Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Salerno v. Prudential Insurance Company of America

August 3, 2009

RONALD SALERNO, PLAINTIFF,
v.
PRUDENTIAL INSURANCE COMPANY OF AMERICA, DEFENDANT.



MEMORANDUM-DECISION AND ORDER

Plaintiff Donald C. Salerno ("Plaintiff" or "Salerno") commenced this action against Defendant Prudential Insurance Company of America ("Defendant" or "Prudential") pursuant to § 504(a)(1)(B) of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132(a)(1)(B), challenging the denial of long-term disability ("LTD") benefits under Group Policy number 16171 (the "Plan"). See generally Amended Complaint (Dkt. No. 4). Presently before this Court is Defendant's Motion for judgment on the pleadings seeking dismissal of the Amended Complaint in its entirety. (Dkt. No. 17). For the reasons discussed below, Defendant's Motion is granted and Plaintiff's Amended Complaint is dismissed.

I. BACKGROUND

Plaintiff was employed by Prudential Securities, Inc. ("PSI") from May 1, 1992 through April 30, 1994. Am. Compl. ¶ III.C; Answer ¶ 7 (Dkt. No. 9). As an employee of PSI, Plaintiff was covered for LTD benefits under the Plan, which was issued by Defendant to PSI. Id. at ¶ 7; see Answer, Ex. A. Although PSI initially hired Plaintiff to work as director of a training facility from May 1992 until May 1994, PSI relieved him of his duties after twenty-eight (28) days of work. Pl.'s Memo. of Law in Opp'n at 2 (Dkt. No. 22). Nevertheless, PSI continued to compensate Plaintiff in accordance with his employment contract through the termination of the contract on April 30, 1994. Id. Plaintiff's coverage under the Plan also continued until the termination of his employment contract. Id.; Answer ¶ 7.

Under the Plan, covered individuals suffering from a long period of total disability*fn1 are eligible for LTD benefits, provided a proper claim pursuant to the terms and conditions of the Plan had been filed. Answer, Ex. A. The Plan provides, in relevant part:

CLAIM RULES

These rules apply to payment of benefits under a Coverage when the Coverage states that they do.

Notice of Claim: This paragraph applies only to Employee Long Term Disability Coverage. Prudential must be given written notice that a claim will be made. The notice must be given to Prudential within 30 days after the end of the Elimination Period (defined in the Coverage). But, Failure to meet that time limit will not make the claim invalid if the notice if given as soon as reasonably possible. The notice may be given by you or for you. It must show your name, the Employer's name and the Group Contract Number.

Proof of Loss: Prudential must be given written proof of the loss for which claim is made under the Coverage. This Proof must cover the occurrence, character and extent of that loss. It must be furnished within 90 days after the date of the loss, except that:

(1) If the Coverage is Employee Long Term Disability Coverage, both of these time limits must be met:

(a) Initial proof of loss must be furnished within 90 days after the end of the first month following the Elimination Period.

(b) Proof for each later month of continuing loss must be furnished within 90 days after the end of that month.

(2) If any other Coverage provides for periodic payment of benefits at monthly or shorter intervals, the proof of loss for each period must be furnished within 90 days after its end.

(3) If payment under a Coverage is to be made for charges incurred during a Calendar Year, the proof for that Calendar year must be furnished within 90 days after its end.

A claim will not be considered valid unless the proof is furnished within these time limits. However, it may not be reasonably possible to do so. In that case, the claim will still be considered valid if ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.