Figlioli v. Liberty Life Assurance Company of Boston et al

Filing 24

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS DKT. NO. 18 . Court GRANTS the defendants Motion for Partial Judgment on the Pleadings (Dkt. No. 18), GRANTS judgment in favor of the defendants with regard to Count Two of Figliolis complaint, and DISMISSES Count Two with PREJUDICE. Court DIRECTS the Clerk to enter a separate judgment order. Signed by Senior Judge Irene M. Keeley on 2/12/2018. (copy counsel of record)(jmm)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF WEST VIRGINIA
RICHARD FIGLIOLI,
Plaintiff,
v.

//

CIVIL ACTION NO. 1:17CV171
(Judge Keeley)

LIBERTY LIFE ASSURANCE COMPANY
OF BOSTON and GROUP LIFE INSURANCE
AND DISABILITY PLAN OF UNITED
TECHNOLOGIES CORPORATION,
Defendants.
MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
For the reasons that follow, the Court GRANTS the defendants’
Motion for Partial Judgment on the Pleadings (Dkt. No. 18).
I. BACKGROUND
On

October

10,

2017,

the

plaintiff,

Richard

Figlioli

(“Figlioli”), sued the defendants, Liberty Life Assurance Company
of Boston (“Liberty Life”) and Group Life Insurance and Disability
Plan of United Technologies Corporation (“the Plan”) (Dkt. No. 1),
alleging that, while working at Pratt & Whitney as a Materials
Supervisor in Bridgeport, West Virginia, he became unable to work
on September 17, 2007, due to injuries sustained when he fell from
a tree. Figlioli’s internist issued medical restrictions outlining
that he was “unable to work on a consistent basis . . . due to a
severe disorder of the spine, including arachnoiditis, spinal

FIGLIOLI V. LIBERTY LIFE, ET AL.

1:17CV171

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
stenosis and degenerative disk disease as a result of vertebral
fractures resulting in the compromise of the nerve root.” Id. at 2.
The defendants paid long-term disability benefits for Figlioli
for approximately eight years, finding he was “unable to perform,
with reasonable continuity, the material and substantial duties of
any occupation.” However, in reliance on a “non-examining paperreview,” Liberty Life denied Figlioli further benefits as of March
7, 2017. Following an appeal, Liberty Life issued a final denial
letter on September 5, 2017. Figlioli has not received monthly
benefits since March 6, 2017. Id. at 1-2.
Following the final denial of benefits, Figlioli requested “a
complete copy of the applicable plan(s), summary plan descriptions,
policies

and

claims

file,

including

but

not

limited

to

the

documents” further described in his letter (Dkt. No. 19-3 at 2). He
specifically requested that the defendants provide those documents
contemplated by 29 U.S.C. §§ 1024, 1029, and 1132, as well as 29
C.F.R. § 2560.503. Id. In response, Liberty Life provided a copy of
the claim files and the applicable policies, but advised that
other documents must be sought from the plan administrator (Dkt.
No. 19-4 at 2).
Figlioli claims he is entitled to disability benefits under
the Plan, and that the defendants failed to comply with their
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FIGLIOLI V. LIBERTY LIFE, ET AL.

1:17CV171

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
statutory and regulatory duties to provide an adequate response to
his document request. Id. at 3-7. Consequently, Count One makes a
claim for benefits under the Plan, while Count Two makes a claim
related to the defendants’ alleged duty to provide documents under
29 U.S.C. §§ 1132(a)(1)(A) and (c)(1). Id. Figlioli seeks 1) a
declaration that the defendants must pay his past due benefits, 2)
the assessment of a $110 per day penalty for failing to provide
Plan documents, 3) an order requiring the defendants to provide all
relevant documents, 4) an award of retroactive long-term disability
benefits

and

the

reinstatement

of

future

benefits,

and

5)

attorneys’ fees and costs. Id. at 7.
On January 19, 2018, the defendants moved for judgment on
Count Two (Dkt. No. 18), arguing that they cannot be held liable
for statutory penalties under 29 U.S.C. § 1132(c) because neither
is the “Plan Administrator,” and that statutory penalties are
unavailable

