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Briggs v. National Fire Union Insurance Co.

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

July 6, 2018

KAREN BRIGGS, individually and as personal representative of the ESTATE OF CHRISTOPHER A. NEUMANN, Plaintiff,
v.
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA, et al., Defendants.

          OPINION

          GORDON J. QUIST UNITED STATES DISTRICT JUDGE

         Plaintiff, Karen Briggs, sued Defendants alleging various claims under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1001 et seq. Briggs is the mother of decedent Christopher Neumann, as well as the personal representative of his estate, and a beneficiary of a group Accidental Death and Dismemberment (AD&D) policy that Neumann obtained through his employer, Weber Shandwick. Weber Shandwick is a subsidiary of Defendant Interpublic Group of Companies, Inc. (IPG). Briggs also sued the IPG Welfare Benefit Plan (the Plan) and National Union Fire Insurance Company of Pittsburgh (National Union), which provided the AD&D policy.

         On August 8, 2017, the Court issued an opinion and order regarding the Defendants' motions to dismiss. The Court granted the motions in part, dismissing Count II against IPG but not the Plan, Counts III and V against IPG and the Plan, and Count IV against National Union. (ECF No. 45.) The Court dismissed Briggs' claims for equitable relief because Briggs could not show that Defendants IPG and National Union misrepresented terms of the insurance plan. Briggs argued that the Benefits Guide was a misrepresentation because it failed to disclose terms that could defeat coverage, and that Neumann only received the Benefits Guide and no other documents regarding the Accidental Death and Dismemberment (AD&D) policy coverage. The Court rejected this argument because the Benefits Guide contains explicit language stating that it was not an official plan document or summary plan description. Briggs' remaining claims are as follows:

Count I against National Union: for benefits under 29 U.S.C. § 1132(a)(1)(B);
Count II against the Plan: for benefits under 29 U.S.C. § 1132(a)(1)(B);
Count IV against IPG: for civil penalties under 29 U.S.C. § 1132(c)(1)(B).

         Briggs and National Union filed motions for judgment on the administrative record (ECF Nos. 65 & 61), and IPG and the Plan filed a motion for summary judgment. (ECF No. 62.) The motions are fully briefed. On June 28, 2018, the Court heard oral argument on the parties' motions.

         DISCUSSION

         A) Claim for Benefits

         Briggs seeks benefits from either NUFIC or the Plan under 29 U.S.C. § 1132(a)(1)(B). It is undisputed that the benefits that Briggs seeks are expressly excluded by the AD&D policy. The Court previously held that “[n]o reasonable employee would be misled into believing that the Benefits Guide represented the terms and conditions of a policy when it explicitly states otherwise.” Briggs v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, No. 1:16-CV-1197, 2017 WL 3392765, at *4 (W.D. Mich. Aug. 8, 2017). National Union and the Plan's alleged failure to disclose the full policy provisions does not entitle Briggs to a substantive award for benefits. See, e.g., Lewandowski v. Occidental Chem. Corp., 986 F.2d 1006, 1009 (6th Cir.1993); Schornhorst v. Ford Motor Co., 606 F.Supp.2d 658, 668 (E.D. Mich. 2009). Therefore, even under de novo review[1], Briggs' claim for benefits is untenable. Briggs has not shown that the Benefits Guide should serve as the operative insurance plan.

         The Sixth Circuit's recent decision in Pearce v. Chrysler Group LLC Pension Plan, ---F.3d ---, 615 Fed.Appx. 342 (6th Cir. June 20, 2018), is unavailing. The instant facts are distinguishable from those in Pearce-the plaintiff in Pearce chose to reject a buy-out offer due to his reliance on the Summary Plan Description (SPD) plus conversations he had with Chrysler personnel, only to be denied benefits he thought he was entitled. Furthermore, Pearce's claim went forward to determine whether he was entitled to equitable relief pursuant to 29 U.S.C. § 1132(a)(3). Here, Briggs did not rely upon the Benefits Guide in making a choice as in Pearce- her son, Christopher Neumann, died, and she is seeking benefits. Briggs has not presented any admissible evidence that her son would not have purchased the AD&D policy if he knew it excluded death benefits when the death occurs from the crash of a private airplane.. In the absence of any admissible evidence as to what the deceased, Neumann, said was on his mind when he purchased the policy, Briggs' testimony, and any statements about the decedent's thoughts, intentions, and decisions regarding the AD&D policy are speculative.

         The Supreme Court has also emphasized looking to the plan itself, not summary plan descriptions-making summaries enforceable “might bring about complexity that would defeat the fundamental purpose of the summaries, ” i.e., to provide clear, simple, comprehensible, and general descriptions of a plan. CIGNA Corp. v. Amara, 563 U.S. 421, 436-38, 131 S.Ct. 1866, 1877-78 (2011); see also Pearce, 615 Fed.Appx. at 346 (applying the explicit terms of the plan for claim under ERISA § 502(a)(1)(b), and citing CIGNA, 563 U.S. at 438, 131 S.Ct. at 1878).

         In Candeub v. Blue Cross Blue Shield of Michigan, 577 F.Supp.2d 918 (W.D. Mich. 2006), another judge in this district observed that “[t]he massive weight of authority, then, is that insurance booklets do not qualify as SPDs, unless they contain all or substantially all of the required information under the statute and regulation.” Id. at 931. Magistrate Judge Scoville rejected the plaintiff's argument that a benefits guide, similar to the Benefits Guide at issue here, qualified as a controlling SPD. The reasoning in Candeub is persuasive, and the Benefits Guide is not controlling.[2]

         B) ...


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