Moore v. Metropolitan Life Insurance Co. et al
OPINION. Signed by Honorable Judge Myron H. Thompson on 6/10/13. (scn, )
IN THE DISTRICT COURT OF THE UNITED STATES FOR THE
MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION
INSURANCE CO.; et al.,
CIVIL ACTION NO.
defendants Metropolitan Life Insurance Company; Southern
Company Services, Inc.; and Group Life Insurance Plan,
Dependent Life Benefits for Southern Company Services,
Inc., and Associated or Affiliated Companies, claiming a
violation of the Employee Retirement Income Security Act
of 1974 (“ERISA”), 29 U.S.C. §§ 1001, et seq. and seeking
to recover benefits pursuant to 29 U.S.C. § 1132(a)(1).
Jurisdiction over Ms. Moore’s federal claim is proper
under 28 U.S.C. § 1331 (federal question).
This case is
currently before the court on a review of the insurance
company’s denial of benefits to Ms. Moore.
reasons that follow, the court holds that Ms. Moore is
entitled to benefits.
division of defendant Southern Company.
As an employee,
Metropolitan Life serves as both the
plan’s administrator of claims as well as the payor of
The plan documents state that a claimant must submit
proof satisfactory to Metropolitan Life to get a benefit
under the plan.
The plan defines “spouse” as “your
“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.”
Claims File - Part Two (Doc. No. 57-4) at 38.
discretionary authority shall have effect unless it was
arbitrary and capricious.
In 2003, Ms. Moore enrolled in the plan to secure
$ 50,000 in dependent-life-insurance coverage for her
common-law husband, Mr. Moore.
Moore died of lung cancer.
In September of 2009, Mr.
After his death, Alabama
Power submitted a claim for Ms. Moore to Metropolitan
Life certifying that she had enrolled and had certifiable
coverage and that Mr. Moore was her spouse.
- Part One (Doc. No. 57-1) at 2-5.
As part of the claims process, Ms. Moore completed a
common-law marriage questionnaire for Metropolitan Life.
Id. at 14-23.
On the questionnaire, she listed the
address of the couple’s shared rented residence, date the
She also provided the names
and contact information of three people who would affirm
that they knew the Moores as husband and wife (of whom
two had known the Moores for 23 years).
that both she and Mr. Moore had listed “single” as their
marital status on the last federal income-tax return.
She provided the names and personal information of the
requesting information for joint checking, savings, and
Ms. Moore also voluntarily attached three documents
to the questionnaire: an insurance policy from 2004 where
Mr. Moore listed her as his spouse, a birth certificate
for one of their children showing both Mr. and Ms. Moore
After Ms. Moore sent all of this information to
Metropolitan Life, she received a letter denying her
In November 2009, Metropolitan Life notified Ms.
Moore that, based on the documentation in her file, her
claim was denied.
Id. at 27-28.
The initial denial
letter states that “documentation within the claim file
acknowledges that yourself [sic] and Mr. Moore were
Id. at 27.
The insurance company
explained that, because the Moores’ cohabitation began
validity of common-law marriage--it was denying the
Ms. Moore appealed the decision in December 2009.
Id. at 29.
In her appeal letter, she stated that,
although the Moores’ cohabitation began in Wisconsin,
they had been residing together permanently in Alabama
since 1995 and thus did have a common-law marriage under
Alabama law. Later that month, Metropolitan Life upheld
its adverse-claim determination reiterating its earlier
claim that: “Wisconsin, the state in which your commonlaw marriage was established does not recognize the
validity of common-law marriage.
Therefore, based on
the record before MetLife, we denied your claim on
November 25, 2009.” Id. at 34-35. The insurance company
then addressed Ms. Moore’s statement that it had applied
the wrong State’s laws, writing: “Although Alabama does
recognize common-law marriage, you have not provided our
office with any documentation to substantiate that a
common-law marriage existed.
