Pentland v. Metro. Life Ins. Co.
Pentland v. Metro. Life Ins. Co.
Opinion of the Court
BACKGROUND
Tony Pentland was an employee at Schlumberger and insured under a group life insurance plan administered by defendant Metropolitan Life Insurance Company ("MetLife"). Complaint, ECF No. 1 at ¶¶ 7-8. On March 30, 2017, Schlumberger terminated Mr. Pentland. Id. at ¶ 8. On April 11, 2017, MetLife sent a letter to Mr. Pentland informing him that he was eligible to convert $ 207,000 in basic life coverage and $ 525,000 in optional life coverage to an individual life insurance policy. Id. at ¶ 9. They gave him a conversion application to complete and suggested he contact a financial professional with Massachusetts Mutual Life Insurance Company to assist him with converting this coverage. Id. at ¶¶ 9-10. Mr. Pentland and his spouse received assistance from a financial services representative with the company, Robert Lucke, in completing the conversion application. Id. at ¶¶ 11-12. Mr. Pentland elected to convert $ 207,000 in basic life coverage and $ 525,000 in optional life coverage from the Schlumberger group plan to an individual policy. Id. at ¶ 12.
MetLife issued Mr. Pentland a policy with Policy Number 217012877A, the "Individual Policy," with an effective date of May 1, 2017.
After Mr. Pentland's death, Ms. Pentland submitted a claim for benefits under the Individual Policy. However, in a letter dated December 12, 2017, MetLife notified Ms. Pentland that it was rescinding the Individual Policy after a review of the terms of the Schlumberger Group Life, Accidental Death & Dismemberment, and Business Travel Accident Plan (the "Group Plan"). MetLife asserted that Mr. Pentland was still covered by the Group Plan at the time of his death, and therefore "the conversion to the individual policy was not necessary." ECF No. 12, Ex. 2. MetLife refunded Ms. Pentland $ 11,945.64 for the premiums paid on the Individual Policy. Id. ; ECF No. 1 at ¶ 20. MetLife also payed Ms. Pentland the amount it concluded she was entitled to receive under the Group Plan: $ 326,066.99. However, Ms. Pentland *1131asserts that the Individual Policy was in effect on the date of Mr. Pentland's death, and as the sole, primary beneficiary of the Individual Policy, she is entitled to the value of the Individual Policy: $ 732,000. ECF No. 1 at ¶¶ 14, 22, 23.
In February 2018, Ms. Pentland filed a complaint in this court alleging breach of Colorado state law - specifically, breach of contract and tortious breach of duty of good faith and fair dealing. ECF No. 1. The basis for jurisdiction was diversity jurisdiction under
ANALYSIS
Section 514(a) of ERISA provides that the statute preempts all state laws that "relate to any employee benefit plan."
Congress enacted ERISA to protect ... the interests of participants in employee benefit plans and their beneficiaries by setting out substantive regulatory requirements for employee benefit plans.... The purpose of ERISA is to provide a uniform regulatory regime over employee benefit plans. To this end, ERISA includes expansive pre-emption provisions, see ERISA § 514,29 U.S.C. § 1144 , which are intended to ensure that employee benefit plan regulation would be exclusively a federal concern.
To determine whether ERISA preempts Ms. Pentland's state law claims in this case there are two questions I must answer. Because plaintiff asserts claims for benefits under the Individual Policy, the first question is whether the Individual Policy is subject to ERISA regulation as an ERISA plan. See Demars v. CIGNA Corp. ,
Two cases from the Ninth Circuit are instructive on this second question: Waks ,
On the other hand in Reynolds , the Ninth Circuit found that a dispute about an insured's converted life insurance policy was preempted by ERISA where the insured was seeking to file a claim both under an employee group life insurance plan and under her converted policy. The Ninth Circuit reasoned that the defendant insurance company necessarily had to consider a "one payment only" provision in the group plan covered by ERISA in deciding how to pay benefits under either policy. Therefore, claims under the converted policy were sufficiently related to the group plan to justify preemption.
