Ruth Duarte v. Aetna Life Insurance Company et al

Filing 39

JUDGMENT by Judge Josephine L. Staton, in favor of Ruth Duarte against Aetna Life Insurance Company. Therefore, the Court orders Judgment in favor of Plaintiff and against Aetna on the STD benefits in the amount of $12,560.46. (twdb)

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UNITED STATES DISTRICT COURT
CENTRAL DISTRICT OF CALIFORNIA

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RUTH DUARTE, an individual,

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Plaintiff,
v.

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AETNA LIFE INSURANCE
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inclusive,
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Case No. SACV 13-00492-JLS (RNBx)
JUDGMENT
Judge:
Ctrm.:

Josephine L. Staton
10A (Santa Ana)

Defendant.

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TO THE COURT, ALL PARTIES, AND THEIR ATTORNEYS OF
RECORD:
Judgment shall be entered in favor of Ruth Duarte (“Plaintiff”) and against
Defendant Aetna Life Insurance Company (“Aetna”) as follows:
1.

Plaintiff was insured under a disability insurance policy issued by

Aetna in which Plaintiff was a participant. The plan provided short-term (“STD”)
and long-term disability (“LTD”) benefits.
2.

Plaintiff’s pre-disability annual base salary for benefits purposes was

$139,602.

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JUDGMENT

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3.

Pursuant to the Findings of Fact and Conclusions of Law (Docket No.

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33), the Court has ruled that Plaintiff is entitled to short-term disability benefits

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from Aetna from August 3, 2012, through December 2, 2012.

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4.

There is a seven-day elimination period.

After that, the benefit

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amount is $2,147.72 per week (80% weekly rate) for twelve weeks. After that,

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$1,610.79 per week (60% weekly rate) is payable for thirteen more weeks. After

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that, the benefit is $6,980.10 (60% monthly rate) per month.

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5.

From August 3, 2012, through September 2, 2012, the benefits due are

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$2,147.72 per week less $1,011.00 received by Plaintiff from California State

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Disability (“SDI”). The first weekly period is four days, so that week the amount

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due after the SDI offset is $216.27 (($2,147.72 * 4 / 7) - $1,011). The amount due

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for the next four weeks after the SDI offset is $1,136.72 per week ($2,147.72 -

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$1,011), for a total of $4,546.89 ($1,136.72 * 4). The total owed by Aetna for

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August 3, 2012, through September 2, 2012, is therefore $4,763.16 ($216.27 +

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$4,546.89).

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6.

From September 3, 2012, through December 2, 2012, the benefits due

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are $1,610.79 per week less $1,011.00 received by Plaintiff from California State

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Disability, for a net weekly amount of $599.79 ($1,610.79 - $1,011.00). The total

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owed by Aetna for September 3, 2012, through December 2, 2012, is therefore

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$7,797.30 ($599.79 * 13).

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7.

The net amount of STD benefits owed to Plaintiff by Aetna is

therefore $12,560.46 ($4,763.16 + $7,797.30).
8.

Therefore, the Court orders Judgment in favor of Plaintiff and against

Aetna on the STD benefits in the amount of $12,560.46.
9.

As for LTD benefits, the Court has ruled that the determination of

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LTD benefits is remanded to Aetna so that it can re-review Plaintiff’s medical

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evidence and determine, in good faith, whether she qualifies for LTD benefits.

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JUDGMENT

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10.

Plaintiff is granted leave to file a motion for attorneys’ fees, costs, and

interest.

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SO ORDERED:

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DATED: May 19, 2014
___________________________
Honorable Josephine L. Staton
United States District Judge

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JUDGMENT