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AGUILAR v. NEW UNITED MOTOR MANUFACTURING

August 29, 2005.

RICHARD H. AGUILAR, Plaintiff,
v.
NEW UNITED MOTOR MANUFACTURING, INC. DISABILITY INSURANCE INCOME PLAN, Defendant.



The opinion of the court was delivered by: WILLIAM SCHWARZER, Senior District Judge

FINDINGS OF FACT AND CONCLUSIONS OF LAW

I. INTRODUCTION

Plaintiff Richard H. Aguilar brings this action, arising under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132, against Defendant New United Motor Manufacturing, Inc. Disability Insurance Income Plan ("the Plan"), challenging the denial of his claim for short-term and long-term disability benefits that he alleges are due to him under the terms of the Plan.

  A pretrial conference was held on October 25, 2004, at which the Court (White, J.) appropriately determined — and the parties conceded — that Plaintiff's claim would be reviewed de novo because the Plan contains no language delegating authority to the Plan Administrator to interpret the terms of the Plan. See Kearney v. Standard Ins. Co., 175 F.3d 1084, 1089 (9th Cir. 1999) (citing Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 109 (1989)). The Court additionally held that it would not exercise its discretion to admit evidence outside of the administrative record in its evaluation of the Plan Administrator's decision. See id. at 1090-91.

  The parties submitted trial briefs and proposed findings of fact and conclusions of law, and made arguments at a bench trial hearing on February 4, 2005. The case was reassigned to the undersigned on June 27, 2005.

  The Court, having reviewed the administrative record, the hearing transcripts, and the papers submitted by the parties, now finds for Defendant and against Plaintiff.

  II. JURISDICTION

  The action arises under ERISA, 29 U.S.C. § 1132, and this Court has jurisdiction over Plaintiff's claim pursuant to 29 U.S.C. § 1132(e) .

  III. FINDINGS OF FACT

  The following facts are taken from the administrative record ("PLAN") submitted by the parties, which contains the only relevant and admissible evidence in the trial of this matter. See Kearney, 175 F.3d at 1090-91.

  Plaintiff was employed by New United Motor Manufacturing, Inc. ("NUMMI") from February 1985 to December 2000, as a production line inspector. PLAN 0284-85. As an employee of NUMMI, Plaintiff was a participant in NUMMI's employee welfare benefit Plan, which was funded through the purchase of a group insurance policy issued by the Life Insurance Company of North America ("LINA"). PLAN 0001-32.

  A. The NUMMI Disability Income Insurance Plan

  The Plan provides for disability benefits if, because of injury or sickness, an employee is unable to perform all the material duties of any occupation available at the Plant for which he is or may reasonably become qualified based on his education, training or experience. PLAN 0005, 0309.

  Under the Plan, short-term disability benefits are payable for a maximum of 52 weeks after a seven-day benefit waiting period during which the participant must be continuously and totally disabled. PLAN 0027. Long-term disability benefits are payable after 52 weeks of continuous disability. PLAN 0009. If a participant is 50 or older when the disability began, long-term benefits are payable until the earlier of ...


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