Ministeri v. Reliance Standard Life Ins. Co.

• Decision Date: 10 February 2021
• Docket Number: Civil No. 18-10611-LTS
• Citation: 523 F.Supp.3d 157
• Parties: Renee MINISTERI, Personal Representative of the Estate of Anthony Ministeri, Plaintiff, v. RELIANCE STANDARD LIFE INSURANCE COMPANY, Defendant.
• Court: U.S. District Court — District of Massachusetts

523 F.Supp.3d 157

Renee MINISTERI, Personal Representative of the Estate of Anthony Ministeri, Plaintiff,

v.RELIANCE STANDARD LIFE INSURANCE COMPANY, Defendant.

Civil No. 18-10611-LTS

United States District Court, D. Massachusetts.

Filed February 10, 2021

Richard J. Sullivan, Eugene F. Sullivan, Jr., Sullivan & Sullivan LLP, Wellesley, MA, Teresa A. Monroe, Pro Hac Vice, Monroe Law LLP, Albany, NY, for Plaintiff.

Joshua Bachrach, Pro Hac Vice, Wilson, Elser, Moskowitz, Edelman & Dicker, LLP, Philadelphia, PA, Kara G. Thorvaldsen, Wilson, Elser, Moskowitz, Edelman & Dicker, LLP, Boston, MA, for Defendant.

MEMORANDUM AND ORDER ON THE PARTIES’ CROSS MOTIONS FOR SUMMARY JUDGMENT

SOROKIN, United States District Judge

In this action, Plaintiff Renee Ministeri claims the proceeds of a life insurance policy purchased by her late husband from Defendant Reliance Standard Life Insurance Company. Before the Court are the parties’ cross motions for summary judgment. For the reasons which follow, Mrs. Ministeri's Motion for Summary Judgment (Doc. No. 31)¹ is ALLOWED and Reliance's Cross Motion for Summary Judgment (Doc. No. 34) is DENIED.

I. BACKGROUND

A. Factual Background

Anthony Ministeri was hired by AECOM Technology Corporation on April 1, 2014 to work part time (twenty-four hours per week) as a Construction Services Executive² with an annual salary of $156,000. AR0142–43; AR1984. According to his job description, Mr. Ministeri's work mostly involved travel, networking, and giving presentations to large groups. AR0209–10. As part of his employment package, Mr. Ministeri was eligible to receive both basic and supplemental life insurance coverage through a group policy administered by Reliance. AR0142. Mr. Ministeri opted for basic and supplemental coverage, resulting in a total amount of $1,092,000 in life insurance. Doc. No. 49 ¶ 8.

On May 2, 2014, Mr. Ministeri was on a business trip to New York City when he became disoriented and was unable to find his way to his hotel room. Id. ¶ 9. On May 7, 2014, an MRI of Mr. Ministeri's head revealed a lesion in his brain and he was hospitalized for two nights until his initial neuro-oncology consult on May 9, 2014. Id. ¶ 10; AR0514. Mr. Ministeri's medical chart notes that he had been "feeling completely normal" until suddenly becoming disoriented in New York City and had continued to intermittently experienced similar episodes of confusion, incoordination, and dizziness since returning home. AR0514. Following his initial consult, Mr. Ministeri returned to the hospital on May 12, 2014 and May 21, 2014 to undergo brain biopsies

. AR551. These revealed he had developed a glioblastoma, a particularly aggressive type of brain tumor. AR551, AR562, AR371; Doc. No. 49 ¶¶ 11–12.

Mr. Ministeri began a course of radiation and chemotherapy treatment which concluded in July 2014. AR0213. All agree Mr. Ministeri remained employed by AECOM during this period and that he did some amount of work for the company from his home. Doc. No. 33-10 at 4; AR215. Following his final chemotherapy appointment, Mr. Ministeri met with Dr. Elizabeth J. Collins on July 31, 2014 to discuss his prognosis. AR0213. He stated his chemotherapy treatment had "definitely worked because he [felt] much better." AR0214. Dr. Collin's notes record that Mr. Ministeri was upbeat and that he explained he had "been doing some work from home online" and was looking forward to becoming "more active," although he recognized it would be some time before he could resume his regular schedule of business trips. AR0215. When asked about his cognitive ability, Mr. Ministeri reported he felt "a little bit slow in the uptake," explaining that "cognitively he [was] there, but sometimes [was] not as quick as he had been" before the onset of symptoms in May. AR0215.

Roughly a week later, Mr. Ministeri was discovered unconscious by his wife after suffering a thrombosis

, or massive pulmonary embolism. AR0449; AR0464. Although he survived due to Mrs. Ministeri's swift action and the efforts of the medical personnel at Anna Jaques Hospital, Mr. Ministeri was left severely disabled and unable to work. He formally took leave from his role at AECOM effective August 8, 2014, AR1044, and applied for Long Term Disability ("LTD") Benefits under a separate policy issued by Reliance, which the insurer approved after determining that Mr. Ministeri's last day at AECOM was August 6, 2014. AR1445. Mr. Ministeri passed away just over one year later, on October 2, 2015. Doc. No. 49 ¶ 29.