Therefore, based on the
record before MetLife, we uphold our denial of your
claim.” Claims File - Part Two (Doc. No. 57-1) at 35
In August 2010, Ms. Moore again wrote Metropolitan
Life requesting reconsideration of its denial.
File - Part Two (Doc. No. 57-2) at 4-5.
supplemented the items already submitted by laying out
that the Moores had lived together as husband and wife
for more that two decades.
She reasserted that the
couple had resided together permanently in Alabama since
1995, holding themselves out as married to those who
knew them (she took his surname) and raised three
children together (who all took the Moore name as well).
Without repudiating its earlier denial of benefits
based on Wisconsin law, Metropolitan Life wrote to Ms.
Moore requiring documents that it claimed could possibly
substantiate a common-law marriage. Id. at 14.
insurance company required submission of at least two of
the following three items: (1) documentation of a joint
lease or deed; (2) documentation showing joint bank
accounts, credit cards, or other investments; (3) a copy
of federal-tax returns showing joint filing.
In December 2010, Ms. Moore notified Metropolitan
Life that, absent a repudiation of its decision based on
Wisconsin law or a final ruling on the appeal, she would
not submit any more information. Id. at 26-27.
insurance company responded that same month with a
letter stating that she had exhausted her administrative
remedies under the Plan and that it would consider no
further appeals. Id. at 31.
After litigation began in this case, Metropolitan
Life conceded that Alabama law governs the couple’s
Id. at 33-34.
Ms. Moore challenges Metropolitan Life’s denial of
her claim for spousal-death benefits.
She argues that
she had a valid common-law marriage under Alabama law
and that the insurance company erred in denying her
Metropolitan Life claims that
Ms. Moore failed to submit satisfactory proof of a
The insurance company argues that
its decision was correct, reasonable, and not affected
by a conflict of interest.
A. ERISA Standard of Review
This court must determine whether a reasonable basis
existed for the ERISA plan administrator’s benefits
The court uses a modified version of the test
articulated in Williams v. Bell South Telecomm., Inc.,
373 F.3d 1132, 1137-38 (11th Cir. 2004).
reviewing an ERISA-plan benefit denial must:
“(1) Apply the de novo standard to
decision is ‘wrong’ (i.e. the court
disagrees with the administrator’s
decision); if it is not, end judicial
inquiry and affirm the decision.
“(2) If the administrator’s decision
in fact is ‘de novo wrong,’ then
determine whether he was vested with
discretion in reviewing claims; if not
end the judicial inquiry and reverse
“(3) If the administrator’s decision
is ‘de novo wrong’ and he was vested
with discretion in reviewing claims,
then determine whether ‘reasonable’
grounds supported it (hence, review
deferential arbitrary and capricious
“(4) If no reasonable grounds exist,
then end the inquiry and reverse the
reasonable grounds do exist, then
determine if he operated under a
conflict of interest.
“(5) If there is no conflict, then end
the inquiry and affirm the decision.
“(6) If there is a conflict of
interest, the conflict should merely
be a factor for the court to take into
account when determining whether an
administrator’s decision was arbitrary
Blankenship v. Metropolitan Life Ins. Co., 644 F.3d
1350, 1355 (11th Cir. 2011); see also Capone v. Aetna
Life Ins. Co., 592 F.3d 1189, 1195-96 (11th Cir. 2010)
(“[T]he Williams methodology remains intact except for
the sixth step.”).
reviewed de novo unless the plan states otherwise.
Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115
(1989). Where the plan provides discretionary authority
to the administrator, an abuse-of-discretion standard is
Id. at 111; see also Metro. Life Ins. Co.
v. Glenn, 554 U.S. 105, 111 (2008). Review of the
administrator at the time it made its decision.
Jett v. Blue Cross & Blue Shield of Ala., 890 F.2d 1137,
1140 (11th Cir. 1989).
administrator’s benefits-denial decision is “wrong.”
Blankenship, 644 F.3d at 1355.
