United States Court of Appeals

for the Fifth Circuit ____________

No. 23-50558

____________

Shantyry Martin, 

Plaintiff—Appellant, 

versus

Sedgwick Claims Management Services, Incorporated; 

General Electric Company, 

Defendants—Appellees. 

______________________________

Appeal from the United States District Court 

for the Western District of Texas

USDC No. 5:23-CV-169

______________________________

Before Higginson, Willett, and Oldham, Circuit Judges.

Per Curiam:*

Shantyry Martin sued General Electric and Sedgwick Claims 

Management for disability benefits. The district court held Martin’s suit is 

time-barred. We agree.

_____________________

* This opinion is not designated for publication. See 5th Cir. R. 47.5.

United States Court of Appeals

Fifth Circuit

FILED

May 9, 2024

Lyle W. Cayce

Clerk

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I.

Shantyry Martin began working as a quality inspector for General 

Electric in 2015. Soon after, Martin was diagnosed with systemic lupus 

erythematosus, rheumatoid arthritis, gout, and fibromyalgia. Martin’s 

rheumatologist eventually told her that the demands of her work were 

causing accelerated progression of these diseases, so Martin retired. Her last 

day of work was June 6, 2018.

As a GE employee, Martin was automatically enrolled in a disability 

benefits program called the Salary Continuation Program (“SCP”). The 

terms of the SCP are set forth in two GE handbooks: the Disability Benefits 

Handbook and the Administrative Handbook. SCP is designed to provide a 

participant with all or a portion of her regular pay for up to 26 weeks if GE 

determines she is “unable to perform the duties of [her] regular job” or 

another job that is both available and medically appropriate. ROA.96. To 

qualify for SCP benefits, a doctor must certify that the participant is disabled, 

and the GE Disability Benefits & Leave Center (“DBLC”) must approve the 

doctor’s certification.

Martin submitted an SCP claim to DBLC on June 7, 2018, the day 

after she retired. DBLC denied the claim on June 29. It explained Martin’s

physician failed to submit a statement certifying her disability even though 

DBLC prompted him multiple times.

The Administrative Handbook provides that SCP participants may 

appeal denial of an SCP claim, and it sets forth the procedures governing 

those appeals. Martin appealed DBLC’s denial of her claim pursuant to the 

Handbook procedures, and her doctor submitted a certification and other 

information respecting Martin’s disability during the appeal period.

Sedgwick Claims Management Services, DBLC’s claims manager, reviewed

Martin’s file and determined it did not support Martin’s claim that her 

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disability rendered her incapable of performing her essential job functions.

So on September 4, 2018, DBLC affirmed its denial of Martin’s claim. Martin 

appealed two more times; both times DBLC reaffirmed its denial for 

substantially the same reason it had already given. DBLC’s decision 

respecting Martin’s claim became final when it disposed of her third appeal. 

See ROA.194 (“This represents the [DBLC] Appeals Unit final decision with 

respect to your . . . claim.”). That decision issued on February 12, 2019.

On February 10, 2023, Martin filed suit against GE and Sedgwick. 

Martin alleged the SCP constituted a contract between GE and its employees 

and that GE and Sedgwick breached that contract by denying Martin benefits

they owed her. GE and Sedgwick moved to dismiss the suit on the ground 

that Martin’s sole claim is time-barred.

The district court agreed with GE and Sedgwick. It explained the 

terms of the SCP contract between GE and its employees were set forth in 

the Disability Handbook and the Administrative Handbook. And in the 

district court’s view, Section 2.1.2 the Administrative Handbook provides

that a lawsuit related to the denial of an SCP claim must be brought no more 

than three years after DBLC initially denies the claim. DBLC first denied 

Martin’s claim on June 29, 2018, and Martin did not file suit until February 

10, 2023, so the district court held that Martin’s breach-of-contract claim was

time-barred. Martin timely appealed. Our review is de novo. Ruiz v. Brennan, 

851 F.3d 464, 468 (5th Cir. 2017).

II.

Martin contends the district court erred by applying the contractual 

limitations provision to her breach-of-contract claim. We need not reach that 

issue, however, because Martin’s suit is untimely even if that provision does 

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not apply.

1 That is because absent contractual alteration, Texas applies a 

four-year limitations period to breach-of-contract actions. Tex. Civ. 

Prac. & Rem. Code § 16.051. Martin sued on February 10, 2023, which 

means her suit is time-barred under § 16.051 if her claim accrued before

February 11, 2019. And it did. 

Under Martin’s theory, the SCP is essentially an insurance contract. 