B. Terms of the Group Policy

1. Eligibility Criteria

Coverage under the RSL Employer Trust Agreement (the "Group Policy") is limited to "Eligible Classes," defined as "Each Active Full-time and Fixed Part-time Corporate Vice President and above of AECOM Technology Corporation." AR0007. The term "Corporate Vice President" is not defined. Id. Nor is the term "Active." Id. The terms "Full-time" and "Part-time" are defined as follows:

"Full-time" means working for [AECOM] for a minimum of 20 hours during a person's regularly scheduled work week.

"Part-time" means working for [AECOM] for a minimum of 20 hours during a person's regularly scheduled work week.

AR0009.³

The Group Policy does not define "regularly scheduled work week."

2. Termination and Continuation Provisions

An individual's insurance under the Group Policy terminates on "the date the Insured ceases to be in a class eligible for this insurance." AR0014. Notwithstanding this, the Group Policy allows for an individual who has been "terminated" to retain coverage under the Group Policy's "continuation provision." This provision reads:

The insurance of an Insured may be continued, by payment of premium, beyond the date the Insured ceases to be eligible for this insurance, but not longer than:

(1) twelve (12) months, if due to illness or injury; or

(2) three (3) months, if due to temporary lay-off or approved leave of absence; or

(3) one hundred twenty (120) days, if due to a furlough.

AR0015.

3. Conversion and Portability Provisions

Individuals who are no longer eligible under the Group Policy may also "convert" elements of their coverage under the Group Policy into an individual life insurance policy pursuant to the "conversion provision." The provision begins "An Insured can use this privilege when his/her insurance is no longer in force" and continues:

If the insurance ceases due to termination of employment or membership in any of the Participating Unit's classes, an individual Life Insurance Policy may be issued. The Insured is entitled to a policy without disability or supplemental benefits. A written application for the policy must be made by the Insured within sixty (60) days after he/she terminates. The first premium must also be paid within that time.

...

If an Insured dies during the time ... in which he/she is entitled to apply for an individual policy, we will pay the benefit under the Group Policy that he/she was entitled to convert. This will be done whether or not the Insured applied for the individual policy.

AR0016.

This provision further requires that an Insured be notified of their right to convert, stating, as relevant here:

If an Insured is entitled to have an individual policy issued to him/her without proof of health, then he/she must be given notice of this right at least fifteen (15) days before the end of the period specified above. Such notice must be: (1) in writing; and (2) presented or mailed to the Insured by [AECOM⁴ ]. If not, the Insured will have an additional period in order to do so.

Id.

The Group Policy also contains a separate "portability provision" which allows individuals to maintain, subject to certain conditions, their supplemental insurance coverage even after ceasing to be a member of an Eligible Class. That provision reads:

An Insured may continue Supplemental Insurance coverage under this Policy if coverage would otherwise terminate because he/she ceases to be an Eligible Person ... provided he/she:

(1) notifies us in writing within sixty (60) days from the date he/she ceases to be eligible; and

(2) remits the necessary premiums when due; and

(3) is not approved for extension of coverage under the Waiver of Premium in Event of Total Disability provision, if applicable; and

(4) has not been terminated under the Waiver of Premium in Event of Total Disability provision, if applicable, and

(5) has been covered for twelve (12) months under this Policy and/or the prior group life insurance policy.

The amount of Supplemental Insurance coverage available under the Portability provision will be the current amount of coverage the Insured and that of his/her insured Dependents, if any, is insured for under this Policy on the last day he/she was Actively at Work. However, the amount of coverage will never be more than:

(1) the highest amount of life insurance available to Eligible Persons; or

(2) a total of $500,000 from all RSL group life and accidental death and dismemberment insurance combined, whichever is less.

AR0025.

C. Mrs. Ministeri's Claim and Reliance's Denial

Mrs. Ministeri filed a proof of claim with Reliance in April of 2016, in which she sought the proceeds of her husband's basic and supplemental life insurance coverage, for a total of $1,092,000. Doc. No. 33-1.

Reliance denied Mrs. Ministeri's claim in a letter dated July 8, 2016, finding that "no insurance was in force" on the date of Mr. Ministeri's death. Doc. No. 33-10 at 2. In this initial decision letter, Reliance noted the Group Policy limits coverage to AECOM employees who are "Active Full-time [or] Fixed Part-time" and defines "part-time" to mean working for AECOM "for a minimum of 20 hours during a person's regularly scheduled work week." Id. at 3 (alteration in original). Thus, according to Reliance, if Mr. Ministeri "fell below 20 hours of work per week, his insurance under the Policy would terminate as he would no longer be considered ‘Part-time.’ " Id. Reliance highlighted that "Mr. Ministeri's job consisted primarily of business travel"...