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Butler v. FCA US, LLC

United States District Court, E.D. Michigan, Southern Division

November 14, 2016

John Butler, an individual, Plaintiff,
v.
FCA US, LLC, a Delaware limited liability company, Defendant.

          OPINION & ORDER

          SEAN F. COX UNITED STATES DISTRICT JUDGE.

         This is an ERISA[1] benefits case. Plaintiff John Butler (“Plaintiff” or “Butler”) alleges, in Count I, that Defendant FCA US, LLC[2] (“Defendant” or “FCA”) wrongfully denied his claim for benefits after he was seriously injured in an automobile accident. He also claims that FCA should be equitably estopped from denying his claim for benefits (in Count III) and that FCA failed to provide him with requested plan documents, in violation of the statute (in Count IV). The matter is currently before the Court on: 1) FCA's Motion for Summary, that seeks summary judgment in its favor as to all three remaining counts; and 2) Plaintiff's Motion for Partial Summary Judgment, which seeks summary judgment in his favor as to Counts I and IV (but not Count III). The parties have fully briefed the issues. The Court finds that oral argument would not aid the decisional process. See Local Rule 7.1(f)(2), U.S. District Court, Eastern District of Michigan. The Court therefore orders that the motions will be decided upon the briefs. For the reasons that follow, the Court shall DENY Plaintiff's Motion for Partial Summary Judgment and GRANT Defendant's Motion for Summary Judgment.

         BACKGROUND

         On December 16, 2014, Butler filed this action against FCA, asserting the following claims: 1) “Claim for Benefits Pursuant to 29 U.S.C. § 1132(a)(1)(B)” (Count I); 2) “Claim for Failure to Provide Notice of Deletion of Benefits to 29 U.S.C. § 1132(a)(1)(B)” (Count II); 3) “Claim for Equitable Estoppel 29 U.S.C. § 1132(a)(3)(B)” (Count III); and 4) “Claim for Failure to Provide Documents Pursuant to 29 U.S.C. § 1024(b)(4)” (Count IV). (D.E. No. 1, Pl.'s original complaint).

         On February 17, 2015, FCA filed a Motion to Dismiss (D.E. No. 4). In its Motion to Dismiss, FCA argued “that all of Plaintiff's claims in this case are barred by the doctrine of res judicata, which is also known as claim preclusion.” (Id. at 5). In the alternative, FCA argued that Counts II and IV should be dismissed because they each fail to state a claim upon which relief may be granted. (Id.)

         This Court granted FCA's Motion to Dismiss in part and denied it in part. The Court granted the motion to the extent that it dismissed Count II (“Claim for Failure to Provide Notice of Deletion of Benefits to 29 U.S.C. § 1132(a)(1)(B)”). (Id. at 14-15 & 17).

         The Court denied the motion with respect to FCA's challenge to Count IV, allowing that count to proceed. (Id. at 15-17).

         Finally, the Court denied without prejudice “Defendant's motion to dismiss the entire Complaint based on the affirmative defense of res judicata.” (Id.). In the body of the Opinion & Order, the Court stated that “[i]f Defendant believes that it can better support its res judicata defense at the summary judgment stage, Defendant may raise it again at that time.” (Id. at 12).

         FCA filed its Answer and Affirmative Defenses on August 26, 2015. (D.E. No. 19). FCA filed its First Amended Answer and Affirmative Defenses on September 16, 2015. (D.E. No. 22).

         On November 2, 2015, this Court issued the Scheduling Order (D.E. No. 23) that includes a March 1, 2016 deadline for discovery, a motion-filing deadline of April 1, 2016, a Final Pretrial Conference of August 29, 2016, and set the trial for September/October 2016.

         On or about November 13, 2015, Plaintiff received MetLife's response to a subpoena for records and that response consisted of MetLife's claim file regarding Plaintiff's claim for disability benefits resulting from his accident and the 2007 Chrysler LLC Summary Plan Description.

         On December 7, 2015, the parties stipulated to Plaintiff withdrawing his jury demand.

         On March 9, 2016, Plaintiff filed a Motion for Leave to File First Amended Complaint (D.E. No. 38), which this Court denied in a May 17, 2016 Opinion & Order. (D.E. No. 44).

