Rengifo v. Hartford Life and Accident Insurance Company

Filing 28

ORDER granting 13 Motion for partial summary judgment, dismissing Count I, with leave to filed an amended complaint within fourteen days, dismissing Count II with prejudice, and striking demand for jury trial and request for punitive damages. Signed by Judge Elizabeth A. Kovachevich on 12/13/2010. (JM)

Rengifo v. Hartford Life and Accident Insurance Company

Doc. 28

UNITED

STATES

DISTRICT

COURT

MIDDLE

DISTRICT TAMPA

OF

FLORIDA

DIVISION

JAYNE RENGIFO,

Plaintiff,
v.

CASE NO.
LIFE AND

8:09-CV-1725-T-17MAP

HARTFORD ACCIDENT

INSURANCE

COMPANY,
Defendant.

/

ORDER

This

cause

is

before

the Court

on:

Dkt.
Dkt.

13
14

Motion for Partial Summary Judgment
Notice

Dkt. Dkt. Dkt. Dkt. Dkt.

15 18 21 24 27

Response Reply Supplemental Response Reply Response

T h e C o m p l a i n t i n c l u d e s P l a i n t i f f ' s c l a i m f o r b r e a c h of c o n t r a c t b a s e d on D e f e n d a n t ' s n o n - p a y m e n t of t h e p r o c e e d s of a

life i n s u r a n c e p o l i c y to P l a i n t i f f J a y n e Rengifo, a n d a c l a i m for b r e a c h of f i d u c i a r y duty. The C o m p l a i n t was f i l e d in P i n e l l a s

C o u n t y C i r c u i t C o u r t and was r e m o v e d to the U.S. D i s t r i c t C o u r t
for the Middle District of Florida.

D e f e n d a n t n o w m o v e s for e n t r y of p a r t i a l s u m m a r y j u d g m e n t .
Defendant Hartford Life and Accident Insurance Company

("Hartford")

s e e k s a d e t e r m i n a t i o n t h a t t h i s a c t i o n is g o v e r n e d

by the E m p l o y e e R e t i r e m e n t I n c o m e S e c u r i t y Act of 1974

("ERISA"),

and r e q u e s t s the d i s m i s s a l of C o u n t II of the C o m p l a i n t .

Dockets.Justia.com

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

Defendant

further seeks a determination that

Plaintiff has no

e n t i t l e m e n t to a j u r y t r i a l o r p u n i t i v e d a m a g e s .

P l a i n t i f f J a y n e R e n g i f o has i n c o r p o r a t e d the f o l l o w i n g
documents by reference into Plaintiff's Supplemental Response (Dkt. 21) in o p p o s i t i o n to D e f e n d a n t ' s M o t i o n f o r P a r t i a l S u m m a r y
Judgment: Dkt. 2, C o m p l a i n t w i t h a t t a c h e d e x h i b i t , Dkt. 15, 11,

Plaintiff's Response with attached exhibits,

and Dkt.

P l a i n t i f f ' s R e s p o n s e to M o t i o n f o r P a r t i a l S u m m a r y J u d g m e n t .

I.

Standard of

Review

S u m m a r y j u d g m e n t s h o u l d b e r e n d e r e d if t h e p l e a d i n g s , d i s c o v e r y a n d d i s c l o s u r e m a t e r i a l s on file,

the

and any affidavits

s h o w t h a t t h e r e is n o g e n u i n e i s s u e as t o a n y m a t e r i a l f a c t a n d

t h a t t h e m o v a n t is e n t i t l e d to j u d g m e n t as a m a t t e r of law.
Fed.R.Civ.P. 56(c).

The plain language of Rule 56(c) mandates the entry of summary judgment after adequate time for discovery and upon motion, against a p a r t y w h o f a i l s to m a k e a s h o w i n g s u f f i c i e n t
to establish the existence of an element

e s s e n t i a l to t h a t p a r t y ' s case, a n d o n w h i c h t h a t p a r t y w i l l b e a r t h e b u r d e n of p r o o f at
trial."

Celotex Corp.

v.

Catrett,

477 U.S.

317

(1986).

The appropriate substantive law will guide the determination
of which facts are material and which facts are... irrelevant.

A n d e r s o n v. L i b e r t y L o b b y ,

Inc.,

4 7 7 U.S.

242,

248

(1986).

All

reasonable doubts about the facts and all justifiable inferences
are resolved in favor of the non-movant. See F i t z o a t r i c k v. City

Case N o . 8 : 0 9 - C V - 1 7 2 5 - T - l 7 M A P

of Atlanta, 2 F.3d 1112, 1115 (11th Cir. 1993).

A dispute is

g e n u i n e " i f t h e e v i d e n c e is s u c h t h a t a r e a s o n a b l e j u r y c o u l d

return a verdict for the non-moving party." U.S. at 248. But,

See Anderson,

477

" [ i ] f t h e e v i d e n c e is m e r e l y c o l o r a b l e . . . o r is

not s i g n i f i c a n t l y p r o b a t i v e . . . s u m m a r y j u d g m e n t m a y b e g r a n t e d . "
Id. at 2 4 9 - 5 0 .

II.

Statement

of

Facts

1. Lines,
par.

P l a i n t i f f J a y n e R e n g i f o has b e e n e m p l o y e d b y D e l t a A i r Inc. s i n c e A u g u s t 22, 1994. (Rengifo Affidavit, Dkt. 21-6,

2).

2.

Plaintiff Jayne Rengifo asserts that Plaintiff married ( Massachusetts.

D o n a l d o R e n g i f o on J a n u a r y 15, 1 9 9 1 in B r o o k l i n e , (Rengifo Affidavit, Dkt. 21-6, par. 3).

3.

P l a i n t i f f J a y n e R e n g i f o a s s e r t s t h a t D e l t a A i r Lines,

Inc. i s s u e d a p o l i c y of i n s u r a n c e on the life of D o n a l d o Rengifo,
Jr. (Complaint, Dkt. 2, p a r . 4).

4.

