106 F.3d 413 (10th Cir. 1997), 95-2172, LaMure v. Mutual Life Ins. Co. of New York

Docket Nº:95-2172.
Citation:106 F.3d 413
Party Name:David S. LaMURE, Sr., Plaintiff-Appellant, v. MUTUAL LIFE INSURANCE COMPANY OF NEW YORK, Defendant-Appellee.
Case Date:January 14, 1997
Court:United States Courts of Appeals, Court of Appeals for the Tenth Circuit

Page 413

106 F.3d 413 (10th Cir. 1997)

David S. LaMURE, Sr., Plaintiff-Appellant,

v.

MUTUAL LIFE INSURANCE COMPANY OF NEW YORK, Defendant-Appellee.

No. 95-2172.

United States Court of Appeals, Tenth Circuit

January 14, 1997

Editorial Note:

This opinion appears in the Federal reporter in a table titled "Table of Decisions Without Reported Opinions". (See FI CTA10 Rule 36.3 regarding use of unpublished opinions)

97 CJ C.A.R. 126

Before SEYMOUR, Chief Judge, ANDERSON and BRORBY, Circuit Judges.

ORDER AND JUDGMENT [*]

Plaintiff David S. LaMure, Sr. appeals the district court's summary judgment holding that the disability insurance policy of which he was the beneficiary was part of an employee welfare benefit plan as defined in the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001-1461 (1994). We affirm the district court's holding.

Dr. LaMure was a beneficiary of a long-term disability insurance policy issued by Defendant Mutual Life Insurance Company of New York ("Mutual Life"). The policy was a group policy issued through the College of American Pathologists Group Insurance Trust, and in order to be eligible for benefits under the policy one had to be a member of the College, which Dr. LaMure was.

Dr. LaMure's employer was Pathology Consultants of New Mexico Ltd. ("Pathology Consultants"), a professional corporation of which Dr. LaMure was a shareholder. Pathology Consultants paid both Dr. LaMure's dues for membership in the College of American Pathologists and the semi-annual premiums for his coverage under the disability policy. It also provided administrative functions relating to the policy.

Dr. LaMure began receiving benefits under the policy in June of 1989. Thereafter, he was incarcerated in a New Mexico prison, and Mutual Life terminated all benefits. Dr. LaMure filed a complaint against Mutual Life seeking resumption of the disability benefits, asserting state law claims for breach of contract, bad faith failure to pay, and bad faith termination of benefits.

The district court found the disability policy was part of an employee welfare benefit plan as defined by the Employee Retirement Income Security Act, and that that act preempted Dr. LaMure's state law claims. Accordingly, the court dismissed Dr. LaMure's complaint, although it granted him leave to amend his complaint to state a claim under the Employee Retirement Income Security Act.

In this appeal, Dr. LaMure contends the disability policy was not part of an employee welfare benefit plan, and therefore the Employee Retirement Income Security Act does not preempt his state law causes of action. Dr. LaMure apparently concedes that if the disability policy is part of an employee welfare benefit plan, the Employee Retirement Income Security Act preempts his state law claims.

The determination of whether an insurance policy is governed by the Employee Retirement Income Security Act is a mixed question of fact and law. Peckham v. Gem State Mut. of Utah, 964 F.2d 1043, 1047 n. 5 (10th Cir.1992). Because this mixed question essentially involves conclusions drawn from undisputed facts, it is primarily a legal question which we review de novo. Id. Even if such were not the case, our standard of review would be de novo because the district court issued its ruling on summary judgment. Kaul v. Stephan, 83 F.3d 1208, 1212 (10th Cir.1996).

Although normally as a corollary of de novo review of summary judgment "we examine the factual record and reasonable inferences therefrom in the light most favorable to the party opposing summary judgment," id., that favoritism is greatly restricted in this case. Because Dr. LaMure failed to comply with District of New Mexico Local Rule 56.1, which required him to specifically contest Mutual Life's statement of undisputed facts, we depart from our "usual posture of construing all facts in favor of the non-moving party" and accept as true all material facts contained in Mutual Life's statement of undisputed facts. 1 See Johnson v. Gudmundsson, 35 F.3d 1104, 1108 (7th Cir.1994) (approving use of a nearly identical local rule of the Northern District of Illinois); Waldridge v. American Hoechst Corp., 24 F.3d 918 (7th Cir.1994) (same); cf. Hagelin for President Comm. of Kansas v. Graves, 25 F.3d 956, 959 (10th Cir.1994) ("Because the state failed to submit any materials contradicting plaintiffs' statement of facts in support of their motion for summary judgment, these facts are deemed admitted."), cert. denied, 11 S.Ct. 934 (1995). However, we will review facts other than those contained in Mutual Life's statement of undisputed facts and reasonable inferences therefrom in the light most favorable to Dr. LaMure. See Kaul, 83 F.3d at 1212.

Dr. LaMure advances several arguments supporting his contention the disability policy was not part of an employee welfare benefit plan. Perhaps the most noteworthy is his claim that, to fall within the Employee Retirement Income Security Act, an employee welfare benefit plan must provide benefits to at least one employee who is not also an owner or employer; a plan whose sole beneficiaries are the company's owners cannot qualify as an Employee Retirement Income Security Act plan. Dr. LaMure claims the only persons entitled to disability insurance were himself and his two fellow...

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