Filed: Feb. 16, 2012
Latest Update: Feb. 22, 2020
Summary: and Smith, * District Judge.grant of summary judgment. See Madera v. Marsh, USA, Inc., 426 F.3d 56, 63 (1st Cir.Hutcheon's benefit eligibility under the plan.15, 2010, the plan issued a letter denying the claim.judicial review.evidence from the Kingsburys supporting Hutcheon's entitlement.
Not for Publication in West's Federal Reporter
United States Court of Appeals
For the First Circuit
No. 11-1253
JOAN KINGSBURY,
Plaintiff, Appellant,
v.
MARSH & McLENNAN COMPANIES, INC. RETIREMENT PLAN,
a/k/a MARSH & McLENNAN COMPANIES, INC.,
Defendant, Appellee.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MASSACHUSETTS
[Hon. Leo T. Sorokin, U.S. Magistrate Judge]
Before
Boudin and Lipez, Circuit Judges,
and Smith,* District Judge.
Patrick M. Groulx, with whom Polis Legal, and Ralph C.
Copeland, were on brief for appellant.
Edward Cerasia II, with whom Daniel B. Klein, and Seyfarth
Shaw LLP, were on brief for appellee.
February 16, 2012
*
Of the District of Rhode Island, sitting by designation.
Per Curiam. Joan Kingsbury appeals from the district
court's grant of summary judgment affirming the denial of a claim
for retirement benefits purportedly owed to Kingsbury's deceased
sister, Lorna Hutcheon, under the Employee Retirement Income
Security Act ("ERISA"), 29 U.S.C. § 1132(a)(1)(B). The district
court affirmed the denial of benefits by Marsh & McLennan
Companies, Inc. Retirement Plan, a/k/a Marsh & McLennan Companies,
Inc. (the "plan" or "Marsh & McLennan"), on the grounds that the
claim was barred by the statute of limitations and that the plan
administrator's decision was not arbitrary and capricious.
On appeal, the court reviews de novo a district court's
grant of summary judgment. D & H Therapy Assocs., LLC v. Boston
Mut. Life Ins. Co., 640 F.3d 27, 34 (1st Cir. 2011). With respect
to a plan administrator's decision, where an ERISA plan gives the
administrator discretion to determine benefit eligibility or to
construe the terms of the plan, and the plan administrator makes a
benefit determination under the plan, a court will only reverse the
administrator's decision when it is "arbitrary, capricious, or an
abuse of discretion."
Id. (quoting Cusson v. Liberty Life
Assurance Co. of Boston,
592 F.3d 215, 224 (1st Cir. 2010)).1
1
This deferential standard of review is triggered by the
instant plan's language, which vests in the administrator
discretionary authority to determine benefit eligibility under the
plan and to interpret the terms of the plan. See Madera v. Marsh
USA, Inc., 426 F.3d 56, 63 (1st Cir. 2005). While Kingsbury states
that the court should employ de novo review of the plan
administrator's decision, she does not expand on this averment, and
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Under these circumstances, "summary judgment is simply a vehicle
for deciding the [benefits] issue and the non-moving party is not
entitled to the usual inferences in its favor." Scibelli v.
Prudential Ins. Co. of Am., 666 F.3d 32, No. 11-1372,
2012 WL
75395, at *7 (1st Cir. Jan. 11, 2012) (quoting Gent v. CUNA Mut.
Ins. Soc'y,
611 F.3d 79, 82–83 (1st Cir. 2010)) (alteration in
original) (internal quotation marks omitted).
In October 2007, Joan Kingsbury's husband, Richard
Kingsbury, who was Hutcheon's brother-in-law and in favor of whom
Hutcheon had executed a power of attorney, contacted Marsh &
McLennan in writing regarding Hutcheon's eligibility for benefits
under the plan. Hutcheon had fallen ill and the Kingsburys
believed Hutcheon was entitled to benefits under the plan because,
according to the Kingsburys, she had worked for Marsh & McLennan
for over twenty years, the plan was non-contributory (i.e., the
only requirement for plan membership was that the employee be a
salaried employee) with vesting after ten years of qualified
service, and eligible participants were entitled to benefits
shortly after obtaining sixty-five years of age, which Hutcheon
so we take it that she has waived the conflict of interest argument
that she raised before the district court. Moreover, even if the
argument were not waived, she clearly has not met her burden of
demonstrating that the alleged conflict influenced the plan's
decision to deny her claim. See Cusson v. Liberty Life Assurance
Co. of Boston, 592 F.3d 215, 225 (1st Cir. 2010) (stating that the
burden is on the claimant to show that a conflict of interest
affected the administrator's decision).