Plaintiff Jayne Rengifo asserts that Donaldo Rengifo,
2 0 0 6 in C o l o m b i a , 5; Dkt. 21-6, par. South America. 5).

Jr. d i e d o n D e c e m b e r 17, (Complaint, Dkt. 2, par.

4.

P l a i n t i f f a s s e r t s that the s u b j e c t i n s u r a n c e p o l i c y
(Complaint,

n a m e s P l a i n t i f f J a y n e R e n g i f o as t h e b e n e f i c i a r y . Dkt. 2, par. 6).

5.

Plaintiff Jayne Rengifo asserts that Plaintiff Rengifo

has performed all conditions precedent to payment under the

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

policy, or those conditions have occurred.
par. 7).

(Complaint, Dkt. 2,

6.

Delta Air Lines,

Inc. a p p l i e d to C o n t i n e n t a l C a s u a l t y

C o m p a n y for a p o l i c y of i n s u r a n c e p r o v i d i n g c o v e r a g e for "24 H o u r
A l l A c c i d e n t P r o t e c t i o n " f o r D e l t a ' s e m p l o y e e s on A p r i l 22, 1994. (Master Group Application, Dkts. 24-4, 2 4 - 5 ) .

6.

Defendant Hartford asserts that Defendant issued Policy (Dkt. 14-1,

No. S R - 8 3 0 1 5 5 4 1 t o D e l t a e f f e c t i v e J a n u a r y 1, 2 0 0 3 .
p. 3)

7.

P o l i c y No. S R - 8 3 0 1 5 5 4 1 was i s s u e d b y C o n t i n e n t a l p. 5). Defendant Hartford

C a s u a l t y C o m p a n y ( " C N A " ) ( D k t . 24-2,

a c q u i r e d t h e G r o u p B e n e f i t s d i v i s i o n of C N A on J a n u a r y 1, 2004.

(Spring D e p o s i t i o n ,

Dkt. 21-8, p. 3).

A f t e r t h e a c q u i s i t i o n , the

s u b j e c t p o l i c y w a s r e i s s u e d to D e l t a by D e f e n d a n t H a r t f o r d . ( C e r t i f i c a t e o f I n s u r a n c e f o r 2006, Dkt. 24-3, Dkt. 21-7, p. 4)).

8.

T h e s u b j e c t P o l i c y p r o v i d e s i n s u r a n c e c o v e r a g e to Retired Employees, and Disabled if a n y " (Dkt. 14-1,

"Active Employees,

Employees... together with their Dependents,
p. 3)

9.

The subject Policy provides that the Policy "is issued

in c o n s i d e r a t i o n o f t h e a p p l i c a t i o n o f D e l t a . . . a n d t h e p a y m e n t ,

by t h e I n s u r e d E m p l o y e e s ,

of the p r e m i u m . "

(Dkt.

14-1,

p. 3).

10.

The Policy provides that "This Policy (including the

e n d o r s e m e n t s a n d t h e a t t a c h e d papers)

a n d t h e a p p l i c a t i o n of

Delta constitutes the entire contract between the parties."
4

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

(Dkt.

14-1,

p.

14) .

11.

T h e P o l i c y d e s c r i b e d e l i g i b i l i t y for coverage:

E a c h p e r s o n w h o is an E m p l o y e e , as d e s c r i b e d in I t e m 5 of t h e A p p l i c a t i o n f o r t h i s P o l i c y , is e l i g i b l e to b e c o m e an I n s u r e d E m p l o y e e
hereunder.

New Employees who enroll during their designated enrollment period shall become i n s u r e d as of t h e f i r s t d a y of t h e p a y p e r i o d following their enrollment deadline. In o r d e r t o b e c o m e i n s u r e d o r t o c h a n g e c o v e r a g e . . . t h e E m p l o y e e m u s t be a c t i v e l y w o r k i n g o n t h e d a t e the r e q u e s t is r e c e i v e d b y D e l t a as e v i d e n c e d b y D e l t a ' s r e c o r d s . (Dkt. 14-1, 12. p. 10).

Item 5 of the Application provides:

5.

CLASSIFICATION OF EMPLOYEES:

Classification:

All permanent employees and temporary employees ( w i t h 30 d a y s s e r v i c e ) and their eligible dependents, (including
disabled and retired

employees and eligible dependents) of Delta Air Lines, Inc., who are on t h e U.S. d o m e s t i c p a y r o l l p l u s t h o s e e m p l o y e e s in Canada, United Kingdom,
Puerto Rico, Bermuda and

the Bahamas, are eligible for coverage hereunder. (Dkt. 24-4, p. 1) .

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

13.

T h e P o l i c y p r o v i d e s t h a t the P o l i c y " c o n t i n u e s in f o r c e 2003 and may

for a p e r i o d of s i x t y m o n t h s f r o m J a n u a r y 1, thereafter be renewed, for like periods,

u n t i l t e r m i n a t e d in

accordance with the Termination Provision...of this Policy."
(Dkt. 14-1, p. 3) .

14.

The Policy's Termination Provision provides:

T h e C o m p a n y or D e l t a m a y t e r m i n a t e t h i s P o l i c y as of t h e l a s t d a y of a n y s i x t y (60) m o n t h P o l i c y T e r m by m a i l i n g w r i t t e n n o t i c e t o t h e o t h e r party, n o t less t h a n o n e h u n d r e d e i g h t y (180) d a y s p r i o r to s u c h t e r m i n a t i o n
date."

Dkt.

14-1,

p.

15) .

15.

The Policy provides that its terms could be changed "by

a m e n d m e n t to t h i s P o l i c y s i g n e d by D e l t a a n d an E x e c u t i v e O f f i c e r
of t h e C o m p a n y . " (Dkt. 14-1, p. 15).

16.

The Policy specifies the benefits available under the

P o l i c y ( i n c l u d i n g the d e a t h b e n e f i t s o u g h t by Plaintiff)

and

provides specific procedures for making claims for benefits and
for the p a y m e n t of claims. (Dkt. 14-1, pp. 14-15).

17.

