Barrilleaux v. Hartford Life and Accident Insurance Company et al
Filing
125
ORDER AND REASONS - IT IS ORDERED that Sea Support's 48 motion for summary judgment is GRANTED. Plaintiff's claims against Sea Support under ERISA and state law for benefits under the LTD Policy are DISMISSED WITH PREJUDICE. Signed by Judge Susie Morgan. (bwn)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF LOUISIANA
CHRISTOPHER BARRILLEAUX,
CIVIL ACTION
Plaintiff
VERSUS
NO. 12-1542
HARTFORD LIFE AND
ACCIDENT INSURANCE
COMPANY, et al.
SECTION "E"
Defendants
ORDER AND REASONS
The Court has pending before it Defendant Sea Support Ventures, LLC's ("Sea
Support") motion for summary judgment.1 The Court has reviewed the briefs,2 the record,
the applicable law, and now issues this order and reasons granting the motion for summary
judgment.
BACKGROUND
Plaintiff Christopher Barrileaux was employed by Defendant Sea Support Ventures,
LLC. Barrileaux contends that, as part of the terms of his employment, he was entitled to
long-term disability ("LTD") benefits pursuant to a Policy sponsored by Sea Support and
administered by Defendant Hartford. The parties agree that ERISA governs the LTD
Policy.
The circumstances surrounding Barrilleaux's enrollment (or attempted) enrollment
in the LTD Policy are at least obfuscated, if not genuinely disputed. But the facts material
1
R. Doc. 48.
2
R. Docs. 57, 68, 109, 115.
1
to Sea Support's motion for summary judgment are not subject to serious dispute.
Plaintiff began employment with Sea Support in September 2005.3 Pursuant to
unambiguous terms of the Policy, he became eligible to enroll for benefits under the LTD
Policy on October 1, 2006.4 For thirty-one days after becoming eligible, Plaintiff could have
enrolled without providing any evidence of insurability; after that thirty-one day window
expired, Plaintiff was required to provide evidence of insurability to enroll for LTD
benefits.5 It is undisputed that Plaintiff did not enroll, or was not enrolled, for LTD benefits
in the thirty-one day window following eligibility. There is no record evidence suggesting
that Plaintiff ever submitted evidence of insurability.
Plaintiff allegedly became disabled as a result of a workplace injury in March 2007.6
He filed a personal injury lawsuit in state court against Sea Support on or about July 26,
2007.7 At some point Plaintiff made a claim to Hartford for benefits under the LTD Policy,
which Hartford denied in written correspondence dated April 8, 2008 on the basis that he
was not enrolled in the Policy and had not provided evidence of insurability.8
In October 2010, Plaintiff lost his state-court negligence lawsuit against Sea
Support.9 In May 2012, he filed this lawsuit, alleging that Sea Support breached a fiduciary
3
R. Doc. 48-7 at 8.
4
R. Doc. 48-8 at 16.
5
Id. at 17-18.
6
R. Doc. 48-7 at 23.
7
R. Doc. 48-3.
8
R. Doc. 48-6.
9
R. Doc. 48-5.
2
duty or a contractual obligation by failing to enroll him in the LTD Policy when he became
eligible.10 Defendants removed to this Court. Plaintiff has since amended his complaint to
invoke ERISA and supplement his allegations.11
Sea Support now moves for summary judgment, contending (1) res judicata based
on the resolution of Plaintiff's previous lawsuit bars all claims against Sea Support; (2) Sea
Support is not liable to Plaintiff as an ERISA fiduciary for failing to enroll him in the LTD
Policy; and (3) ERISA preempts Plaintiff's state-law claims for breach of contract based on
the failure to enroll him in the LTD Policy.
STANDARD OF LAW
Summary judgment is appropriate only “if the movant shows that there is no genuine
dispute as to any material fact and the movant is entitled to judgment as a matter of law.”
Fed. R. Civ. P. 56; see also Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986).
If the dispositive issue is one on which the moving party will bear the burden of proof
at trial, the moving party “must come forward with evidence which would ‘entitle it to a
directed verdict if the evidence went uncontroverted at trial.’” Int’l Shortstop, Inc. v.
