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Polnicky v. Liberty Life Assur. Co.

United States District Court, N.D. California

November 18, 2013

STEVEN POLNICKY, Plaintiff,
v.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON; WELLS FARGO & COMPANY LONG TERM DISABILITY PLAN, Defendants

For Steven Polnicky, Plaintiff: Corinne Chandler, LEAD ATTORNEY, Kantor & Kantor, Northridge, CA; Beth Davis, Kantor and Kantor LLP, Northridge, CA; Peter Steffens Sessions, Kantor & Kantor, LLP, Northridge, CA.

For Liberty Life Assurance Company of Boston, Wells Fargo & Company Long Term Disability Plan, Defendants: Blake J Russum, LEAD ATTORNEY, ROPERS, MAJESKI KOHN & BENTLEY, Redwood City, CA; Pamela E. Cogan, LEAD ATTORNEY, Ropers Majeski Kohn & Bentley, Redwood City, CA.

OPINION

Page 1145

ORDER GRANTING PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT AND DENYING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT

SUSAN ILLSTON, United States District Judge.

Cross-motions for summary judgment, filed by plaintiff Steven Polnicky and defendants Liberty Life Assurance Company

Page 1146

of Boston (" Liberty Life" ) and Wells Fargo & Company Long Term Disability Plan (" the Plan" ), are scheduled for hearing on November 22, 2013. Pursuant to Civil Local Rule 7-1(b), the Court determines that this matter is appropriate for resolution without oral argument and VACATES the hearing. For the reasons set forth below, the Court GRANTS plaintiff's motion for summary judgment and DENIES defendants' motion for summary judgment.

BACKGROUND

This is an action brought under the Employee Retirement Income Security Act of 1974 (" ERISA" ), 29 U.S.C. § 1001 et. seq. The Plan is an " employee welfare benefit plan" under 29 U.S.C. § 1002(1). Docket No. 27, Morris Decl. ¶ 3. The Plan is established and sponsored by Wells Fargo & Company for the benefit of its employees. Id. The Plan is insured by a group disability income policy issued by Liberty Life to Wells Fargo, Policy No. GF3-850-289424-01 (" the Policy" ). Id. ¶ 4; Docket No. 26, McGee Decl. ¶ 3. The Policy has an effective date of January 1, 2010, and the Policy's anniversaries occur each January 1st beginning in 2011. Docket No. 27-1, Morris Decl. Ex. A.

Plaintiff was employed by Wells Fargo and was a covered participant in the Plan. Docket No. 1, Compl. ¶ 7. On March 30, 2011, plaintiff submitted a claim for disability benefits to Liberty Life under the Wells Fargo & Company Short Term Disability Plan with a disability date of March 30, 2011. Docket No. 26, McGee Decl. ¶ 8, Ex. C. Liberty Life approved plaintiff's short term disability claim and plaintiff was paid benefits through September 27, 2011, the maximum duration for short term disability. Id. ¶ 10, Ex. E.

On August 12, 2011, Liberty Life began its investigation of plaintiff's claim for long term disability benefits under the Plan. Docket No. 26, McGee Decl. ¶ 11, Ex. F. The disability date for plaintiff's long term disability claim was also March 30, 2011. Id. On October 10, 2011, Liberty Life sent plaintiff a letter stating that he would receive long term disability benefits under the Policy while Liberty Life continued its investigation into his claim. Id. ¶ 12, Ex. G. On June 1, 2012, Liberty Life sent a letter to plaintiff stating that it had determined that plaintiff was not entitled to long term disability benefits under the Policy. Id. ¶ 13, Ex. H. Plaintiff appealed Liberty Life's denial of benefits. Id. ¶ 14. On February 19, 2013, Liberty Life sent a letter to plaintiff denying his appeal and upholding its prior determination that he was not entitled to long term disability benefits under the Policy. Id. ¶ 14, Ex. I.

On April 2, 2013, plaintiff filed a complaint against defendants, alleging a cause of action under 29 U.S.C. § 1132(a)(1)(B) to recover benefits due to him under the terms of his plan. Compl. ¶ ¶ 6-17. By the present motions, the parties move for summary adjudication of whether the de novo or abuse of ...


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