T h e P o l i c y p r o v i d e s that:

Delta shall

maintain

the enrollment

records

w i t h r e s p e c t to e a c h I n s u r e d E m p l o y e e . Delta shall furnish periodically such information' r e l a t i n g to n e w p e r s o n s , a d j u s t m e n t s b e c a u s e

of changes, and t e r m i n a t i o n s of, i n s u r a n c e as m a y be r e q u i r e d by the C o m p a n y to a d m i n i s t e r
6

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

this insurance. The Company shall provide t h e n e c e s s a r y e m p l o y e e s to a d m i n i s t e r t h e p r o g r a m on the p r e m i s e s of Delta. (Dkt. 14-1, p. 16).

18.

The P o l i c y p r o v i d e s that " T h e C o m p a n y w i l l i s s u e to

Delta for d e l i v e r y to e a c h I n s u r e d E m p l o y e e an i n d i v i d u a l c e r t i f i c a t e s e t t i n g f o r t h a s t a t e m e n t as to the i n s u r a n c e

protection to which the Insured Employee is e n t i t l e d and to whom
i n d e m n i t i e s p r o v i d e d by this Policy are p a y a b l e . "
15) .

(Dkt. 14-1, p.

19.

D e f e n d a n t H a r t f o r d ' s p o l i c y w a s to i s s u e a p l a n b o o k l e t

explaining the p r o v i s i o n s of the insurance policy, and containing
an i n s u r a n c e c e r t i f i c a t e , to D e l t a to p r o v i d e to e a c h e n r o l l e d

e m p l o y e e on an a n n u a l basis.

(Taylor A f f i d a v i t ,

Dkt. 24-1, p. 2).

Delta p u t s the p l a n b o o k l e t on its i n t e r n a l w e b s i t e to p r o v i d e it
to D e l t a ' s e m p l o y e e s . (Dkt. 24-1, p. 2).

III.

Discussion

A.

Applicable Insurance Policy

D e f e n d a n t H a r t f o r d a s s e r t s t h a t G r o u p P o l i c y No. S R - 8 3 0 1 5 5 4 1

is the a p p l i c a b l e policy. a t t a c h e d policy).

(Dkt. 14-1, T a y l o r A f f i d a v i t , w i t h

P o l i c y No. SR-83015541, i s s u e d by C o n t i n e n t a l

C a s u a l t y Company, s t a t e s that the p o l i c y was i s s u e d p u r s u a n t to
Delta's application, a n d w a s to c o n t i n u e in f o r c e f o r s i x t y
(Dkt. 14-1, p.

m o n t h s f r o m i t s i s s u e d a t e of J a n u a r y 1, 2 0 0 3 .
3) .

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

Plaintiff Rengifo argues that the January 1, 2003 policy is
not the a p p l i c a b l e policy. P l a i n t i f f R e n g i f o a r g u e s that the is the

2 0 0 6 H a r t f o r d p o l i c y a t t a c h e d to the C o m p l a i n t (Dkt. 2)
applicable policy. (Dkt. 21, p. 1).

The d o c u m e n t s a t t a c h e d to the C o m p l a i n t c o m p r i s e a
C e r t i f i c a t e of I n s u r a n c e i s s u e d p u r s u a n t to P o l i c y No. S R 83015541, i s s u e d to D e l t a A i r L i n e s , Inc. (Dkt. 2, pp. 4-18).

T h e C e r t i f i c a t e of I n s u r a n c e e x p r e s s l y r e f e r s to t h e P o l i c y on
its face.

Defendant Hartford does not dispute that Defendant Hartford

p u r c h a s e d t h e a c c i d e n t a l p o l i c y l i n e s of b u s i n e s s f r o m C o n t i n e n t a l C a s u a l t y in 2004, a n d l a t e r c o n v e r t e d a l l p o l i c i e s o v e r to H a r t f o r d p o l i c i e s . Defendant Hartford further does not

d i s p u t e t h a t an a n n u a l c e r t i f i c a t e of i n s u r a n c e w a s i s s u e d to
Delta employees. These facts do not transform an annual

C e r t i f i c a t e of I n s u r a n c e i s s u e d to a D e l t a e m p l o y e e i n t o t h e i n s u r a n c e p o l i c y i s s u e d to D e l t a A i r L i n e s , Inc.

T h e C o u r t n o t e s t h a t P o l i c y No. S R - 8 3 0 1 5 5 4 1 p r o v i d e s :

ENTIRE CONTRACT: CHANGES: This Policy (including the endorsements and attached p a p e r s ) a n d t h e a p p l i c a t i o n of D e l t a ,
constitute the entire contract between the

parties and any statement made by Delta shall be deemed a representation and not a
warranty.
No such in statement defense to shall a void the insurance or unless

reduce the benefits under this Policy or be
used claim hereunder

it is c o n t a i n e d in a w r i t t e n a p p l i c a t i o n signed by the applicant, nor shall such
8

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P statement of Delta be used at all to void

t h i s P o l i c y a f t e r it has b e e n in f o r c e f o r t w o (2) y e a r s f r o m t h e d a t e of t h e i n s u r a n c e c o v e r a g e w i t h r e s p e c t to w h i c h c l a i m is m a d e . No c h a n g e in t h i s P o l i c y s h a l l be v a l i d u n l e s s a p p r o v e d by an E x e c u t i v e O f f i c e r of t h e C o m p a n y a n d e v i d e n c e d by e n d o r s e m e n t of t h i s P o l i c y , o r by a m e n d m e n t to t h i s P o l i c y s i g n e d by D e l t a and an E x e c u t i v e O f f i c e r of the C o m p a n y . No a g e n t has a u t h o r i t y to c h a n g e t h i s P o l i c y or to w a i v e a n y of its provisions.
(Dkt. 14-1, p. 14).

T h e C o u r t c o n c l u d e s t h a t t h e p o l i c y a t t a c h e d to t h e T a y l o r A f f i d a v i t is t h e a p p l i c a b l e p o l i c y (Dkt. 14-1), a n d that t h e

a n n u a l C e r t i f i c a t e o f I n s u r a n c e i s s u e d to D e l t a e m p l o y e e s is n o t

the a p p l i c a b l e i n s u r a n c e p o l i c y .

