Mayhew v. Hartford Life & Accident Insurance Company et al
Filing
31
ORDER by Judge Samuel Conti denying 18 Motion to Dismiss (sclc1, COURT STAFF) (Filed on 10/21/2011)
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IN THE UNITED STATES DISTRICT COURT
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FOR THE NORTHERN DISTRICT OF CALIFORNIA
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MELINDA MAYHEW,
Plaintiff,
v.
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For the Northern District of California
United States District Court
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HARTFORD LIFE AND ACCIDENT
INSURANCE COMPANY; FORMFACTOR,
INC. GROUP WELFARE BENEFIT PLAN,
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Defendants.
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Case No. 11-2908 SC
ORDER DENYING MAYHEW'S
MOTION TO DISMISS
COUNTERCLAIM
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I.
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INTRODUCTION
Plaintiff Melinda Mayhew ("Mayhew") commenced this action for
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declaratory, injunctive, and monetary relief pursuant to
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§ 502(a)(1) of the Employee Retirement Security Act ("ERISA"), 29
20
U.S.C. § 1132(a)(1), against Defendants Hartford Life and Accident
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Insurance Company ("Hartford") and Formfactor, Inc. Group Welfare
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Benefit Plan (collectively, "Defendants").
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1.
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for restitution.
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the Court is Mayhew's Motion to Dismiss the Counterclaim, which is
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fully briefed.
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For the reasons set forth below, Mayhew's Motion is DENIED.
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ECF No. 1 ("Compl.") ¶
In answering the Complaint, Hartford asserted a Counterclaim
ECF No. 16 ("Counterclaim") ¶¶ 67-72.
Now before
ECF Nos. 18 ("Mot."), 22 ("Opp'n"), 23 ("Reply").
1
II.
BACKGROUND
As it must on a motion to dismiss Hartford's Counterclaim
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3
pursuant to Rule 12(b)(6), the Court assumes the veracity of
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Hartford's well-pleaded factual allegations.
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Formfactor, Inc. ("Formfactor") employed her as a technical writer
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between January 15, 2001 and December 15, 2006.
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all relevant times, Mayhew was a participant in Formfactor's Group
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Welfare Benefit Plan ("the Plan"), which was funded by Hartford
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through a group insurance policy.
Mayhew alleges that
Id. ¶¶ 4-5.
Compl. ¶ 9.
At
Mayhew alleges that
United States District Court
For the Northern District of California
10
she has been diagnosed with Graves Disease, an autoimmune disorder
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that leads to overactivity of the thyroid gland.
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further alleges that her condition significantly worsened in
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November 2006 and, as a result, she ceased working altogether on
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December 15, 2006.
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commenced paying Mayhew monthly benefits under the Plan in March
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2007.
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Mayhew's Long Term Disability ("LTD") and Waiver of Premium claim.
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Id. ¶ 30; Compl. ¶ 30.
Id. ¶¶ 10, 16.
Counterclaim ¶ 68.
Id. ¶ 10.
Mayhew
Hartford alleges that it
In June 2010, Hartford terminated
In addition to receiving benefits under the Plan, Hartford
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alleges that Mayhew was also awarded lump sum Social Security
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Disability ("SSDI") benefit in the amount of $65,342.50 and
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Dependent Social Security Disability ("DSSD")1 benefits in the
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amount of $910,000.
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the SSDI and DSSD payments after it had terminated Mayhew's claims.
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Id.
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Counterclaim ¶¶ 61, 65.
Hartford learned of
Hartford alleges that, due to the SSDI and DSSD awards,
1
While it is not pled in the Complaint or Counterclaim, the
parties' papers indicate that Mayhew's child qualified for the DSSD
benefits.
28
2
1
Mayhew's claim under the Plan was overpaid by $79,393.51 and that
2
Mayhew has yet to reimburse Hartford for the overpayments.
3
65.
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to Hartford, Mayhew stated, "I am willing to pay Hartford all that
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I owe [with respect to the SSDI benefits] but I am requesting an
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extension to pay the overpayment."