Rally’s, Inc., 939 F.2d 1257, 1263-64 (5th Cir. 1991). If the moving party fails to carry this
burden, the motion must be denied. If the moving party successfully carries this burden,
the burden then shifts to the non-moving party to show that a genuine issue of material fact
exists. Id. at 322-23. Once the burden has shifted, the non-moving party must direct the
Court’s attention to something in the pleadings or other evidence in the record that sets
forth specific facts sufficient to establish that a genuine issue of material fact does indeed
10
R. Doc. 1-1 at 2.
11
R. Docs. 17, 102.
3
exist. Id. at 324.
If the dispositive issue is one on which the non-moving party will bear the burden
of proof at trial, however, the moving party may satisfy its burden by simply pointing out
that the evidence in the record is insufficient with respect to an essential element of the
non-moving party’s claim. See Celotex, 477 U.S. at 325. The nonmoving party must then
respond, either by “calling the Court’s attention to supporting evidence already in the
record that was overlooked or ignored by the moving party” or by coming forward with
additional evidence. Celotex, 477 U.S. at 332-33 & 333 n.3.
“An issue is material if its resolution could affect the outcome of the action.”
DIRECTV Inc. v. Robson, 420 F.3d 532, 536 (5th Cir. 2005). When assessing whether a
material factual dispute exists, the Court considers “all of the evidence in the record but
refrains from making credibility determinations or weighing the evidence.” Delta & Pine
Land Co. v. Nationwide Agribusiness Ins. Co., 530 F.3d 395, 398 (5th Cir. 2008); see also
Reeves v. Sanderson Plumbing, Inc., 530 U.S. 133, 150-51 (2000). All reasonable
inferences are drawn in favor of the non-moving party. Little v. Liquid Air Corp., 37 F.3d
1069, 1075 (5th Cir. 1994). There is no genuine issue of material fact if, even viewing the
evidence in the light most favorable to the non-moving party, no reasonable trier of fact
could find for the non-moving party, thus entitling the moving party to judgment as a
matter of law. Smith v. Amedisys, 298 F.3d 434, 440 (5th Cir. 2002).
ANALYSIS
A.
Res Judicata
"For res judicata to apply, the following four-part test must be satisfied: (1) the
parties must be either identical or in privity; (2) the judgment in the prior action must have
4
been rendered by a court of competent jurisdiction; (3) the prior action must have been
concluded to a final judgment on the merits; and (4) the same claim or cause of action must
have been involved in both actions." See United States v. Davenport, 484 F.3d 321, 326
(5th Cir. 2007) (internal quotation marks and alterations omitted). Two suits involve "the
same claim or cause of action" if they are "based on the same nucleus of operative facts."
See id. (internal quotation marks omitted).
Res judicata does not apply here. The first lawsuit was a personal injury suit; the
nucleus of operative facts relevant to that case was whether Sea Support's negligence caused
a personal injury to Plaintiff. This lawsuit is an ERISA/contract suit; the nucleus of
operative facts revolves around the circumstances of Plaintiff's employment contract and
his enrollment (or attempted enrollment) in the LTD Benefits Policy. There might be some
overlap between the quantum of damages Plaintiff would be entitled to under either theory,
but the two lawsuits are legally and factually distinct and do not arise out of "a single
wrongful invasion of a single primary right of the plaintiff, namely, the right of bodily
safety." See Baltimore S.S. Co. v. Phillips, 274 U.S. 316, 321 (1927). Summary judgment
on the basis of res judicata is denied.
B.
Sea Support's Status as a Fiduciary
Plaintiff alleges that Sea Support was a fiduciary with respect to enrolling him in the
LTD Policy and breached its duty.
ERISA § 502(a)(3) "authorizes lawsuits for
individualized equitable relief for breach of fiduciary obligations." Radford v. Gen.
Dynamics Corp., 151 F.3d 396, 398-99 (5th Cir. 1998).12 The question, then, is whether Sea
12
"A civil action may be brought . . . by a participant, beneficiary, or fiduciary
(A) to enjoin any act or practice which violates any provision of this subchapter or the terms
5
Support was a fiduciary with respect to enrolling him in the LTD Policy. ERISA requires
a plan to "provide for one or more named fiduciaries who jointly or severally shall have
authority to control and manage the operation and administration of the plan." 29 U.S.C.