B.

ERISA

In o r d e r to c o r r e c t l y a n a l y z e t h e i s s u e s in t h i s c a s e , at the o u t s e t t h e C o u r t m u s t d e t e r m i n e w h e t h e r t h e s u b j e c t c l a i m is
an ERISA claim or a breach of contract claim.

ERISA regulates "employee welfare benefit plans."
v. UnumProvident Corp., 369 F.3d 1257, 1263 (11"" C i r .

Anderson
2004). An

e m p l o y e e w e l f a r e b e n e f i t p l a n is a n y " p l a n ,

fund,

or program"

t h a t is " e s t a b l i s h e d or m a i n t a i n e d b y an e m p l o y e r " f o r t h e

p u r p o s e of " p r o v i d i n g b e n e f i t s to p a r t i c i p a n t s or t h e i r
beneficiaries."

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

E R I S A p r e e m p t s " a n y a n d a l l S t a t e l a w s i n s o f a r as

t h e y . . . r e l a t e to a n y e m p l o y e e b e n e f i t p l a n . "

H a l l v. B l u e

C r o s s / B l u e S h i e l d of Ala.,

134 F.3d 1063, 1 0 6 5 (11th Cir. 1998).
a n d is

A s t a t e l a w c a u s e of a c t i o n " r e l a t e s to" an E R I S A p l a n , preempted, plan."

if it " h a s a c o n n e c t i o n w i t h or r e f e r e n c e to s u c h a Inc. v. C e n t u r y Med. Health

V a r i e t y C h i l d r e n ' s Hosd.,

Plan, Inc., 57 F . 3 d 1040, 1042 (11th Cir. 1995).

E R I S A c o m p l e t e l y preempts state law c l a i m s when:
a relevant ERISA plan;

1) t h e r e is

2) t h e p l a i n t i f f h a s s t a n d i n g t o s u e u n d e r

the plan; 3) t h e d e f e n d a n t is an E R I S A e n t i t y ;

a n d 4) t h e

c o m p l a i n t s e e k s c o m p e n s a t o r y r e l i e f a k i n to t h a t a v a i l a b l e u n d e r
Sec. 1132(a). S e e B u t e r o v. R o y a l M a c c a b e e s L i f e I n s . Co., 174

F . 3 d 1207,

1212

(ll'; Cir.

1999).

T h e e x i s t e n c e of an E R I S A p l a n is a q u e s t i o n of fact,

to be

a n s w e r e d in l i g h t of all the s u r r o u n d i n g f a c t s a n d c i r c u m s t a n c e s
f r o m t h e p o i n t of v i e w of a r e a s o n a b l e p e r s o n .
Connecticut General Life Insurance Company, 8 67

K a n n e v.
F.2d 4 89 (9th

Cir.

1988).

T h e c r i t i c a l i s s u e is w h e t h e r t h e e m p l o y e r t o o k

s t e p s to " e s t a b l i s h or m a i n t a i n a p l a n to p r o v i d e b e n e f i t s to its

e m p l o y e e s as p a r t of the e m p l o y m e n t r e l a t i o n s h i p . "

M o o r m a n v.

U n u m P r o v i d e n t Corp. , 464 F.3d 1260, 1264 (11th Cir. 2006).

A p r o g r a m w h i c h is w i t h i n E R I S A ' s " s a f e h a r b o r " p r o v i s i o n is

exempt f r o m t h e p r o v i s i o n s of ERISA.

M o o r m a n v.

UnumProvident

Corp. , 464 F.3d 1260, 1265 (11th Cir. 2006).

C e r t a i n "group or
See 28

g r o u p - t y p e i n s u r a n c e p r o g r a m s " are not E R I S A plans.
C.F.R. Sec. 2 5 1 0 . 3 - 1 (j).

Four elements establish a "safe

harbor"--a non-ERISA plan:

10

Case No. 8:09-CV-1725-T-17MAP

1. No c o n t r i b u t i o n s are m a d e by an e m p l o y e r or employee organization; 2. Participation in the program is completely voluntary for employees...;
3. T h e s o l e f u n c t i o n s of t h e e m p l o y e r . . . w i t h

respect to the program are, without endorsing the program, to permit the insurer to
p u b l i c i z e t h e p r o g r a m to e m p l o y e e s or m e m b e r s , to c o l l e c t p r e m i u m s t h r o u g h p a y r o l l
deduction or dues checkoffs and to remit them
to the insurer; and in

4.

T h e e m p l o y e r ... receives no c o n s i d e r a t i o n
form of cash or otherwise

in the

connection with the program.

In c o n s i d e r i n g t h e s a f e h a r b o r e x e m p t i o n ,
apply the above requirements. As

the Court must strictly
if a n e m p l o y e r

to e n d o r s e m e n t ,

p e r f o r m s a n y f u n c t i o n s in a d d i t i o n t o t h e f u n c t i o n s c i t e d a b o v e ,

publication and the collection and remission of premiums, p o l i c y is d i s q u a l i f i e d f r o m E R I S A ' s s a f e h a r b o r .

the

Defendant Hartford argues that Delta Air Lines, e s t a b l i s h e d a w e l f a r e b e n e f i t plan,

Inc.

and the subject insurance

p o l i c y was i s s u e d p u r s u a n t to D e l t a ' s w e l f a r e b e n e f i t plan.
Defendant Hartford further argues that the subject insurance p o l i c y is n o t w i t h i n E R I S A ' s s a f e h a r b o r .

" W h i l e an e m p l o y e r ' s f a i l u r e to a d h e r e to t h e s a f e h a r b o r p r o v i s i o n d o e s n o t n e c e s s i t a t e a f i n d i n g t h a t it maintained' an E R I S A plan, ' e s t a b l i s h e d or

its a d h e r e n c e to t h e p r o v i s i o n d o e s
A n d e r s o n v. U n u m P r o v i d e n t C o r p . , 322

preclude such a finding."

