Kamler v. H/N Telecommunication Services, Inc.
| Decision Date | 16 September 2002 |
| Docket Number | No. 01-2995.,01-2995. |
| Parties | Brent KAMLER, Plaintiff-Appellant, v. H/N TELECOMMUNICATION SERVICES, INC., et al., Defendants-Appellees. |
| Court | U.S. Court of Appeals — Seventh Circuit |
Constantine J. Gekas (argued), Gekas & Associates, Chicago, IL, for Plaintiff-Appellant.
Martha A. Pagliari (argued), Cassiday, Schade & Gloor, Chicago, IL, for Defendants-Appellees.
Before CUDAHY, COFFEY and WILLIAMS, Circuit Judges.
In this appeal, Brent Kamler challenges a grant of summary judgment entered against him on his ERISA-related claims against H/N Telecommunication Services, Inc., formerly known as PAL Telecom Group, Inc. (PAL), PAL Telecom Group, Inc. Employee Welfare Plan (PAL Plan) and Royal & SunAlliance (Royal). This case presents a tangled factual scenario which we will try to untangle as best as we can.
The relationship between Kamler and PAL arose when PAL decided to hire three managers for a construction project in Brazil. George Lamplota, PAL's director of project management, telephoned Kamler for an initial telephone interview. During this interview, Kamler asked Lamplota for an annual salary of $95,000, full medical benefits plus per diem expenses. Kamler, who resides in California, demanded health insurance before he would go to Brazil. Lamplota allegedly responded that Kamler would be insured. Lamplota offered Kamler medical benefits under the PAL Plan, but there is a factual dispute about whether Kamler stated that he did not want PAL's health insurance if he had to pay premiums. See Kamler v. H/N Telecommunication Serv., Inc., No. 00-C-4024, 2001 WL 740516, *1 (N.D.Ill. June 29, 2001).
On March 17, Kamler signed a letter of commitment memorializing the agreement with respect to his compensation package, but this letter is silent about health insurance coverage. Two days later, Kamler left for Brazil. A short time later, Lamplota obtained a personnel manual and an enrollment form for the PAL Plan for Kamler, which was to be faxed via PAL's office in Sao Paolo, Brazil. The personnel manual's section on insurance states "medical, life and long-term disability insurance are carried by the firm on a group basis for the benefit of its employees." Kamler, 2001 WL 740516, at *2.
The PAL Plan was an employee welfare benefit plan established by PAL for eligible employees through participation in a group medical, life and disability insurance program. The PAL Plan is governed by the Employee Retirement Income Security Act (ERISA). The PAL Plan was underwritten by Trustmark Insurance Company and administered by Star Marketing & Administration, Inc. (Starmark). Kamler, 2001 WL 740516, at *3. The Plan provided that all eligible employees must apply for coverage by filling out an enrollment form. Id. If an employee applied before working 30 continuous days, his effective date occurred at the end of the 30-day period, and if he applied after this date, the effective date was the first day of the month following the date he applied. Id. This 30-day period could be waived by a request submitted with the enrollment form. Id. The enrollment form provided in part:
To be completed by the employees only. Failure to provide complete facts may be cause for cancellation of your coverage as of its effective date.
NOTE: As part of our routine underwriting procedure, you may receive a phone call ... to obtain personal information needed to evaluate your insurability.... Unless waived above, I request insurance under my employer's insurance plan.... I authorize my employer to make deductions from my earnings for my share of the cost, if any, for the benefits for which I may become entitled.
Kamler, 2001 WL 740516, at *4. The PAL Plan also provided that, after an employee filled out an enrollment form and was accepted by Trustmark (the insurance company providing coverage), the employee would receive a certificate of insurance.
On March 30, Lamplota faxed the personnel manual and enrollment form to Victor Jaworski in PAL's Brazil office with the following cover memorandum:
Victor: Enclosed please find [PAL's]... Personnel Manual and the Employee Enrollment Form (Insurance) to be forwarded to Brent Kamler.... [He] should fill out the Employee Enrollment Form and return it back to me as soon as possible, the coverage is to start by 05-01-1998.
Kamler, 2001 WL 745016, at *3. Jaworski did not recall receiving this fax before May 1998.
