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Cerone v. Reliance Std. Life Ins. Co.

United States District Court, S.D. California

March 28, 2014

DEBRA CERONE, Plaintiff,
v.
RELIANCE STANDARD LIFE INSURANCE COMPANY and THE PICERNE GROUP HEALTH & WELFARE PLAN, Defendants

Page 1146

For Debra Cerone, Plaintiff: John P. Stennett, LEAD ATTORNEY, Stennett and Stennett, San Diego, CA.

For Reliance Standard Life Insurance Company, Defendant: Dennis J Rhodes, LEAD ATTORNEY, Wilson Elser Moskowitz, San Francisco, CA; Nicole Y. Blohm, LEAD ATTORNEY, Meserve Mumper & Hughes LLP, Los Angeles, CA.

Page 1147

ORDER:

GRANTING PLAINTIFF'S MOTION FOR PARTIAL SUMMARY JUDGMENT [Doc. No. 37]

DENYING DEFENDANT'S CROSS-MOTION FOR PARTIAL SUMMARY JUDGMENT [Doc. No. 38]

Hon. Michael M. Anello, United States District Judge.

This action involves a claim for accidental death benefits arising under the Employee Retirement Income Security Act of 1974 (" ERISA" ), 29 U.S.C. § 1001, et. seq. Plaintiff Debra Cerone and Defendants Reliance Standard Life Insurance Company and The Picerne Group Health & Welfare Plan (collectively " Defendants" ) have filed cross motions for partial summary judgment on the applicable standard of review. Doc. Nos. 37, 38. The Court, in its discretion, found the motions suitable for determination on the papers and without oral argument, pursuant to Civil Local Rul 7.1(d)(1). For the reasons set forth below, the Court GRANTS Plaintiff's motion for partial summary judgment and DENIES Defendants' cross-motion.

Background

Plaintiff Debra Cerone (" Plaintiff" ) brings this action for accidental death benefits under ERISA. The relevant group life and accidental benefit insurance policy was issued by Defendant Reliance Standard

Page 1148

Life Insurance Company (" Reliance" ) to The Picerne Group (" Picerne" ) for the benefit of its employees. See Stennett Decl. Ex. 1, Group Policy No. GL 137371 (" the Policy" ). The Policy was delivered in California. The Policy has an effective date of July 1, 2004, and has an anniversary date of January 1 of each year, beginning January 1, 2005.

Plaintiff's husband, Donald Cerone, was an employee of Picerne and covered under the Policy. In the event of Donald Cerone's accidental death, the Policy provided benefits in the amount of $250,000.

On August 8, 2011, Donald Cerone died in a car crash. Plaintiff then filed a claim for accidental death benefits under the Policy. The Policy grants Reliance discretionary authority to interpret the Policy and determine eligibility for benefits. On January 10, 2012, Reliance denied Plaintiff's claim, citing two policy exclusions in which either alcohol intoxication or voluntary consumption of a controlled substance is a contributing factor. Plaintiff timely appealed the denial of benefits. On August 20, 2012, Reliance denied Plaintiff's appeal.

On January 23, 2013, Plaintiff filed this ERISA action, seeking review of Reliance's denial of benefits. The parties now move for partial summary ...


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