United States District Court, W.D. Oklahoma
TIMOTHY D. DeGIUSTI, UNITED STATES DISTRICT JUDGE
Court has reviewed the briefs filed in response to the Order
of December 28, 2018, which directed the parties to state
“their positions regarding how best to proceed in light
of recent developments regarding Plaintiff's benefit
claim.” See 12/28/18 Order [Doc. No. 81]
(hereafter, “Order”). Although the parties'
responses are not very helpful, the following information and
positions can be gleaned from their respective briefs:
Standard Insurance Company (“Standard”), which is
the administrator of the welfare benefit plan that is the
subject of Plaintiff's ERISA claims, states that it
“replaced the denial of Plaintiff's [benefit] claim
with a decision to pay Plaintiff's claim for the
insurance benefit under the amended policy” and its
payment was made “as part of the claims process after
the policy in question was amended resulting in coverage for
Plaintiff's claim as of June 14, 2018.”
See Standard's Br. [Doc. No. 84] at 1. The Court
assumes this coverage date is the effective date of the plan
does not identify any mechanism by which Plaintiff's
original benefit claim may have been reopened. Standard does
not explain why Plaintiff apparently received no notice that
his claim had been reopened, no written explanation of an
amended decision, and no notice of his right of appellate
review, as required by ERISA. Standard does not state any
intention of curing these omissions. Thus, at this point, the
record contains no basis for the Court to determine that
Plaintiff's ERISA action has been rendered unripe, as
originally appeared to be the case. Apparently, Standard did
not reopen the administrative record for Plaintiff's
benefit claim or reconsider the prior denial; it simply made
a new decision, apparently acting on its own initiative,
under a later plan amendment.
devotes much of his brief to addressing matters - such as
attorney fees and discovery regarding recovery of attorney
fees - that have no bearing on whether a ripe or live
controversy exists regarding the merits of his ERISA action.
He does confirm, however, that he received no pre-decisional
notice of the plan amendment and did not request the
reopening of his benefit claim. Plaintiff does not indicate
that he asked to amend his claim or submitted a new claim for
benefits under the plan amendment. Thus, Plaintiff's
submission reinforces the Court's conclusion that it
cannot say his pending ERISA action is no longer ripe.
Accordingly, the Court reaches a negative answer to the
question of “whether the case should be stayed or
dismissed while the administrative process is
completed” for a new or amended benefit claim.
See Order at 6.
other things can be determined from the parties' briefs.
First, Standard's decision to deny Plaintiff's
original benefit claim remains unchanged. Standard maintains
that Plaintiff had no right to payment under the prior ERISA
plan but, instead, his claim became payable when the
amendment changed a coverage requirement. See
Standard's Br. at 1. Second, Standard has implicitly
acknowledged that a term of the ERISA plan, as set out in the
group life insurance policy for which Mrs. Smith purchased
coverage, provides for the accrual of interest on a benefit
payment. Standard's present brief suggests it
calculated the amount of Plaintiff's benefit based on
coverage triggered by the amendment as of June 14, 2018.
Under Plaintiff's pending ERISA claim, his benefit
payment would include interest calculated from a much earlier
date under the original policy. Thus, a right to recover
interest before June 14, 2018, as claimed by Plaintiff,
parties' supplemental briefs confirm the correctness of
one conclusion reached in the December 28 Order:
“Plaintiff's pending ERISA action is based on
Standard's denial of a life insurance benefit under the
policy in effect when Mrs. Smith died, but Standard has now
replaced the denial with a decision to pay Plaintiff's
claim for the insurance benefit under the amended
policy.” See Order at 6. It now appears,
however, that the replacement was not accomplished through
further administrative action pursuant to ERISA. Further, due
to different dates of coverage under the parties'
competing views and Plaintiff's right to collect
interest, there remains an unresolved dispute that affects
the amount of Plaintiff's benefit payment. Because
Plaintiff claims he was entitled to interest on the benefit
amount under the terms of the ERISA plan in effect before the
amendment, and that interest remains unpaid despite payment
of the principal benefit and a lesser amount of interest
after the amendment, his pending ERISA action is not moot.
See Templin v. Indep. Blue Cross, 487 Fed.Appx. 6,
11-12 (3d Cir. 2012).
examination of the parties' prior briefs regarding the
merits of Plaintiff's ERISA claims, the Court finds no
discussion of what interest is due on the principal benefit
amount if Plaintiff succeeds in establishing coverage under
the life insurance policy in effect when Mrs. Smith died or
otherwise establishes a right of recovery. Although this
issue could arguably be decided through a post-judgment
motion, the Court finds under the circumstances - where it is
the sole remaining issue (because the principal amount has
been paid) and Plaintiff seeks to recover it as a benefit to
which he was entitled under the ERISA plan or insurance
policy (although he alternatively seeks an equitable award) -
the parties should be required to address the issue of
prejudgment interest as part of their merits briefing.
THEREFORE ORDERED that the case shall proceed to a
determination of the merits of Plaintiff's ERISA claims
based on the existing record and prior briefs, together with
supplemental briefs regarding the issue of prejudgment
interest due either as a policy benefit under 29 U.S.C.
§ 1132(a)(1)(B) or an equitable remedy under 29 U.S.C.
§ 1132(a)(3). Plaintiff shall file a supplemental brief
on this issue within 21 days from the date of this Order.
Defendants shall respond within 14 days thereafter. Each
party's brief shall not exceed 10 pages in length.
 Defendant Carlisle Corporation, the
sponsor of the ERISA plan, proposes in its brief that these
omissions could be cured. But Carlisle merely speculates that
Standard could reopen the record for Plaintiff's
benefit claim and could compile or supplement the
administrative record, and that Plaintiff could
exhaust the internal review process before proceeding with
his ERISA claims. See Carlisle's Br. [Doc. No.
82] at 1. The Court rejects Carlisle's apparent
suggestion that this case should be dismissed in favor of one
that does not, and may never, exist.
 Standard included interest payments in
the checks tendered to Plaintiff when it approved his claim
under the policy amendment. See Notice [Doc. No.
69]; Standard's Mot. ...