Id. ¶
Hartford further alleges that in a September 30, 2010 letter
Id. ¶ 63.
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Mayhew filed this action on June 13, 2011, alleging that
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Defendants violated ERISA by terminating her claim for LTD and her
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Life Insurance Waiver of Premium benefit under the Plan.
Compl. ¶¶
United States District Court
For the Northern District of California
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40, 43.
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restitution of the alleged LTD overpayments resulting from Mayhew's
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receipt of SSDI and DSSD benefits.
13
Hartford filed the Counterclaim on August 8, 2011, seeking
Counterclaim at ¶¶ 19-20.
Mayhew now moves to dismiss Hartford's Counterclaim on the
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grounds that: (1) it is preempted and otherwise prohibited by
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ERISA, and (2) the Plan does not permit offsets for DSSD benefits.
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III. LEGAL STANDARD
A motion to dismiss under Federal Rule of Civil Procedure
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12(b)(6) "tests the legal sufficiency of a claim."
Navarro v.
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Block, 250 F.3d 729, 732 (9th Cir. 2001).
21
on the lack of a cognizable legal theory or the absence of
22
sufficient facts alleged under a cognizable legal theory."
23
Balistreri v. Pacifica Police Dep't, 901 F.2d 696, 699 (9th Cir.
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1988).
25
should assume their veracity and then determine whether they
26
plausibly give rise to an entitlement to relief."
27
Iqbal, 129 S. Ct. 1937, 1950 (2009).
"Dismissal can be based
"When there are well-pleaded factual allegations, a court
28
3
Ashcroft v.
However, "the tenet that a
1
court must accept as true all of the allegations contained in a
2
[claim] is inapplicable to legal conclusions.
3
of the elements of a cause of action, supported by mere conclusory
4
statements, do not suffice."
5
Twombly, 550 U.S. 544, 555 (2007)).
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complaint or counterclaim must be both "sufficiently detailed to
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give fair notice to the opposing party of the nature of the claim
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so that the party may effectively defend against it" and
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"sufficiently plausible" such that "it is not unfair to require the
Threadbare recitals
Id. (citing Bell Atl. Corp. v.
The allegations made in a
United States District Court
For the Northern District of California
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opposing party to be subjected to the expense of discovery."
11
Starr
v. Baca, 633 F.3d 1191, 1204 (9th Cir. 2011).
12
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IV.
DISCUSSION
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A.
ERISA § 502(a)(3)
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Under § 502(a)(3) of ERISA, a fiduciary may bring a civil
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action "(A) to enjoin any act or practice which violates any
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provision of this title or the terms of the plan, or (B) to obtain
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other appropriate equitable relief (i) to redress such violations
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or (ii) to enforce any provisions of this title or the terms of the
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plan."
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"those categories of relief that were typically available in equity
22
(such as injunction, mandamus, and restitution, but not
23
compensatory damages)."
24
256 (1993).
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29 U.S.C. § 1132(a)(3).
This provision authorizes only
Mertens v. Hewitt Assocs., 508 U.S. 248,
Mayhew contends that, in spite of its label, Hartford's
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Counterclaim for restitution constitutes a claim for legal or money
27
damages, which is barred by ERISA.
28
4
Mot. at 5.
Hartford responds
1
that the Counterclaim is equitable in nature and thus permissible.
2
Opp'n at 6-7.
3
decisions in Great-West Life & Annuity Insurance Company v.
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Knudson, 534 U.S. 204 (2002) and Sereboff v. Mid Atlantic Medical
5
Services, Inc., 547 U.S. 356 (2006).
The parties' dispute turns on the Supreme Court's
Knudson dealt with the reimbursement provision of an insurance
6
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plan that gave the insurer, Great-West, the "right to recover from
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the [beneficiary] any payment for benefits" paid by Great-West
9
which was later recovered from a third party.