F.Supp.2d 1272,
Cir. 2004).

1275 (M.D. Ala. 2002), aff'd 369 F.3d 1257 (11th
the Court first addresses whether the and then

Therefore,

s u b j e c t i n s u r a n c e p o l i c y is w i t h i n E R I S A ' s s a f e h a r b o r ,

w h e t h e r D e l t a e s t a b l i s h e d or m a i n t a i n e d an E R I S A p l a n .

11

Case No. 8:09-CV-1725-T-17MAP
1. Safe Harbor

In o r d e r to f i n d that the i n s u r a n c e p o l i c y is w i t h i n E R I SA ' s

safe harbor, all four of the above requirements must be met.
Delta Air Lines, Inc. d i d m o r e t h a n p e r m i t t h e i n s u r e r to

If

publicize the p r o g r a m to Delta's employees, and did more than
collect a n d r e m i t the premiums, then the s u b j e c t i n s u r a n c e p o l i c y
is not within ERISA's safe harbor.

The undisputed evidence establishes that Delta's employees p a i d t h e e n t i r e p r e m i u m f o r the s u b j e c t i n s u r a n c e p o l i c y t h r o u g h payroll deduction; insurance coverage. D e l t a d i d n o t c o n t r i b u t e to t h e c o s t of t h e The undisputed evidence also establishes

that p a r t i c i p a t i o n in p r o g r a m is v o l u n t a r y for D e l t a employees,
a n d t h a t D e l t a r e c e i v e s no c o m p e n s a t i o n in c o n n e c t i o n w i t h t h e insurance program. T h e i s s u e of w h e t h e r D e l t a e n d o r s e d t h e

i n s u r a n c e p r o g r a m is d i s p u t e d .

D e f e n d a n t H a r t f o r d a r g u e s t h a t Delta,

through various

a c t i o n s and p r o v i s i o n s of the policy, e n d o r s e d the plan.
Plaintiff Rengifo argues that Defendant merely allowed

p u b l i c a t i o n of the plan, and c o l l e c t e d a n d r e m i t t e d premiums.
P l a i n t i f f R e n g i f o h a s o f f e r e d a l e t t e r f r o m D e l t a in w h i c h D e l t a
a s s e r t s t h a t p r i o r t o J a n u a r y 1, 2 0 0 8 , Delta did not provide

g r o u p a c c i d e n t c o v e r a g e u n d e r an E R I S A b e n e f i t p l a n .

The letter

f u r t h e r s t a t e s that " e f f e c t i v e J a n u a r y 1, 2008, D e l t a a d o p t e d the
Delta Air Lines, Inc. O p t i o n a l I n s u r a n c e s Plan, (Dkt. 2 1 - 1 ) . under which

insurance coverage was included."

The i s s u e of w h e t h e r an e m p l o y e r has e n d o r s e d a p o l i c y of i n s u r a n c e is a m i x e d q u e s t i o n of fact and law.
12

"An employee

Case No. 8.09-CV-1725-T-17MAP

organization will be considered to have endorsed a group or group-type insurance program if the employee organization expresses to its members any positive, normative judgment regarding the program...An endorsement within the meaning of [§]
2510.3-1(j) occurs if the employee organization urges or encourages member participation in the program or engages in
a c t i v i t i e s t h a t w o u l d l e a d a m e m b e r r e a s o n a b l y to c o n c l u d e t h a t

the program is part of a benefit arrangement e s t a b l i s h e d or
maintained by the employee organization. 94-26A, 1994 W L 3 6 9 2 8 2 ( J u l y 11, 1 9 9 4 ) . " E R I S A Op. L e t t e r No.

S e e M o o r m a n v.

U n u m P r o v i d e n t Corp.,

464 F.3d 1260, 1267 ( 1 1 " Cir. 2006).

The Court notes that the Complaint contains admissions which

establish that the subject insurance policy was provided through

Delta Air Lines,

Inc.

(Dkt. 2, p. 1, par. 4), a n d the p o l i c y
24). Defendant

states that Delta applied for the policy (Dkt.

H a r t f o r d has p r o v i d e d a c o p y of D e l t a ' s M a s t e r G r o u p A p p l i c a t i o n (Dkts. 24-5, 24-6, 24-7). D e l t a is t h e p o l i c y - h o l d e r . The

a p p l i c a t i o n e s t a b l i s h e s that Delta a p p l i e d for the
insurance to the carrier selected. Plaintiff has offered no

e v i d e n c e w h i c h e s t a b l i s h e s a factual d i s p u t e as to t h i s issue. No e v i d e n c e has b e e n p r o v i d e d that D e l t a ' s e m p l o y e e s a s k e d Delta
to p r o c u r e i n s u r a n c e c o v e r a g e for a c c i d e n t s , and that Delta's

a p p l i c a t i o n for c o v e r a g e was d e s i g n e d to a c c o m m o d a t e the employees' r e q u e s t for i n s u r a n c e c o v e r a g e f r o m C o n t i n e n t a l C a s u a l t y Company. O t h e r c o u r t s h a v e f o u n d that the e m p l o y e r ' s

a p p l i c a t i o n f o r i n s u r a n c e a n d s t a t u s as p o l i c y h o l d e r c o n s t i t u t e

e n d o r s e m e n t w h i c h d i s q u a l i f y an i n s u r a n c e p o l i c y f r o m E R I S A ' s
safe harbor. S e e B u t e r o v. R o y a l M a c c a b e e s L i f e Ins. Co., 174

F.3d 1207, 1 2 1 3 (11th Cir. 1999); Hall v. S t a n d a r d Ins. Co.. 381
F . S u p p . 2 d 526, 529 (W.D. Va. 2 0 0 5 ) ; S t o u d e m i r e v.
13

Provident Life

Case N o . 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

a n d Ace.

Ins. Co.,

24 F.

S u p p . 2 d 1252,

1257-58

(M.D. Ala.

1 9 9 8 ) ( e m p l o y e r ' s s t a t u s as " d e s i g n a t e d G r o u p P o l i c y h o l d e r "
considered evidence of endorsement); D a v i s v. G u a r a n t e e L i f e Ins.