On May 5, Lamplota resent the March 30th memorandum with the attachments to Jaworski. Id. On May 6, Jim Oliva faxed this information to Kamler's hotel in Brazil, with a cover note that read: Id. Oliva then followed up with a phone call to Kamler.
After Kamler received the enrollment form, he promptly called Lamplota with questions about it. This was the first time since his initial telephone interview in mid-March 1998 that Kamler had discussed health insurance coverage with Lamplota. Id. Kamler told Lamplota that he was concerned that the enrollment form required him to provide information that he felt violated his right of privacy. Kamler asked Lamplota for verification of exactly what information the insurance company wanted, and why. Lamplota told Kamler that he would contact the insurance company and call Kamler back. Lamplota did not tell Kamler that Kamler would not receive coverage without filling out and submitting the form. Lamplota also did not advise Kamler to contact Starmark or anyone else for answers to his questions. Lamplota allegedly did not call Kamler back with answers to his inquiries, and Kamler never completed the enrollment process.
On June 3, 1998, Lamplota telephoned Kamler to terminate him because Kamler had completed his assignment early and there was no further work to do. Kamler returned to the United States. Two weeks later, Kamler had a heart attack and was admitted to a hospital for treatment. On his hospital bill, the name of his insurance carrier is blank because he was never able to provide the hospital with the information. Id.
On August 4, 1998, Kamler submitted a claim to PAL (but not to the PAL Plan) for payment of the medical expenses arising from his heart attack. This claim was subsequently submitted, either by Kamler or PAL, to Royal (PAL's liability insurance carrier). Neither PAL nor the PAL Plan has ever paid Kamler's medical expenses.
In October 1999, CH2M HILL Telecommunications Group, LLP ("Hill"), and PAL transitionally merged, and in October 2000, Hill purchased PAL's assets. Kamler, 2001 WL 740516, at *5. On December 31, 1999, the PAL Plan was terminated. Id. The former PAL employees were covered under a new group plan that used a different insurance carrier than the PAL Plan did. Id.
On March 6, 2000, Lamplota received a letter from Kamler's attorney requesting the PAL Plan insurance documents. Id. The letter was referred by Lamplota to Nestor Popowych, the president of PAL, and eventually to legal counsel. It was then passed on to Royal. On November 24, Royal denied Kamler's claim for payment of his hospital bill based upon the results of its investigation. Kamler never contacted Starmark, and no one requested information regarding the PAL Plan or submitted a claim for benefits to Starmark.
On March 20, 2001, Kamler filed his second amended complaint against PAL, the PAL Plan, Royal and Starmark. The defendants moved for summary judgment. The district court granted the motion. The district court held that Kamler did not have standing to bring a claim for medical benefits because Kamler was not a participant in the PAL Plan. In connection with the issue of standing, the district court held that Kamler did not have a colorable claim for medical benefits because alleged misrepresentations on the part of an employer's agents are insufficient to provide standing. Alternatively, Kamler did not have standing because he failed to satisfy his duties of self help and due diligence by neglecting to file his enrollment papers with Starmark. The district court also denied the claim for statutory penalties against PAL and Royal for failure to respond to a request for information. It concluded that Kamler should have made his request for information to Starmark, rather than to PAL or Royal. Moreover, the information requested was outdated since the PAL Plan had been terminated over a year and half earlier, and the request was made very late. Subsequently, the claims against Starmark were dismissed by stipulation of settlement. Kamler appeals from the judgment of the district court on the remaining claims against PAL, the PAL Plan and Royal.
This court has jurisdiction under 28 U.S.C. § 1291. We review the grant of a motion for summary judgment de novo, drawing all reasonable inferences in favor of the non-movant. Neuma, Inc. v. AMP, Inc., 259 F.3d 864, 871 (7th Cir.2001). We will affirm a grant of summary judgment if "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Fed.R.Civ.P. 56(c); see also Neuma, 259 F.3d at 871. Cf. Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 114, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989) (). We review a district court decision to impose or not to impose statutory penalties for an abuse of discretion. 29 U.S.C. § 1132(c)(1); see also Neuma, 259 F.3d at 879.
Kamler seeks to recover his medical expenses from PAL and the PAL Plan...
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