The opinion of the court was delivered by: Breyer, District Judge.
Rowena Leung ("Mrs.Leung") filed this suit to collect on life
insurance benefits under a policy that her husband, now
deceased, had with his employer, Skidmore, Owings, & Merrill LLP
("SOM"). Mrs. Leung has named SOM, Skidmore, Owings & Merrill
Group Life Insurance Plan (the "Insurance Plan"), and
Connecticut General Life Insurance Company ("Connecticut
General") and their parent CIGNA as defendants.
At a hearing on May 24, 2002, the Court granted plaintiffs
motion to amend her complaint. The amended complaint states
three causes of action. Now before the Court are defendants'
motions to dismiss. For the reasons stated below, summary
judgment in favor of all defendants is hereby GRANTED.*fn1
SOM hired Edmund Leung as a structural engineer in 1968. He
received long-term disability ("LTD") and life insurance
benefits through SOM's cafeteria plan. In August 1989, Mr.
Leung's physician, Dr. Robert Kubin, diagnosed severe
hypertension and Mr. Leung left work. Mr. Leung's symptoms
included severe memory loss, speech difficulties, and
incontinence. Because he was unable to return to work within a
year, Mr. Leung was terminated on August 7, 1990. With the help
of SOM employees, Mr. Leung was eventually able to secure LTD
On November 27, 1990, Mr. Leung signed a "Benefit Payment and
Withholding Election Form" liquidating his 401(k) plan. Aguirre
Decl., Ex. A. Mr. Leung did not fill in the blank asking for the
date of retirement or termination. Id. However, the withdrawal
made by Mr. Leung was possible only after termination of
employment. Over the next several years, SOM and the Leungs
corresponded regarding LTD benefits, and at least once with
regard to the Leungs' purchase of a home. This correspondence is
relevant only so far as it goes to the issue of whether Mr.
Leung was aware of his termination in 1990 or whether he
believed he was still technically "employed" by SOM and on
disability leave. This correspondence will be highlighted where
Mr. Leung died on June 9, 1997. Mrs. Leung spent the next year
and a half investigating the circumstances of her husband's
death. In the spring of 1999 Mrs. Leung began to investigate her
husband's life insurance policy with the help of her daughter,
Allison Wakefield. She started by visiting SOM's office where
she met with Frances Redwine. Subsequently she sent several
letters to Redwine.
SOM's life insurance carrier had changed several times since
Mr. Leung stopped working at SOM. As a result, Mrs. Leung
apparently submitted claims to several carriers that never
insured Mr. Leung. She also named multiple carriers in this
suit. While the details of the confusion do not appear to be
particularly important, the confusion was not Mrs. Leung's
alone. Initially, SOM had difficulty determining which carrier
provided Mr. Leung's life insurance.
Only employees who worked 30 hours per week were eligible for
life insurance under the plan. See Id. at 288. The SPD also
states that coverage terminated when the employee "leave[s]
active service." Id. at 289. Two further provisions are of
particular importance here. First, premiums were waived for a
year upon sufficient proof that the employee has been totally
disabled for a period of nine months or more. Second, an
employee could convert his group coverage to individual coverage
if application was made within 31 days of termination of the
In a letter dated April 5, 2000, CIGNA, the parent of
Connecticut General, informed SOM that Mr. Leung's coverage had
been canceled because Mr. Leung never applied for a Waiver of
Premium or Conversion after he went out on disability on August
4, 1989. A copy of this letter was forwarded to plaintiff.
Summary judgment is appropriate when 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 judgment as a matter of law." Fed.R.Civ.P. 56(c).
An issue is "genuine" only if there is sufficient evidence for a
reasonable fact finder to find for the nonmoving party. See
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248-49, 106
S.Ct. 2505, 91 L.Ed.2d 202 (1986). A fact is "material" if the
fact may affect the outcome of the case. See id. at 248, 106
S.Ct. 2505. "In considering a motion for summary judgment, the
court may not weigh the evidence or make credibility
determinations, and is required to draw all inferences in a
light most favorable to the nonmoving party." Freeman v.
Arpaio, 125 F.3d 732, 735 (9th Cir. 1997). A principal purpose
of the summary judgment procedure is to identify and dispose of
factually unsupported claims. See Celotex Corp. v. Catrett,
477 U.S. 317, 323-24, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986).
The party moving for summary judgment bears the initial burden
of identifying those portions of the pleadings, discovery, and
affidavits which demonstrate the absence of a genuine issue of
material fact. See id. at 323, 106 S.Ct. 2548. Where the
moving party will have the burden of proof on an issue at trial,
it must affirmatively demonstrate that no reasonable trier of
fact could find other than for the moving party. See id. Once
the moving party meets this initial burden, the non-moving party
must go beyond the pleadings and by its own evidence "set forth
specific facts showing that there is a genuine issue for trial."
Fed.R.Civ.P. 56(e). The non-moving party must "identify with
reasonable particularity the evidence that precludes summary
judgment." Keenan v. Allan, 91 F.3d 1275, 1279 (9th Cir. 1996)
(quoting Richards v. Combined Ins. Co., 55 F.3d 247, 251 (7th
Cir. 1995), and noting that it is not a district court's task to
"scour the record in search of a genuine issue of triable
fact"). If the non-moving party fails to make this showing, the
moving party is entitled to judgment as a matter of law. See
Celotex, 477 U.S. at 323, 106 S.Ct. 2548.
Plaintiffs complaint states the following three causes of
action: 1) an ERISA § 502(a)(1) claim for life insurance
benefits, 2) an ERISA § 502(a)(3) claim for other relief, and 3)
a claim that SOM violated a ERISA § 502(c) by failing to provide
requested documents and information.
I. Claim for Benefits under ERISA § 502(a)(1) (against all
Plaintiff brings a claim under ERISA § 502(a)(1) for payment
of benefits under her husband's life insurance policy.
Defendants raise several defenses to this claim.
Defendants claim that this action is barred because plaintiff
has failed to exhaust her administrative remedies under the
plan. The "general rule governing ERISA claims [is] that a
claimant must avail himself or herself of a plan's own internal
review procedures before bringing suit in federal court." Diaz
v. United Agr. Employee Welfare Ben. Plan and Trust,
50 F.3d 1478, 1483 (9th Cir. 1995). As plaintiff points out, however,
the exhaustion requirement is generally waived where resort to
the plan's procedures would be futile or inadequate. See id.
There is no dispute that plaintiff did not technically exhaust
her claim. In fact, she never formally submitted a claim for
life insurance benefits to Connecticut General. However, in a
letter dated April 5, 2000, CIGNA, the parent of Connecticut
General, informed Mrs. Leung that it would "need . . .
documentation" of "Waiver of Premium or Conversion" to process
her claim. See Pennasilico Decl.Ex. B. Plaintiff admits that
she has no such documentation. Accordingly, if her efforts ...