Life based its preliminary denials on Wisconsin law,
Moore argues--and the insurance company now concedes-that Alabama law applies to the determination of whether
the Moores had a valid common-law marriage. As such,
determining whether the Moores had a common-law marriage
under Alabama law.
Alabama has recognized common-law marriage since
Campbell’s Adm’r v. Gullatt, 43 Ala. 57, 59
A party seeking to prove a common-law marriage
Lofton v. Estate of Weaver, 611 So. 2d 335,
336 (Ala. 1992).
In Alabama, recognition of common-law
marriage requires proof of “(1) capacity; (2) present,
relationship as a marriage and public assumption of
marital duties and cohabitation.” Boswell v. Boswell,
487 So. 2d 479, 480 (Ala. 1986).
marriage exist is a question of fact.
Stringer, 689 So. 2d 194, 195 (Ala. Civ. App. 1997)
(citing Johnson v. Johnson, 120 So. 2d 739, 740 (Ala.
Whether the parties had the intent, or the
mutual assent, to enter the marriage is also a question
Id. at 195.
“Each case must be determined on
situations of the parties and their status in life.
pertinent inquiry is to determine the attitude of the
parties with respect to marriage and the common law
relationship.” Etheridge v. Yeager, 465 So. 2d 378, 380
(Ala. 1985) (quoting Goodman v. McMillan, 61 So. 2d 55,
59 (Ala. 1952)).
With these standards in mind, this court turns to
the first element: capacity.
Alabama courts have held
that parties do not have the capacity to marry if they
See, e.g., Beck v. Beck, 246 So. 2d 420, 425
(Ala. 1971) (unsound mind); Steele v. Steele, 522 So. 2d
269, 270 (Ala. 1988) (already married); Adams v. Boan,
559 So. 2d 1084, 1086-87 (Ala. 1990) (underage).
is nothing in the record to indicate that either Mr. or
Ms. Moore lacked capacity.
The second element is a present, mutual agreement to
exclusion of all other relationships.
2d at 480.
Boswell, 487 So.
No particular words of consent, nor proof of
words of consent, are required.
See Beck, 246 So. 2d at
circumstances. See Moore v. Heineke, 24 So. 374, 378-79
(Ala. 1898), overruled on other grounds by Alexander v.
Gibson, 57 So. 760 (Ala. 1912).
If the couple consents
and rears children together and others recognize them
through their declarations and conduct as being married,
a trier of fact may infer that a marriage exists.
see also Sloss-Sheffield Steel & Iron Co. v. Watford, 17
So. 2d 166 (Ala. 1944).
The same behavior that evinces agreement to marry
may also satisfy the third element: public recognition
of the relationship as a marriage and public assumption
of marital duties and cohabitation. Crosson v. Crosson,
668 So. 2d 868, 870 (Ala. Civ. App. 1997).
this third prong, Alabama courts have looked to many
See, e.g., Cross v. Rudder, 380 So. 2d 766,
773 (Ala. 1979) (man’s reliance on advice of lawyer that
he had common-law marriage with the mother of his
married); Adams v. Boan, 559 So. 2d 1084, 1086 (Ala.
Richardson, 551, So. 2d 353, 355 (Ala. 1989) (maintained
joint accounts); Crosson, 668 So. 2d at 871 (referred to
or introduced each other as spouse, filed joint-tax
returns); Aaberg v. Aaberg, 512 So. 2d 1375, 1377 (Ala.
1987) (used the same surname); Downs v. Newman, 500 So.
2d 1062, 1063 (Ala. 1986) (parties’ own designations of
themselves on documents); Mills v. Bose, 435 So. 2d 1264
(Ala. 1983) (reared children together).
But the most
crucial part of establishing this third element is that
others in the public recognize them as husband and wife.
See, e.g., Vinson v. Vinson, 69 So. 2d 431, 432, (Ala.
1953) (finding “no proof that [the parties’] neighbors
or friends knew of them as husband and wife”); John B.
Crawley, Is the Honeymoon over for Common-Law Marriage:
Common-Law Marriage Doctrine, 29 Cumb. L. Rev. 399, 40910 (1999).
