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Curt A. Wykstra v. Life Insurance Company of North America; Borgwarner

February 2, 2012

CURT A. WYKSTRA, PLAINTIFF,
v.
LIFE INSURANCE COMPANY OF NORTH AMERICA; BORGWARNER, INC,; BORGWARNER MORSE TEC, INC.; AND BORGWARNER FLEXIBLE BENEFITS PLAN, DEFENDANTS.



The opinion of the court was delivered by: Neal P. McCurn, Senior District Judge

MEMORANDUM - DECISION and ORDER

I. Introduction

Presently before the court in this ERISA action are cross motions for summary judgment. The motions, which have been fully briefed, are decided on the submitted papers without oral argument.

Plaintiff, Curt A. Wykstra, brings this action against defendants, Life Insurance Company of North America ("LINA"); BorgWarner, Inc.; BorgWarner Morse TEC Inc.; and BorgWarner Flexible Benefits Plan seeking damages and declaratory relief on his claim for wrongful termination of his long term disability ("LTD") benefits pursuant to section 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. ("ERISA"). See 29 U.S.C. § 1132(a)(1)(B). Plaintiff also seeks prejudgment interest and attorney's fees.

II. Legal Standard

A motion for summary judgment shall be granted "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a). The movant has the initial burden to show the court why it is entitled to summary judgment. See Salahuddin v. Goord, 467 F.3d 263, 272 (2d Cir. 2006) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S. Ct. 2548 (1986)). If the movant meets its burden, the burden shifts to the non-movant to identify evidence in the record that creates a genuine issue of material fact. See id., at 273 (citing Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 586, 106 S. Ct. 1348 (1986)).

When the court is deciding a motion for summary judgment, it must resolve all ambiguities and draw all reasonable inferences in the non-movant's favor. See Vermont Teddy Bear Co., Inc. v. 1-800 Beargram Co., 373 F.3d 241, 244 (2d Cir. 2004) (citing Adickes v. S. H. Kress & Co., 398 U.S. 144, 157, 90 S. Ct. 1598 (1970)). Where, as here, a court is considering cross-motions for summary judgment, each party's motion must be evaluated "on its own merits, taking care in each instance to draw all reasonable inferences against the party whose motion is under consideration." Byrne v. Rutledge, 623 F.3d 46, 53 (2d Cir. 2010) (quotation and citation omitted).

III. Factual Background

The facts in this case are largely undisputed. Plaintiff is a former employee of defendant, BorgWarner Morse TEC Inc., which is a subsidiary of defendant BorgWarner, Inc. Plaintiff received LTD benefits under the Group Insurance Policy (Policy number LK 0030479) ("the Policy") issued by defendant LINA to BorgWarner, Inc. LINA terminated Plaintiff's LTD benefit because it concluded that he no longer met the definition of disabled under the Policy. The sole issue in this case is whether LINA's decision to terminate Plaintiff's LTD benefits was supported by substantial evidence.*fn1 Therefore, the dispute between the parties boils down to an interpretation of the facts as opposed to a dispute regarding the accuracy of the facts themselves.

Plaintiff was employed by BorgWarner Morse TEC from June 1, 1981 until June 22, 2004, when he went out on medical leave. At the time he went out on medical leave, Plaintiff worked as a Senior Designer/Automotive Design Drafter. In terms of exertion level, that position is considered to be a "light" occupation, requiring lifting, carrying, pushing and pulling twenty pounds occasionally and ten pounds frequently; walking and/or standing frequently; and pushing and/or pulling arm and/or leg controls.

As part of Plaintiff's employment, he participated in the BorgWarner Flexible Benefits Plan ("the Plan"), which included, among other things, LTD coverage provided by the Policy issued by LINA. Covered employees who become disabled while insured under the Policy, and remain disabled during a six month elimination period, receive benefits as long as the employee remains under the appropriate care of a physician and submits satisfactory records to LINA proving their continued disability as defined in the Policy. The Policy includes the following definition of disability:

The employee is considered disabled if, solely because of injury or sickness, he or she is either:

1. unable to perform all the material duties of his or her regular occupation or a qualified alternative, or

2. unable to earn 80 percent or more of his or her indexed covered earnings.

After disability benefits have been payable for 30 months, the employee is considered disabled if, solely due to injury or sickness, he or she is either:

1. unable to perform all the material duties of any occupation for which he or she is, or may reasonably become, qualified based on education, training or experience; or

2. unable to earn 80 percent or more of his or her indexed covered earnings.

See Administrative Record of Def. LINA at ex. C to Decl. of Emily A. Hayes, Dec. 1, 2010, Dkt. No. 36-1 ("Hayes Decl."). LINA is responsible for both the payment of benefits due under the Policy and decisions regarding whether to grant or deny claims for benefits under the Policy.

The Policy provides for a gross monthly payment of sixty percent of the employees's monthly covered earnings, minus other income benefits, including, among other things, Social Security Disability. The Policy requires beneficiaries to apply for such benefits and to sign a reimbursement agreement. If the beneficiary does not do so, LINA assumes the receipt of such benefits and will offset the assumed benefits from the beneficiary's LTD benefit. The Policy further provides that benefits are paid through the earlier of the date the ...


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