Hendrix v. Wall-Mart Stores, Inc. et al
Filing
38
OPINION ON DISMISSAL. (Signed by Judge Lynn N Hughes) Parties notified. (wbostic, 4)
UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF TEXAS District Court
United States
Southern District of Texas
ENTERED
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Kimberly D. Hendrix,
Plaintiff,
versus
Wal-Mart Stores, Inc.,
et
al.,
Defendants.
August 25, 2016
David J. Bradley, Clerk
Civil Action H-15-1920
Opinion on Dismissal
r.
Introduction.
A widow sues an insurance company, an employee plan, and her husband's
former employer for denying her claim on his company's group life insurance policy.
She does not describe a transaction that the law protects.
2.
Background.
Kimberly D. Hendrix sued (a) Wal-Mart Stores, Inc.,
(b) Associates Health and
Welfare Plan, and (c) The Prudential Insurance Company of America because they
denied her claim for benefits under her late husband's employer-sponsored life
msurance.
Randy Hendrix worked for Wal-Mart untiljuly II, 2012, when he retired. On
August 27, he died of a heart attack. His life was insured by a group policy that was
sponsored by Wal-Mart, part of Associates, and administered by Prudential. Hendrix
filed a claim under that policy; Prudential denied it. Hendrix says it was wrong to deny
the claim.
3·
According to Hendrix.
Hendrix says that Prudential denied the claim because her husband was not
covered on the date of his death. Onjuly 23, 2012, Prudential sent Randy Hendrix a
letter, notifying him that he had 3 1-days to convert his group policy into an individual
one or he would lose coverage.
Hendrix says Prudential cannot prove it sent the letter because (a) it did not
send it in a manner that required a signature upon receipt and (b) she cannot find the
letter. Neither ofher standards is supported by the law. Prudential has records ofhaving
sent it, including a copy; it is not obliged to have records of her husband's receipt.
Apparently she has no record of the letter, but her ignorance cannot be extrapolated
into knowledge of a fact - that it was not sent.
4·
Parties.
Hendrix sues three parties but only describes facts about one of them -
Prudential. She says that it administered the policy and denied her claim. She describes
no facts about Wal-Mart or the Associates. Wal-Mart and the Associates could only
be liable if they exercised control over the determination of coverage. Hendrix does not
state a claim against Wal-Mart or Associates for denial of coverage.
Hendrix also refers to rights to a bonus, unpaid salary, and unused sick time,
but does not support this claim without supporting data. Even assuming she could
substantiate those claims, she sued over two years after her husband left Wal-Mart.
Claims for unsettled benefits are barred by limitations. Abstractions do not make valid
claims.
Associates is responsible for the whole plan and could be liable if it had
wrongfully denied coverage. It did not, and the law allows it to delegate the claims
function.
S·
Denial of Benefits.
In her pleadings, Hendrix concedes that she does not know whether she has a
claim against Prudential. Despite having seen the letter notifying her husband of his
option to convert the policy, she supposes that it may not have sent it or he many not
have received it. Hendrix cannot sue Prudential on speculative ruminations.
She also says that Prudential did not give her sufficient information to pursue
her appeal. Prudential denied coverage because it notified Hendrix's husband and he did
not convert the policy. Prudential gave notice. It was not required to give her
information "concerning all aspects of her husband's employment." It had to give her
data about the notice - the basis for her appeal.
Hendrix does not describe a claim: She wants the money. If she cannot
articulate facts that tether that relief to the hard cold facts of the administration of the
policy and claims, she will lose against Prudential.
Signed on August
'2'>,
2.016,
at Houston, Texas.
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Lynn N. Hughes
United States District]udge
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