United States District Court, E.D. Michigan, Southern Division
ANGELA J. FIELDS, Plaintiff,
PIERRE OCTAVIUS ASHFORD, et al., Defendants.
ORDER GRANTING LIFE INSURANCE COMPANY OF NORTH
AMERICA'S MOTION FOR SUMMARY JUDGMENT (ECF #32)
MATTHEW F. LEITMAN UNITED STATES DISTRICT JUDGE.
action arises of an automobile accident between Plaintiff
Angela Fields (“Fields”) and Defendant Pierre
Octavius Ashford. In her Complaint, Fields asserts one claim
(Count V) against Defendant Cigna Life and Health Insurance
Company (“Cigna”) for failing to pay benefits
under her long-term disability policy (the
“Policy”) after she suffered injuries in the
automobile accident with Ashford. (See Compl. at
¶¶ 37-44, ECF #1 at Pg. ID 19-20.)
did not file an Answer to the Complaint. Instead, Life
Insurance Company of North America (“LINA”) filed
an Answer addressing the claim in Count V. (See LINA
Ans., ECF #5.) LINA explained that it was filing the Answer
because it issued the long-term disability policy in question
and Cigna did not. (See Id. at Pg. ID 38.)
has now filed a motion for summary judgment on its own behalf
and on behalf of Cigna. (See Mot. for Summ. J., ECF
#32.) LINA argues that it is entitled to summary judgment on
two independent bases: (1) there is no case or controversy
because it has paid all benefits to which Fields is entitled
and (2) Fields' claim is deficient because she failed to
exhaust her administrative remedies under the Policy before
filing suit. (See id.) For the reasons stated below,
the Court GRANTS LINA's motion for
summary judgment because Fields did not exhaust her
administrative remedies under the Policy before filing suit.
25, 2016, a vehicle driven by Ashford and a vehicle driven by
Fields were involved in an automobile accident. (See
Compl. at ¶¶ 11-12, ECF #1 at Pg. ID 11.) Fields
allegedly sustained injuries as a result of the collision.
(See Id. at ¶15, Pg. ID 12.)
time of the accident, Fields had long term disability
insurance coverage through LINA. (See Policy, ECF
#36 at Pg. ID 278-309.) After the Policy's required
90-day waiting period, LINA began paying Fields long-term
disability benefits under the Policy. (See Decl. of
Lisa Mekkelsen (“Mekkelsen Decl.”) at ¶4,
ECF #32-1 at Pg. ID 255.) LINA never made a formal decision
to finally deny any claim for benefits by Fields, and Fields
never filed any administrative appeal of any decision
affecting her right to benefits. (See Id. at
¶6, Pg. ID 256.)
LINA never denied a claim for benefits by Fields, it did
withhold certain amounts from some of her benefits payments.
(See ECF #36 at Pg. ID 335.) It did so based upon
its erroneous belief that it was entitled to deduct from
Fields' benefit amounts paid by other insurers. (See
id.; Resp. to Mot for Summ. J., ECF #36 at Pg. ID 271.)
LINA ultimately rectified its error by making an $8, 000
payment to Fields after she filed this action. (See
ECF #36 at Pg. ID 334-35.) Fields does not appear to argue
that LINA is currently delinquent in the payment of any
benefits owing under the Policy. However, Fields does contend
that LINA owes her interest for the period during which it
wrongly withheld the $8, 000 in benefits. (See Resp.
to Mot. for Summ. J., ECF #36 at Pg. ID 272.)
movant is entitled to summary judgment when it “shows
that there is no genuine dispute as to any material fact . .
. .” SEC v. Sierra Brokerage Servs., Inc., 712
F.3d 321, 326-27 (6th Cir. 2013) (citing Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 251-52 (1986))
(quotations omitted). When reviewing the record, “the
court must view the evidence in the light most favorable to
the non-moving party and draw all reasonable inferences in
its favor.” Id. “The mere existence of a
scintilla of evidence in support of the [non-moving
party's] position will be insufficient; there must be
evidence on which the jury could reasonably find for [that
party].” Anderson, 477 U.S. at 252. Summary
judgment is not appropriate when “the evidence presents
a sufficient disagreement to require submission to a
jury.” Id. at 251-52. Indeed,
“[c]redibility determinations, the weighing of the
evidence and the drafting of legitimate inferences from the
facts are jury functions, not those of a judge . . . .”
Id. at 255.
first argues that there is no case or controversy with
respect to Fields' claim in Count V because Fields
“has already received-and is continuing to receive-all
of the relief she is seeking” in that count. (Mot. for
Summ. J., ECF #32 at Pg. ID 252.) The Court disagrees. As
noted above, Fields is seeking interest on the erroneously
withheld benefits. The remaining claim for interest is thus a
live issue that satisfies the constitutional requirement of a
case or controversy. See, e.g., Templin v.
Indep. Blue Cross, 487 Fed.Appx. 6, 11 (3d Cir. 2012)
(“Dismissal of the claims as moot without considering
the plaintiffs' entitlement to interest was error.
Voluntary payment of ...