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Martin Hann v. Reliance Standard Life Insurance Company

November 15, 2012

MARTIN HANN,
PLAINTIFF,
v.
RELIANCE STANDARD LIFE INSURANCE COMPANY, DEFENDANT.



The opinion of the court was delivered by: Hon. John E. Jones III

MEMORANDUM

November 15, 2012 Presently pending before the Court are the cross-motions for summary judgment of Plaintiff Martin Hann ("Plaintiff") (doc. 16) and Defendant Reliance Standard Life Insurance Company ("Reliance") (doc. 13). The Motions have been fully briefed and are thus ripe for our review. For the reasons fully articulated herein, the Court will grant Reliance's Motion and deny the Plaintiff's Motion.

I. PROCEDURAL HISTORY

As the parties are aware, this matter was previously before the Court, see Hann v. Reliance Standard Life Insurance Company ("Hann I"), No. 1:09-CV-2496, in substantially similar form. In his Complaint in Hann I, Plaintiff averred that Reliance, with whom he had a long term disability ("LTD") insurance policy, had deducted from his LTD payments his monthly Social Security Disability Income ("SSDI") and an estimated SSDI dependent award. In his Complaint in Hann I, Plaintiff contended that N.H., the child for whom Reliance had deducted SSDI dependent benefits, was not his natural child nor his dependent and that Reliance's deduction of the estimated SSDI dependent award was thus contrary to the evidence and inconsistent with the terms of the policy.

Thereafter, both parties filed Motions for Summary Judgment. The Court referred the Motions to Magistrate Judge Malachy E. Mannion for a report and recommendation ("R&R"). Judge Mannion issued an R&R recommending that the Court remand the case to Reliance for further investigation and review of the Plaintiff's claims consistent with the dictates of the R&R (doc. 32), and this Court issued an Order (doc. 34) adopting the R&R and remanding the action to Reliance for further investigation and reconsideration on April 8, 2011. Thereafter, on December 30, 2011, Plaintiff commenced the above-captioned action, which for all intents and purposes is a reiteration and continuation of Hann I.

II. STATEMENT OF FACTS

The parties are intimately familiar with the factual predicate of this case, previously discussed at length in Hann I, and we summarize only the most pertinent, and largely undisputed, background here. Plaintiff Martin Hann ("Plaintiff") was previously employed as an information technology specialist at ProSoft, a technical services company located in Mechanicsburg, Pennsylvania. Plaintiff was covered by a long-term disability ("LTD") policy purchased by ProSoft and issued by Defendant Reliance Standard Life Insurance Company ("Reliance"). Plaintiff suffers from severe Multiple Sclerosis which has rendered him totally disabled. He began receiving benefit checks from Reliance on December 16, 2007. Thereafter, on December 1, 2008, Reliance advised Plaintiff that they were recalculating his benefit amount by taking into consideration his Social Security Disability Insurance ("SSDI") benefits which began that year and an estimated SSDI dependent award. Reliance offset his LTD benefit by his SSDI benefit in the amount of $1,783 and his estimated SSDI benefit for a dependent child in the amount of $891. His total benefit payable by Reliance accordingly resulted in a negative number, and he was entitled only to the minimum monthly benefit of $100.

Plaintiff appealed Reliance's recalculation on March 3, 2009. In support of his appeal, he explained that N.H., the child for whom benefits were deducted, was neither his natural child nor his dependent. He submitted an affidavit certifying that while the decree of divorce signed by he and his former wife identified N.H. as a child of the marriage, he had actually undergone a vasectomy prior to the marriage rendering him unable to father a child. In further support, Plaintiff submitted tax returns establishing that he had never claimed N.H. as a dependent. Reliance denied the appeal because they were not persuaded that N.H. was not Hann's dependent. Reliance relied, in large part, on forms submitted by Plaintiff to Reliance identifying N.H. as his minor child and Plaintiff's divorce decree which identified N.H. as a child of his marriage. Plaintiff thereafter filed his Complaint in Hann I, asserting that Reliance had wrongfully calculated his benefits and seeking relief pursuant to 29 U.S.C. §§ 1132(a)(1)(d) and 1132(a)(3).

Thereafter, both parties filed Motions for Summary Judgment. As above noted, the Court referred the Motions to Magistrate Judge Mannion, who issued an R&R recommending that the Court remand the case to Defendant Reliance for further investigation and compliance with the statutory and regulatory framework of the Social Security Act as outlined in the comprehensive R&R. We agreed with Judge Mannion's analysis and ultimate recommendation and remanded the case to Reliance, noting that Plaintiff's affidavits and tax returns should "at the very least, prompt further investigation into whether the child is a dependent for the purposes of Social Security benefits" and ordering Reliance to "conduct the proper inquiry as to the minor's status as a child of Hann and as a dependent or otherwise." Hann I, No. 1:09-CV-2496, Doc. 34, p. 11.

On May 27, 2011 sent a second denial letter to Plaintiff, this time including discussion of the Social Security Act and applicable regulations and analyzing the Plaintiff's claims under Pennsylvania law, as directed by the regulations. Reliance again concluded that N.H. was both Plaintiff's child and his dependent. Plaintiff filed his Complaint (doc. 1) again challenging Reliance's determination on December 30, 2011. Reliance answered the Complaint on May 15, 2012 and included a counterclaim, asserting that it had a contractual right to repayment for the period of time in which Plaintiff received both LTD benefits and SSDI benefits. (Doc. 7). Reliance filed an Amended Answer and Counterclaim on May 9, 2012. (Doc. 12). The parties thereafter filed cross motions for summary judgment (docs. 13, 16) on all claims. These motions have been fully briefed (docs. 14, 18, 21, 23, 24) and are ripe for our review.

III. STANDARD OF REVIEW

Summary judgment is appropriate if the record establishes "that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(c). Initially, the moving party bears the burden of demonstrating the absence of a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). The movant meets this burden by pointing to an absence of evidence supporting an essential element as to which the non-moving party will bear the burden of proof at trial. Id. at 325. Once the moving party meets its burden, the burden then shifts to the non-moving party to show that there is a genuine issue for trial. Fed. R. Civ. P. 56(e)(2). An issue is "genuine" only if there is a sufficient evidentiary basis for a reasonable jury to find for the non-moving party, and a factual dispute is "material" only if it might affect the outcome of the action under the governing law. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248-49 (1986).

In opposing summary judgment, the non-moving party "may not rely merely on allegations of denials in its own pleadings; rather, its response must . . . set out specific facts showing a genuine issue for trial." Fed. R. Civ. P. 56(e)(2). The non-moving party "cannot rely on unsupported allegations, but must go beyond pleadings and provide some evidence that would show that there exists a genuine issue for trial." Jones v. United Parcel Serv., 214 F.3d 402, 407 (3d Cir. 2000). Arguments made in briefs "are not evidence and cannot by themselves create a factual dispute sufficient to defeat a summary judgment motion." Jersey Cent. Power & Light Co. v. Twp. of Lacey, 772 F.2d 1103, 1109-10 (3d Cir. 1985). However, the facts and all reasonable inferences drawn therefrom must be viewed in the light most favorable to the non- moving party. P.N. v. Clementon Bd. of Educ.,442 F.3d 848, 852 (3d Cir. 2006).

Summary judgment should not be granted when there is a disagreement about the facts or the proper inferences that a fact finder could draw therefrom. Peterson v. Lehigh Valley Dist. Council, 676 F.2d 81, 84 (3d Cir. 1982). Still, "the mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported motion for summary judgment; there ...


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