534 U.S. at 207.
United States District Court
For the Northern District of California
10
After Great-West paid a portion of the Knudsons' medical expenses
11
resulting from a car accident, the Knudsons entered into a
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settlement agreement with a car manufacturer which established a
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special needs trust to provide for the Knudsons' medical care.
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at 207-08.
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reimbursement claim because the settlement funds sought were in a
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special needs trust rather than the Knudsons' possession.
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214.
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relief but "the imposition of personal liability for the benefits
19
that they conferred upon [the Knudsons]."
20
Id.
The Supreme Court rejected Great-West's § 502(a)(3)
Id. at
The Court concluded that Great-West was not seeking equitable
Id. at 214.
In Sereboff, the Supreme Court allowed an insurer's claim for
21
reimbursement under similar facts.
The Sereboffs were injured in a
22
car accident, received insurance benefits for medical expenses
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incurred, and later settled against third parties involved in the
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accident.
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insurer, Mid Atlantic, sought to enforce a plan provision which
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required "a beneficiary who receives benefits under the plan . . .
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to reimburse [Mid Atlantic] for those benefits from [a]ll
Sereboff, 547 U.S. at 360.
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5
Pursuant to § 502(a)(3), the
1
recoveries from a third party."
2
marks omitted).
3
Knudson on the grounds that the Sereboffs' settlement funds were
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not held by a trust and, as such, Mid Atlantic was seeking
5
particular funds in the Sereboffs' possession, not the imposition
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of personal liability.
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Mid Atlantic's claim was permissible under ERISA.
8
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United States District Court
For the Northern District of California
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Id. at 359 (internal quotation
The Supreme Court distinguished Sereboff from
Id. at 362-63.
The Court concluded that
Id. at 369.
The Supreme Court found that the reimbursement provision in
the Sereboffs' insurance plan gave rise to an equitable lien by
agreement.
Id. at 363-365.
The Court explained:
[T]he Sereboffs' plan specifically identified a
particular fund, distinct from the Sereboffs' general
assets--"[a]ll recoveries from a third party (whether by
lawsuit, settlement, or otherwise)"--and a particular
share of that fund to which Mid Atlantic was entitled-"that portion of the total recovery which is due [Mid
Atlantic] for benefits paid."
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Id. at 364.
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"follow[] a portion of the recovery 'into the [Sereboffs'] hands'
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'as soon as [the settlement fund] was identified,' and impos[e] on
19
that portion a constructive trust or equitable lien."
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(quoting Barnes v. Alexander, 232 U.S. 117, 123 (1914)).
21
Supreme Court noted that "the fund over which a lien is asserted
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need not be in existence when the contract containing the lien
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provision is executed."
24
rules" apply to an equitable lien by agreement.
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Accordingly, the property to which the lien attached could be
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converted to other property without destroying the lien.
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at 364-65.
Under "a familiar rule of equity," the insurer could
Id. at 366.
28
6
Id.
The
Further, no "strict tracing
Id. at 365.
See id.
Mayhew argues that Hartford's counterclaim is barred under
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Knudson since Hartford "seeks to impose personal liability on
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[Mayhew] for her alleged breach of the plan."
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responds that it seeks permissible equitable relief under Sereboff
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because the Plan created an equitable lien by agreement.
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6.
The Court agrees with Hartford.
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Mot. at 8.
Hartford
Opp'n at
The Plan created an equitable
8
lien as it "specifically identified a particular fund, distinct
9
from [Mayhew's] general assets. . . and a particular share of that
Seberoff, 547 U.S. at 364.
United States District Court
For the Northern District of California
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fund to which [Hartford] was entitled."
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The particular fund is identified by the Plan as the "benefit for
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loss of income, provided to you or to your family, as a result of
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the Period of Disability . . . includ[ing] . . . disability
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benefits under the United States Social Security Act."
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Decl.2 Ex. 1 ("Plan") at 30.
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identified as "any amount that is an overpayment of benefits under
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this plan."
Roberts
The particular share of that fund is
Id. at 28.