As to the present case, Metropolitan Life argues
documentation to substantiate that a common-law marriage
This court disagrees.
administrative record that Metropolitan Life possessed
regarding Ms. Moore’s claim from the time she filed for
administrative remedies were exhausted. The information
Ms. Moore submitted to Metropolitan Life states that she
and Mr. Moore cohabitated for over 24 years, the last 14
of which were in Alabama.
The Moores reared children
together. They held themselves out as husband and wife;
she took his name.
They also listed each other as
spouse on some, but not all, documents.
Ms. Moore provided the names of three individuals who
would testify that they knew the couple as husband and
The standards for common-law marriage in Alabama,
weighed with the documentation Ms. Moore provided to
Metropolitan Life, lead this court to conclude that the
recognition to establish a common-law marriage.
insurance company is quick to point out that there were
inconsistencies in the way the Moores characterized
their marital status and argues that this undermines Ms.
Moore’s claim to benefits. However, these instances are
Ms. Moore did not see herself as
“married,” but rather as “common-law married.” When she
was presented with a choice between married or single,
she listed single.
When given the option to choose
“other,” she always chose “other” and wrote out to the
side, “common-law married.”
While this case would be
even more clear-cut if Ms. Moore had consistently listed
“married,” “once a couple is married by common-law,
subsequent representations of a single status do not
invalidate the marriage by common law anymore than such
ceremony.” See Matter of Estate of Stodola, 519 N.W. 2d
97, 100 (Iowa Ct. App. 1994) (citing In re Estate of
Fisher, 176 N.W. 2d 801 (Iowa 1970)).
In addition, to
fault Ms. Moore, who is not learned in legal niceties,
for drawing a distinction between common-law married and
just married is not only to exalt form over substance,
it suggests an unsavory relish in the use of the petty
Because Metropolitan Life’s decision was de novo
“wrong” under the first step of the modified Williams
The parties dispute whether Metropolitan Life had
discretionary authority to construe the plan’s terms.
Ms. Moore argues that the plan did not expressly grant
the insurance company discretionary authority to make
eligibility determinations or construe the plan’s terms.
Her argument misses the mark.
The plan explicitly
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.”
Benefit Plan - Part Two (Doc. No. 57-4) at 38.
Furthermore, the Eleventh Circuit Court of Appeals
has held that language requiring submission of proof
“satisfactory to” an administrator confers discretionary
authority on the administrator.
See, e.g., Tippitt v.
Reliance Standard Life Ins. Co., 457 F.3d 1227, 1233-34
(11th Cir. 2006) (holding that language requiring the
administrator conferred discretionary authority on the
Metropolitan Life’s plan documents
state that, when filing a claim for benefits, Ms. Moore
must submit “proof” “satisfactory to” the insurance
Benefit Plan - Part Two (Doc. No. 57-4) at 7,
Thus, under the plan, Metropolitan Life did have
discretion to “interpret the terms of the Plan and to
benefits in accordance with the terms of the Plan.” Id.
Because the administrator’s decision is “de novo
wrong” and it was vested with discretion in reviewing
claims, this court moves on to step three to determine
In other words: Was the insurance
company’s decision arbitrary and capricious?
reasonableness of Metropolitan Life’s decision: which
decision is reviewable and whether sufficient evidence
had been submitted for a proper determination.
Metropolitan Life’s first reason for denying Ms.
Moore’s claim was that her marriage was invalid because
Wisconsin, a State that does not recognize common-law
Even after Ms. Moore notified the insurance
company that the couple had resided in Alabama since
1995 and Alabama law applied, the insurance company
upheld its initial denial based on Wisconsin law.
Moore argues that it is inexcusable that Metropolitan
Life, having been made aware of its error in choice of
law, would continue to insist on an untenable position.