Co., 2 0 0 1 WL 5 1 5 2 5 2 ,

*2-3

(E.D. La. M a y 11, 2 0 0 1 ) ( c o m p l e t i o n of

a p p l i c a t i o n c o n s i d e r e d e v i d e n c e of e n d o r s e m e n t ) .

The Court notes that Delta's Master Application for

i n s u r a n c e r e s t r i c t s e l i g i b i l i t y to p e r m a n e n t e m p l o y e e s a n d temporary employees who have completed thirty days of service. R e s t r i c t i o n of e l i g i b i l i t y has b e e n h e l d to i n d i c a t e t h e p r e s e n c e of an E R I S A p l a n o u t s i d e of the s a f e h a r b o r .
P e t e r s o n v. Comocare Health Services Ins.

See Brundaqe877 F.2d 509,

Corp.,

510-11 (7th Cir. 1989) (plan c r e a t e d by c o n t r a c t a n d e l i g i b l e
employees designated).

T a s k s s u c h as c o l l e c t i n g p r e m i u m s ,

p r o v i d i n g c l a i m f o r m s to

e m p l o y e e s , c o m p l e t i n g t h e " e m p l o y e r " p o r t i o n of c l a i m f o r m s , s u b m i t t i n g c l a i m f o r m s to the i n s u r a n c e c o m p a n y , and keeping

t r a c k of e m p l o y e e e l i g i b i l i t y h a v e b e e n d e e m e d a d m i n i s t r a t i v e
t a s k s w h i c h d o n o t e s t a b l i s h t h a t an e m p l o y e r e n d o r s e d t h e

policy.
function.

T h e s e t a s k s m a y be c o n s i d e r e d a n c i l l a r y to a p e r m i t t e d
J o h n s o n v. W a t t s R e g u l a t o r C o . , 63 F . 3 d 1 1 2 9 (1st C i r .

1995).
policy:

T h e C o u r t n o t e s t h e f o l l o w i n g p r o v i s i o n of t h e i n s u r a n c e

RECORDS MAINTAINED:

Delta

shall maintain

the

e n r o l l m e n t r e c o r d s w i t h r e s p e c t to e a c h insured Employee. Delta shall furnish p e r i o d i c a l l y s u c h i n f o r m a t i o n r e l a t i n g to n e w p e r s o n s , a d j u s t m e n t s b e c a u s e of c h a n g e s in, a n d t e r m i n a t i o n s of, i n s u r a n c e as m a y b e required by the Company to administer this insurance. Then Company shall provide the

14

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

n e c e s s a r y e m p l o y e e s to a d m i n i s t e r t h e p r o g r a m on the premises of Delta.
(Dkt. 24-2, p. 18). The subject insurance policy provides that with the

the insurance company will administer the program,

C o m p a n y p r o v i d i n g t h e n e c e s s a r y e m p l o y e e s to a d m i n i s t e r t h e p r o g r a m on D e l t a ' s p r e m i s e s . While the fact that the insurance

c a r r i e r a d m i n i s t e r s t h e p r o g r a m w o u l d w e i g h a g a i n s t a f i n d i n g of e n d o r s e m e n t , p e r m i t t i n g t h e i n s u r a n c e c o m p a n y ' s e m p l o y e e s to a d m i n i s t e r t h e p r o g r a m w i t h i n D e l t a ' s w o r k p l a c e on a n o n g o i n g

basis goes b e y o n d p u b l i c i z i n g the program, a n d c o l l e c t i n g and
remitting premiums.

Defendant Hartford argues that the Booklet-Certificate which

D e l t a p r o v i d e d to i t s e m p l o y e e s s t a t e s o n t h e c o v e r p a g e in l a r g e print, as p a r t of t h e p l a n title,
(Dkt. 21-3,

t h a t t h e p l a n w a s d e s i g n e d for
Other courts have held
Provident Life

employees of Delta
that

p. 1).

this constitutes

endorsement.

S a n f i l i o p o v.

and Ace.

Ins.

Co.,

1 7 8 F . S u p p . 2 d 450, Ins. Co.,

456

(S.D.N.Y.

2002); Weber *10 (D.

v. H a r t f o r d L i f e a n d A c e .

2008 WL 3932014,

Ariz. A u g u s t 25, 2 0 0 8 ) ( p o l i c y c u s t o m i z e d t o m e e t n e e d s of
[employer] and [its] employees).

I n A n d e r s o n v.

UnumProvident Corp.,

supra,

the district

court concluded that the employer endorsed the plan because,

inter alia, the e m p l o y e r ' s logo a p p e a r e d on the c o v e r p a g e of the
s u m m a r y p l a n d e s c r i p t i o n ("SPD"), w i t h no m e n t i o n of t h e insurance carrier. In t h i s case, t h e t i t l e on t h e c o v e r p a g e of

t h e S P D w h i c h s p e c i f i e s t h a t t h e p r o g r a m is d e s i g n e d for D e l t a e m p l o y e e s d o e s a p p e a r p r o m i n e n t l y in l a r g e p r i n t . The insurance a l b e i t on

c a r r i e r ' s l o g o a l s o a p p e a r s on t h e c o v e r p a g e as w e l l , a s m a l l e r s c a l e c o m p a r e d w i t h the title.
15

(Dkt. 2 4 - 3 ,

p. 5).

Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P While the facts in this case do not mirror those in Anderson

exactly, after consideration, the Court finds that an objectively
r e a s o n a b l e e m p l o y e e v i e w i n g the c o v e r p a g e w o u l d c o n c l u d e that

the insurance p r o g r a m was part of the company's benefit package,
b a s e d on an u n d e r s t a n d i n g t h a t the p r o g r a m w a s t a i l o r e d to D e l t a employees.