18
Mayhew argues that the Plan, unlike the reimbursement
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provision in Sereboff, did not purport to create a lien of any
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kind.
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from the Plan is sufficient to create an equitable lien:
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the right to recover from you any amount that is an overpayment of
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benefits under this plan.
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amount."
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27
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Reply at 3.
3
The Court finds that the following language
"We have
You must refund to us the overpaid
Plan at 28.
2
Michelle L. Roberts ("Roberts"), Mayhew's attorney, submitted a
declaration in support of the Motion. ECF No. 19 ("Roberts
Decl.").
3
The First and Third Circuits as well as district courts in the
Ninth Circuit have found similar provisions sufficient to create an
7
The Court also rejects Mayhew's contention that Hartford must
1
2
identify a fund containing the overpayments that is directly
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traceable to Mayhew's custody, control, or possession.
4
at 9.
5
possession of the settlement funds was sufficient to distinguish
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the case from Knudson, where the settlement funds at issue had been
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held in a special needs trust.
8
stated:
9
United States District Court
For the Northern District of California
10
11
12
See Reply
In Sereboff, the Supreme Court found that the Sereboffs'
Specifically the Supreme Court
The impediment to characterizing relief in Knudson as
equitable is not present here. . . . [I]n this case Mid
Atlantic sought specifically identifiable funds that were
within the possession and control of the Sereboffs--that
portion of the tort settlement due Mid Atlantic under the
terms of the ERISA plan, set aside and preserved [in the
Sereboffs'] investment accounts.
13
14
547 U.S. at 362-63.
15
the Sereboffs' contention that Mid Atlantic was required to trace
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its property to a particular fund or asset held by the Sereboffs to
17
state a claim for equitable relief.
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"the familiar rul[e] of equity that a contract to convey a specific
19
object even before it is acquired will make the contractor a
However, the Supreme Court ultimately rejected
Id. at 365.
The Court noted
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21
22
23
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25
26
27
28
equitable claim for Social Security benefits enforceable under §
502(a)(3). See Funk v. CIGNA Group Ins., 648 F.3d 182, 193-195
(3rd Cir. 2011) (permitting counterclaim for overpaid LTD benefits
where the plan provided that a Social Security offset "shall be . .
. . payable . . . by the recipient"); Cusson v. Liberty Life
Assurance Co. of Boston, 592 F.3d 215, 230-31 (1st Cir. 2010)
(counterclaim for LTD benefits constituted an equitable claim
allowable under § 502(a)(3)); Pollok v. Northrop Grumman Health
Plan, CV09-7006 JST, 2011 U.S. Dist. LEXIS 41716, at *7, 13-14
(N.D. Cal. Apr. 12, 2011) (permitting counterclaim for overpaid LTD
benefits where plan provided "the payments you receive under the .
. . LTD plans are offset dollar for dollar by other disability
income benefits that you receive"); DeBenedictis v. Hartford Life &
Accident Ins. Co., 701 F. Supp. 2d 1113, 1134 (D. Ariz. 2010)
(Defendant entitled to recover overpaid LTD benefits, even though
benefits were not specifically traceable).
8
1
trustee as soon as he gets a title to the thing."
Id. at 363-64
2
(quotation marks and citations omitted).
3
instant action, there is no indication that Mayhew's benefits were
4
distributed to a trust outside of her possession.
5
Hartford's equitable lien attached when Mayhew came into possession
6
of the overpayments, Hartford may state a claim under § 503(a)(3)
7
without directly tracing the overpayments to particular property
8
within Mayhew's possession.
Unlike in Knudson, in the
Further, as
Mayhew points to two Ninth Circuit decisions where the court
9
United States District Court
For the Northern District of California
10
found that ERISA claims for restitution were not equitable and were
11
thus barred under § 502(a)(3): Honolulu Joint Apprenticeship &
12
Training Committee of United Association Local Union No. 675 v.
