Shafer v. Metro. Life Ins. Co.

80 F.Supp.3d 1244

Marilyn O. Shafer, Plaintiff

v.Metropolitan Life Insurance Company, a New York Insurance Company, and Schlumberger Technologies, Inc., a Texas Corporation, Defendants.

Civil Action No. 14–CV–00656–RM–KMT

United States District Court, D. Colorado.

Signed February 19, 2015

Jeffery L. Weeden, Katelyn Barbara Marie Ridenour, Charles Eugene King, Thomas N. Scheffel & Associates, P.C., Denver, CO, for Plaintiff.

Jack M. Englert, Jr., Holland & Hart, LLP, Greenwood Village, CO, Shira Radinsky Yoshor, Tina Quy Phi Nguyen, Baker Botts, LLP, Houston, TX, for Defendants.

ORDER

RAYMOND P. MOORE, United States District Judge

This matter concerns Plaintiff Marilyn O. Shafer's claim for life insurance benefits allegedly due under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq.

This matter is before the Court on Plaintiff's motion for partial summary judgment regarding the proper standard of review under ERISA for a benefit denial claim. (ECF No. 26.) Plaintiff contends that she is entitled to a de novo standard of review and a jury trial due to a Colorado statute concerning the subject. Defendants Metropolitan Life Insurance Company (“MetLife”) and Schlumberger Technology Corporation¹ (“STC”) oppose Plaintiff's motion. (ECF No. 29.)

For the reasons stated below, the Court DENIES Plaintiff's motion regarding the proper standard of review. The Court concludes that while the part of Colo. Rev. Stat. § 10–3–1116(3) (2008) providing for a de novo standard of review, standing alone, would not be preempted, the part of Colo. Rev. Stat. § 10–3–1116(3) providing for a jury trial conflicts with ERISA's remedial structure by altering the judiciary's role. Thus, the Court concludes that ERISA preempts, in its entirety, Colo. Rev. Stat. § 10–3–1116(3).

I. BACKGROUND

Plaintiff's deceased husband, Michael Shafer, was a participant in the Schlumberger Group Welfare Benefits Plan (the “Plan”), effective January 1, 2012. (ECF Nos. 20–2 at 43–44, 20–17 at 1–2, 20–27 at 28–30; Shafer Rec. 0093–94, 0801–02, 1328–30.) STC is the group policyholder of the 2012 Plan. (ECF No. 20–1 at 3; Shafer Rec. 0003.) The Plan provides that the “Plan Administrator” and “other Plan fiduciaries” have “discretionary authority to interpret the terms of the Plan and to determine eligibility for and entitlement to Plan benefits in accordance with the terms of the Plan.” (ECF No. 20–2 at 36; Shafer Rec. 0086.) The Plan Administrator and Plan Sponsor is STC. (ECF Nos. 20–2 at 32, 20–8 at 26; Shafer Rec. 0082, 0376.) The Plan Administrator and Plan Sponsor are based in Houston, Texas. (ECF Nos. 20–2 at 32, 20–8 at 26; Shafer Rec. 82, 376.)

MetLife issued the 2012 Plan to STC in Texas. (ECF Nos. 20–1 at 2–3, 20–2 at 32; Shafer Rec. 0002–03, 0082.) STC issued the 2012 Plan to Mr. Shafer in Colorado. (ECF No. 20–1 at 23, 38; Shafer Rec. 0002–03, 0038.)

MetLife informed Plaintiff of its decision to deny benefits over the amount of $873,000.00. (ECF No. 20–10 at 30–31; Shafer Rec. 0480–81.) On June 6, 2013, Plaintiff appealed this denial of benefits under the 2012 Plan. (ECF No. 20–21 at 2–10; Shafer Rec. 1002–10.) MetLife confirmed receipt of Plaintiff's appeal letter via fax on June 12, 2013. (ECF No. 20–21 at 12–13; Shafer Rec. 1012–13.) On July 29, 2013, MetLife upheld its denial of benefits for any amount over $873,000.00. (ECF No. 20–21 at 27–28; Shafer Rec. 1027–28.)

On March 3, 2014, Plaintiff filed this lawsuit against Defendants challenging the denial of benefits for any amount over $873,000.00. (ECF No. 1.) By motion for partial summary judgment (ECF No. 26), Plaintiff seeks both de novo review and trial by jury on the claim denial under Colo. Rev. Stat. § 10–3–1116(3).

II. LEGAL STANDARDS

Summary judgment is appropriate only if there is no genuine dispute of material fact and the moving party is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(a) ; Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986) ; Henderson v. Inter–Chem Coal Co., Inc., 41 F.3d 567, 56970 (10th Cir.1994). Whether there is a genuine dispute as to a material fact depends upon whether the evidence presents a sufficient disagreement to require submission to a jury or is so one–sided that one party must prevail as a matter of law. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 251–52, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986) ; Stone v. Autoliv ASP, Inc., 210 F.3d 1132, 1136 (10th Cir.2000). Once the moving party meets its initial burden of demonstrating an absence of a genuine dispute of material fact, the burden then shifts to the non-moving party to move beyond the pleadings and to designate evidence which demonstrates the existence of a genuine dispute of material fact to be resolved at trial. See 1–800–Contacts, Inc. v. Lens.com, Inc., 722 F.3d 1229, 1242 (10th Cir.2013) (citation omitted). A fact is “material” if it pertains to an element of a claim or defense; a factual dispute is “genuine” if the evidence is so contradictory that if the matter went to trial, a reasonable jury could return a verdict for either party. Anderson, 477 U.S. at 248, 106 S.Ct. 2505. In considering whether summary judgment is appropriate, the facts must be considered in a light most favorable to the non-moving party. Cillo v. City of Greenwood Vill., 739 F.3d 451, 461 (10th Cir.2013) (citations omitted).