with

regard

to

document

production

mandated

by

regulation (Dkt. No. 19). Figlioli has withdrawn his request for
statutory

penalties,

but

continues

to

seek

discovery

of

the

documents at issue (Dkt. No. 21).
II. STANDARD OF REVIEW
Fed. R. Civ. P. 12(c) provides that, “[a]fter the pleadings
are closed - but early enough not to delay trial - a party may move
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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
for judgment on the pleadings.” “The standard of review for Rule
12(c) motions is the same standard applied to Rule 12(b)(6) motions
to dismiss.” Carter v. Nat’l City Mortg., Inc., No. 1:14CV70, 2015
WL 966260, at *3 (N.D.W.Va. Mar. 4, 2015) (citing Independence
News, Inc. v. City of Charlotte, 568 F.3d 148, 154 (4th Cir.
2009)). As the Court has noted, “[t]he only difference between a
Rule 12(c) motion and a Rule 12(b)(6) motion is timing.” Id.
Fed. R. Civ. P. 12(b)(6) allows a defendant to move for
dismissal on the grounds that a complaint does not “state a claim
upon which relief can be granted.” When reviewing the sufficiency
of a complaint, a district court “must accept as true all of the
factual allegations contained in the complaint.” Anderson v. Sara
Lee Corp., 508 F.3d 181, 188 (4th Cir. 2007) (quoting Erickson v.
Pardus, 551 U.S. 89, 94 (2007)). “While a complaint . . . does not
need detailed factual allegations, a plaintiff’s obligation to
provide the ‘grounds’ of his ‘entitle[ment] to relief’ requires
more than labels and conclusions, and a formulaic recitation of the
elements of a cause of action will not do.” Bell Atl. Corp. v.
Twombly, 550 U.S. 544, 555 (2007) (internal citation omitted). A
court is “not bound to accept as true a legal conclusion couched as
a factual allegation.” Papasan v. Allain, 478 U.S. 265, 286 (1986).

4

FIGLIOLI V. LIBERTY LIFE, ET AL.

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
In order to be sufficient, “a complaint must contain ‘enough
facts to state a claim to relief that is plausible on its face.’”
Anderson, 508 F.3d at 188 n.7 (quoting Twombly, 550 U.S. at 547).
“A claim has facial plausibility when the plaintiff pleads factual
content that allows the court to draw the reasonable inference that
the defendant is liable for the misconduct alleged.” Ashcroft v.
Iqbal, 556 U.S. 662, 678 (2009). A motion to dismiss “does not
resolve contests surrounding the facts, the merits of a claim, or
the applicability of defenses.” Republican Party of N.C. v. Martin,
980 F.2d 943, 952 (4th Cir. 1992).
In deciding on the motion, the Court need not confine its
inquiry

to

the

complaint;

it

may

also

consider

“documents

incorporated into the complaint by reference, and matters of which
a court may take judicial notice.” Tellabs, Inc. v. Makor Issues &
Rights, Ltd., 551 U.S. 308, 322 (2007). “A copy of a written
instrument that is an exhibit to a pleading is a part of the
pleading for all purposes.” Fed. R. Civ. P. 10(c). The Court may
also consider documents attached to the motion to dismiss, so long
as they are integral to the complaint and authentic.” Philips v.
Pitt Cty. Mem’l Hosp., 572 F.3d 176, 180 (4th Cir. 2009). The
defendants attached the following documents to their motion for
judgment

on

the

pleadings:

the
5

policy,

the

summary

plan

FIGLIOLI V. LIBERTY LIFE, ET AL.

