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McCann v. Unum Provident

United States District Court, D. New Jersey

January 31, 2013

Kevin M. McCANN, M.D., Plaintiff,
UNUM PROVIDENT, et al., Defendants.

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Benjamin Clarke, Jason D. Attwood, DeCotiis, Fitzpatrick & Cole, LLP, Teaneck, NJ, for Plaintiff.

Janet Nagotko, Steven P. Del Mauro, McElroy Deutsch Mulvaney & Carpenter LLP, Newark, NJ, Kathleen Ann Mullen, Pepper Hamilton LLP, Harrisburg, PA, for Defendants.


COOPER, District Judge.


The plaintiff, Kevin M. McCann, M.D., brings this action against, among others, the defendant Provident Life and Accident Insurance Company, sued here as " Unum Provident" (" Provident" ). ( See generally dkt. entry no. 1, Compl., Count I.) McCann alleges that he purchased a supplemental long-term disability (" LTD" ) insurance policy (" the Policy" ) from Provident in 1991. He also alleges that Provident, in 2008, determined that he was " totally disabled" under the terms of the Policy and eligible for monthly benefit payments, and began issuing such payments. ( See id. at ¶¶ 22, 31.) But McCann also alleges that Provident thereafter improperly determined that he was no longer totally disabled, and terminated his benefit payments. ( See id. at ¶¶ 34-35, 37.) He thus raises a breach of contract claim against Provident, seeking payment for his allegedly past-due benefits and reinstatement of monthly benefit payments. ( See id. at ¶ 49.)

Provident now moves for summary judgment pursuant to Federal Rule of Civil Procedure (" Rule" ) 56 and Local Civil Rule (" Local Rule" ) 56.1(a), seeking a declaration that Count I of the Complaint is governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (" ERISA" ). ( See dkt. entry no. 32, Provident Mot.) Provident argues in support of the Provident Motion that: (1) the Policy is part of the Residents' Supplemental Disability Insurance Plan (" RSDP" ); (2) the RSDP is an employee welfare benefit plan; and (3) Count I of the Complaint is governed by ERISA.

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( See dkt. entry no. 32-4, Provident Br. at 6-24.)

McCann opposes the Provident Motion, and cross-moves for summary judgment, seeking a declaration that ERISA is inapplicable. ( See generally dkt. entry no. 36, McCann Opp'n Br.; dkt. entry no. 33, McCann Cross Mot.) He argues that the Policy is not part of the RSDP and is not separately an employee welfare benefit plan. ( See McCann Opp'n Br. at 8-15; dkt. entry no. 33-1, McCann Br. at 8-13.) He alternatively argues that the ERISA Safe Harbor Provision promulgated by the United States Department of Labor, 29 C.F.R. § 2510.3-1(j), removes the Policy— and thus removes Count I of the Complaint— from the sphere of ERISA's coverage. ( See McCann Opp'n Br. at 15-17; McCann Br. at 14-18.)

The Court has considered all of the arguments raised by Provident and McCann, both in their respective papers and at oral argument. ( See dkt. entry no. 51, Minute Entry for 12-14-12 Oral Arg.) The Court now concludes, for the reasons set forth below, that Count I of the Complaint is governed by ERISA.


The Court will grant a motion for summary judgment only if the movant demonstrates both that: (1) no genuine disputes of material fact exist; and (2) the movant is entitled to judgment as a matter of law. See Fed.R.Civ.P. 56(a); Koenig v. Automatic Data Processing, 156 Fed.Appx. 461, 466 (3d Cir.2005).

