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Gilcrest v. Unum Life Insurance Co. of America

August 4, 2006

ROBERT GILCREST, PLAINTIFF,
v.
UNUM LIFE INSURANCE CO. OF AMERICA, ET. AL., DEFENDANTS.



The opinion of the court was delivered by: Judge Gregory L. Frost

Magistrate Judge Abel

OPINION & ORDER

Plaintiff Robert Gilcrest ("Gilcrest") and Defendant Unum Life Insurance Company of America ("Unum") have filed cross motions for summary judgment on Unum's counterclaims. (Doc. # # 33, 35). After thorough consideration, the Court DENIES Gilcrest's motion (Doc. # 33) and GRANTS Unum's motion (Doc.# 35).

BACKGROUND

Government Liquidation.Com Long Term Disability Plan ("GLC") formerly employed Gilcrest. During his employment with GLC, Gilcrest was eligible for, and a participant in, GLC's employee welfare benefit plan ("Plan"). The Plan was established and maintained pursuant to the provisions of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. GLC was the Plan administrator; Unum provided benefits under the Plan.

Gilcrest injured his back on September 12, 2003 while he was still a GLC employee. Gilcrest applied for and was granted short term disability benefits under the Plan. See Gilcrest Aff. Gilcrest also applied for and was awarded Social Security disability benefits. Id.

Subsequently, Gilcrest applied for and was awarded long term disability benefits under the Plan from October 2003 through October 12, 2004. Id. After that date, Unum suspended Gilcrest's long term disability benefits upon determining that he was no longer disabled under the Plan's terms. Id. Gilcrest appealed Unum's denial twice; each time, Unum affirmed its previous determination.

Gilcrest filed the instant action on October 6, 2005 seeking an order requiring Unum to:

(1) reinstate his long-term disability benefits; (2) pay all past due benefits; (3) pay pre-judgment and post-judgment interest; and (4) pay his attorney's fees and costs. (Doc. # 1 at ¶ ¶ 1-13). Defendants then filed an Answer and Counterclaims. (Doc. # 4). Specifically, the Defendants' counterclaims allege that the Plan required Unum to subtract the amount of any Social Security Award received by the insured from the insured's disability payment under the Plan. Id. at ¶ 4. Although Gilcrest received approximately $3,564.00 in Social Security payments from October 2003 to March 2004, Unum failed to subtract that amount from his long term disability benefits and Gilcrest has not repaid that amount to the Defendants. See Gilcrest Aff. Thus, the Defendants assert two counterclaims against Gilcrest--the first for breach of contract, the second for unjust enrichment.

The parties filed cross-motions for judgment on the administrative record regarding Gilcrest's ERISA claims and Unum's counterclaims. The Court ruled in Unum's favor on the ERISA claims in its June 30, 2006 Opinion & Order, but noted that Buchanan v. Aetna Life Ins. Co., No. 05-3380, 2006 U.S. App. LEXIS 11046, at *9 (6th Cir. 2006) required the Court to convert the parties' motions regarding the counterclaims to motions for summary judgment. (Doc. # 31 at 8). Accordingly, the Court provided the parties additional time to supplement their previous arguments on Unum's counterclaims with the new standard in mind. That briefing is now complete, and the Court now turns to an examination of the parties' cross motions for summary judgment on Unum's counterclaims.

STANDARD OF REVIEW

Summary judgment is appropriate "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Fed. R. Civ. P. 56(c). The Court must therefore grant a motion for summary judgment if the nonmoving party who has the burden of proof at trial fails to make a showing sufficient to establish the existence of an element that is essential to that party's case. See Muncie Power Prods., Inc. v. United Techs. Auto., Inc., 328 F.3d 870, 873 (6th Cir. 2003) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986)).

In viewing the evidence, the Court must draw all reasonable inferences in favor of the nonmoving party, which must set forth specific facts showing that there is a genuine issue of material fact for trial. Id. (citing Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986)); Hamad v. Woodcrest Condo. Ass'n, 328 F.3d 224, 234 (6th Cir. 2003). A genuine issue of material fact exists "if the evidence is such that a reasonable jury could return a verdict for the nonmoving party." Muncie, 328 F.3d at 873 (quoting Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986)). Consequently, the central issue is " 'whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.' " Hamad, 328 F.3d at 234-35 (quoting Anderson, 477 U.S. at 251-52). However, in ruling on a motion for summary ...


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