United States District Court, D. Massachusetts
ORDER ADOPTING REPORT AND RECOMMENDATION
GEORGE A. O'TOOLE, Jr., District Judge.
The magistrate judge to whom this matter was referred has recommended that Metropolitan Life Insurance Company's ("MetLife") motion for summary judgment be granted and that Southboro Medical Group, Inc.'s ("SMG") motion for summary judgment be denied. The plaintiff and SMG have since filed objections to the Report and Recommendation ("R&R").
I. Lynn Brenner's Objections
Brenner contends that the R&R erred in disregarding substantial evidence of MetLife's involvement in decisions regarding her husband's insurance. However, the R&R acknowledges these materials and concludes that the only evidence Brenner has presented as to communications between broker Robert Muenzberg and SMG's Director of Human Resources Kathryn Tomashunas is inadmissible hearsay. See Kenney v. Floyd , 700 F.3d 604, 609 (1st Cir. 2012) (explaining that hearsay evidence cannot be considered for the truth of the matter asserted at summary judgment). In her objection, Brenner argues for the first time that this evidence is not being offered for its truth, but to show the fact of MetLife's involvement in these decisions. Brenner did not present this argument in her opposition (when she had a full opportunity to rebut MetLife's hearsay claims), and an objection to an R&R is not the proper venue to present new legal arguments. Paterson-Leicht Co., Inc. v. Massachusetts Mun. Wholesale Elec. Co. , 840 F.2d 985, 990-91 (1st Cir. 1988) ("[Rule 72(b)] does not permit a litigant to present new initiatives to the district judge.").
Brenner also argues that the magistrate judge erred in concluding that MetLife was not required to send conversion notice. The magistrate judge provided a detailed and careful discussion of the relevant provisions of the SMG plan and pertinent case law, and I agree with that analysis.
II. SMG's Objections
SMG contends that the magistrate judge relies too heavily on emails exchanged between the plaintiff and Tomashunas. Specifically, SMG argues that these communications do not demonstrate that Tomashunas (and therefore SMG) had an affirmative duty to inform the plaintiff of issues regarding Mr. Brenner's life insurance coverage.
In Watson v. Deaconess Waltham Hosp. , 298 F.3d 102 (1st Cir. 2002), the First Circuit explained that an ERISA fiduciary has an affirmative duty to convey material information about a plan to beneficiaries when there is "some particular reason that the fiduciary should have known that his failure to convey the information would be harmful." Id. at 114-15. I agree with the magistrate judge's analysis that the communications could support a finding of an affirmative duty in this case. In her emails, the plaintiff repeatedly sought information regarding her husband's various insurance plans, at one point inquiring as to the monthly payout for his life insurance. (Emails, Ex. C at 6 (dkt. no. 58-3).) The emails repeatedly touch on the gravity of Mr. Brenner's medical condition, with the plaintiff informing Tomashunas that her husband "still cannot talk or write" and remained in the intensive care unit. (Id. at 2, 5.) At the very least, these communications raise a genuine issue of material fact as to whether Tomashunas owed such a duty to the plaintiff, which is all that is necessary to survive summary judgment.
Having reviewed the relevant pleadings and submissions, as well as the objections to the R&R, I approve and ADOPT the magistrate judge's recommendation in its entirety.
Accordingly, SMG's Motion for Summary Judgment (dkt. no. 50) is DENIED and MetLife's Motion for Summary Judgment (dkt. no. 52) is GRANTED.
It is SO ORDERED.
REPORT AND RECOMMENDATION ON MOTIONS FOR SUMMARY JUDGMENT (#50, #52).
Plaintiff Lynn Brenner brought this action against Defendants Metropolitan Life Insurance Company ("MetLife") and Southboro Medical Group, Inc. ("SMG") for damages arising out of a life insurance plan that was issued to her husband, Alan Brenner. The only count at issue here is Count VI of the amended complaint, a claim for equitable relief for breach of fiduciary duties under § 502(a)(3) of the Employment Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1132(a)(3). Defendants filed motions for summary judgment (SMG's motion, #50; MetLife's motion, #52); Plaintiff responded in opposition (#56, #59); and MetLife filed a reply (#62). For the reasons that follow, I recommend that MetLife's motion for summary judgment be ALLOWED, and that SMG's motion for summary judgment be DENIED.
Except where otherwise noted, the parties have agreed on the following facts. In June 2004, Dr. Alan Brenner, a rheumatologist, was hired by Southboro Medical Group. (#54 at 1.) Dr. Brenner participated in an employee benefit plan administered by SMG that provided group life insurance coverage. (Id. ) The plan is an "employee welfare benefit plan" as defined by ERISA. (#53-2 at 54-59.) Dr. Brenner named his wife, Lynn Brenner, as beneficiary of the policy. (Id. at 2.) MetLife provided the life insurance; SMG paid premiums to MetLife on behalf of its employees on a monthly basis. (Id. at 2-3.)
