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Jette v. United of Omaha Life Insurance Co.

United States District Court, D. Massachusetts

July 11, 2019

KAREN JETTE, Plaintiff,
v.
UNITED OF OMAHA LIFE INSURANCE COMPANY, Defendant.

          ORDER ON PLAINTIFF'S MOTION TO DISMISS COUNTERCLAIM [DOCKET NO. 9]

          JENNIFER C. BOAL UNITED STATES MAGISTRATE JUDGE

         In this ERISA action, plaintiff Karen Jette seeks to recover long-term disability benefits from defendant United of Omaha Life Insurance Company (“United”). United has filed counterclaims against Jette, seeking to recover $15, 745.99 it allegedly overpaid to Jette due to her receipt of disability benefits under the Social Security Act. Jette has moved to dismiss United's counterclaims. Docket No. 9.[1] This Court heard oral argument on July 10, 2019. For the following reasons, this Court grants the motion without prejudice to United seeking leave to amend the answer to add counterclaims after limited discovery.

         I. FACTS [2]

         Jette seeks long-term disability (“LTD”) benefits under an employee welfare benefit plan sponsored and maintained by her former employer (the “Plan”). Counterclaim at ¶ 6. LTD benefits under the Plan were at all relevant times funded by a group disability insurance policy issued by United to Jette's former employer. Id. at ¶ 7. United served as the Claim Administrator of the Plan. Id. at ¶ 8.

         Jette applied for and received LTD benefits under the Plan. Id. at ¶ 9. The Plan defines the monthly LTD benefit, in part, as follows:

Total Disability
If you are Disabled and earning less than 20% of Your Basic Monthly Earnings, the Monthly Benefit while Disabled is the lesser of:
a) 60% of Your Basic Monthly Earnings, less Other Income Sources; or
b) the Maximum Monthly Benefit, less any Other Income Sources . . .

Id. at ¶ 10. The Plan defines “Other Income Sources, ” in part, as follows:

We take into account the total of all Your income from other sources of income in determining the amount of Your Monthly Benefit. Your Other Income Sources are any of the following amounts that You receive or are eligible to receive as a result of Your Disability or the Sickness and/or Injury that caused, in whole or in part, Your Disability: . . .
(e) Any benefits for You or Your Spouse and Dependent Child under: 1. the U.S. Social Security Act; . . .

Id. at ¶ 11. The Plan provides United the right to seek a refund from a Plan participant in the event of an overpayment:

Refund to Us
If it is found that We paid more benefits than We should have paid under the Policy, We have the right to a refund from You ...

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