Watson v. Deaconess Waltham Hospital

141 F. Supp. 2d 145, 2001 U.S. Dist. LEXIS 9075, 2001 WL 432409
CourtDistrict Court, D. Massachusetts
DecidedApril 10, 2001
DocketCIV.A. 00-10583-WGY
StatusPublished
Cited by10 cases

This text of 141 F. Supp. 2d 145 (Watson v. Deaconess Waltham Hospital) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Watson v. Deaconess Waltham Hospital, 141 F. Supp. 2d 145, 2001 U.S. Dist. LEXIS 9075, 2001 WL 432409 (D. Mass. 2001).

Opinion

MEMORANDUM AND ORDER

YOUNG, Chief Judge.

I. Introduction

A. Summary of Amended Complaint

The plaintiff, Larkin D. Watson, IV (“Watson”), has brought this action against his former employer, Deaconess Waltham Hospital (“Deaconess”), pursuant to the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq. 1 *147 Watson seeks restitution for breach of fiduciary duty under ERISA § 404(a), 29 U.S.C. § 1104(a). 2 Am. Compl. ¶ 1.

B. Procedural Posture and Relevant Legal Standard

On February 9, 2001, Deaconess moved for summary judgment on Watson’s claims under Federal Rule of Civil Procedure 56, and on February 22, 2001, Watson filed a cross-motion for summary judgment. At the motion hearing held on March 12, 2001, the parties agreed that the issues would be submitted for decision by this Court as a case stated. Cont’l Grain Co. v. P.R. Mar. Shipping Auth., 972 F.2d 426, 429 n. 7 (1st Cir.1992) (observing that the submission of a matter to the court as a case stated promotes judicial efficiency); Boston Five Cents Sav. Bank v. Dep’t of Hous. & Urban Dev., 768 F.2d 5, 12 (1st Cir.1985) (Breyer, J.) (same). This Court must review the record, draw such inferences as are reasonable, decide any significant issues of material fact, and, applying the governing law, enter such judgment as may be appropriate. Cont’l Grain Co., 972 F.2d at 429 n. 7; Boston Five Cents Sav. Bank, 768 F.2d at 11-12.

II. Factual Background

The facts in this case consist of (i) Deaconess’s Statement of Material Facts of Record as to Which There Is No Genuine Issue to be Tried (“Def.’s Stmt.”) and Watson’s response thereto (“Pl.’s Resp. to Def.’s Stmt.”); (ii) an affidavit by Watson (“Watson Aff.”); (iii) Watson’s deposition (“Watson Dep.”); (iv) an affidavit by Fred E. Sussman (“Sussman”), Deaconess’s Director of Human Resources (“Sussman Aff.”); (v) Sussman’s deposition, taken pursuant to Federal Rule of Civil Procedure 30(b)(6) (“Sussman Dep.”); and (vi) written documents that speak for themselves. The following recitation of facts draws from these sources.

A. The Parties and the Employee Benefit Plans

On October 5,1992, Watson was hired to work part-time by Waltham-Weston Hospital (“Weston”) as an addictions management counselor. Sussman Aff. ¶ 6. At that time, Weston provided eligible employees with long-term disability insurance through Confederation Life Insurance Company (“Confederation”). Id. ¶ 9. On November 1, 1994, Weston replaced the Confederation group disability plan with a plan provided by Northwestern Mutual Life Insurance Company (“Northwestern”). Id. ¶ 12. This plan remained in effect until January 1,1996. Id.

On February 1, 1995, Weston became Deaconess Waltham Hospital, a subsidiary of Pathway Health Network. Watson Aff. ¶ 8; Pl.’s Resp. to Def.’s Stmt, at 3, ¶ 1. A new parent company, CareGroup, was formed on October 1, 1996. Pl.’s Resp. to Def.’s Stmt, at 3, ¶ 1.

From January 1, 1996 to the present, Deaconess has obtained its group benefits plan from Liberty. Sussman Aff. ¶ 15. Under the Plan, Deaconess is the employer, id., and CareGroup is the named sponsor and administrator, id. ¶ 15 & Ex. 5.

