Young v. Reliance Standard Life Insurance Company

CourtDistrict Court, W.D. Texas
DecidedFebruary 1, 2021
Docket1:20-cv-00739
StatusUnknown

This text of Young v. Reliance Standard Life Insurance Company (Young v. Reliance Standard Life Insurance Company) is published on Counsel Stack Legal Research, covering District Court, W.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Young v. Reliance Standard Life Insurance Company, (W.D. Tex. 2021).

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS AUSTIN DIVISION

JASON THOMAS YOUNG, § Plaintiff § v. § § RELIANCE STANDARD LIFE § CIVIL NO. 1:20-CV-739-LY-SH INSURANCE COMPANY and § MATRIX ABSENCE § MANAGEMENT, INC.,1 § Defendants

REPORT AND RECOMMENDATION OF THE UNITED STATES MAGISTRATE JUDGE

TO: THE HONORABLE LEE YEAKEL UNITED STATES DISTRICT JUDGE Before the Court are Defendants’ Motion to Dismiss Plaintiff’s First Amended Complaint (Dkt. 11), filed November 3, 2020; Plaintiff’s Amended Motion for Attorney’s Fees (Dkt. 17), filed November 17, 2020; and the associated response and reply briefs. On October 27, 2020, the District Court referred all pending and future non-dispositive and dispositive motions to the undersigned Magistrate Judge for resolution and Report and Recommendation,2 pursuant to 28 U.S.C. § 636(b)(1), Federal Rule of Civil Procedure 72, and Rule 1 of Appendix C of the Local Rules of the United States District Court for the Western District of Texas. I. General Background In January 2019, Plaintiff Jason Thomas Young worked as a truck driver for Pilot Travel Centers, L.L.C., and participated in a long-term disability benefits plan governed by the Employee

1 Plaintiff misnamed Matrix Absence Management, Inc. as “Matrix Absence Management Company” in the style of the case. See Dkt. 11 at 1.

2 Pursuant to FED. R. CIV. P. 54(d)(2)(D), a court “may refer a motion for attorney’s fees to a magistrate judge under Rule 72(b) as if it were a dispositive pretrial matter.” Absent consent of the parties, dispositive matters may be referred only for report and recommendation. 28 U.S.C. § 636(b). Accordingly, the Court issues its findings in the form of a report and recommendation. Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001-1461 (“Plan” or “Policy”). The Plan provided that Plaintiff would receive a “Monthly Benefit” if Plaintiff became totally disabled. Dkt. 7 at ¶ 14. The Plan also provided that “Other Income Benefits3 are to be deducted from the Monthly Benefit.” Id. Reliance Standard Life Insurance Company (“Reliance”) is the insurer of the Plan, and Matrix Absence Management, Inc. (“Matrix”) is the administrator.

On January 2, 2019, Plaintiff sustained “permanent and disabling injuries” in a car collision. Id. ¶ 6. After the collision, Plaintiff submitted to Reliance a claim for long-term disability benefits under the Plan. Reliance agreed that Plaintiff was totally disabled and agreed to pay him a monthly benefit of $3,150.76. After Plaintiff received $153,774.14 from a settlement with the third party that had caused the accident, however, Reliance notified Plaintiff on January 17, 2020, that it would offset his benefits by the settlement amount (“Settlement Offset”) because it considered the settlement to be “Other Income Benefits” under the Plan. Id. ¶ 17. Accordingly, Reliance immediately reduced Plaintiff’s monthly benefit by $2,562.90, to $587.86 per month. On March 17, 2020, Plaintiff appealed Reliance’s decision, arguing that the settlement of a

third-party tort liability suit and the payment of underinsured motorist benefits were not included in Other Income Benefits under the Plan. On June 5, 2020, Reliance affirmed its original decision that it was entitled to the Offset.

3 Plaintiff alleges that under the Plan, “Other Income Benefits” includes: all benefits (except medical or death benefits) including any settlement made in place of such benefits (whether or not liability is admitted) an Insured is eligible to receive because of his/her Total Disability under: (a) Workers’ Compensation Laws; (b) occupational disease law; (c) any other laws of like intent as (a) or (b) above; and (d) any compulsory benefit law; Dkt. 7 ¶ 15. On July 10, 2020, Plaintiff filed this action against Reliance and Matrix (“Defendants”) “to clarify the rights to benefits under a policy of long term disability benefits.” Dkt. 1 at 1. Specifically, in his Original Complaint, Plaintiff alleged a claim under 29 U.S.C. § 1132(a)(1)(B) that “there is no basis in the policy for any offset or reduction based on the third party settlement that Plaintiff made.” Id. ¶ 26. Plaintiff further alleged that Defendants violated their duties under

29 U.S.C. § 1133 by failing to advise him “in the initial denial letter that they did not consider any of the settlement monies received by him to have been based on medical expenses incurred in the past or future.” Id. ¶ 28. In the alternative, Plaintiff alleged that he is entitled to equitable relief pursuant to 29 U.S.C. § 1132(a)(3). Plaintiff sought to recover benefits due, to enforce his rights to benefits under the Policy, and to clarify his future rights to benefits under the terms of the Reliance policy, as well as attorney’s fees and pre-judgment and post-judgment interest. Eighteen days after Plaintiff filed suit, Reliance sent Plaintiff an email notifying him that “at this time we will be terminating the offset in the amount of $2,562.90 (monthly), and will refund Mr. Young the monies that have been offset to date.” Dkt. 7-1 at 2. Reliance’s email, however,

also warned Plaintiff that “under the policy, any monies paid under a compulsory benefit law, such as PIP coverage (i.e. wage loss), are to be offset.” Id. The email asked Plaintiff to “advise if you will be requesting a formal Dismissal of the lawsuit recently file[d]. If not we will refer the matter to our outside counsel.” Id. On September 24, 2020, Defendants filed their first motion to dismiss, arguing that Plaintiff’s claims for benefits should be dismissed for lack of subject matter jurisdiction. Defendants contend that “the claims in this lawsuit have been mooted” because Reliance “reversed its prior decision and is now paying benefits in the amount claimed by Plaintiff.” Dkt. 2 at 2, 4. Plaintiff filed his First Amended Complaint (Dkt. 7) on October 26, 2020. The undersigned dismissed as moot Defendants’ first motion to dismiss by text order issued November 18, 2020. In his First Amended Complaint, Plaintiff alleges all claims in his Original Complaint, but adds a claim under § 1132(a)(1)(B) that “[t]here is no basis in the policy for any offset or reduction based on any payment of PIP benefits that Plaintiff has received.” Dkt. 7 ¶ 33. Plaintiff seeks the

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Young v. Reliance Standard Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/young-v-reliance-standard-life-insurance-company-txwd-2021.