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Colon v. Guthrie Clinic

March 7, 2008

DEBBIE COLON, PLAINTIFF,
v.
GUTHRIE CLINIC, LTD. AND UNUMPROVIDENT, DEFENDANTS.



The opinion of the court was delivered by: Michael A. Telesca United States District Judge

DECISION and ORDER

INTRODUCTION

Plaintiff Debbie Colon, ("Colon") originally brought this action in New York State Supreme Court against defendants Guthrie Clinic, Ltd. and UNUM Life Insurance Company of America (incorrectly sued as "Unumprovident") claiming that the defendants failed to honor a change in her deceased husband's life insurance policy that would have provided her with increased benefits upon the death of her late husband George Colon, Jr., ("Mr. Colon"). Specifically, the plaintiff alleges that she and her late husband, who was an employee of the Guthrie Clinic, met with a human resources representative of the Clinic on or about November 4, 2004, and altered his existing life insurance policy to increase his death benefit. Shortly thereafter, on January 1, 2005, Mr. Colon passed away. According to the plaintiff, however, she did not receive the enhanced death benefit. Plaintiff also seeks a declaration that she is entitled to half of Mr. Colon's pension benefits.

On October 24, 2006, the defendants removed this action to Federal Court on grounds that the insurance policy at issue is governed by the Employee Retirement Income and Security Act of 1974 ("ERISA"). Defendant UNUM Life Insurance Company of America ("UNUM") now moves for summary judgment against the plaintiff on grounds that plaintiff has failed to establish any violation of ERISA, and is not entitled to increased benefits under the life insurance policy. Defendant Guthrie Clinic moves to dismiss plaintiff's First Cause of Action relating to the life insurance policy on grounds that plaintiff has failed to state a cause of action upon which relief may be granted. Specifically, both defendants contend that because Mr. Colon was neither an active employee of the Guthrie Clinic at the time he attempted to change his policy, nor at the time he passed away, under the express terms of the policy, the proposed change in his coverage never wentr into effect. Plaintiff opposes the defendants' motions, and seeks remand of this action to state court.

For the reasons set forth below, I grant the defendants' motions to dismiss and for summary judgment, and dismiss plaintiff's Complaint with prejudice in its entirety against UNUM, and dismiss with prejudice plaintiff's First Cause of Action against defendant Guthrie Clinic.

BACKGROUND

Plaintiff Debbie Colon is the widow of George Colon, Jr., who passed away on January 1, 2005. Prior to his death, Mr. Colon had been an employee of the Guthrie Clinic in Sayre, Pennsylvania, working as a maintenance technician. Mr. Colon participated in a group life insurance plan offered by the Guthrie Clinic and underwritten by UNUM. (hereinafter the "plan" or "policy"). Pursuant to the terms of his policy, plaintiff (as beneficiary of Mr. Colon's policy) was entitled to a death benefit of $50,000.

Prior to September 10, 2004, Mr. Colon was diagnosed with liver cancer. On September 11, 2004, Mr. Colon began short-term disability leave, and as a result, was no longer considered (for purposes of the life insurance policy) an active employee of the Clinic. On or about November 4, 2004, the plaintiff and Mr. Colon met with Mary King, ("King") a human resources representative of the Guthrie Clinic.*fn1 At that meeting, Mr. and Mrs. Colon expressed an interest in amending Mr. Colon's life insurance policy to increase his death benefit from $50,000 to $108,000, which was approximately three-times the amount of his annual salary. According to the plaintiff, King assured the Colons that notwithstanding express language written on the amendment form that Mr. Colon signed which stated that the increased coverage would not go into effect until after he resumed employment, the change to the policy was valid, and would become effective on January 1, 2005.

On January 1, 2005, Mr. Colon passed away. On January 19, 2005, Mrs. Colon received a death benefit from UNUM in the amount of $50,000, plus interest. Plaintiff contends that based on the change to the policy made in November, 2004, she was entitled to $108,000 plus interest. She claims that when she attempted to collect these benefits, she was informed by UNUM that under the express terms of the policy, the purported changes to Mr. Colon's policy were not effective because Mr. Colon was not an active employee at the time the changes were made, nor was he an active employee at the time he passed away. Following the denial of plaintiff's request for increased benefits, plaintiff brought the instant action in New York State Supreme Court, Stueben County. The action was thereafter removed to this court.

DISCUSSION

I. Summary Judgment and Motion to Dismiss Standards

Summary judgment is proper when "there is no genuine issue as to any material fact and...the moving party is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(c). In evaluating a motion for summary judgment, courts must draw all reasonable inferences in favor of the non-movant. See, generally, Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 255 (1986).

Rule 12(b)(6) of the Federal Rules of Civil Procedure provides for dismissal of the Complaint where the plaintiff has failed to state a claim upon which relief can be granted. When evaluating a Rule 12(b)(6) motion, the court must ascertain, after presuming all factual allegations in the pleading to be true and viewing them in the light most favorable to the plaintiff, whether or not the plaintiff has stated any valid ground for relief. Ferran v. Town of Nassau, 11 F.3rd 21, 22 (2d Cir. 1993), cert. denied, 513 U.S. 1014 (1994). The court may grant a Rule 12(b)(6) motion only where "`it appears beyond doubt that the plaintiff can prove no set of facts in support ...


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