Snow v. Bos. Mut. Ins. Co., Case No. 3:11–cv–813–MEF.

915 F.Supp.2d 1273

Dorothy SNOW, Plaintiff,

v.BOSTON MUTUAL INSURANCE COMPANY, et al., Defendants.

Case No. 3:11–cv–813–MEF.

United States District Court,

M.D. Alabama,

Eastern Division.

Jan. 15, 2013.

David Paul Martin, James Guy Martin, III, Jason E. Burgett, The Martin Law Group, LLC, Tuscaloosa, AL, Philip Dale Segrest, Sr., The Segrest Law Firm, Tallassee, AL, for Plaintiff.

Andrea D. Germany, John David Collins, Lee Edmundson Bains, Jr., Maynard, Cooper & Gale, P.C., Birmingham, AL, for Defendants.

MEMORANDUM OPINION AND ORDER

MARK E. FULLER, District Judge.

Before the Court are (1) Plaintiff Dorothy Snow's Motion for Summary Judgment (Doc. # 31), and (2) Defendant Boston Mutual Insurance Company's Motion for Summary Judgment (Doc. # 32). For the reasons set forth below, the Court finds that Plaintiff's motion is due to be DENIED, and Defendant's motion is due to be GRANTED IN PART and DENIED IN PART.

I. INTRODUCTION

This is an ERISA ¹ case involving two distinct claims for relief brought by Plaintiff Dorothy Snow (“Plaintiff” or “Snow”), the widow and designated beneficiary under a life insurance policy issued to James Francis Snow (“Mr. Snow”), against Boston Mutual Insurance Company (“Boston Mutual” or “Defendant”) and Mr. Snow's former employer, Meadowcraft, Inc. (“Meadowcraft”), for the payment of certain life insurance benefits. Count I of Plaintiff's Amended Complaint alleges that Boston Mutual wrongfully denied payment of approximately $115,000 in life insurance benefits in violation of 29 U.S.C. § 1132(a)(1)(B). Count II of Plaintiff's Amended Complaint asserts an alternative claim for equitable relief under 29 U.S.C. §§ 1132(a)(3) and 1133 based upon Boston Mutual's breach of certain fiduciary duties it purportedly owed to Plaintiff as a Plan Administrator and claims adjudicator.

Plaintiff and Boston Mutual have filed cross-motions for summary judgment, each arguing in their briefs that they are entitled to judgment as a matter of law on both of Plaintiff's claims. Specifically, Plaintiff argues that: (1) under the terms of the policy at issue, and in accordance with 29 U.S.C. § 1132(a)(1)(B), she is entitled to approximately $115,000 in life insurance benefits as a matter of law; and (2) Boston Mutual breached certain fiduciary duties that it owed to her, thus entitling Plaintiff to equitable relief under 29 U.S.C. §§ 1132(a)(3) and 1133. Boston Mutual disagrees with Plaintiff, arguing that: (1) under the terms of the policy at issue, and in accordance with 29 U.S.C. § 1132(a)(1)(B), Boston Mutual is not obligated to pay any life insurance benefits to Plaintiff because her husband was not coveredunder the policy at the time of his death; and (2) Boston Mutual neither owed nor breached any fiduciary duties to Plaintiff that would entitle her to equitable relief under 29 U.S.C. §§ 1132(a)(3) and 1133.

In sum, this case boils down to two issues. First, does Boston Mutual owe Plaintiff any life insurance benefits under the policy at issue? Second, did Boston Mutual owe any fiduciary duties to Plaintiff and, if so, did it breach any of those duties, thereby entitling Plaintiff to any of the equitable remedies she seeks? Each of these issues is addressed in turn below.

II. JURISDICTION AND VENUE

The court has subject matter jurisdiction over this matter pursuant to 28 U.S.C. § 1331 (federal question) and 29 U.S.C. § 1132(e)(1) (ERISA). The parties do not contest personal jurisdiction or venue, and the court finds sufficient factual bases for both.

III. SUMMARY JUDGMENT STANDARD

A. Summary Judgment Standard

A motion for summary judgment looks to “pierce the pleadings and to assess the proof in order to see whether there is a genuine need for trial.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986). A court should grant summary judgment when the pleadings and supporting materials show that no genuine issue exists as to any material fact and that the moving party deserves judgment as a matter of law. Fed.R.Civ.P. 56(c); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). The party moving for summary judgment “always bears the initial responsibility of informing the district court of the basis for its motion, and identifying” the relevant documents that “it believes demonstrate the absence of a genuine issue of material fact.” Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). To shoulder this burden, the moving party can present evidence to this effect, or it can show that the non-moving party has failed to present evidence in support of some element of its case on which it ultimately bears the burden of proof. Id. at 322–23, 106 S.Ct. 2548.