It is the ultimate “decision” that a court must affirm
or reverse, but a full and fair review includes “a
review that takes into account all documents, records,
and other information submitted by the claimant relating
to the claim, without regard to whether such information
was submitted or considered in the initial benefit
essential because the insurance company’s final decision
is the result of multiple frivolous denials and the
Metropolitan Life’s repeated references to Wisconsin
law–-even after it was aware that Ms. Moore claimed
willingness to review fairly Ms. Moore’s file.
court, therefore, cannot look at the insurance company’s
final decision in a vacuum.
Metropolitan Life’s second argument is that Ms.
Moore failed to satisfy the “public recognition” prong
of the Alabama common-law-marriage test.
second appeal, the insurance company notified her that,
pursuant to the insurance company’s own policies and
procedures, she must provide two of three specific
documents to substantiate her marriage.
While a joint
lease or deed, joint bank accounts, credit cards or
other investments, or a jointly filed federal-tax return
common-law marriage, they are not a sine qua non under
Alabama law for any marriage.
In other words, Alabama
law does not restrict proof to two of the three and only
two of the three.
documents troubling for several reasons.
items required in this list were already requested in
the common-law questionnaire that Ms. Moore completed.
deemed necessary for Ms. Moore to produce represent only
seven questions on a 26-question survey and are not
identified as requisite, or even of increased import.
Second, Ms. Moore had already responded that she rented
The questionnaire asked for a copy of the
omission of a copy of the lease points to the fact that
it likely did not show joint leasehold and thus would
not have satisfied Metropolitan Life, even if provided.
Next, there were only three questions on the entire
requesting information for joint checking, savings, and
Metropolitan Life determined to be required.
Metropolitan Life was marital status on the last federal
The insurance company, in requiring two out
satisfied, demanded financial entanglement of spouses
couples. Furthermore, the insurance company’s responses
to Ms. Moore show that it ignored evidence that was
already in hand.
While Metropolitan Life may require proof of a
common-law marriage to avoid fraudulent claims, it may
not use its discretionary authority to require evidence
to establish that the claimant is “legally” entitled to
recover damages when Alabama law itself does not require
that same evidence to prove legality.
The Supreme Court of Alabama has examined heightened
In Walker v. GuideOne Specialty Mut. Ins.
Co., the Alabama Supreme Court examined an insurance
company’s denial of benefits under an uninsured-motorist
834 So. 2d 769 (Ala. 2002).
The court held
evidence requirement contractually raised the burden of
proof higher than it was under Alabama law, it was void
and unenforceable because to hold otherwise would permit
the insurance company to alter Alabama law.
Id. at 773.
The court also stated that, if the insured was “legally
evidence to bar legally entitled [individuals] from
recovery ... in its policy.” Id.
The Supreme Court of
Alabama recognized that, while the insurance company had
a valid desire to protect against fraud, neither the
court nor the insurance company could impose a heightened
situation to warrant the requirement. Id. at 774. While
the uninsured-motorist provision in Walker was in a
statute and common-law marriage in Alabama is by its very
definition created by the judiciary, this court sees no
basis for creating a new common-law-marriage requirement
under Alabama law.
The effect is the same.
Neither this court, nor Metropolitan Life can read
into Alabama law a common-law-marriage requirement that
simply is not there. The insurance company may interpret
the terms of its plan, but it may not rewrite the laws
of Alabama. The terms of Ms. Moore’s plan stated “lawful
spouse.” Under Alabama law, Mr. Moore was Ms. Moore’s
The insurance company’s decision to
restrict the documents that may establish a common-law
marriage in Alabama is unreasonable.
Because Metropolitan Life’s basis for denial was
arbitrary and capricious, this court need not reach the
issue of whether the insurance company operated under a
conflict of interest.
As such, the insurance company’s
decision is reversed, and Ms. Moore should obtain full
access to benefits under the plan.
An appropriate judgment in favor of Ms. Moore and
against Metropolitan Life and the other defendants will
DONE, this the 10th day of June, 2013.
/s/ Myron H. Thompson
UNITED STATES DISTRICT JUDGE
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