§ 1102(a)(1). A "named fiduciary" is a fiduciary named in the plan instrument itself. Id. at
§ 11021(a)(2). Hartford, not Sea Support, is identified as "the claims fiduciary for benefits
provided under the Policy" and granted "full discretion and authority to determine
eligibility for benefits and to construe and interpret all terms and provisions of the Policy."13
Thus, Sea Support is not liable as a named fiduciary.
"'[A]nyone else who exercises discretionary control or authority over the plan's
management, administration, or assets'" is also a fiduciary. White v. HCA, Inc., 240 F.
Supp. 2d 600, 603 (E.D. La. 2002) (quoting Mertens v. Hewitt Assocs., 508 U.S. 248, 251
(1993). But "[a]n ERISA fiduciary for one purpose is not necessarily a fiduciary for other
purposes." See Kirschbaum v. Reliant Energy, Inc., 526 F.3d 243, 251 (5th Cir. 2008). Sea
Support contends that it had no other "discretionary control or authority over the plan's
management, administration, or assets" at all, and certainly not with respect to anything
having to do with interpreting the terms of the Policy or eligibility for benefits.14
In response, Plaintiff contends that Sea Support "wore many hats" with respect to
the LTD Policy and therefore is liable as a fiduciary because its breach resulted in the denial
of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations
or (ii) to enforce any provisions of this subchapter or the terms of the plan." 29 U.S.C. §
1132(a)(3).
13
R. Doc. 39-1 at 43, 45.
14
R. Doc. 48-1 at 10-12.
6
of Plaintiff's LTD benefits.15 But Plaintiff fails to explain how any of these "hats" gave Sea
Support discretionary control over any matter relevant to the issues in this lawsuit or made
Sea Support a fiduciary with respect to enrolling Plaintiff in the LTD Policy. For example,
Sea Support's status as the employer, policyholder, sponsor, and agent for service of legal
process have no apparent connection to any discretionary control over the Policy or
enrollment therein. And although Sea Support is named as the Plan Administrator, an
"administrator" is still only a fiduciary "to the extent that he exercises any discretionary
authority or control." See Estate of Bratton v. Nat'l Union Fire. Ins. Co. of Pittsburgh, 215
F.3d 516, 521 (5th Cir. 2000). Sea Support's discretion as Plan Administrator "to terminate,
suspend, withdraw, reduce, amend or modify the Plan" as a matter of law does not make
it a fiduciary. See Kirschbaum, 526 F.3d at 251. Thus, Plaintiff has not pointed to any "hat"
worn by Sea Support which made it a fiduciary in any sense pertaining to Plaintiff's claim
regarding his ineligibility for benefits under the LTD Policy.
Plaintiff also relies on Kenseth v. Dean Health Plan, Inc., 610 F.3d 452 (7th Cir.
2010), apparently to contend that Sea Support can be liable for failing to train customer
service representatives, such as the Sea Support employee who was purportedly responsible
for enrolling him in LTD Benefits.16 But the liable fiduciary in Kenseth was a named
fiduciary responsible for granting or denying claims. See 610 F.3d at 462. Here, Sea
Support was not a claims fiduciary and had no other discretion or control over the plan
giving rise to any fiduciary liability to Plaintiff with respect to enrollment for or denial of
15
16
R. Docs. 57-1 at 10-11; 109 at 3-5.
R. Doc. 109 at 5.
7
LTD benefits.17 Thus, Sea Support's motion is granted with respect to Plaintiff's claims that
Sea Support breached a fiduciary duty by failing to enroll Plaintiff in the LTD Policy.
C.
ERISA Preemption
Subject to exceptions not relevant here, ERISA "supersede[s] any and all State laws
insofar as they may now or hereafter relate to any employee benefit plan." See 29 U.S.C.
§ 1144(a). "The language of the ERISA preemption clause is deliberately expansive, and has
been construed broadly by federal courts." Hubbard v. Blue Cross & Blue Shield Ass'n, 42
F.3d 942, 945 (5th Cir. 1995). "A state cause of action relates to an employee benefit plan
whenever it has a connection with or reference to such a plan." Id. (internal quotation
marks omitted). Thus, a state-law cause of action is barred "if (1) the state law claim
addresses an area of exclusive federal concern, such as the right to receive benefits under
the terms of an ERISA plan; and (2) the claim directly affects the relationship between the
traditional ERISA entities–the employer, the plan and its fiduciaries, and the participants
and beneficiaries." Id.