The Court further notes that the subject policy provides that t h e p o l i c y c o u l d b e a m e n d e d o n l y b y a w r i t i n g s i g n e d b y D e l t a a n d an E x e c u t i v e O f f i c e r of t h e C o m p a n y . The Court also

n o t e s t h a t D e l t a h a d t h e p o w e r to t e r m i n a t e t h e s u b j e c t p o l i c y as provided within the policy. These provisions show that Delta

e x e r c i s e d a d e g r e e of c o n t r o l o v e r t h e s u b j e c t i n s u r a n c e p o l i c y .

After consideration of the above factors,

the Court

c o n c l u d e s t h a t an o b j e c t i v e l y r e a s o n a b l e e m p l o y e e w i t h k n o w l e d g e
of the above factors would conclude that Delta endorsed the

subject policy.

Plaintiff Rengifo's subjective personal belief

t h a t D e l t a d i d n o t e n d o r s e t h e i n s u r a n c e p o l i c y is n o t dispositive. Since Delta did more than collect and remit

p r e m i u m s a n d p e r m i t D e f e n d a n t H a r t f o r d to p u b l i c i z e t h e i n s u r a n c e

program,
within

the C o u r t f i n d s that the i n s u r a n c e p r o g r a m d o e s not fall
safe harbor.

ERISA's

2.

Establish or Maintain Employee Welfare Benefit Plan

The Court first considers whether a plan exists,
whether Delta established or maintained a plan.

and then

16

Case No. 8:09-CV-l 725-T-17MAP

In determining whether an employee welfare benefit plan exists, the Court must determine whether, from the surrounding
circumstances, a reasonable person could ascertain the intended benefits, beneficiaries, source of financing, and procedures for receiving benefits. Donovan v. Dillingham, 688 F.2d 1367, 1371
(11th Cir. 1982) . Defendant Hartford must show five things to
e s t a b l i s h t h a t an E R I S A p l a n g o v e r n s its r e l a t i o n s h i p w i t h
P l a i n t i f f : "1) a p l a n , or m a i n t a i n e d ; f u n d or p r o g r a m ; 2) [ h a s been] established

3) b y an e m p l o y e r . . . ; 4) for t h e p u r p o s e of

p r o v i d i n g b e n e f i t s in the e v e n t o f . . . d e a t h ; 5)
their beneficiaries." D o n o v a n v. D i l l i n g h a m ,

to p a r t i c i p a n t s or
supra, at 1371.

T h e C o u r t n o t e s t h a t t h e s u b j e c t i n s u r a n c e p o l i c y d o e s not
refer to ERISA. However, the lack of reference to ERISA does not

n e c e s s a r i l y m e a n t h a t t h e i n s u r a n c e p o l i c y is n o t a n E R I S A plan. The undisputed record evidence establishes that a "plan" exists. Delta Air Lines, Inc., the employer, a p p l i e d f o r a n d o b t a i n e d the

subject insurance policy.
intended benefits,

The insurance policy identifies the
death benefits, and claim

in this case,

procedures.

T h e p o l i c y p r o v i d e s a m e a n s to d e s i g n a t e

b e n e f i c i a r i e s , a n d P l a i n t i f f Rengifo,

a plan participant, asserts

t h a t P l a i n t i f f is t h e b e n e f i c i a r y of t h e i n s u r a n c e p o l i c y at
issue.

A p l a n is " e s t a b l i s h e d " w h e n t h e r e has b e e n s o m e d e g r e e of i m p l e m e n t a t i o n by the e m p l o y e r b e y o n d the a m e r e i n t e n t to c o n f e r
a benefit. B u t e r o v. Royal Maccabees Life Ins. Co., 174 F.3d

1207, 1215 (11th Cir. 1999) .

No single act by itself
f u n d or

n e c e s s a r i l y c o n s t i t u t e s t h e e s t a b l i s h m e n t of a plan,

program.

T h e p u r c h a s e of i n s u r a n c e does not c o n c l u s i v e l y
17

Case No. 8:09-CV-l 7 2 5 - T - 1 7 M A P

establish a plan, fund or program, but the purchase is
c i r c u m s t a n t i a l e v i d e n c e of t h e e s t a b l i s h m e n t of a plan, f u n d or

program.
1982) .

Donovan v. Dillingham, 688 F.2d 1367, 1374 (11th Cir.

I n B u t e r o v.

Royal Maccabees Life Ins.

Co.,

174

F.3d 1207,

1215 (11th Cir. 1999),

the E l e v e n t h C i r c u i t C o u r t of A p p e a l s

s u g g e s t s s e v e n f a c t o r s that may be r e l e v a n t in d e t e r m i n i n g
w h e t h e r an e m p l o y e r h a s e s t a b l i s h e d or m a i n t a i n e d a plan: 1) the

e m p l o y e r ' s r e p r e s e n t a t i o n s in i n t e r n a l l y d i s t r i b u t e d d o c u m e n t s ; 2) the e m p l o y e r ' s o r a l r e p r e s e n t a t i o n s ; 3) t h e e m p l o y e r ' s

e s t a b l i s h m e n t of a f u n d to p a y b e n e f i t s ; 4) a c t u a l p a y m e n t o f benefits; 5) t h e e m p l o y e r ' s d e l i b e r a t e f a i l u r e to c o r r e c t k n o w n

p e r c e p t i o n s of a p l a n ' s e x i s t e n c e ; 6) t h e r e a s o n a b l e u n d e r s t a n d i n g o f t h e e m p l o y e e s ; a n d 7) t h e e m p l o y e r ' s i n t e n t .

A)

R e p r e s e n t a t i o n s in I n t e r n a l l y D i s t r i b u t e d D o c u m e n t s

T h e r e is no r e p r e s e n t a t i o n as to E R I S A in t h e a n n u a l

" B o o k l e t C e r t i f i c a t e s " d i s t r i b u t e d to Delta e m p l o y e e s , the f o r m of the d o c u m e n t s ,

but, from

i n c l u d i n g the r e p r e s e n t a t i o n that the

p o l i c y was d e s i g n e d for D el t a employees, a r e a s o n a b l e e m p l o y e e
c o u l d i n f e r t h a t D e l t a e s t a b l i s h e d or m a i n t a i n e d a p l a n .

