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DOE v. CIGNA LIFE INSURANCE CO. OF NEW YORK

January 26, 2004.

JOHN DOE, Plaintiff
v.
CIGNA LIFE INSURANCE CO. OF NEW YORK and LIBERTY LIFE ASSURANCE CO. OF BOSTON, Defendants



The opinion of the court was delivered by: WILLIAM SKRETNY, District Judge

DECISION & ORDER

I. INTRODUCTION

In this case, Plaintiff John Doe seeks to recover long-term disability benefits from Defendants Cigna Life Insurance Company of New York ("Cigna") and Liberty Life Assurance Company of Boston ("Liberty") pursuant to § 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974 ("ERISA"). In addition, Plaintiff claims that he is entitled to equitable relief pursuant to ERISA § 502(a)(3) because Liberty breached its fiduciary duty. Currently before this Court is Liberty's Motion for Summary Judgment.*fn1

  II. BACKGROUND

 A. Facts

  The facts of this case, which are undisputed for purposes of the instant motion, may be summarized as follows.*fn2 In July of 1998, Plaintiff began working as an attorney at Page 2 Harris, Beach, & Wilcox ("Harris Beach"), a law firm located in Rochester, New York. (Liberty's Rule 56 Statement, ¶ 1). Plaintiff was eventually promoted to partner. Id.

  Defendant Liberty is an insurance company licensed to do business in the State of New York. (Amended Complaint, ¶ 3). In 1995, Liberty issued a Group Disability Income Policy (the "Policy") to Harris Beach. (Liberty's Rule 56 Statement, ¶ 2). The Policy, which became effective on July 1, 1995, provided long-term disability benefits to certain eligible classes of Harris Beach employees, including partners. Id. at ¶¶ 2-3.

  On August 14, 1997, Plaintiff was hospitalized for three weeks after contracting encephalitis and spinal meningitis. (Plaintiff's Memorandum of Law, p. 1). Except for a brief period in September, Plaintiff was absent from work as a result of his illness until December of 1997. (Liberty's Rule 56 Statement, ¶ 16).

  On October 31, 1997, Susan Dearstyne, Harris Beach's administrative manager, composed and mailed a letter to Liberty (the "Dearstyne Letter").*fn3 Id. at 17. In her letter, Ms. Dearstyne stated that she wanted to provide Liberty with "preliminary notice of a disability claim which may be made on behalf of one of [Harris Beach's] partners." (Dearstyne Letter, at LL-00048, attached as Exhibit C to Affidavit of Paula McGee). The letter did not identify the partner or describe the nature of his illness, but advised that Ms. Dearstyne would provide Liberty with additional information if the situation progressed. Id.

  After returning to work in December of 1997, Plaintiff continued to practice law at Harris Beach until July 31, 1998, when he joined the law firm of Trevett, Lenweaver, & Page 3 Salzer, P.C. ("Trevett").*fn4 (Liberty's Rule 56 Statement, ¶ 29-30).

  On June 22, 2000, Plaintiff submitted a Disability Claim Form to Liberty. Id. at 15. Plaintiff claimed that he was entitled to long-term disability benefits under the terms of the Policy because he had suffered "encephalitis and spinal meningitis resulting in permanent brain damage" while employed at Harris Beach. (Disability Claim Form, at LL-00047, attached as Exhibit C to McGee Affidavit). After reviewing the claim, Liberty determined that Plaintiff had not provided timely notice of his claim as required under the Policy. (Liberty's Rule 56 Statement, ¶ 23). Thereafter, Liberty informed Plaintiff that his claim was denied. (Notice of Rejection of Claim, at LL-00044, attached as Exhibit E to McGee Affidavit).

 B. Procedural History

  Plaintiff commenced this action on October 24, 2000, by filing a Summons and Complaint in the New York State Supreme Court, Monroe County. Defendant Liberty removed the case to the United States District Court for the Western District of New York on November 27, 2000.*fn5

  On April 26, 2002, Defendant Libertyfiled a Motion for Summary Judgment pursuant to Rule 56 of the Federal Rules of Civil Procedure.*fn6 Thereafter, this Court referred this Page 4 matter to the Honorable Leslie G. Foschio, United States Magistrate Judge, to hear Liberty's summary judgment motion and issue a Report and Recommendation.

  Judge Foschio filed a Report and Recommendation on September 11, 2003, recommending that Liberty's motion be granted in all respects. On October 8, 2003, Plaintiff filed Objections to the Report and Recommendation.*fn7 This Court heard oral ...


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