Sea Support contends that ERISA preempts Plaintiff's claim for breach of a promise
of LTD benefits. It cites Cefalu v. B.F. Goodrich Co., in which the Fifth Circuit concluded
that ERISA preempted a claim that an employer misrepresented the quantum of retirement
17
Plaintiff suggests in his final supplemental brief that Sea Support employee
Ginger Curole "was responsible for enrolling plaintiff . . . for long-term disability insurance
or filling out an enrollment form." R. Doc. 109 at 5. Even accepting that factual assertion
as true, Plaintiff fails to explain how Ms. Curole was acting in a fiduciary capacity by
completing and submitting a form on his behalf. Hartford, not Sea Support, was the sole
fiduciary with respect to interpreting the LTD Policy, including enrollment procedures.
Even if "personnel [of the employer] routinely assume responsibility" for assisting
participants and beneficiaries, that mere "performance of mechanical administrative tasks"
does not create a fiduciary duty. See White, 240 F. Supp. 2d at 603.
8
benefits a plaintiff would receive because "[t]o compute these damages, the Court must
refer to the pension plan under which [plaintiff] was covered when he worked for
Goodrich." See 871 F.2d 1290, 1294 (5th Cir. 1989). The Fifth Circuit has since cast some
doubt on the breadth of that statement. See Rozzell v. Security Servs., Inc., 38 F.3d 819,
822 (5th Cir. 1994) (referring to the holding as dicta). But the Fifth Circuit has also
continued to cite Cefalu for the proposition that "a state-law claim by an ERISA plan
participant against her employer is preempted when based upon a denial of benefits under
the defendant's ERISA plan." See Smith v. Tex. Children's Hosp., 84 F.3d 152, 155 (5th Cir.
1996).
In response, Plaintiff contends that his state-law contract claim is not preempted
because it arises out of an employment contract between himself and Sea Support, and
therefore does implicate an ERISA plan.18 Plaintiff did not supplement this contention in
later briefing, nor has he cited any case finding an analogous claim against an employer for
promised LTD benefits not to be preempted.19
Plaintiff does not overcome the inescapable fact that his state-law breach of
employment contract claim "relates" to the LTD Policy. Plaintiff is pursuing benefits under
the LTD Policy denied because Sea Support breached a purported promise to enroll him.
Therefore, his measure of damages must be computed under the Policy, which strongly
suggests a relationship between the claim and ERISA, regardless of the continuing vitality
of Cefalu. Moreover, the crux of Plaintiff's claim is that Sea Support should have but failed
18
R. Doc. 57-1 at 12-13.
19
R. Doc. 109 at 6.
9
to enroll him for benefits under the Policy when he became eligible;20 therefore, the merits
of his claim will require the Court to interpret the enrollment provisions of the Policy.
Plainly, his claim addresses his right to receive benefits under the LTD Policy, an area of
exclusive federal concern, and directly affects the relationship between himself, Sea
Support, and Hartford, the traditional ERISA entities. See Hubbard, 42 F.3d at 945; Smith,
84 F.3d at 155. Thus, the breach of contract claim relates to ERISA and is preempted. Sea
Support's motion for summary judgment as to any and all state-law claims is granted.
CONCLUSION
For the foregoing reasons, IT IS ORDERED that Sea Support's motion for
summary judgment is GRANTED. Plaintiff's claims against Sea Support under ERISA and
state law for benefits under the LTD Policy are DISMISSED WITH PREJUDICE.
Plaintiff's claim that Sea Support breached a different fiduciary duty by failing to provide
him with a copy of the LTD Policy, is the subject of a separate pending motion for partial
summary judgment21 and remains at issue.
New Orleans, Louisiana, this 29th day of July, 2014.
____________________________
SUSIE MORGAN
UNITED STATES DISTRICT JUDGE
20
R. Doc. 102 at 4.
21
R. Doc. 116.
10
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?