Hood v. Prudential Ins. Co. of America
Hood v. Prudential Ins. Co. of America
Opinion
This appeal by Myra Hood is from a summary judgment entered in behalf of the Prudential Insurance Company of America and an entity created under an Act of Congress known as the Employee Retirement Income Security Act ("ERISA") called the "Plan." We reverse.
Courtaulds moved for, and the trial court granted, dismissal of Courtaulds on the grounds there was no genuine issue as to any material fact regarding the claims against it. Provident was dismissed on a settlement stipulation among the interested parties. These dismissals left Prudential *Page 1229 and the Plan as the only defendants. They are the appellees here.
Hood's complaint sounds both in contract and in tort. Hood's contract claim against Prudential is based on a group long term disability policy issued by Prudential to Courtaulds for the benefit of its employees. Hood asserted a similar cause of action against the Plan, pursuant to ERISA, which includes and governs any disability benefit program maintained by an employer in interstate commerce for the benefit of its employees and funded by a group insurance policy.
The trial court struck Hood's claims for punitive damages against Prudential and against the Plan. Appellant's motion to reconsider the order striking punitive damages against Prudential, filed after the decision in Chavers v. NationalSecurity Fire and Casualty Co.,
In January of 1983, the trial court entered summary judgment in favor of both the Plan and Prudential on the remaining contract claims. In March of 1983, the court denied Hood's motions challenging the entry of summary judgments.
In 1968, while Hood was still an employee, Courtaulds established the employee welfare benefit plan to which we previously alluded, and of which Courtaulds is the administrator. ERISA requires that a summary description of the plan be given to plan participants. That document as provided to Courtauld's employees provides, in part, as follows:
"ERISA imposes duties upon the people who are responsible for the operation of the plan. The people who operate your plan, called `fiduciaries' of the plan, have a duty to do so prudently and in the interest of you and the other plan participants and beneficiaries."
Under a section entitled "Rights and Protections," the summary of the plan provides:
"If you have a claim for benefits which is denied or ignored in whole or in part, you may file suit in a state or federal court."
Hood proceeds against the Plan under the terms of ERISA.
Hood states the issues on appeal to be:
*Page 1230"1. The Plaintiff's discharge from employment did not invalidate her claim thereafter submitted for benefits for physical disability developing before her discharge. Therefore her claim is valid and the summary judgment is erroneous.
"2. The Plaintiff timely submitted her claim for benefits in accordance with the policy and the Plan. Therefore the summary judgment is erroneous.
"3. The Plaintiff did not fail to exhaust any administrative remedy. Therefore the summary judgment is erroneous.
"4. The Plaintiff's actions against Prudential and the Plan for bad faith failure or refusal to honor her claim for benefits are validly stated, are not barred by the statute of limitations, and are supported by at least a scintilla of evidence. Therefore the summary judgment and the orders striking the claims for punitive damages are erroneous.
"5. ERISA does not preempt Alabama jurisprudence recognizing the tort of bad faith as it applies to Prudential. Therefore the summary judgment in favor of Prudential and the orders striking the claims for punitive damages against Prudential are erroneous."
These propositions, stated as issues, are Hood's replications to the defenses offered by appellees upon which they prevailed. The issues for review determinative of the outcome of this appeal are:
(A) Whether ERISA preempts or supersedes Alabama law, which recognizes the tort of bad faith refusal to pay a valid insurance claim, as it applies to Prudential.
(B) Whether ERISA permits the recovery of punitive damages against the Plan for its bad faith failure or refusal to honor Hood's claim.
(C) Whether the trial court erred by entry of summary judgment.
We now turn to the resolution of the above.
"(a) Except as provided in subsection (b) of this section, the provisions of this subchapter and subchapter III of this chapter shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan . . ."
This sweeping provision is modified, however, by the saving clause found in subparagraph § 1144 (b)(2)(A), which reads:
"(2)(A) Except as provided in subparagraph (B), nothing in this subchapter shall be construed to exempt or relieve any person from any law of any State which regulates insurance, banking, or securities."
Hood argues that under the above saving clause, Alabama law continues to govern and regulate insurance companies, including Prudential. We agree.
It is evident that through federal legislation Congress sought to protect ERISA styled pension plans from the intrusion of state regulation. See Alessi v. Raybestos-Manhattan,
Prudential relies heavily upon Alessi v. Raybestos-Manhattan,
In contrast to the situation in Alessi, a bad faith refusal to pay action brought against Prudential, an insurance company, neither directly nor indirectly affects the terms or conditions of employee benefit plans governed by ERISA. See
Title
"(B) Neither an employee benefit plan described in section 1003 (a) of this title, . . . nor any trust established under such *Page 1231 a plan, shall be deemed to be an insurance company or other insurer, bank, trust company, or investment company or to be engaged in the business of insurance or banking for purposes of any law of any State purporting to regulate insurance companies, insurance contracts, banks, trust companies, or investment companies."
This provision further prohibits the state regulation of ERISA plans, under the authority of the saving clause, simply because the plan may act as self-insurer on all of its benefits.Wadsworth v. Whaland,
Based upon the foregoing, we must conclude that Hood's bad faith refusal to pay claim against Prudential does not affect the terms and conditions of ERISA pension plans and is authorized by
As we have indicated above, ERISA preempts all state laws which "relate to" the covered employee benefit plans. In contrast to state claims brought against insurance companies which fund pension plans, such as Prudential, see Wadsworth v.Whaland,
It follows that any state claim brought against the Plan must arise under
Insofar as Hood's fifth cause of action against the Plan presents a state claim for bad faith refusal to honor a claim, it is preempted. See Ogden v. Michigan Bell Telephone Co.,
Whether
Title
The policy considerations militating against punitive damages were persuasively set out recently in Whitaker v. Texaco, Inc.,
Id.,"[T]he legislative history of ERISA indicates that Congress did not want to burden employers with additional costs and requirements in order to insure the future of the voluntary pension and benefit plans. Congress also indicated its preference for criminal sanctions, rather than punitive damages, as a deterrent to willful violations of ERISA by adopting
29 U.S.C. § 1131 ." (Footnotes omitted.)
Additionally, Whitaker correctly points out that courts have declined to allow suits for punitive damages under federal acts similar to ERISA. Id., at 752.
For the foregoing reasons, we hold that
Hood has presented evidence that she was physically disabled prior to her dismissal by Courtaulds and that her dismissal was directly related to her physical disabilities. There is further evidence Hood's disabilities are of the type covered by the group long term disability policy issued by Prudential to Courtaulds for the benefit of Hood and other employees. She has presented affidavits which indicate she submitted her claims for coverage properly and that the defendants were aware there was no debatable reason for a failure or refusal to pay her claim. Lastly, Hood has presented evidence which indicates defendants failed to pay her claim within a reasonable period of time. Because of this, and other evidence, there are genuine issues of material fact remaining. Summary judgment is inappropriate when there is, as here, evidence supporting the party against whom the motion is made. Savage v. Wright,
Therefore, for the above stated reasons, we reverse the judgment of the circuit court as to all issues, except the issue regarding the recovery of punitive damages against the Plan, and this cause is remanded to that court for further proceedings consistent with this opinion.
AFFIRMED IN PART, REVERSED IN PART AND REMANDED.
TORBERT, C.J., and FAULKNER, ALMON and ADAMS, JJ., concur.
Reference
- Full Case Name
- Myra F. Hood v. the Prudential Insurance Company of America
- Cited By
- 10 cases
- Status
- Published