Wray v. American United Life Insurance

503 F. App'x 377
CourtCourt of Appeals for the Sixth Circuit
DecidedOctober 31, 2012
Docket10-4297, 10-4560
StatusUnpublished

This text of 503 F. App'x 377 (Wray v. American United Life Insurance) 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
Wray v. American United Life Insurance, 503 F. App'x 377 (6th Cir. 2012).

Opinion

MARTHA CRAIG DAUGHTREY, Circuit Judge.

Defendant American United Life Insurance Company appeals the judgment of the district court reversing an administrative determination that plaintiff Elfriede Wray was not a designated beneficiary of James M. Fleck’s life insurance policy with American United. After the district court concluded that Wray was indeed a proper beneficiary, however, the insurance company sought leave to file a cross-claim against Fleck’s two sons, James R. Fleck and Scott Fleck, in order to recover insurance proceeds paid to them that the court concluded should have been distributed to Wray. The district court denied leave to file the cross-claim, and American United now also alleges error in that exercise of the court’s discretion. We conclude that the district court failed to engage in the proper analysis in deciding whether to permit the cross-claim and, therefore, reverse that portion of the judgment and remand the case to the district court for further consideration.

FACTUAL AND PROCEDURAL BACKGROUND

American United sold a group life insurance policy to The Countrymark Co-op Member Group Benefits Plan Trust. 1 As senior vice-president of Southwest Landmark, Inc., an “insured unit” under the policy, James M. Fleck was authorized to purchase life insurance from American *379 United and did so. The initial application filled out by Fleck was signed and dated on December 29, 2000, and did not give an indication on the form that any particular persons were to be listed as either “basic and supplemental insurance” beneficiaries or as “accidental death and dismemberment” beneficiaries. Instead, a separate, undated, unsigned page also appearing in the record listed Fleck’s then-wife Lynn, and his two sons as primary beneficiaries of the basic and supplemental life insurance policy and apportioned 20 percent of the proceeds of the policy to Lynn and 40 percent to each of the sons.

A subsequent application signed and dated by James M. Fleck on December 8, 2002, included the notation “See Attached” in the space provided for listing the primary beneficiary for the basic and supplemental life insurance proceeds. A sheet, presumably attached to the application, again lists Lynn, Scott, and James R. Fleck as primary life insurance beneficiaries, but adjusts the percentage portions to be received by those individuals to 10 percent for Lynn and 45 percent for each of the two sons.

Finally, on December 30, 2003, James M. Fleck signed and dated the policy application that is the focus of this litigation. On that form, the insured checked a box indicating that he wished to change the beneficiaries of the policy and, in the spaces provided on the form for designating the beneficiaries of the basic and supplemental life insurance policy and the accidental death and dismemberment policy, wrote the word “Attached.” As with the 2000 and 2002 applications that either began coverage or changed the percentages to be distributed to the beneficiaries, the appellate record contains a copy of an additional sheet of paper that lists the names, addresses, and percentage distributions for the selected beneficiaries. The 2003 application attachment, however, removed Lynn Fleck (from whom James M. Fleck was then divorced) as a beneficiary, added Elfriede Wray as a primary beneficiary, and assigned one-third of the proceeds of the basic and supplemental life insurance to Wray and each of his two sons.

Unfortunately, James M. Fleck died in an automobile accident on June 16, 2007. Three days later, Gayle Wubbolding, the client services coordinator for Employee Benefit Management Corporation, an entity specializing in the servicing of self-funded benefit programs, contacted plaintiff Wray by letter and informed Wray that she was one of the three listed beneficiaries on James M. Fleck’s life insurance policy and on his accidental death and dismemberment policy. Wubbolding offered to file Wray’s claim for benefits under the policies once Wray provided her with two certified copies of James M. Fleck’s death certificate, Wray’s birth date and Social Security number, the birth dates and Social Security numbers of James R. and Scott Fleck, the police report of James M. Fleck’s accident, and any newspaper articles about the accident.

Wray evidently provided Wubbolding with the requested information because three months later, Wubbolding sent letters to both American United and to The Hartford enclosing the documentation necessary to secure payment of the insurance benefits to the three beneficiaries listed on the policy application. In both letters, Wubbolding further requested that the insurance companies contact her should they “have any questions or need any further information” regarding the claims.

Less than two weeks later, The Hartford mailed letters to the Fleck brothers and to Wray approving their claims under the accidental death policy. The Hartford then deposited one-third of the value *380 of that policy into separate accounts for the benefit of each of the three individuals. But, Wray’s dealings with American United were not as trouble-free. In two identical letters dated 11 days apart, the defendant insurance company, although expressing its condolences to Wray “for [her] loss,” explained that “[b]ased on information submitted by the employer/policyholder, [there] is no signed and dated beneficiary designation. The proceeds under the insured’s group life insurance policy are payable to the ‘Estate of James Fleck.’ ” Thereafter, American United issued a check for the full amount of the policy, plus interest, to the “Estate of James Fleck” only.

In response, Wray filed an action against American United, Employee Benefit Management Corporation, James R. Fleck, and Scott Fleck in Ohio state court, seeking payment of one-third of the benefits of James M. Fleck’s life insurance policy. The case was eventually removed to federal court and the Employee Benefit Management Corporation was dismissed as a defendant. After a hearing, the district court issued a written order that first concluded that Wray had adequately exhausted her administrative remedies in seeking to overturn the insurance company’s adverse decision. The district judge further ruled that Wray was not equitably estopped from pursuing her claim, and that the documents submitted to American United showed conclusively that James M. Fleck had indeed designated the plaintiff as a beneficiary of his life insurance policy. Consequently, the district court entered judgment in favor of Wray for one-third of the value of the policy, plus interest from the date of Fleck’s death, and costs.

In light of the district court’s ruling, American United moved for leave to file a cross-claim against James R. Fleck and Scott Fleck for recoupment of the money the insurance company had paid to the Estate of James M. Fleck instead of to Wray. The district judge denied that motion, however, stating:

The proposed cross claim states at ¶ 10 that “Because the beneficiary designation was not signed and dated as required by the [American United] policy, [American United] paid benefits to the Estate of the Decedent ...”
This allegation is inconsistent with the law of the case as it presently stands.

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Bluebook (online)
503 F. App'x 377, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wray-v-american-united-life-insurance-ca6-2012.