If a movant properly supports a motion for summary judgment, the opposing party may not rest on the allegations contained in her complaint, but must respond with specific facts showing a genuine factual issue for trial. Fed. R. Civ. P. 56(e) ; Scott v. Harris, 550 U.S. 372, 380, 127 S.Ct. 1769, 167 L.Ed.2d 686 (2007) (holding that “[t]he mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported motion for summary judgment; the requirement is that there be no genuine issue of material fact”) (citation omitted).

Only admissible evidence may be considered when ruling on a motion for summary judgment. Jaramillo v. Colo. Judicial Dep't, 427 F.3d 1303, 1314 (10th Cir.2005) (citation omitted) (holding that hearsay evidence is not acceptable in opposing a summary judgment motion); World of Sleep, Inc. v. La–Z–Boy Chair Co., 756 F.2d 1467, 1474 (10th Cir.1985). Affidavits must be based on personal knowledge and must set forth facts that would be admissible evidence at trial. Murray v. City of Sapulpa, 45 F.3d 1417, 1422 (10th Cir.1995) (quotations and citation omitted). “Conclusory and self-serving affidavits are not sufficient.” Id. The Court will not consider statements of fact, or rebuttals thereto, which are not material or are not supported by competent evidence. Fed. R. Civ. P. 56(c)(1)(A), 56(e)(2), 56(e)(3). “[O]n a motion for summary judgment, it is the responding party's burden to ensure that the factual dispute is portrayed with particularity, without depending on the trial court to conduct its own search of the record.” Cross v. The Home Depot, 390 F.3d 1283, 1290 (10th Cir.2004) (internal quotation and citation omitted). The Court is “not obligated to comb the record in order to make [Plaintiff's] arguments for [her].” See Mitchell v. City of Moore, Okla., 218 F.3d 1190, 1199 (10th Cir.2000). Further, Local Rule 7.1(e) provides that “[e]very citation in a motion, response or reply shall include the specific page or statutory subsection to which reference is made.” D.C. Colo. L. Civ. R. 7.1(e).

III. ANALYSIS

At issue in this matter is Section 10–3–1116(3) of the Colorado Revised Statutes² . Section 10–3–1116(3) states:

An insurance policy, insurance contract, or plan that is issued in this state shall provide that a person who claims health, life, or disability benefits, whose claim has been denied in whole or in part, and who has exhausted his or her administrative remedies shall be entitled to have his or her claim reviewed de novo in any court with jurisdiction and to a trial by jury.

Colo. Rev. Stat. 10–3–1116(3) (emphasis added). Further, the Colorado General Assembly declares that this “section is a law regulating insurance.” Colo. Rev. Stat. 10–3–1116(7).

A. Applicability of Colorado Revised Statute § 10–3–1116(3)

Defendants contend that a predicate condition to the applicability of Section 10–3–1116(3) has not been met, i.e., that the 2012 Plan was not “issued in this state [of Colorado].” (ECF No. 29 at 9–10.) MetLife issued the 2012 Plan to STC in Texas as a “group policyholder.” (ECF Nos. 20–1 at 2–3, 20–2 at 32; Shafer Rec. 0002–03, 0082; ECF No. 29 at 9.) STC administers the 2012 Plan in Texas. (ECF Nos. 20–2 at 32, 20–8 at 26; Shafer Rec. 0082, 0376.) STC, however, then issued the 2012 Plan to Mr. Shafer. (ECF No. 20–1 at 2–3; Shafer Rec. 0002–03.)

Both parties agree that “issued” means one of the following: (1) the preparation and signing of the policy; (2) the delivery and acceptance of the policy; or (3) the preparation, execution and delivery of the policy. (ECF No. 29 at 9; ECF No. 32 at 6.) The parties disagree as to whether “plan issuance” ends at MetLife's issuing the group policy to STC or whether it continues to STC's issuing the 2012 Plan to Mr. Shafer.

The principle objective of ERISA is to protect plan participants and beneficiaries. 29 U.S.C. §§ 1001(b), 1001(c), 1103(c)(1), 1104(a)(1), 1108(a)(2), 1132(a)(1)(B) ; Boggs v. Boggs, 520 U.S. 833, 845, 117 S.Ct. 1754, 138 L.Ed.2d 45 (1997) (citation omitted). ERISA defines the term “participant” as “any employee or former employee of an employer, or any member or former member of an employee organization, who is or may become eligible to receive a benefit of any type from an employee benefit plan which covers employees of such employer or members of such organization, or whose beneficiaries may be eligible to receive any such benefit.” 29 U.S.C. § 1002(7). ERISA defines the term “beneficiary” as “a person designated by participant, or by the terms of an employee benefit plan, who is or may become entitled to...