When MetLife issued the policy, it granted SMG access to an online administrative manual and provided copies of documents for SMG to distribute to plan participants. (#54 at 2.) According to SMG, these documents, (called the "Plan Documents" or "the SMG Plan"), included the MetLife Certificate of Insurance, which contains the terms and provisions of the group policy, and information relevant to ERISA. ( See #55 at 1.) Defendants claim that SMG provided Dr. Brenner and his wife with the Plan Documents on multiple occasions. (#54 at 2; #55 at 3, 5.) Plaintiff asserts that there are substantial issues of fact about whether Dr. Brenner or Lynn Brenner ever received copies of these documents. (#58 at 2, 3; #61 at 5, 7-8.) Plaintiff further asserts that even if Dr. Brenner was provided with the documents, from the time he became sick until his death, he was "medically incapable of reviewing the SMG Plan even if it was in his possession, " and that SMG was aware of his condition. (#58 at 2.)
The Plan Documents provide that, in order to remain eligible for coverage under the policy, an employee must be actively at work, that is, performing all usual duties of his job on a full-time basis, which is defined as thirty or more hours per week. (#54 at 3.) A plan participant's coverage may end on the last day of the month in which he ceases active work, or, a participant's life insurance policy may remain in effect for nine months after he ceases active work if (i) he stopped work because of an injury, illness, or disease, and (ii) SMG continues to pay premiums for the coverage. (Id. at 3-4.) The administrative manual provides that if there are changes in an employee's status that may affect his life insurance coverage, it is SMG's responsibility to inform MetLife by completing a form. (Id. at 3.)
The Plan Documents provide for a "Conversion Option, " allowing a qualified plan participant to convert to an individual policy upon the expiration of his participation in the group policy. (Id. at 4.) A participant in group coverage must submit an application if he wishes to convert to an individual policy. (Id. ) The application period cannot exceed 91 days from the date that the group insurance ends. (Id. at 5.)
In 2009, Dr. Brenner began suffering from Guillain-Barre Syndrome, "a neurological autoimmune disease" that left him "paralyzed, unresponsive, and unable to speak or write." (#57 at 2.) As a result of his illness, Dr. Brenner stopped working in March 2009. (#54 at 5.) Because he stopped working due to illness and SMG continued to pay premiums, his life insurance coverage was continued for an additional nine months, through December 31, 2009. (Id. at 6.) As Dr. Brenner never submitted an application for the Conversion Option, his employee-sponsored life insurance coverage ended after December 31, 2009, nine months after he ceased active employment. (Id. )
Dr. Brenner never returned to work. (Id. ) Lynn Brenner claims that neither he nor she was informed that the group policy coverage would end on December 31, 2009, nor did they ever receive notice of the right to convert to an individual policy. (Amended Complaint, #16 at 4.) She alleges, however, that from the outset of her husband's illness, she regularly informed Kathryn Tomashunas, SMG's Human Resources Director, about Dr. Brenner's condition and made inquiries about the status of his benefits. (#60 at 2-4, 7.) For instance, in May, 2009, she emailed Tomashunas to ask if her checks for benefits were being received and "to be sure everything is still in place." (#58 at 7.) Tomashunas reponded by asking Jaimee Lazano, a benefits coordinator who worked under her, to "confirm with Lynn Brenner that we have our check and everything is ok." (Id. )
Plaintiff also claims that, without her knowledge, in August 2009, Tomashunas checked with the SMG insurance broker, Robert Muenzburg, to get "advice about the best way to proceed" with Dr. Brenner's life insurance. (#60 at 2-3; see Tomashunas Deposition, #58-1, at 21, 67.) Tomashunas's purpose in speaking to Muenzberg was to ensure that Dr. Brenner would remain covered under his life insurance policy. (#58 at 8.) Plaintiff states that, based on those conversations, Tomashunas "decided to keep [Dr. Brenner] on the SMG Plan and continue paying his benefits." (#60 at 2-3.)
Tomashunas testified at a deposition that she knew that Dr. Brenner could convert to an individual policy, but she decided not to send the conversion notice or otherwise pursue conversion because she felt that it might be too expensive for him to do so. (#58 at 10.) Tomashunas and Lozano believed that Dr. Brenner would continue to be covered under the policy as long as SMG continued to "keep him on the SMG Plan, " and did not ...