*148 B. Timeline of Events

During his orientation by Weston’s Human Resources Department on October 5, 1992, Watson received and signed a list that identified the benefits available to part-time employees. Watson Aff. ¶¶ 3-4; Sussman Aff. ¶ 8 & Ex. 2. Although Weston offered long-term disability insurance through a group insurance plan with Confederation, Sussman Aff. ¶ 9, Watson was barred from enrolling because the plan required that an employee work at least thirty-six hours per week to be eligible, id.

On November 5, 1993, Watson changed to full-time employment. Id. ¶ 10. Although Watson met with employees in Weston’s Human Resources Department to discuss benefits available under his new full-time position and to submit applications for health and dental insurance, he was never told that his full-time employment qualified him for disability benefits. Watson Aff. ¶¶6-7.

For health reasons, on March 17, 1996, Watson changed to part-time employment at the suggestion of his supervisor. Watson Aff. ¶ 9; Sussman Aff. ¶ 14. Watson was not informed that this change in his employment status might affect his eligibility for benefits under the hospital’s long and short-term disability benefits policy. Watson Aff. ¶ 9. .

At his own request, Watson changed his status' from part-time to full-time employment on March 29, 1999. Id. ¶¶ 10, 15; Watson Dep. at 135-36; Sussman Aff. f 22. At that time, he was advised that as a full-time employee, he was eligible for long-term disability insurance under the Liberty Plan. Sussman Aff. ¶ 22. He was also told that Liberty would waive the six-month eligibility waiting period, but not the preexisting condition exclusion. Watson Dep. at 119-20; Sussman Aff. ¶ 22.

On April 28, 1999, Watson’s physician advised Deaconess that because of his angina, Watson would not be able to return to work. Watson Aff. ¶ 16; Watson Dep. at 136; Def.’s Stmt. ¶ 22. Having become totally disabled, Watson filed a claim for long-term disability benefits with Liberty on July 28, 1999, which was denied on November 19, 1999, because Watson had not been a full-time employee for a sufficient time period. Watson Aff. ¶¶ 17, 19; Sussman Aff. ¶¶ 25-26. On or about March 6, 2000, Liberty sustained its earlier denial of Watson’s claim because his condition was preexisting. Watson Aff. ¶ 21; Sussman Aff. ¶ 28. Watson asserts that his claim would not have been denied if Deaconess had “properly informed [him] of his rights and benefits before Deaconess induced him to become a part-time employee,” Am. Compl. ¶ 16, and that Liberty’s denial of coverage is “directly attributable to the acts and omissions of Deaconess and ... amounts to a breach of Deaconess’s fiduciary duties to [Watson] under ERISA,” id. ¶ 17.

III. Discussion

A. Background

ERISA § 404(a) establishes that:

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

Related

Ellis v. Fidelity Management Trust Co.
257 F. Supp. 3d 117 (D. Massachusetts, 2017)
Altshuler v. Animal Hospitals, Ltd.
901 F. Supp. 2d 269 (D. Massachusetts, 2012)
Smith v. Jefferson Pilot Financial Insurance
607 F. Supp. 2d 266 (D. Massachusetts, 2009)
Livick v. Gillette Co.
492 F. Supp. 2d 1 (D. Massachusetts, 2007)
Eusebio Cotto Villegas v. Federal Express Corp.
468 F. Supp. 2d 293 (D. Puerto Rico, 2006)
Green v. ExxonMobil Corp.
413 F. Supp. 2d 103 (D. Rhode Island, 2006)
J.E. Pierce Apothecary, Inc. v. Harvard Pilgrim Health Care, Inc.
365 F. Supp. 2d 119 (D. Massachusetts, 2005)
Radford Trust v. First Unum Life Insurance Co. of America
321 F. Supp. 2d 226 (D. Massachusetts, 2004)
Watson v. Deaconess Waltham Hospital
298 F.3d 102 (First Circuit, 2002)

Cite This Page — Counsel Stack

Bluebook (online)
141 F. Supp. 2d 145, 2001 U.S. Dist. LEXIS 9075, 2001 WL 432409, Counsel Stack Legal Research, https://law.counselstack.com/opinion/watson-v-deaconess-waltham-hospital-mad-2001.