of two separate enrollment forms in order to convert his coverage. (R. 24-13.) The letter stated that a reply must be received by September 26, 2008. The letter also stated:

Please note, there will be no further communications if we do not receive a response by the requested date. If the requirements are not received within the given grace period; portability will no longer be an option and the check submitted with your initial application will be voided and subsequently destroyed after a certain amount of time. It is important to note that this offer to accept late requirements is not an extension of benefits. Your life insurance coverage under your employer’s group policy remains in effect for 31 days after the date of termination or reduction of coverage.

(Id.) Mr. Moss passed away on September 24, 2008. Plaintiff Rose Moss is Mr. Moss’s widow and life insurance beneficiary.

On October 24, 2008, Unum sent another letter to Mr. Moss indicating that he had not completed the required forms and that his file was closed. (R. 24-14.) On November 10, 2008, Unum agreed to reopen the file and provide life insurance benefits to Mrs. Moss in the amount of $110,000. Unum did not pay any sum of money to Mrs. Moss for supplemental life insurance.

On October 8, 2009, Mrs. Moss’s counsel wrote to Unum requesting copies of all *587 insurance policies, plans, and applications. On November 12, 2009, Unum wrote to Mrs. Moss’s counsel advising Mrs. Moss that Mr. Moss was not covered by a group policy and the issue of converted coverage was being addressed separately by the Conversion Unit. On December 22, 2009, the Conversion Unit advised Mrs. Moss’s counsel that no supplemental coverage had been converted by Mr. Moss. An appeal of this decision was filed on February 10, 2010. Mrs. Moss’s claim for supplemental life insurance benefits was again denied by letter dated March 2, 2010.

On November 13, 2009, Mrs. Moss filed suit in state court to recover supplemental life insurance benefits under the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”). 1 Unum removed the case to the United States District Court for the Western District of Kentucky on December 16, 2009.

On July 9, 2010, Defendants Service-Master and the Plan filed a motion to dismiss the Amended Complaint, or in the alternative, motion for summary judgment. Defendants ServiceMaster and the Plan also filed a motion for protective order as to certain discovery requests, or in the alternative, motion for extension of time to respond to discovery. On the same day, Defendant Unum filed a motion to dismiss Counts II through VII of the Amended Complaint and the ERISA penalty claim.

On September 24, 2010, the district court granted judgment to Mrs.

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495 F. App'x 583, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rose-moss-v-unum-life-insurance-company-ca6-2012.