         Accordingly, at this stage of the litigation, the following three counts remain pending in this action: Count I: “Claim for Benefits Pursuant to 29 U.S.C. § 1132(a)(1)(B), ” Count III: “Claim for Equitable Estoppel 29 U.S.C. § 1132(a)(3)(B), ” and Count IV: “Claim for Failure to Provide Documents Pursuant to 29 U.S.C. § 1024(b)(4).” Following the close of discovery, Plaintiff and FCA each filed a dispositive motion. FCA filed a motion “To Dismiss Count I and for Summary Judgment on Counts I, III and IV.” (D.E. No. 46). Plaintiff filed a “Motion for Summary Judgment of Count I and Count IV” of his Complaint. (D.E. No. 54).

         This Court's practice guidelines, which are expressly included in the Scheduling Order issued in this case, provide, consistent with Fed.R.Civ.P. 56 (c) and (e), that:

a. The moving party's papers shall include a separate document entitled Statement of Material Facts Not in Dispute. The statement shall list in separately numbered paragraphs concise statements of each undisputed material fact, supported by appropriate citations to the record. . .
b. In response, the opposing party shall file a separate document entitled Counter-Statement of Disputed Facts. The counter-statement shall list in separately numbered paragraphs following the order or the movant's statement, whether each of the facts asserted by the moving party is admitted or denied and shall also be supported by appropriate citations to the record. The Counter-Statement shall also include, in a separate section, a list of each issue of material fact as to which it is contended there is a genuine issue for trial.
c. All material facts as set forth in the Statement of Material Facts Not in Dispute shall be deemed admitted unless controverted in the Counter-Statement of Disputed Facts.

(Docket Entry No. 30 at 2-3).

         In compliance with this Court's guidelines, in support of its Motion, Defendant FCA filed a “Statement of Material Facts Not In Dispute” (D.E. No. 49) (“Defs.' Stmt. A). In response to that submission, Plaintiff filed a “Counter-Statement of Disputed Facts” (D.E. No. 54 at Pg ID 2682-2688) (Pl.'s Stmt. A”). In support of his Motion, Plaintiff filed a “Statement of Material Facts Not In Dispute” (D.E. No. 49) (“Pl.'s Stmt. B). In response to that submission, FCA filed a “Counter-Statement of Disputed Facts” (D.E. No. 53) (Def.'s Stmt. B”).

         Plaintiff worked for Chrysler LLC and it predecessor entities from 1967 until his retirement effective May 31, 2011.

         The 2002 SPD

         In 2002, Plaintiff was a participant in Chrysler LLC's Voluntary Group Accident Insurance (“VGAI”) Program. (Pl.'s & Def.'s Stmt. B at ¶ 2). Plaintiff's copy of the 2002 Summary Plan Description (“SPD”) for the VGAI is attached to Plaintiff's Complaint. (D.E. No. 1-3 at Pg ID 17). On the front page of that SPD, either Plaintiff or his wife wrote “Old Book - Life & Disability.” (Id.; Pl.'s Dep. at 30-32). It is undisputed that the 2002 SPD included a “Permanent Total Disability” (“PTD”) Benefit . (See D.E. No. 1-3 at Pg ID 23 & 63). That benefit was described as follows in the 2002 SPD:

         Permanent Total Disability Benefit (Employee Only)

         A permanent total disability benefit is payable provided:

• You sustain a covered accidental injury while insured.
• You are under age 70 when the injury occurs.
• You become permanently and totally disabled as a result of that injury within 180 days of the date of the accident so as to be unable to perform every duty of your occupation during the first year of disability, and thereafter be unable to engage in any occupation for the remainder of your life for which you are reasonably qualified by education, training, or experience.
• The disability has existed continuously for more than one year from the date you became permanently and totally disabled.
The full benefit amount for which you are insured on the date of your injury is payable to you less any amount paid or payable as a Voluntary Group Accident benefit because of a loss sustained as a result of your accident.

(Id. at Pg ID 63).