13
Foster, 332 F.3d 1234 (9th Cir. 2003), and Carpenters Health and
14
Welfare Trust for Southern California v. Vonderharr, 384 F.3d 667
15
(9th Cir. 2004).
16
decision in Sereboff, which clarified the types of equitable claims
17
available under ERISA.4
18
Ins. Plan, C 09-4420 MEJ, 2010 U.S. Dist. LEXIS 110292, at *25
19
(N.D. Cal. Sep. 30, 2010).5
See Mairena v. Enter. Rent-A-Car Hosp.
Mayhew argues that, even if the Counterclaim states a claim
20
21
However, these cases pre-date the Supreme Court's
for equitable relief, the Social Security Act expressly prohibits
22
23
24
25
26
27
28
4
Additionally, Foster is distinguishable since, in that case, "no
funds were actually transferred to [defendant] -- [plaintiff]
merely seeks reimbursement for the costs it incurred for his
training." 332 F.3d at 1238.
5
Plaintiff also relies on Martorello v. Sun Life Company of
Canada, C 09-0912 PJH, 2009 U.S. Dist. LEXIS 41465 (N.D. Cal. May
1, 2009), where the district court dismissed an insurance company's
counterclaim for restitution of overpaid disability benefits on the
grounds that the insurance company's claim was not equitable.
However, that case did not cite to or address Sereboff.
9
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the attachment of Social Security benefits.
2
Social Security Act states:
3
5
6
7
9
United States District Court
For the Northern District of California
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15
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17
42 U.S.C. § 407(a).
The Court finds that § 407(a) does not bar the
Counterclaim because Hartford "is not attempting to recover
[Mayhew's] SSDI benefits.
Rather, [Hartford] seeks to recover in
equity from funds [Hartford] itself already paid under the LTD
plan."
Cusson, 592 F.3d at 232.
in accord.
The authority cited by Mayhew is
See Epolito v. Prudential Ins. Co. of Am., 737 F. Supp.
2d 1364, 1383 n.9 (M.D. Fla. 2010) ("[T]he Court recognizes that 42
U.S.C. § 407(a) is not applicable to this matter insofar as
Prudential seeks to impose the equitable lien, not on the SSD[I]
benefits, but on the overpaid long term disability benefits.").6
18
19
The
The right of any person to any future payment under this
title shall not be transferable or assignable, at law or
in equity, and none of the moneys paid or payable or
rights existing under this title shall be subject to
execution, levy, attachment, garnishment, or other legal
process, or to the operation of any bankruptcy or
insolvency law.
4
8
Reply at 4.
For these reasons, the Court finds that Hartford's
Counterclaim for restitution is an equitable claim and permissible
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21
22
23
24
25
26
27
6
The Court also rejects Mayhew's argument that the Plan's
reimbursement provision cannot be applied in good conscience
because Hartford terminated Mayhew's claim. Mot. at 8-9. Mayhew
reasons that Hartford "effectively recoup[ed]" any moneys owed by
withholding benefits, despite a finding of disability by the Social
Security Administration. Id. at 9. She argues that she should not
"pay Hartford money for a decision it refused to accept." Id.
Mayhew offers no authority in support. In any event, the Court is
not currently in a position to determine whether Hartford had an
adequate basis for terminating Mayhew's claim.
28
10
1
under § 502(a)(3) of ERISA.7
2
equitable lien on Mayhew's overpaid LTD benefits.
Hartford may seek to impose an
3
B.
Offset for DSSD Benefits
4
The parties also dispute whether Hartford may offset the DSSD
5
benefits for Mayhew's child against Mayhew's LTD benefits.
6
Plan allows Hartford to offset "Other Income Benefits," which are
7
defined as:
8
[T]he amount of any benefit for loss of income, provided
to you or to your family, as a result of the period of
Disability for which you are claiming benefits under this
plan. This includes any such benefits for which you or
your family are eligible or that are paid to you, or to a
third party on your behalf, pursuant to any: . . .
9
United States District Court
For the Northern District of California
10
11
12
5. disability benefits under the United States
Social Security Act . . . or similar plan or act
that, your spouse and children are eligible to
receive because of your Disability.