-3-
accomplished on July 5, 2000. The Kingsburys and Marsh & McLennan
exchanged correspondence over the next year and a half, debating
Hutcheon's benefit eligibility under the plan. During this
process, the plan scoured its records for information on Hutcheon,
but nothing surfaced. At the plan's request for more information,
Kingsbury produced, among other things, a ledger from the Social
Security Administration indicating that Hutcheon worked for Marsh
& McLennan between 1956 and 1977, an affidavit by Hutcheon
attesting that she had been employed by Marsh & McLennan from May
1956 to February 1977, and an affidavit by Richard Kingsbury
reciting his conversations with Hutcheon and other past and current
Marsh & McLennan employees about Hutcheon's eligibility for
benefits. Hutcheon died in April 2008; Kingsbury purports to be
her sole heir.
In July 2009, Kingsbury submitted what the plan construed
as a formal claim for benefits on Hutcheon's behalf, and on January
15, 2010, the plan issued a letter denying the claim. The letter
stated that the plan does not maintain records for individuals who
do not have a current or potential entitlement to benefits under
the plan and that it does not maintain records affirmatively
evidencing that a person does not have a current or potential
entitlement. The letter also stated that Marsh & McLennan
maintains controls to ensure the accuracy and reliability of its
records. The letter further noted that Kingsbury failed to come
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forward with any additional information or documents. Finally, the
letter described several circumstances under which a former
employee would not be entitled to benefits under the plan.
Kingsbury appealed the denial to the plan's benefits determination
committee, which also denied her claim, adopting the analysis set
forth in the earlier denial letter. Kingsbury thereafter sought
judicial review.
The plan administrator's decision to deny the claim was
measured and well considered; the plan exerted substantial effort
researching the claim and searching for evidence of Hutcheon's
purported entitlement, as evidenced by the correspondence between
Marsh & McLennan and the Kingsburys, and it received and considered
evidence from the Kingsburys supporting Hutcheon's entitlement.
While Kingsbury argues that there is no conclusive evidence
supporting the plan's determination, it is not surprising that the
plan does not have any documentation indicating that either
Hutcheon no longer was eligible for benefits, or never was eligible
in the first place, some thirty years after Hutcheon ceased
employment with Marsh & McLennan. Kingsbury cites statutory
authority to support her argument that the plan, as a fiduciary,
was required to maintain complete and accurate records, see 29
U.S.C. § 1027, but, indeed, that statute requires a plan to
maintain certain records relating to plan participants for only six
years. Moreover, the plan enumerated many reasons why Hutcheon may
-5-
not have a current entitlement to benefits; for example, she may
have already received a distribution of her plan contributions or
benefits. Notably, none of the competent evidence presented by the
Kingsburys establishes that Hutcheon was eligible to participate in
the plan, was vested in the plan, was entitled to a plan benefit at
any point, or had not already received any benefit due to her.
Kingsbury essentially asks the court to hold that the plan
administrator acted in an arbitrary and capricious manner by
declining to adopt a rebuttable presumption that employees who may
be eligible under the terms of the plan have a current entitlement
to benefits. Like the district court, we find no basis for such a
holding.
Because Hutcheon's claim is largely based on speculation
and hearsay, and because of the dearth of evidence as to Hutcheon's
eligibility under the plan, the plan's demonstrated effort in
researching the claim, and its plausible explanation for Hutcheon's
ineligibility, the Court cannot say that the plan administrator's
denial was arbitrary, capricious, or an abuse of discretion.
Accordingly, summary judgment granted by the district court in
favor of Marsh & McLennan is affirmed. Because we affirm on the
merits, we need not reach the statute of limitations issue.
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