The opinion of the court was delivered by: Thomas M. Rose United States District Judge
ENTRY AND ORDER GRANTING RELIANCE'S MOTION FOR JUDGMENT ON THE ADMINISTRATIVE RECORD (Doc. #11); OVERRULING MS. REYNOLDS' MOTION FOR JUDGMENT ON THE ADMINISTRATIVE RECORD (Doc. #12) AND TERMINATING THIS CASE
This is an ERISA claim for the recovery of life insurance benefits by Jane S. Reynolds ("Ms. Reynolds"), the widow and beneficiary of J. Richard Reynolds ("Mr. Reynolds"). Mr. Reynolds is now deceased. The claim for benefits was denied and the denial affirmed by Defendant Reliance Standard Life Insurance Company ("Reliance").
Now before the Court are motions for judgment on the administrative record*fn1 and memorandums in opposition filed by both parties. The Stipulated Administrative Record ("AR") has also been filed. The motions for judgment on the administrative record are, therefore, ripe for decision. A brief factual background will first be set forth followed by the standard of review and an analysis of the motions.
Mr. Reynolds was employed by Weiss-Aug Co. ("Weiss") and was a participant in the company's employee benefit plan. He stopped working on November 7, 1997, at age 59, due to non-small cell lung cancer. (AR 160-61, 109, 164-74.) Mr. Reynolds subsequently became eligible for continued group life insurance coverage under the Waiver of Premium provision of the group life insurance policy No. GL 16843 (the "Policy") that was part of Weiss's employee benefit plan. (AR 160-61, 109, 164-74.)
The Waiver of Premium provision extends coverage under the Policy without payment of premiums in the event an insured suffers from a Total Disability. (AR 0018.) The Policy then limits the Waiver of Premiums as follows:
The Amount of Insurance extended for an Insured will cease on the earliest of:
(1) the date he/she can return to any Full-time, active work;
(2) the date he/she refuses to be examined;
(3) the date he/she fails to furnish the required proof of Total Disability;
(4) the date he/she becomes age 70; or
(5) the date he/she retires. (Id.) In addition, the definition section of the Policy states:
The date he/she retires: or "retirement" means the effective date of an Insured's:
(1) retirement pension benefits under any plan of a federal, state, county or municipal retirement system, if such pension benefits include any credit for employment with you;
(2) retirement pension benefits under any plan which you sponsor, or make or have made contributions; or
(3) retirement benefits under the United States Social Security Act of 1935, as amended, or under any similar plan or act. (AR 0009).
On January 20, 1999, Reliance approved Mr. Reynolds' claim for waiver of his life insurance premiums. (AR 109-10.) In the approval letter, Reliance indicated that premiums would be waived and the life insurance extended provided that Mr. Reynolds remains totally disabled in accordance with Policy provisions. (Id.) Reliance also indicated that the insurance being extended would terminate at age 70 or the date Mr. Reynolds retires, whichever occurs first. (Id.) This same letter was forwarded to a different individual at Weiss on January 26, 1999. (AR 106-07.) Both of these letters indicate that they were copied to Mr. Reynolds. (AR 106-07, 109-10.)
The next relevant correspondence is a letter dated March 7, 2002, from Reliance to Mr. Reynolds thanking him for completing the disability claim form. (AR 102.) Reliance told Mr. Reynolds that his life insurance would continue to be extended and premiums waived for another year while he remains totally disabled. (Id.) This letter also indicates that, "[t]he amount of life insurance being extended under waiver of premium will terminate the date you turn age 65, plus 2 months, 8/10/2003."*fn2 (Id.) Finally, Mr. Reynolds was told that he would be contacted "at this time next year" for completion of the annual disability claim form. (Id.)
Approximately one year later, in a letter dated April 21, 2003, Reliance thanked Mr. Reynolds for again completing a disability claim form. (AR 0098.) Reliance again told Mr. Reynolds that the life insurance was being extended and premiums waived. (Id.) This letter also indicates that, "[t]he amount of life insurance being extended under waiver of premium will terminate the date you turn age 70; the date you retire; or the date you are no longer totally disabled, whichever occurs first." (Id.) ...