1:17CV171

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
description, Figlioli’s letter requesting documents, and Liberty
Life’s response (Dkt. Nos. 19-1; 19-2; 19-3; 19-4). Given that
these documents are integral to the complaint, and Figlioli does
not contest their authenticity, the Court will consider them.
III. LEGAL FRAMEWORK
Under ERISA, the “administrator” of a benefit plan is:
(i) the person specifically designated by the terms of
the instrument under which the plan is operated;
(ii) if an administrator is not so designated, the plan
sponsor; or
(iii) in the case of a plan for which an administrator is
not designated and a plan sponsor cannot be identified,
such other person as the Secretary may by regulation
prescribe.
29 U.S.C. § 1002(16)(A). Administrators are statutorily required
to, “upon written request of any participant or beneficiary,
furnish a copy of the latest updated summary[] plan description,
and the latest annual report, any terminal report, the bargaining
agreement, trust agreement, contract, or other instruments under
which the plan is established or operated.” 29 U.S.C. § 1024(b)(4).
The Secretary of Labor (“the Secretary”) has general authority
to “prescribe such regulations as he finds necessary or appropriate
to carry out the provisions” of the subchapter regarding protection
of employee benefit rights. 29 U.S.C. § 1135. He is given further

6

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
authority to “prescribe the format and content of the summary plan
description . . . and any other report, statements or documents
. . . which are required to be furnished or made available to plan
participants and beneficiaries receiving benefits under the plan.”
29 U.S.C. § 1029(c).
Pursuant to this authority, the Secretary has promulgated
regulations requiring “the claims procedure of a plan . . . [to]
[p]rovide that a claimant shall be provided, upon request and free
of charge, reasonable access to, and copies of, all documents,
records, and other information relevant to the claimant’s claim for
benefits.”

29

U.S.C.

§

2560.503-1(h)(2)(iii).

The

Secretary

defined “relevant” documents at 29 C.F.R. § 2560.503-1(m)(8).
ERISA provides for civil enforcement when an administrator
“fails or refuses to comply with a request for any information
which such administrator is required by this subchapter to furnish
to a participant or beneficiary . . . by mailing the material
requested to the last known address of the requesting participant
or beneficiary within 30 days after such request.” 29 U.S.C.
§ 1132(a)(1)(A), (c)(1). The Court may impose a fine up to $110 per
day

“from

the

date

of

such

failure

§ 1132(c)(1); 29 C.F.R. § 2575.502c-1.

7

or

refusal.”

29

U.S.C.

FIGLIOLI V. LIBERTY LIFE, ET AL.

1:17CV171

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
IV. DISCUSSION
Neither

defendant

is

a

“plan

administrator”

subject

to

statutory penalties under § 1132(c). It is plain that the Plan
itself cannot be the plan administrator, as the terms “plan” and
“plan administrator” are entirely distinct. See Bruce v. Hardford,
No. 1:14CV18, 2014 WL 3443823, at *9 (E.D.Va. July 10, 2014)
(citing Wilczynski v. Lumbermens Mut. Cas. Co., 93 F.3d 397, 406
(7th Cir. 1996); Groves v. Modified Ret. Plan for Hourly Paid Emps.
of Johns Manville Corp. & Subsidiaries, 803 F.2d 109, 116 (3d Cir.
1986)) (“[T]he Plan itself is not a ‘plan administrator.’”).
Furthermore, as the parties concede, Liberty Life does not
meet the statutory definition of a “plan administrator.” The
summary

plan

description

unambiguously

identifies

Pension

Administration Committee (“PAC”) as the plan administrator, and
delegates the related responsibilities to UTC Benefits Center (Dkt.
No. 19-2 at 41). Pursuant to the plain language of 29 U.S.C.
§ 1002(16)(A), PAC is the plan administrator.
Figlioli relies on case law from outside the Fourth Circuit to
argue that the defendants are “defacto” plan administrators within
the meaning of ERISA. For instance, in Law v. Ernst & Young, the
First

Circuit

employer]

reasoned

acted

as

that

the

“[i]f,

plan

to

all

appearances,

administrator
8

in

respect

[the
to

FIGLIOLI V. LIBERTY LIFE, ET AL.

