Webb v. Liberty Mutual Insurance Company
Filing
37
OPINION and ORDER granting Defendant's 21 Motion for Summary Judgment; denying Plaintiff's 24 Motion for Judgment on the Administrative Record and denying Plaintiff's 10 Motion for Partial Summary Judgment and to Permit Limited Discovery. Signed by Judge Thomas W. Thrash, Jr. on 6/1/16. (jkl)
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF GEORGIA
ATLANTA DIVISION
MELINDA WEBB,
Plaintiff,
v.
CIVIL ACTION FILE
NO. 1:15-CV-2508-TWT
LIBERTY LIFE ASSURANCE
COMPANY OF BOSTON,
Defendant.
OPINION AND ORDER
This is an action to recover optional life insurance benefits and an accidental
death insurance benefit under ERISA. It is before the Court on the Plaintiff’s Motion
for Partial Summary Judgment and to Permit Limited Discovery [Doc. 10], the
Defendant’s Motion for Summary Judgment [Doc. 21], and the Plaintiff’s Motion for
Judgment on the Administrative Record [Doc. 24]. For the reasons stated below, the
Plaintiff’s Motion for Partial Summary Judgment and to Permit Limited Discovery is
DENIED. The Defendant’s Motion for Summary Judgment is GRANTED and the
Plaintiff’s Motion for Judgment on the Administrative Record is DENIED.
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I. Background
The Defendant, Liberty Life Assurance Company of Boston, issued an
insurance policy to Adobe Systems Incorporated.1 Adobe employed Ronald Webb, the
deceased husband of the Plaintiff, Melinda Webb.2 The insurance policy funds life
insurance and accidental death benefits under an employee welfare benefit plan
sponsored and maintained by Adobe pursuant to the Employee Retirement Income
Security Act (“ERISA”).3 Mr. Webb began employment with Adobe on May 11,
2012.4 Under the plan, he elected coverage of basic life insurance of $250,000,
optional life insurance of $1 million, basic accidental death insurance of $250,000,
and optional accidental death insurance of $1 million.5 The Plaintiff was designated
as the sole beneficiary of Mr. Webb’s basic life insurance and his accidental death
insurance.6 The Plaintiff and Kim Princiotta were designated as co-beneficiaries of
Mr. Webb’s optional life insurance, at 96% and 4%, respectively.7
1
Def.’s Statement of Facts ¶ 1.
2
Id.
3
Id. ¶ 2.
4
Id. ¶ 3.
5
Id. ¶ 4.
6
Id. ¶ 5.
7
Id.
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On December 27, 2013, around 8:42 PM, Mr. Webb sustained a gunshot wound
to the head.8 The incident occurred in the home shared by Mr. Webb and the Plaintiff.9
The Plaintiff was in the home during the incident and called 911 immediately
following the gunshot.10 The Forsyth County Sheriff’s Office responded to the scene.11
Mr. Webb was transported to a hospital and died there at 10:40 PM.12 The Coroner
later determined that Mr. Webb’s death was the result of a self-inflicted gunshot
wound to the head and that the death was a suicide.13
In a December 28, 2013, email, Adobe notified the Defendant that Mr. Webb
had died.14 Adobe returned a completed Employee Proof of Death form to the
Defendant on December 30, 2013.15 Adobe also notified the Defendant by December
31, 2013, that the cause of Mr. Webb’s death was a “possible suicide.”16 On January
8
Id. ¶ 12.
9
Id. ¶ 13.
10
Id. ¶¶ 14-15.
11
Id. ¶ 16.
12
Id. ¶ 17.
13
Id. ¶¶ 33-34.
14
Id. ¶ 18.
15
Id. ¶ 19.
16
Id. ¶ 22.
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2, 2014, the Defendant’s claims examiner, Priscille Boston, spoke to the Plaintiff by
telephone.17 Ms. Boston explained to the Plaintiff that optional life insurance benefits
and accidental death benefits would not be payable due to the policy’s suicide
exclusions.18 On January 6, 2014, the Defendant provided the Plaintiff with a claim
form and requested a copy of Mr. Webb’s death certificate.19 The Defendant received
the Plaintiff’s completed and signed beneficiary statement, as well as Mr. Webb’s
death certificate on January 24, 2014.20 In a January 27, 2014, letter, the Defendant
notified the Plaintiff that it would pay basic life insurance benefits but not optional
benefits.21 The letter included a check for the basic life insurance benefits, plus
interest.22 The letter also informed the Plaintiff of her right to appeal the decision
under ERISA.23
17
Id. ¶¶ 23-24.
18
Id. ¶ 27.
19
Id. ¶ 28.
20
Id. ¶ 29.
21
Id. ¶¶ 35-38.
22
Id. ¶¶ 39-40.
23
Id. ¶ 41.