         The 2004 SMM

         In January of 2004, Plaintiff received a “Summary of Material Modifications (SMM)” for the VGAI Program. (Ex. B to Pl.'s Motion). It is undisputed that in the 2004 SMM, the VGAI Program still included a PTD Benefit. (Pl.'s & Def.'s Stmt. B at ¶ 5).

         The 2007 SPD

         In September of 2007, Plaintiff received a 2007 SPD. (Pl.'s & Def.'s Stmt. B at ¶ 6). Plaintiff's copy of the 2007 SPD he received is attached as Exhibit D to his motion. On the cover page of that document, there is handwriting that says “New Book - No Mention of Permanent Total Disability Benefit. Should Be in Policy?”

         FCA asserts in its Statement that the 2007 SPD did not include a PTD Benefit. Plaintiff denies that, but does not direct the Court to anywhere in that SPD where a PTD Benefit is listed. (Def.'s & Pl.'s Stmt. A at ¶ 9; D.E. No. 1-5).

         This Court has reviewed the 2007 SPD. Unlike the 2002 SPD, the 2007 SPD does not contain a PTD Benefit, in either the table of contents or the body of the SPD where the benefits are spelled out. The 2007 SPD lists the various benefits that are included in the VGAI Program (a Paralysis Benefit, Comotose Benefit, Education Benefit, Child Care Benefit, Repatriation of Remains Benefit, Common Disaster Benefit, Seat Belt and Air Bag Benefit, Traumatic Brain Injury Benefit, Exposure and Disappearance Benefit, etc.) But there is no PTD Benefit listed.

         The only place in the 2007 SPD that Plaintiff points to is a reference in the following paragraph:

Special Tax Considerations
Certain benefits, such as the Total Permanent Disability Benefit and the Special Education Benefit, may be taxable as ordinary income in the year in which you or your beneficiary receives the benefit. You or your beneficiary should consult with your tax advisor regarding the tax consequences of any benefits received.

(D.E. No. 45-5 at Pg ID 1857).

         The 2007 SPD identified Chrysler as both the Plan Sponsor and the Plan Administrator and listed its address its address as 1000 Chrysler Drive Auburn Hills, MI 48326-2766. (D.E. No. 1-5 at Pg ID 234; Def.'s and Pl.'s Stmt. A at ¶ 12).

         The parties agree that the 2007 SPD specifically advised participants to file their claim and any appeal with the insurance carrier, which was MetLife at the time of Plaintiff's accident.[3](Compl. at Pg ID 3, “MetLife was the insurer, ” D.E. No. 46 at Pg ID 2230; D.E. No. 54 at Pg ID 2706; D.E. No. 1-5 at Pg ID 223-24).

         The claims procedure is described in the 2007 SPD and states that determinations will be made by the insurance carrier. (Def.'s & Pl.'s Stmt. A at ¶ 15; D.E. No. 1-5 at Pg ID 224). The 2007 SPD advises participants of their rights under ERISA and advises that copies of plan documents can be obtained from the plan administrator, upon written request. (Def.'s & Pl.'s Stmt. A at ¶ 16; D.E. No. 1-5 at Pg ID 238).

         Attached to Defendant's Motion as Exhibit F is the actual MetLife Certificate Of Insurance that was issued on March 1, 2008 for the program. It lists the various benefits that were included under the policy. It does not include a PTD Benefit. (Id.; Def.'s & Pl.'s Stmt. A at ¶ 11; White Dep. at 42; White Affidavit). The MetLife Certificate describes how to file a claim for benefits and defines “We, Us, and Our to mean MetLife.” (Id. at ¶¶ 17 & 18).

         Plaintiff Has An Accident On July 8, 2008

         On July 8, 2008, Plaintiff was involved in an automobile accident and suffered a closed head injury. (Def.'s & Pl.'s Stmt. A at ¶ 35).

         It is undisputed that the Summary Plan Description (“SPD”) issued September 2007, attached to Plaintiff's Complaint as Exhibit D, is applicable to Plaintiff based on his July 8, 2008 automobile accident. (Def.'s & Pl.'s Stmt. A at ¶ 8; D.E. No. 1-5).

         Plaintiff's Claims Processing History And Requests ...


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