Trustees of the Operating Engineers Local 965 Health Benefit Plan v. Westfall (In Re Westfall)

379 B.R. 798, 2007 Bankr. LEXIS 3702, 2007 WL 3243137
CourtUnited States Bankruptcy Court, C.D. Illinois
DecidedNovember 1, 2007
Docket19-80135
StatusPublished
Cited by14 cases

This text of 379 B.R. 798 (Trustees of the Operating Engineers Local 965 Health Benefit Plan v. Westfall (In Re Westfall)) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, C.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Trustees of the Operating Engineers Local 965 Health Benefit Plan v. Westfall (In Re Westfall), 379 B.R. 798, 2007 Bankr. LEXIS 3702, 2007 WL 3243137 (Ill. 2007).

Opinion

OPINION

MARY P. GORMAN, Bankruptcy Judge.

The issue before the Court is whether a non-dischargeable judgment should be entered against the Debtor/Defendant, Lester Westfall, and in favor of the Plaintiff, Trustees of the Operating Engineers Local # 965 Health Benefit Plan (“Plan”) for reimbursement of medical benefits paid on behalf of the Debtor’s ex-wife by the Plan. After considering the testimony of the parties and the arguments of counsel, the Court finds that the Debtor fraudulently failed to inform the Plan of his divorce and the resulting ineligibility of his ex-wife to *802 receive Plan benefits. Accordingly, the non-dischargeable judgment requested by the Plan will be entered.

The Debtor was a member of Operating Engineers Local No. 965 for 44 years. One of the benefits of his union membership was participation in the Plan. The Plan also provided medical benefit coverage for the Debtor’s “legal spouse” and dependents.

The Plan imposes an affirmative duty on participants to notify the Plan within 60 days of a divorce. The Debtor admits that he received copies of the Plan documents which clearly advised him of this duty. Nevertheless, when the Debtor and Ann Westfall divorced in October, 1991, the Debtor did not notify the Plan of the divorce. Instead, he testified that he called the union hall and told the union business manager about the divorce. The Debtor did not produce any evidence to corroborate this call, and there was no evidence that the union ever notified the Plan of the Westfalls’ divorce. The Debtor stated that he had followed the same practice of notifying the union when three of his four prior marriages ended in divorce, but there was also no evidence as to the time of those divorces or the notification requirements of the insurance plans in effect when those divorces occurred.

Between October, 1991, and September, 2005, 277 claims totaling $57,392.31 were paid by the Plan for medical services provided to Ann Westfall. Written explanations of benefits for each of the claims were sent to the Plan participant, Lester Westfall. Each explanation of benefits clearly identified Ann Westfall as the patient. In addition, included with some of the explanations were checks for reimbursement of expenses paid directly by Ann Westfall. Each check was made out to Lester Westfall as the Plan participant rather than to Ann Westfall as the patient. Every check was cashed and each check purported to contain the endorsement of the Debtor.

Although they divorced in 1991, the Debtor and Ann Westfall continued to live in the same house for another seven or eight years. The Debtor testified that, after they stopped living together, he brought the insurance mail over to Ann’s house for her to open. They are not living together at the present time, but Ann Westfall’s mail comes to the Debtor’s house and he forwards it to her at her temporary location in California.

Ann Westfall filed a Chapter 7 petition on October 7, 2005. The Plan filed a dis-chargeability complaint against Ann West-fall for fraudulently obtaining health insurance benefits, and a default judgment in the amount of $57,392.31 was previously entered against her.

Lester Westfall also filed a petition pursuant to Chapter 7 of the Bankruptcy Code on October 7, 2005. The Plan filed an adversary complaint pursuant to 11 U.S.C. § 523(a)(2)(A) alleging that the Debtor fraudulently concealed his divorce from Ann Westfall in order to obtain medical benefit payments for Ann which she was not entitled to receive. The Plan alleges that the Debtor’s silence regarding his divorce from Ann constitutes a false representation that he was still married to Ann. The Plan alleges that it would have terminated Ann Westfall’s insurance coverage if it had known about the divorce. The Debtor alleges that he notified the Plan by calling a union official and that he was unaware that Ann Westfall continued to receive health insurance benefits for 14 years after their divorce. The Plan seeks a judgment for the $57,392.31 it paid on behalf of Ann Westfall after the divorce and a determination that the judgment is non-dischargeable.

This Court must determine the existence of an underlying debt before reach *803 ing the dischargeability issues. In the absence of a prior state or federal judgment fixing an amount due, this Court has authority to hear the issues of liability and damages and to enter a money judgment if it finds in favor of a plaintiff on the required issues. In re Hallahan, 936 F.2d 1496, 1508 (7th Cir.1991); In re Scott, 2006 WL 126757 *3 (Bankr.N.D.Ill.).

The Debtor did not dispute that his ex-wife was ineligible for the benefits she received after their divorce, and he did not argue that he has no liability to reimburse the Plan for those benefits pursuant to the Plan documents. Further, he did not contest the amount of benefits paid by the Plan for Ann Westfall after the divorce. His defense was limited to contesting whether his conduct was such that his debt to the Plan should be determined to be non-dischargeable. This Court finds that the Debtor is liable to the Plan in the amount of $57,392.31, and that a judgment should be entered accordingly.

The Plan relies on § 523(a)(2)(A) of the Bankruptcy Code for its allegations of non-dischargeability. Section 523(a)(2)(A) provides, in part, as follows:

(a) A discharge under section 727 ... of this title does not discharge an individual debtor from any debt—
(2) for money, property, services, or an extension, renewal, or refinancing of credit, to the extent obtained by—
(A) false pretenses, a false representation, or actual fraud, other than a statement respecting the debtor’s or an insider’s financial condition(.)

11 U.S.C. § 523(a)(2)(A).

In order to prove a case under this provision, courts have traditionally required a plaintiff to prove that (i) the debtor made false statements which he knew to be false, or which were made with such reckless disregard for the truth as to constitute willful misrepresentations; (ii) the debtor possessed the requisite scien-ter, i.e. he actually intended to deceive the plaintiff, and (iii) to its detriment, the plaintiff justifiably relied on the representations. Field v. Mans, 516 U.S. 59, 74-75, 116 S.Ct. 437, 446, 133 L.Ed.2d 351 (1995); In re Mayer, 51 F.3d 670, 673 (7th Cir.1995), cert. denied 516 U.S. 1008, 116 S.Ct. 563, 133 L.Ed.2d 488 (1995); In re Sheridan, 57 F.3d 627, 635 (7th Cir.1995); In re Scarlata, 979 F.2d 521, 525 (7th Cir.1992).

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Bluebook (online)
379 B.R. 798, 2007 Bankr. LEXIS 3702, 2007 WL 3243137, Counsel Stack Legal Research, https://law.counselstack.com/opinion/trustees-of-the-operating-engineers-local-965-health-benefit-plan-v-ilcb-2007.