The movant carries the initial burden of demonstrating an absence of genuinely disputed material facts. See Celotex Corp. v. Catrett, 477 U.S. 317, 330, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). Material facts are those that " could affect the outcome" of the proceeding, and " a dispute about a material fact is ‘ genuine’ if the evidence is sufficient to permit a reasonable jury to return a verdict for the non-moving party." Lamont v. New Jersey, 637 F.3d 177, 181 (3d Cir.2011) (citation omitted). The Court, when determining whether the movant has carried this burden, must view the evidence in the light most favorable to the non-movant and draw all reasonable inferences in the non-movant's favor. Scott v. Harris, 550 U.S. 372, 380, 127 S.Ct. 1769, 167 L.Ed.2d 686 (2007); Wishkin v. Potter, 476 F.3d 180, 184 (3d Cir.2007).

If the movant demonstrates an absence of genuinely disputed material facts, then the burden shifts to the non-movant to demonstrate the existence of at least one genuine issue for trial. See Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 586-87, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986); Williams v. Bor. of W. Chester, Pa., 891 F.2d 458, 460-61 (3d Cir.1989). " Where the record taken as a whole could not lead a rational trier of fact to find for the non-moving party, there is no ‘ genuine issue for trial.’ " Matsushita Elec. Indus. Co., 475 U.S. at 587, 106 S.Ct. 1348 (citation omitted). The non-movant cannot, when demonstrating the existence of issues for trial, rest upon argument; the non-movant must show that such issues exist by referring to the record. See Fed.R.Civ.P. 56(c)(1); Matsushita Elec. Indus. Co., 475 U.S. at 586, 106 S.Ct. 1348.

If the non-movant fails to demonstrate that at least one genuine issue exists for trial, then the Court must determine whether the movant is entitled to judgment as a matter of law. A movant is entitled to judgment as a matter of law if, at trial, no reasonable jury could find for the non-moving party. See Celotex Corp., 477 U.S. at 325, 106 S.Ct. 2548; In re Bressman, 327 F.3d 229, 238 (3d Cir.2003); see also Chaplin v. NationsCredit Corp., 307 F.3d 368, 372 (5th Cir.2002) (" To obtain

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summary judgment, ‘ if the movant bears the burden of proof on an issue ... because ... he is asserting an affirmative defense, he must establish beyond peradventure all of the essential elements of the ... defense to warrant judgment in his favor.’ " ).

It appears that Provident bears the burden of proving that the Policy is part of an ERISA-governed employer welfare benefit plan, subject to ERISA governance. See Joy Global, Inc. v. Wis. Dep't of Workforce Dev. (In re Joy Global, Inc.), 346 B.R. 659, 667-68 (D.Del.2006); see also Kanne v. Conn. Gen. Life Ins. Co., 867 F.2d 489, 492 n. 4 (9th Cir.1988). McCann, by contrast, bears the burden of proving that the Safe Harbor Provision removes the Policy from the sphere of ERISA's coverage. See Pfeil v. State St. Bank & Trust Co., 671 F.3d 585, 598-99 (6th Cir.), cert. denied, __ U.S. __, 133 S.Ct. 758, 184 L.Ed.2d 519 (2012); Morris v. Paul Revere Ins. Grp., 986 F.Supp. 872, 878-79 (D.N.J.1997).


Local Rule 56.1(a), a companion to Rule 56, (1) requires parties to present argument by reference to the materials in the record, and (2) where a non-movant fails to present an argument by reference to the record, allows the Court to deem the movant's factual assertions undisputed. See Fed.R.Civ.P. 56(c), (e)(2); Carita v. Mon Cheri Bridals, LLC, No. 10-2517, 2012 WL 3638697, at *1-2 (D.N.J. Aug. 22, 2012). In pertinent part, Local Rule 56.1(a) provides that:

On motions for summary judgment, the movant shall furnish a statement which sets forth material facts as to which there does not exist a genuine issue .... The opponent of summary judgment shall furnish, with its opposition papers, a responsive statement of material facts, addressing each paragraph of the movant's statement, indicating agreement or disagreement and, if not agreed, stating each material fact in dispute and citing to the affidavits and other documents submitted in connection with the motion ; any material fact not disputed shall be deemed undisputed for purposes of the summary judgment motion.