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
dissemination of information concerning plan benefits, it may
properly be treated as such for purposes of liability provided
under § 1132(c).” 956 F.2d 364, 373 (1st Cir. 1992). The Eighth
Circuit took a similar course in Rosen v. TRW, Inc., where it
concluded that, “if a company is administrating the plan, then it
can

be

held

liable

for

ERISA

violations,

regardless

of

the

provisions of the plan document.” 979 F.2d 191, 193-94 (11th Cir.
1992); see also Ctr. for Restorative Breast Surgery, LLC v. Humana
Health Benefit Plan, No. 10-4346, 2015 WL 4394034, at *19 (E.D. La.
July 15, 2015).
The Fourth Circuit has not adopted this approach to the
classification of plan administrators. In Coleman v. Nationwide
Life Ins. Co., 969 F.2d 54, 62 (4th Cir. 1992), it observed:
ERISA provides that if a plan administrator is not
designated in the written plan documents, then the plan
sponsor
is
the
plan
administrator.
29
U.S.C.
§ 1002(16)(A). The statute further indicates that the
plan sponsor is “the employer in the case of an employee
benefit plan established or maintained by a single
employer.” Id. § 1002(16)(B)(i). The written plan in this
case did not designate a plan administrator, but it did
indicate that Roofing Concepts was the plan sponsor.
Thus, by virtue of § 1002(16)(A), Roofing Concepts was
the plan administrator, and as such, it bore the primary
duty
of
notification
with
regard
to
the
plan
participants. Id. § 1024(b); see also 29 C.F.R.
§ 2509.75-8, FR 12-Q (1991) (plan administrator is also
a named fiduciary). While it is true that an insurer will
usually have administrative responsibilities with respect
to the review of claims under the policy, that does not
9

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
give this court license to ignore the statute's
definition of plan administrator and to impose on
Nationwide the plan administrator's notification duties.
Although in Coleman the court did not have to decide how to treat
insurers under § 1132(c), it did cite with favor cases that had
squarely addressed the question. See, e.g., Moran v. Aetna Life
Ins. Co., 872 F.2d 296, 298-300 (9th Cir. 1989) (holding that an
insurer cannot be liable under § 1132(c) because it does not fit
the statutory definition of a “plan administrator”); and Davis v.
Liberty Mut. Ins. Co., 871 F.2d 1134, 1138-39 & n.5 (D.C. Cir.
1989).
Other courts of appeals also have declined to impose liability
on insurers under § 1132. For instance, in Ross v. Rail Car Am.
Grp. Disability Income Plan, the Eighth Circuit reasoned:
The Summary Plan Description unambiguously identifies
Rail Car as the Plan Administrator. Canada Life admits
that it had control over claims under the policy, but
assuming that function did not transform it into the Plan
Administrator. ERISA specifically makes the Plan
Administrator responsible for providing the Plan
documents Ross requested, and the Summary Plan
Description directed that all requests for Plan documents
be made in writing to the Plan Administrator.
285 F.3d 735, 743-44 (8th Cir. 2002) (internal citation omitted).
District courts in the Fourth Circuit have followed this
reasoning. See, e.g., Flores v. Life Ins. Co. of N.A., 770 F. Supp.
2d 768 (D. Md. 2011) (declining to follow the “de facto” plan
10

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS’
MOTION FOR PARTIAL JUDGMENT ON THE PLEADINGS [DKT. NO. 18]
administrator approach in Rosen and Law given the Fourth Circuit’s
reasoning in Coleman); Frye v. Metropolitan Life Ins. Co., No.
3:10-0107, 2010 WL 5343287, at *13 (S.D.W.Va. Dec. 20, 2010).
Following the reasoning in Coleman, the Court declines to
adopt the “de facto” administrator approach and holds that neither
the Plan nor Liberty Life is a plan administrator subject to suit
under 29 U.S.C. § 1132(c).
V. CONCLUSION
For the reasons discussed, the Court GRANTS the defendants’
Motion for Partial Judgment on the Pleadings (Dkt. No. 18), GRANTS
judgment in favor of the defendants with regard to Count Two of
Figlioli’s complaint, and DISMISSES Count Two with PREJUDICE.
It is so ORDERED.
The Court DIRECTS the Clerk to transmit copies of this Order
to counsel of record and to enter a separate judgment order.
DATED: February 12, 2018.
/s/ Irene M. Keeley
IRENE M. KEELEY
UNITED STATES DISTRICT JUDGE

11