13
14
15
The
Plan at 30.
16
Mayhew contends that offsetting DSSD benefits is inappropriate
17
because they constitute support payments, not benefits for "loss of
18
income."
19
intended to replace income lost due to a wage earner's inability to
20
work.
21
requires DSSD offsets because "Other Income Benefits" include
22
payments provided to family members, including Social Security
23
benefits paid to children.
Opp'n. at 18.
Hartford responds that DSSD benefits are
Hartford also argues that the Plan expressly
Opp'n at 14-15.
The Court finds that the express terms of the Plan support
24
25
Mot. at 10.
offsetting the DSSD benefits.
"[A] court must give effect to every
26
27
28
7
As Hartford can state a claim for restitution under ERISA, the
Court need not determine whether it has a valid claim under state
law.
11
1
word or term employed by the parties and reject none as meaningless
2
or surplusage in arriving at the intention of the contracting
3
parties."
4
(quoting United States v. Hathaway, 242 F.2d 897, 900 (9th Cir.
5
1957)).
6
of income, provided to you or to your family," including
7
"disability benefits under the Social Security Act . . . your
8
spouse and children are eligible to receive."
9
that Mayhew's DSSD benefits do not constitute a benefit for loss of
United States District Court
For the Northern District of California
10
Cree v. Waterbury, 78 F.3d 1400, 1405 (9th Cir. 1996)
The plan provides for the offset of "any benefit for loss
Plan at 30.
To hold
income would render this language entirely superfluous.
Neither party cites, nor is the Court aware of, a Ninth
11
12
Circuit decision directly on point.
Mayhew relies on cases holding
13
that plan offset provisions did not apply to DSSD benefits.
14
at 10-16 (citing In re Unisys Corp. Long-Term Disability Plan ERISA
15
Litig., 97 F.3d 710 (3rd Cir. 1996); Carstens v. U.S. Shoe Corp.
16
Long-Term Benefits Disability Plan, 520 F. Supp. 2d 1165 (N.D. Cal.
17
2007); Meeks v. Mutual of Omaha Ins. Co., 70 Ill. App. 3d 800 (Ill.
18
App. Ct. 1979)).
Mot.
None of these cases are controlling.
19
Unisys is distinguishable since the plan provision at issue in
20
that case stated that offsets would only apply to benefits received
21
by the claimant.8
22
provided that the offsets would apply to benefits received "(1) by
23
the protected person or (2) by any other person on his behalf."
24
Ill. App. 3d at 802.
97 F.3d at 712.
Similarly, in Meeks, the plan
70
The court concluded that checks made payable
25
26
27
8
Specifically, the plan provided that "The LTD you receive may be
adjusted if you receive pension benefits from Unisys and/or
disability income from other sources, such as Social Security."
Carstens, 97 F.3d at712 (emphasis in the original).
28
12
1
to the insured on the dependent's behalf did not constitute
2
payments to a protected person.
3
action, the Plan's offset provision expressly applies to benefits
4
paid to Mayhew, her spouse, or her children.
Id.
In contrast, in the instant
Carstens involved a plan providing offsets for "[p]eriodic
5
6
benefits, for loss of time . . .
by reason of . . . the United
7
States Social Security Act . . . , exclusive of benefits paid . . .
8
. to a child of the Employee."
9
court reasoned that loss of time referred to the loss of income
520 F. Supp. 2d at 1166-67.
Id. at 1167.
The
Citing Unysis and Meeks,
United States District Court
For the Northern District of California
10
resulting from disability.
11
the court found that DSSD benefits constituted support payments
12
rather than payments for income replacement under the plan.
13
1168.
14
holding that similar offset provisions applied to DSSD payments.9
15
In light of the weight of authority and the express terms of the
16
Plan, the Court respectfully disagrees with the holding in Carstens
17
to the extent that it is inconsistent with the Court's order in the
18
instant action.
