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
 
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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 (See FI CTA10 Rule 36.3 regarding use of unpublished opinions)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...

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