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On March 26, 2014, the Plaintiff, through her attorney, requested that the
Defendant review its decision to deny benefits.24 Upon review of the file, the
Defendant again decided to deny benefits and informed the Plaintiff of its decision via
letter on June 23, 2014.25 The Plaintiff filed this action on June 12, 2015. The Plaintiff
now moves for partial summary judgment and limited discovery, as well as for
judgment on the administrative record. The Defendant moves for summary judgment
on the basis of a contractual limitations period and for judgment on the administrative
record.
II. Legal Standard
Summary judgment is appropriate only when the pleadings, depositions, and
affidavits submitted by the parties show no genuine issue of material fact exists and
that the movant is entitled to judgment as a matter of law.26 The court should view the
evidence and any inferences that may be drawn in the light most favorable to the
nonmovant.27 The party seeking summary judgment must first identify grounds to
24
Id. ¶ 48.
25
Id. ¶¶ 73-76.
26
FED. R. CIV. P. 56(a).
27
Adickes v. S.H. Kress & Co., 398 U.S. 144, 158-59 (1970).
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show the absence of a genuine issue of material fact.28 The burden then shifts to the
nonmovant, who must go beyond the pleadings and present affirmative evidence to
show that a genuine issue of material fact does exist.29 “A mere ‘scintilla’ of evidence
supporting the opposing party’s position will not suffice; there must be a sufficient
showing that the jury could reasonably find for that party.”30
III. Discussion
The Defendant argues that the Plaintiff’s ERISA claim is barred by the
Plaintiff’s failure to file this action within the contractual limitations period. The
Eleventh Circuit has held that “contractual limitations periods on ERISA actions are
enforceable, regardless of state law, provided they are reasonable.”31 Here, the
insurance policy states that a legal action may not be commenced “more than one year
after the time Proof of claim is required.”32 The policy states that “[s]atisfactory Proof
of loss must be given to Liberty no later than 30 days after the date of loss.”33 The
28
Celotex Corp. v. Catrett, 477 U.S. 317, 323-24 (1986).
29
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 257 (1986).
30
Walker v. Darby, 911 F.2d 1573, 1577 (11th Cir. 1990).
31
Northlake Regional Med. Ctr. v. Waffle House Sys. Empl. Benefit Plan,
160 F.3d 1301, 1303 (11th Cir. 1998).
32
A.R. at 45.
33
Id. at 46.
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policy creates an exception to that rule where it is not reasonably possible to furnish
proof within 30 days.34 Then, proof of loss must be furnished as soon as reasonably
possible, but “in no event, except in the absence of legal capacity of the claimant, later
than one year from the time Proof is otherwise required.”35 Interpreting this same
policy language, the Northern District of Florida found that where proof is required
within 30 days, “a claim cannot be made more than one year plus 30 days from the
date of the loss.”36 Where proof cannot reasonably be furnished within 30 days, that
court found that an additional year would be added to the contractual limitations
period.37 This Court finds the Northern District of Florida Court’s reasoning
persuasive.
Here, Mr. Webb died on December 27, 2013.38 On January 24, 2014, the
Plaintiff submitted the proof required by the insurance policy.39 It is clear that proof
of loss could be reasonably furnished within 30 days of the loss. Proof was therefore
34
Id.
35
Id.
36
Harrison v. Liberty Life Assurance Co. of Boston, No. 5:11-cv-60/RSGRJ, 2011 WL 2118954, at *2 (N.D. Fla. May 27, 2011).
37
Id.
38
A.R. at 231.
39
Id. at 57.
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required within 30 days of the loss. As a result, the contractual limitations period is
one year and 30 days from the date of loss. The Plaintiff was required to file suit by
January 27, 2015. This suit was not filed until June 12, 2015, which means it was not
filed within the contractual limitations period. The Court finds no reason not to
enforce the limitations period as written. The Defendant’s motion for summary
judgment should be granted. Because the Court finds that the Plaintiff did not file her
claim within the contractual limitations period, there is no need to address the motion
for judgment on the administrative record. The Plaintiff’s Motion for Judgment on the
Administrative Record should be denied. The Plaintiff also moves for partial summary
judgment and limited discovery regarding the administrative record. The motion,
however, is essentially a motion to compel. Given that this Court found on January 25,
2016, that no further discovery would be produced, the Plaintiff’s motion should be
denied.
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IV. Conclusion
For the reasons stated above, the Plaintiff’s Motion for Partial Summary
Judgment and to Permit Limited Discovery [Doc. 10] is DENIED. The Defendant’s
Motion for Summary Judgment [Doc. 21] is GRANTED and the Plaintiff’s Motion
for Judgment on the Administrative Record [Doc. 24] is DENIED.
SO ORDERED, this 1 day of June, 2016.
/s/Thomas W. Thrash
THOMAS W. THRASH, JR.
United States District Judge
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