Source: http://wv.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180328_0000347.SWV.htm/qx
Timestamp: 2019-04-26 14:48:21+00:00

Document:
UNITEDHEALTH GROUP, et al, Defendants.
Pending before the Court is Plaintiff Suzette Harrison's Motion for Judgment on Administrative Record, (ECF No. 13), and Defendant Standard Insurance Company's Motion for Summary Judgment, (ECF No. 14). For the reasons discussed herein, the Court GRANTS the Motion for Summary Judgment, DENIES the Motion for Judgment on Administrative Record, and DISMISSES this case from the docket of the Court.
Plaintiff Suzette Harrison (“Ms. Harrison”), a former registered nurse, was formerly employed as a medical case manager for UnitedHealth Group (“UHG”). (ECF No. 1-1 at 5.) Ms. Harrison participated in an employee welfare benefit plan (“the Plan”) established by UHG. Administrative Record at * 00793 (hereinafter “AR ___”). UHG, through the Plan, is the policyholder of a group long-term disability insurance policy (“the policy”) purchased from Defendant Standard Insurance Company (“Standard”). (AR 00012.) Standard is both the insurer responsible for paying claims made by Plan participants and the plan administrator who determines which participants are eligible for benefits. (AR 00033-00034.) The policy, as a component of the Plan, is subject to the regulatory provisions of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”).
Ms. Harrison filed a Motion for Judgment on Administrative Record on May 30, 2017. (ECF No. 13.) Standard filed a response on June 13, 2017, (ECF No. 17), to which Ms. Harrison replied on June 20, 2017, (ECF No. 18.) Standard filed its Motion for Summary Judgment on May 30, 2017. (ECF No. 14.) Ms. Harrison filed a response on June 13, 2017, (ECF No. 16), to which Standard replied on June 20, 2017, (ECF No. 19). As such, the parties' cross-motions are ripe for review by this Court.
A plaintiffs' § 1132 claim challenging a denial of benefits is analogous to a claim arising under the common law of trusts. See Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 113, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). Accordingly, a jury trial is inappropriate, and such claims are properly decided through cross-motions for summary judgment on the basis of the administrative record that was relied upon by the plan administrator who denied the benefits claim. See Berry v. Ciba-Geigy Corp., 761 F.2d 1003, 1007 (4th Cir. 1985), In re Vorpahl, 695 F.2d 318, 320 (8th Cir. 1982).
Caldwell v. Std. Ins. Co., No. 2:14-cv-25242, 2015 U.S. Dist. LEXIS 112122, at *4-5 (S.D. W.Va. August 25, 2015).
Rule 56 of the Federal Rules of Civil Procedure governs motions for summary judgment. That rule provides that a court should grant summary judgment if “there is no genuine issue as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). Summary judgment is inappropriate, however, if there exist factual issues that reasonably may be resolved in favor of either party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250 (1986). “Facts are ‘material' when they might affect the outcome of the case, and a ‘genuine issue' exists when the evidence would allow a reasonable jury to return a verdict for the nonmoving party.” The News & Observer Publ'g Co. v. Raleigh-Durham Airport Auth., 597 F.3d 570, 576 (4th Cir. 2010). When construing such factual issues, the Court must view the evidence “in the light most favorable to” the party opposing summary judgment. Adickes v. S.H. Kress & Co., 398 U.S. 144, 157 (1970); see also Liberty Lobby, 477 U.S. at 255 (“The evidence of the non-movant is to be believed, and all justifiable inferences are to be drawn in his favor.” (citation omitted)).

References: § 1001
 § 1132
 v. 
 v. 
 v. 
 v. 
 v. 
 v.