If the moving party meets its burden, the non-movant must then designate, by affidavits, depositions, admissions, or answers to interrogatories, specific facts showing the existence of a genuine issue for trial. Jeffery v. Sarasota White Sox, Inc., 64 F.3d 590, 593–94 (11th Cir.1995). A genuine issue of material fact exists when the non-moving party produces evidence that would allow a reasonable fact-finder to return a verdict in his or her favor. Waddell v. Valley Forge Dental Assocs., 276 F.3d 1275, 1279 (11th Cir.2001). Thus, summary judgment requires the non-moving party to “do more than simply show that there is some metaphysical doubt as to the material facts.” Matsushita, 475 U.S. at 586, 106 S.Ct. 1348. Indeed, a plaintiff must present evidence demonstrating that he can establish the basic elements of his claim, Celotex, 477 U.S. at 322, 106 S.Ct. 2548, because “conclusory allegations without specific supporting facts have no probative value” at the summary judgment stage. Evers v. Gen. Motors Corp., 770 F.2d 984, 986 (11th Cir.1985).

A court ruling on a motion for summary judgment must believe the non-movant's evidence. Anderson, 477 U.S. at 255, 106 S.Ct. 2505. It also must draw all justifiableinferences from the evidence in the non-moving party's favor. Id. After the non-moving party has responded to the motion, the court must grant summary judgment if there exists no genuine issue of material fact and the moving party deserves judgment as a matter of law. SeeFed.R.Civ.P. 56(c).

B. Standard of Review Applicable to Count I of Plaintiff's Amended Complaint

The Court will consider Plaintiff's claim under 29 U.S.C. § 1132(a)(1)(B), which arises from Boston Mutual's decision to deny payment of life insurance benefits, under the de novo standard of review because the policy at issue does not expressly grant “the administrator discretionary authority to make eligibility determinations or to construe the plan's terms.” Anderson v. Unum Life Ins. Co., 414 F.Supp.2d 1079, 1094 (M.D.Ala.2006). The parties do not contest that this is the appropriate standard of review applicable to Plaintiff's § 1132(a)(1)(B) claim.

IV. PROCEDURAL HISTORY

On August 26, 2011, Plaintiff filed a Complaint in the Circuit Court of Randolph County, Alabama against Boston Mutual. (Doc. # 1–1.) The case was timely removed to federal court on September 28, 2011. (Doc. # 1.) Plaintiff filed an Amended Complaint on November 22, 2011 (Doc. # 18), and Boston Mutual answered on December 6, 2011 (Doc. # 21). The parties agree that Plaintiff exhausted all of her administrative remedies before filing this suit, or that exhaustion of any such remedies would be futile.

As of the date of this Order, Meadowcraft, Mr. Snow's former employer and Boston Mutual's co-defendant in this case, has not appeared in or otherwise defended against this action. As a result, the Clerk of Court entered a default against it.² (Doc. # 25.) Meadowcraft is believed to be a defunct company that has ceased operations.³

On October 3, 2012, Plaintiff and Boston Mutual filed cross-motions for summary judgment (Docs. # 31 & 32), which are now before the Court and ripe for disposition.

V. FACTS

The Court has carefully considered all deposition excerpts and other evidence submitted in support of and in opposition to the parties' summary judgment motions. The submissions of the parties, viewed in the light most favorable to the non-moving party, establish the following facts:

A. The Snows

Plaintiff is the widow of Mr. Snow, who passed away on August 27, 2009. (Affidavit of Dorothy Snow (“Snow Aff.”), Doc. # 33–8, at ¶ 3.) Mr. Snow was sixty-six years and nine months old at the time of his death. (Certificate of Death, Doc. # 33–2, at 16.) Plaintiff is the primary beneficiary designated to receive the life insurance benefits at issue in this case. (Snow Aff., Doc. # 33–8, at ¶ 3.) Beginning on October 25, 1993, Mr. Snow worked as a warehouse supervisor for Meadowcraft until he became disabled on May 17, 2002.

B. The Group Life Insurance Plan

Meadowcraft maintained Group Policy No. 24661 (the “Plan”) for its full-time employees, which included Mr. Snow. (Doc. # 33–1, at 1.) This Plan was underwritten and issued by Boston Mutual and became effective on August 1, 1999. (Doc. # 33–1, at 1.) The amount of life insurance benefits at issue here is approximately $115,000, and if these benefits are due to be paid to Plaintiff, Boston Mutual would be solely responsible for paying them.

Under the Plan, when a disabled employee's Waiver of Premium claim is approved, his life insurance:

will be kept in force: (1) with no further premium cost to him or to the Policyholder; (2) for the life amount in effect at the time; (3) for as long as he is disabled; (4) whether or not the plan stays in force; (5) but in no event beyond the Normal Retirement date in effect as of the date of ... disability.

(Doc. # 33–1, at 7) (emphasis added). Additionally, an employee's insurance under the Plan stops:

on the first of the following dates: (1) when the Plan stops; (2) when he is no longer eligible for insurance under the Plan; (3) at the end of 31 days from when the last premium was due and not paid if the employee is...