Cases from other circuits similarly distinguish between lawsuits involving benefits under a converted policy and lawsuits where a court must consider the conversion rights under an employee benefit plan to determine the existence of benefits under a converted policy. In general, courts have found that state law claims in the former situation are not preempted by ERISA as the purposes of the statute are not implicated, but they are preempted in the latter situation.
By way of example, the First Circuit in Demars v. CIGNA Corp. , faced the question of whether ERISA preempts state law claims related to a converted policy.
To the issue of whether the plaintiff's state law claims were sufficiently related to an employee benefit plan, CIGNA argued that because the plaintiff had obtained the converted policy by virtue of rights granted by the group disability benefits plan, the two policies were related. However, the First Circuit held that this "but-for" relationship was insufficient, and that ERISA's twin purposes of protecting the benefit funds of employees and creating administrative ease for employers would not be furthered in that situation. Because employers have no control over or tie to funds under a converted policy, there is no risk of employers abusing or mismanaging these funds nor do employers bear any administrative responsibility for converted policies.
The First Circuit drew a distinction between conversion rights and converted policies. In doing so it cited several district courts that have made the same distinction. For example, the Southern District of Georgia explained this distinction as that "[a]ny claim that Defendant failed to offer proper conversion plan options ... relates to the ERISA plan and is pre-empted by ERISA," but "[t]he concerns behind ERISA pre-emption are not implicated by state-law claims arising from obligations incurred under the conversion policy itself." Mimbs v. Commercial Life Ins. ,
I agree that the distinction between conversion rights and a converted policy is meaningful in determining ERISA preemption. Applying this distinction to the present case, the issue remains whether Ms. Pentland's state law claims concern the right to convert from the Schlumberger Group Plan to the Individual Policy or whether they concern benefits under the Individual Policy. Ms. Pentland argues that this case only concerns the payment of benefits due to her under the Individual Policy, and that her claims have nothing to do with the Group Plan or conversion rights. MetLife argues that Ms. Pentland's claims necessarily require consideration of whether they mistakenly issued her an Individual Policy, which involves consideration of conversion rights. Dillon v. Metropolitan Life Insurance , though not factually identical, is instructive on this issue.
In Dillon , an employee who participated in a group life insurance plan took an extended medical leave of absence. Contrary to the terms of the group plan, the employee's group life insurance benefits were terminated.
There are some differences between Ms. Pentlands claims and the Dillon claims. The plaintiff in Dillon was contending that she entitled to recover under two policies (both the group plan and the converted policy). While it is not completely clear from the Complaint, it seems that Ms. Pentland is only asking for recovery under the Individual Policy, instead of recovery under the Group Plan. Assuming this is correct, though Ms. Pentland is only asking for payment under the Individual Policy, the core of Ms. Pentland's dispute with MetLife turns on the consequences of the conversion of the Group Plan. Because resolution of this issue involves consideration of the terms of the Group Plan being converted, I find that Ms. Pentland's state law claims are sufficiently related to an *1134employee benefit plan to be preempted by ERISA.
Plaintiff points to a decision from this district, Eberlein v. Provident Life & Acc. Ins. , for support, but I find that the facts of this case are distinguishable.
ORDER
(1) The Court grants the Joint Motion for Order for Determination [ECF No. 17] and finds, in resolving the motion, that ERISA preempts plaintiff's state law claims.
(2) The Court grants plaintiff leave to amend her complaint.
Some courts refer to policies that are converted from an employer's group plan to an individual policy as "converted policies" or "conversion policies." I will use the term "Individual Policy" to refer to Mr. Pentland's policy and the term "converted policy" to refer to these types of insurance policies in general.
Reference
- Full Case Name
- Yvette PENTLAND v. METROPOLITAN LIFE INSURANCE COMPANY
- Status
- Published