David C. Pellegrin
Published by The Pellegrin Firm September 27, 2020
In a recent ruling, U.S. District Court judge Martin Feldman of the Eastern District of Louisiana in New Orleans denied a plaintiff’s motion for summary judgment on the issue of whether the disability insurance policy he was suing on was governed by the Employee Retirement Income Security Act (“ERISA”). ERISA is a federal law that governs insurance policies that are part of group plans sponsored by private employers. In most litigation, the standard of review is more plaintiff-friendly under state insurance law than under ERISA. In addition, state law provides for remedies and penalties that ERISA does not.
In the present instance, the plaintiff was a partner in a law firm when he purchased the insurance policy. He alleged that he paid the premiums on the policy entirely by himself and that the policy covered no one else at the law firm. He attached affidavits to his motion in support of these contentions. The defendant, Provident Life and Accident Insurance Company, argued that it always considered the policy a group policy during its underwriting process. Further, it provided documentation supporting the contention that the plaintiff’s law firm established and maintained the policy.
The court found that the evidence favored the defendants’ view, but in any event, there were disputed issues of material fact precluding summary judgment and the conflicting evidence had to be resolved at trial. Therefore, the plaintiff’s motion for summary judgment on ERISA coverage was denied. The case is McQuiag v. Provident Life & Accident Ins. Co., No. CV 20-23, 2020 WL 5545681 (E.D. La. Sept. 16, 2020).