Id. at
A number of courts have reached a contrary conclusion,
19
Further, the Court rejects Mayhew's contention that the Plan's
20
offset provision does not apply to DSSD benefits because, under the
21
Social Security Act, DSSD benefits belong to the dependent as
22
opposed to the disabled adult.
23
24
25
26
27
Mot. at 11-13.
9
Mayhew points to
See Schultz v. Aviall, Inc., 09 C 2387, 2011 U.S. Dist. LEXIS
37125, at *11-12 (N.D. Ill. Apr. 4, 2011); Potop v. Aetna Life Ins.
Co., CV 09-02949 DMG, 2010 U.S. Dist. LEXIS 141667, at *4, 12 (C.D.
Cal. Sep. 30, 2010); Pennell v. Hartford Life & Accident Ins. Co.,
09 CV 485, 2010 U.S. Dist. LEXIS 4695, at *13-21 (N.D. Ohio Jan.
20, 2010); Fortune v. Group Long Term Disability Plan, 637 F. Supp.
2d 132, 145-46 (E.D.N.Y. 2009), aff'd 391 Fed. Appx. 74, 79-80 (2d
Cir. 2010); Spinella v. Unum Life Ins. Co., 94-411-JD, 1995 U.S.
Dist. LEXIS 11156, at *10-11 (D.N.H. July 14, 1995).
28
13
1
sections of the Social Security Act that provide: a dependent may
2
continue to receive DSSD benefits after her disabled parent dies, a
3
dependent must apply for DSSD benefits, and a dependent is
4
responsible for paying taxes on DSSD benefits.
5
U.S.C. § 402(d)).
6
adults to use DSSD payments for the benefit of the dependent.
7
at 14-15.
8
and most importantly, these provisions have no bearing on the terms
9
of the Plan, which expressly provide that Hartford may offset
Id. (citing 42
Mayhew also points to regulations requiring
This argument fails for at least two reasons.
Id.
First,
United States District Court
For the Northern District of California
10
Social Security benefits received by Mayhew's children.
Indeed,
11
Mayhew cites no statute or other authority which would prohibit
12
Hartford from offsetting her child's DSSD payments.
13
regardless of who the benefits belong to, the purpose of the
14
benefits is to replace income lost due to the disabled parent's
15
inability to work.10
Second,
16
Finally, Mayhew argues that, because she must use the DSSD
17
benefits to pay for her child's specific needs, a DSSD offset would
18
result in her receiving a total income of less than 66 2/3 percent
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of her pre-disability earnings.
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that allowing such an offset would be contrary to the terms of the
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Plan, which provide that she is entitled to receive 66 2/3 percent
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of monthly income loss.
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Plan contemplates offsets for other disability benefits, including
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Id.
Mot. at 16-17.
Mayhew reasons
This argument is unpersuasive.
10
The
See Califano v. Goldfarb, 430 U.S. 199, 213-14 (1977) (the
Social Security Act's Old-Age, Survivors, and Disability Insurance
scheme "is intended to insure covered wage earners and their
families against the economic and social impact on the family
normally entailed by loss of the wage earner's income"); Fortune,
391 Fed. Appx. at 80 ("the purpose of social security disability
benefits is to replace income lost due to the wage earner's
inability to work").
14
1
disability benefits for which Mayhew's spouse or child are
2
eligible.
3
would reduce the amount offset for these particular disability
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benefits.
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into the Plan which were not agreed to by the parties.
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declines to do so.
Mayhew is effectively asking the Court to read new terms
The Court
For these reasons, the Court finds that the Plan permits
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Yet Mayhew can point to no language in the Plan which
offsets for DSSD benefits.
9
United States District Court
For the Northern District of California
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V.
CONCLUSION
The Court DENIES Plaintiff Melinda Mayhew's Motion to Dismiss
Hartford Life and Accident Insurance Company's Counterclaim.
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IT IS SO ORDERED.
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Dated: October 21, 2011
UNITED STATES DISTRICT JUDGE
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