Teisman v. United of Omaha Life Insurance

908 F. Supp. 2d 875, 55 Employee Benefits Cas. (BNA) 2927, 2012 WL 5465466, 2012 U.S. Dist. LEXIS 160130
CourtDistrict Court, W.D. Michigan
DecidedNovember 8, 2012
DocketFile No. 1:11-CV-1211
StatusPublished
Cited by7 cases

This text of 908 F. Supp. 2d 875 (Teisman v. United of Omaha Life Insurance) is published on Counsel Stack Legal Research, covering District Court, W.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Teisman v. United of Omaha Life Insurance, 908 F. Supp. 2d 875, 55 Employee Benefits Cas. (BNA) 2927, 2012 WL 5465466, 2012 U.S. Dist. LEXIS 160130 (W.D. Mich. 2012).

Opinion

OPINION

ROBERT HOLMES BELL, District Judge.

This matter is before the Court on Defendant Jedco, Inc.’s motion for summary judgment. On November 14, 2011, Plaintiff Maryann Teisman brought a four count complaint against United of Omaha Life Insurance Company and Jedco. (Dkt. No. I. ) Plaintiff raised two counts against United: (1) failure to pay life insurance benefits under United Group Policy GLUG-ABA4 (the “General Policy”); and (2) failure to pay life insurance benefits under United Group Policy GVTL-ABA4 (the “Voluntary Policy”). Plaintiff also raised two counts against Jedco: (1) breach of fiduciary duty; and (2) equitable estoppel. On October 29, 2012, 2012 WL 5345081, this Court denied Plaintiffs motion for judgment against United, granted judgment in favor of United, and dismissed Counts I and II of Plaintiffs complaint. (Dkt. Nos. 43, 44.) Jedco filed the present motion for summary judgment on September 18, 2012. For the reasons that follow, this motion will be granted only as to allegations regarding summary plan descriptions.

I.

Jedco hired Plaintiffs husband, Daniel Teisman, on February 6, 2008. (Dkt. No. II, Answer ¶ 6.) Jedco provided a benefit package, which included the General Policy, for eligible employees including Mr. Teisman. (Id. at ¶¶ 7-8.) Jedco was the plan sponsor and plan administrator of the General Policy. (Id. at ¶¶ 10, 11.) On April 17, 2009, Mr. Teisman was laid off due to lack of work. (Id. at ¶ 21.) His layoff notice stated that “[t]he benefits listed below will terminate on the dates noted: ... Life Insurance: n/a.” (AR 785.) Mr. Teisman continued to be billed for the life insurance premium, which Jedco paid. (AR 170-75, 785.) He returned to work on May 4, 2009. According to a Short>-Term Disability Claim Form, Mr. Teisman was diagnosed with metastatic melanoma on May 20, 2009. (Dkt. No. 38, Attach. 19.) During July and August 2009, Mr. Teisman was out on disability. (Dkt. No. 11, Answer ¶ 24.) Jedco continued paying his [878]*878life insurance premiums. (IcL at ¶25.) He returned in September, but was out again from December 2, 2009, until January 4, 2010. (Dkt. No. 35, Attach. 3, Dalrymple Dep. 77-78.) During all of this time, either he or Jedco paid each of his life insurance premiums. (Id.; AR 172-87.)

In December 2009, Mr. Teisman completed an enrollment form for life insurance under the Voluntary Policy. (Dkt. No. 11, Answer ¶ 28.) As with the General Policy, Jedco was the plan sponsor and plan administrator. (Id. at ¶¶ 10,11.) Mr. Teisman worked from January 4, 2010, until January 7, 2010, but was then laid off again. (Id. at ¶ 31.) On January 27, 2010, Jedco’s human resources manager, Sara Dalrymple, wrote to Mr. Teisman indicating that he had missed a few life insurance premiums. (AR 677.) The letter stated: “Please be aware that you do not need to make the payment in full — feel free to make payments that are comfortable for you.” (Id.) Also, Ms. Dalrymple had discussions with Mr. Teisman during this time frame about him needing to keep paying his insurance premiums, including his life insurance premiums. (Dkt. No. 35, Attach. 3, Dalrymple Dep. 80-81.) She told him that if he could not make every payment Jedco would pay the premiums and then deduct his part of those payments from his paycheck when he returned to work. (Id.) Mr. Teisman paid Jedco $200 toward the insurance premiums in both February and March. (AR 675-76, 886.) He returned to work on May 3, 2010, but was off work from May 20 until June 7. (Dkt. No. 35, Attach. 3, Dalrymple Dep. 83-84.) On June 11, Mr. Teisman became disabled and was scheduled to be off work until August 1. (Id. at 84.) He passed away on July 17, 2010. (Dkt. No. 11, Answer ¶ 38.)

On July 23, Mrs. Teisman applied for benefits. (AR 962-66.) With the assistance of Jedco, in particular Ms. Dalrymple, Mrs. Teisman completed a proof of death form for each policy, which Jedco submitted to United. (Dkt. No. 11, Answer ¶40.) On April 25, 2011, United denied her application. (Id. ¶ 41.) Upon review of her administrative appeal, United affirmed the decision to deny benefits because Mr. Teisman’s insurance coverage had terminated when he was laid off and he had not satisfied the 90-day waiting period required for the reinstatement of benefits after an employee was rehired. (Id. at ¶ 43.) Mr. Teisman had never enrolled in one of the alternative options available to him when he was laid off— conversion, portability, or living benefits. (Dkt. No. 34, Br. in Supp. 19; Dkt. No. 35, Resp. Br. 16-17.)

II.

The Federal Rules of Civil Procedure require the Court to grant summary judgment “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). In evaluating a motion for summary judgment the Court must look beyond the pleadings and assess the proof to determine whether there is a genuine need for trial. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986).

In considering a motion for summary judgment, “the district court must construe the evidence and draw all reasonable inferences in favor of the nonmoving party.” Martin v. Cincinnati Gas and Elec. Co., 561 F.3d 439, 443 (6th Cir.2009) (citing Jones v. Potter, 488 F.3d 397, 403 (6th Cir.2007)). Nevertheless, the mere existence of a scintilla of evidence in support of a non-movant’s position is not sufficient [879]*879to create a genuine issue of material fact. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 252, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). The proper inquiry is whether the evidence is such that a reasonable jury could return a verdict for the non-moving party. Id.; see generally Street v. J.C. Bradford & Co., 886 F.2d 1472, 1476-80 (6th Cir.1989).

III.

The General Policy and the Voluntary Policy are employee welfare benefit plans that are governed by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001-1461. ERISA authorizes a beneficiary to bring an action “to obtain other appropriate equitable relief (i) to redress such violations [of ERISA].” 29 U.S.C. § 1132(a)(3)(B).

A. Is Monetary Relief Available Under § 1132(a)(3)?

As a preliminary matter, Plaintiff is requesting a construction of § 1132(a)(3) which would allow monetary damages. (Dkt. No. 35, at 7.) However, Plaintiff relies on the same arguments the Supreme Court found unpersuasive in Mertens v. Hewitt Associates,

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Bluebook (online)
908 F. Supp. 2d 875, 55 Employee Benefits Cas. (BNA) 2927, 2012 WL 5465466, 2012 U.S. Dist. LEXIS 160130, Counsel Stack Legal Research, https://law.counselstack.com/opinion/teisman-v-united-of-omaha-life-insurance-miwd-2012.