Shoop v. Life Insurance Co. of North America

839 F. Supp. 2d 830, 2011 WL 3664842, 2011 U.S. Dist. LEXIS 92939
CourtDistrict Court, E.D. Virginia
DecidedAugust 19, 2011
DocketAction No. 4:10cv125
StatusPublished
Cited by3 cases

This text of 839 F. Supp. 2d 830 (Shoop v. Life Insurance Co. of North America) is published on Counsel Stack Legal Research, covering District Court, E.D. Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shoop v. Life Insurance Co. of North America, 839 F. Supp. 2d 830, 2011 WL 3664842, 2011 U.S. Dist. LEXIS 92939 (E.D. Va. 2011).

Opinion

ORDER

REBECCA BEACH SMITH, District Judge.

This matter comes before the court on the Motions for Summary Judgment, filed by the plaintiffs on April 22, 2011, and by [832]*832the defendant on May 17, 2011. The matter was referred to a United States Magistrate Judge by order of June 1, 2011, pursuant to the provisions of 28 U.S.C. § 636(b)(1)(B) and (C) and Federal Rule of Civil Procedure 72(b), to conduct hearings, including evidentiary hearings, if necessary, and to submit to the undersigned proposed findings of fact, if applicable, and recommendations for the disposition of the motion.

The United States Magistrate Judge conducted a hearing on June 14, 2011. The Magistrate Judge’s Report and Recommendation was filed on July 19, 2011. The magistrate judge recommended that the plaintiffs’ Motion for Summary Judgment be granted; defendant’s Motion for Summary Judgment be denied; and that judgment for the benefit due under the policy be entered. By copy of the Report and Recommendation, the parties were advised of their right to file written objections thereto. On August 2, 2011, the court received defendant’s Objections to the Magistrate Judge’s Report and Recommendation, and on August 15, 2011, the court received plaintiffs’ Reply to the Objections.

The court, having examined the objections to the Report and Recommendation and having made de novo findings with respect thereto, does hereby adopt and approve in full the findings and recommendations set forth in the Report and Recommendation of the United States Magistrate Judge filed July 19, 2011. Accordingly, the plaintiffs’ Motion for Summary Judgment is GRANTED; the defendant’s Motion for Summary Judgment is DENIED; judgment is ENTERED in favor of the plaintiff beneficiaries, Robert M. Shoop and Michael Shoop, for the balance of the coverage elected in the amount of $750,000.00; and, the parties are DIRECTED to file further briefing on the plaintiffs’ claims for prejudgment interest and attorneys’ fees on a schedule to be set by the Magistrate Judge.

The Clerk shall forward a copy of this Order to counsel for the parties.

It is so ORDERED.

REPORT AND RECOMMENDATION

DOUGLAS E. MILLER, United States Magistrate Judge.

Pending motions in this case present two related questions. First, whether Peter Shoop was covered under a group insurance policy issued by the Defendant, Life Insurance Company of North America (LINA) when Shoop died on April 28, 2009, and second, whether LINA’s decision that he was not covered, and its resulting denial of benefits are reviewed de novo by this Court. Because the undersigned concludes the answer to both questions is “yes”, this report recommends that the Court grant Plaintiffs’ Motion for Summary Judgment, deny LINA’s motion and enter judgment for the benefits due under the Policy.

Procedural History

Beneficiaries, and plaintiffs in this case, Robert and Michael Shoop, (“beneficiaries”) initiated this civil action against Life Insurance Company of North America (“LINA”) seeking $750,000 that they claim is owed by LINA under their deceased father’s accidental death and dismemberment policy number OK980037 (the “Policy”). Their father, Peter Shoop, (“Shoop”) was an employee of Northrop Grumman Corporation (“Northrop Grumman”) until he was laid off due to a reduction in force on April 7, 2009. (ECF No. 15 at 1).

While employed by Northrop Grumman, Peter Shoop participated in the optional accidental death and dismemberment policy offered by Northrop Grumman through LINA. Id. On April 28, 2009, Shoop died as a result of a car accident. The Shoops submitted a claim for benefits, but LINA [833]*833determined that Peter Shoop was no longer covered by the Policy at the time of his death. The Company paid the beneficiaries $250,000 under the conversion provision of the Policy. The Plaintiffs claim that they are owed the full amount of coverage under the Policy, $1,000,000.00, and filed this ERISA action for the additional $750,000 in benefits. (ECF No. 1).

The parties stipulated to the relevant facts and filed cross motions for summary judgment with memoranda in support. (ECF Nos. 13, 14, 15, 24, and 25). The motions were referred to the undersigned for a Report and Recommendation, and the Court heard oral argument on June 14, 2011. For the reasons that follow, the undersigned recommends that the Court GRANT the beneficiaries’ motion for summary judgment, DENY LINA’s motion for summary judgment, and enter judgment for the remaining benefits in favor of the Plaintiffs.

A. RECOMMENDED FINDINGS OF UNDISPUTED MATERIAL FACT

Peter Shoop was an employee of Northrop Grumman Corporation until April 7, 2009. (ECF No. 15 at l).1 As an active, full-time employee, he was eligible for, elected, and maintained optional accidental death and dismemberment insurance coverage through LINA in the amount of $1,000,000 (the “Policy”). Id. at 2; (ECF No. 1-2 at 3, 11). The Policy provides optional insurance coverage to eligible employees based on a Schedule of Benefits set out in the Policy document. (ECF No. 1-2 at 11). The Schedule of Benefits defines as “eligible” those persons belonging to a Covered Class. (ECF No. 1-2 at 3, 11). The Policy includes only one Covered Class, Class 1, which is described in the Schedule of Benefits to include “All active, Full-time Employees eligible for coverage under the Northrop Grumman Health Plan....”. Id.

Individual employees electing coverage under the Policy did not make any payments directly to LINA. (ECF No. 15, at 3). Instead, Northrop Grumman, as the Subscriber to the Policy, paid the premiums directly to LINA within the calendar month in which they were due. Id. at 2. The company calculated the monthly premium based on the number of eligible employees who had elected coverage under the Policy as of the last weekend of the immediately preceding month, and submitted one lump sum payment covering the premium for all covered employees. Id. at 3. This monthly premium payment covered all individual employees participating in the Policy’s coverage as of the last weekend of the immediately preceding month and provided coverage for the entire calendar month in which the premium was paid. Id. To recoup the cost of the premiums it paid, Northrop Grumman took bi-weekly payroll deductions from each covered employee’s paycheck. Id. The entire cost of coverage under the Policy was charged to the covered employee in this fashion. Id., See also (ECF No. 1-2 at 5).

On April 7, 2009, Northrop Grumman terminated Peter Shoop’s employment due to a reduction in force. (ECF No. 15 at 2). On April 28, 2009, Peter Shoop died as a result of a car accident. Id. Shoop’s death is a loss which would be covered by the Policy so long as he was a Covered Person under the Policy at the time of his death. (See ECF No. 1-2, pp. 3, 6,19)2.

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Bluebook (online)
839 F. Supp. 2d 830, 2011 WL 3664842, 2011 U.S. Dist. LEXIS 92939, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shoop-v-life-insurance-co-of-north-america-vaed-2011.