B) O r a l R e p r e s e n t a t i o n s

T h e r e is no e v i d e n c e that Delta m a d e o r a l r e p r e s e n t a t i o n s that Delta e s t a b l i s h e d or m a i n t a i n e d an e m p l o y e e w e l f a r e b e n e f i t
p l a n f o r its e m p l o y e e s .

IS

Case No. 8 : 0 9 - C V - l 7 2 5 - T - 1 7 M A P

C)

Establishment of

Fund

The undisputed evidence establishes that the employer,

Delta,

a p p l i e d f o r t h e s u b j e c t i n s u r a n c e p o l i c y a n d is t h e P o l i c y S R 8 3 0 1 5 5 4 1 p r o v i d e s a f u n d to p a y f o r
of covered accidents for enrolled

policyholder.
benefits

in the event

employees.

D)

Actual Payment of Benefits

T h e o n l y e v i d e n c e of a c t u a l p a y m e n t of b e n e f i t s w i t h i n the
r e c o r d is t h e s t a t e m e n t in t h e 2 0 0 6 C e r t i f i c a t e : "Good plan

experience credits over the years have produced the odd coverage amounts." A reasonable employee could infer that benefits have

b e e n p a i d in t h e p a s t .

E)

D e l i b e r a t e F a i l u r e to C o r r e c t K n o w n P e r c e p t i o n s o f P l a n ' s
Existence

T h e C o u r t is n o t a w a r e of a n y e v i d e n c e w i t h i n t h e r e c o r d as
to this factor.

F)

Reasonable Understanding of a Plan's Existence

The Court

notes

that

the annual

Booklet Certificate states

that t h e i n s u r a n c e p o l i c y p r o v i d e s c o m p r e h e n s i v e a c c i d e n t coverage. T h e C o u r t f u r t h e r r e l i e s on t h e f a c t o r s c o n s i d e r e d in

t h e s a f e h a r b o r a n a l y s i s a b o v e as r e l e v a n t to t h e r e a s o n a b l e understanding of Delta employees that Delta established and
maintained an employee welfare benefit plan.

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Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

G) E m p l o y e r ' s I n t e n t

Plaintiff Rengifo has provided documents from Delta which

a s s e r t t h a t p r i o r to J a n u a r y 1, 2008,

Delta did not provide group
(Dkts. 21-1, 21-

accident coverage under an ERISA benefit plan.

2).

The documents indicate that

Delta believed that the group However,

p o l i c y w a s n o t an E R I S A p l a n or p a r t of an E R I S A p l a n .

an e m p l o y e r ' s s u b j e c t i v e i n t e n t is not d i s p o s i t i v e o f t h e i s s u e
o f w h e t h e r an E R I S A p l a n h a s b e e n e s t a b l i s h e d o r m a i n t a i n e d .

T h i s d e t e r m i n a t i o n c a l l s f o r a l e g a l c o n c l u s i o n b a s e d on a l l r e l e v a n t e v i d e n c e s u r r o u n d i n g t h e c r e a t i o n o r i m p l e m e n t a t i o n of

the plan, c o n s i d e r e d f r o m the point of v i e w of an o b j e c t i v e l y
reasonable employee.

B e c a u s e t h e d e t e r m i n a t i o n of w h e t h e r a n E R I S A p l a n e x i s t s a n d has b e e n e s t a b l i s h e d or m a i n t a i n e d c a l l s f o r a l e g a l

c o n c l u s i o n by the C o u r t b a s e d on the a b o v e r e l e v a n t factors, the
C o u r t has n o t c o n s i d e r e d t h e a f f i d a v i t of P l a i n t i f f ' s e x p e r t ,
Mark Johnson, Ph.D., J.D., in i t s d e t e r m i n a t i o n o f t h e i s s u e .

A f t e r c o n s i d e r a t i o n of t h e u n d i s p u t e d r e c o r d e v i d e n c e ,

the

Court finds that an ERISA plan exists which was established and

m a i n t a i n e d by D e l t a Air Lines,
the resolution of this case.

Inc.

Therefore,

ERISA controls

Plaintiff Rengifo may pursue her Sec.

claim for life insurance proceeds under 29 U.S.C.
1132(a)(3).

The Court will dismiss Count I with leave to file an

amended complaint, f i d u c i a r y duty,

a n d w i l l d i s m i s s C o u n t II, f o r b r e a c h of

with prejudice.

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Case No. 8 : 0 9 - C V - 1 7 2 5 - T - 1 7 M A P

3) J u r y T r i a l

T h e r e is n o r i g h t to a j u r y t r i a l in a n a c t i o n to r e c o v e r
ERISA benefits. Shaw v. Connecticut General Insurance Co., 353

F.3d 1276, 1 2 8 6 (11th Cir. 2003).

4) P u n i t i v e D a m a g e s

The

remedies

available

under

ERISA do

not

include

extra-

c o n t r a c t u a l or p u n i t i v e damages.

Amos v. B l u e C r o s s - B l u e S h i e l d

of Alabama, 868 F.2d 430, 431 (11th Cir. 1989).

Any state

s t a t u t e p r o v i d i n g p u n i t i v e d a m a g e s is p r e e m p t e d in an E R I S A case.
B a r b e r v. Unum Life Ins. Co. of Am., 383 F.3d 134, 140-41 (3d

Cir.

2004).

Accordingly,

it is

ORDERED that Defendant's Motion for Partial Summary Judgment
is g r a n t e d . C o u n t I is d i s m i s s e d , with leave to file an amended

complaint without fourteen days which asserts Plaintiff's claim
under 29 U.S.C. Sec. 1132(a)(3), and Count II is dismissed with

prejudice.

P l a i n t i f f ' s r e q u e s t s f o r a j u r y t r i a l a n d for the

a w a r d of p u n i t i v e d a m a g e s a r e s t r i c k e n .

D O N E A N D O R D E R E D in C h a m b e r s ,

in T a m p a ,

Florida on this

l ^ ay

of D e c e m b e r ,

2010.

Copies

to:

A l l p a r t i e s a n d c o u n s e l of r e c o r d

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