L.Civ.R. 56.1(a) (emphasis added).

A movant's statement of facts and a non-movant's related response serve a vital purpose, in that they assist the Court in identifying whether material facts are truly in dispute. See Am. Plaza, LLC v. Marbo Cross Shop, LLC, No. 08-5963, 2010 WL 455349, at *2 (D.N.J. Feb. 3, 2010). Local Rule 56.1(a) thus puts the onus on the parties, rather than the Court, to find evidence of record supporting their respective arguments. See Baker v. Hartford Life Ins. Co., No. 08-6382, 2010 WL 2179150, at *2 n. 1 (D.N.J. May 28, 2010) (" It is not the Court's responsibility to comb the record on behalf of Plaintiff's counsel." ), aff'd, 440 Fed.Appx. 66 (3d Cir.2011); N.J. Auto. Ins. Plan v. Sciarra, 103 F.Supp.2d 388, 408 (D.N.J.1998) (" [I]t is the responsibility of each party to support its own contentions with a proper basis in the record of the case." ). " Given the vital purpose that such rules serve, litigants ignore them at their peril." Cabán Hernández v. Philip Morris USA, Inc., 486 F.3d 1, 7 (1st Cir.2007).

Provident, pursuant to Local Rule 56.1(a), has filed a statement of facts in support of its motion. ( See generally dkt. entry no. 32-5, Provident SOF.) McCann has filed a response, indicating disagreement with the statements in paragraphs 2-4, 11, 13, 18, 24, 29, 34, 36, 40-42, 55-56, 58-59, and 68-69 (" Paragraphs at Issue" ) of the Provident SOF. ( See dkt. entry no. 36-1, McCann Response to Provident SOF). Provident now argues that the Response to the Provident SOF is insufficient,

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insofar as McCann fails to cite affidavits or other documents of record to support it. ( See dkt. entry no. 38, Provident Reply Br. at 1-3, 9.) Provident thus urges the Court to deem the facts recited in the Paragraphs at Issue to be undisputed. ( See id. )

The Court has carefully examined both the Provident SOF and McCann's Response to the Provident SOF, and now concludes that the facts recited in the Paragraphs at Issue are deemed admitted. McCann has not demonstrated the existence of genuine issues of material fact by reference to evidence of record. Instead, he argues that the Court should not accept Provident's recitations of fact based on the credibility of the underlying evidence.

Such arguments are unavailing. McCann's failure to reference evidence of record demonstrates that there is no reason to disbelieve the statements of fact contained in the Paragraphs at Issue. See Healy v. N.Y. Life Ins. Co., 860 F.2d 1209, 1215-16 (3d Cir.1988); Sciarra, 103 F.Supp.2d at 408.[1] The Court will thus deem the facts recited in the Paragraphs at Issue to be undisputed, and incorporate them into the following findings of fact.


A. McCann's Relationship to Henry Ford Hospital

McCann was hired by Henry Ford Hospital (" the Hospital" ) to serve in a two-year fellowship program, the Hospital's Graduate Trainee Physician Program (" the Program" ). He worked in the Hospital's neuro-radiology department from July 1, 1989 until his fellowship concluded on June 30, 1991. ( See Provident SOF at ¶ 5; McCann Response to Provident SOF at ¶ 5; McCann SOF at ¶ 2; dkt. entry no. 35-1, Provident Response to McCann SOF at ¶ 2.)

B. The Employment Benefits Offered by the Hospital

The Hospital agreed to provide McCann a package of employment benefits that included " medical, dental, optical, disability, life insurance, and other benefits in accordance with the [Program] benefit package" . ( See Provident SOF at ¶¶ 7-9; McCann Response to Provident SOF at ¶¶ 7-9; dkt. entry no. 32-3, Del Mauro Cert., Ex. I, McCann Response to Interrogatories at ¶ 3; ...

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