Under Texas law, a claim for breach of an insurance contract accrues on the 

date the insurer issues an unambiguous denial of coverage, unless the insurer 

subsequently takes action to impugn its denial. See Smith v. Travelers Cas. Ins. 

Co. of Am., 932 F.3d 302, 313–14 (5th Cir. 2019) (relying on Pace v. Travelers 

Lloyds of Tex. Ins. Co., 162 S.W.3d 632 (Tex. App.—Houston [14th Dist.]

2005)). Pace suggests a denial of coverage is unambiguous unless it would 

lead a reasonable person to believe that a coverage decision has not been 

made—e.g., if the insurer requests further information, suggests that further 

information is needed to reach a decision, or otherwise implies that a 

coverage decision has not been made. See 162 S.W.3d at 634.

On September 4, 2018, DBLC sent Martin a letter that said: “As the 

medical information in [your] file does not support your inability to perform 

your own occupation, as defined by the Plan . . . we have no alternative other 

than to reaffirm the denial of benefits . . . .” ROA.215. The September 4

letter did not request further information or suggest that further information 

was needed to make a coverage decision, so it constituted an unambiguous 

denial of coverage. Martin’s claim accordingly accrued on September 4, 

_____________________

1 We “may affirm a district court’s grant of a motion to dismiss on a basis not 

mentioned in the district court’s opinion.” Gulf Guar. Life Ins. Co. v. Conn. Gen. Life Ins. 

Co., 304 F.3d 476, 486 (5th Cir. 2002).

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2018, unless DBLC subsequently nullified the letter’s accrual-inducing

effect.

2 

Martin contends DBLC did so by affording her an opportunity to 

request reconsideration of its decision. But Texas law makes clear that an 

insurer’s post-denial willingness to re-investigate a claim, and actual reinvestigation, does not alone operate to nullify the prior accrual date. See

Travelers, 932 F.3d at 314–15. Instead, a claim accrues the moment an 

unambiguous denial is communicated, and that accrual date sticks unless the 

insurer subsequently takes action that is “inconsistent with [the denial]

decision.” Id. (quoting Pace, 162 S.W.3d at 635). Reconsideration is not 

inconsistent action. See Travelers, 932 F.3d at 314 (“[A]n insurer’s postdenial re-investigation . . . is not. . . action inconsistent with the denial

decision.” (quotation omitted)). Martin does not allege that DBLC did 

anything else to nullify the effect of its September 4 denial decision. Her postSeptember-4 appeals accordingly did not affect the date on which her breachof-contract claim accrued.

Martin also argues her claim could not have accrued until DBLC 

denied her final appeal because the Administrative Handbook required her to 

exhaust DBLC appeals before filing a lawsuit. And under Texas law, a claim 

“generally accrues at the time when facts come into existence which 

authorize a claimant to seek a judicial remedy.” Murray v. San Jacinto Agency, 

Inc., 800 S.W.2d 826, 828 (Tex. 1990). But the only Handbook provision that 

could have required Martin to exhaust her claims is Section 2.1.2—the same 

provision containing the contractual limitations provision that Martin says 

_____________________

2 DBLC’s June 29 denial invited further information and so did not constitute the 

kind of unambiguous denial that triggers claim accrual. See ROA.189 (“In order to perfect 

your claim, please provide any missing medical documentation related to your disability 

from recent treating provider visits.”).

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does not apply to her lawsuit. ROA.167. If the contractual exhaustion 

requirement applies, so does the contractual limitations provision, and if the 

contractual limitations provision applies, then Martin’s lawsuit fails.

3

Martin therefore does not base her exhaustion argument on any 

contractual provision. Instead, she argues that exhaustion was required 

because the Handbook adopts ERISA procedures for SCP claims, and an 

ERISA cause of action “does not accrue until the plan issues a final denial.”

Heimeshoff v. Hartford Life & Accident Ins. Co., 571 U.S. 99, 105 (2013). But 

the Handbook expressly statesthat “the SCP is not subject to ERISA and the 

provisions of this handbook shall not be interpreted in a manner that applies 

ERISA (or any of its requirements) to the SCP.” ROA.158 (emphasis added).

There is thus no basis for Martin’s argument that the Handbook somehow 

applies ERISA exhaustion to SCP claims.

AFFIRMED.

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3 Unless we equitably tolled the contractual limitations period. But Martin has not 

shown that she actively pursued her judicial remedies during the statutory period, or that 

she was tricked into allowing her filing deadline to pass, or any other basis for equitable 

tolling. See Bailey v. Gardner, 154 S.W.3d 917, 920 (Tex. App.—Dallas 2005).

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