Opinion ID: 790842
Heading Depth: 3
Heading Rank: 2

Heading: Full-Time

Text: 51 The term full-time is defined to mean[ ] active work on the Participating Employer's regular work schedule for the class of employees to which you belong. The work schedule must be at least 30 hours a week. 52 R.36-1 at 298. Basic to the definition of full-time is the requirement that a covered employee work for more than thirty hours per week. The district court found the term to be unambiguous and determined that Mr. Ruttenberg failed to offer sufficient evidence that he worked the requisite thirty hours per week. 53 U.S. Life urges us to affirm the district court's determinations, both its finding that the term full-time is unambiguous and its conclusion that Mr. Ruttenberg failed to offer sufficient evidence. The company contends that Mr. Ruttenberg failed to provide evidence that he met the thirty-hour requirement, even off of the trading floor; in response to questions about his eligibility Mr. Ruttenberg argued only that he spent more than thirty hours per week working on trades and that it was impossible to spend more than thirty hours per week on the floor. Assuming that the full-time requirement unambiguously includes working more than thirty hours per week, U.S. Life asserts that the district court correctly determined that Mr. Ruttenberg failed to demonstrate his eligibility. 54 In reply, Mr. Ruttenberg submits that the plain language of the definition, requiring active work on the Participating Employer's regular work schedule for the class of employees to which you belong, id. (emphasis added), indicates that the full-time requirement applies only to SMW's common law employees, not to independent traders covered by the policy; he asserts that, at the very least, the thirty-hour requirement's application is ambiguous. As for the evidence presented, he contends that, at certain stages in the litigation, U.S. Life adopted his view that a trader could not work thirty hours on the floor and that he did work more than thirty hours per week in preparing for trades. He points out that other courts have relaxed contractual full-time requirements to find that an insured is covered. See Burke v. Blue Cross Blue Shield of Nebraska, 251 Neb. 607, 558 N.W.2d 577 (1997); Jetson v. CNA Ins. Co., 536 So.2d 569 (La.Ct.App.1988). Mr. Ruttenberg also submits that it would defeat the reasonable expectations of the insured to deny coverage to more than eighty traders, based on a full-time requirement they cannot meet, after they have paid for the insurance. 55 Contrary to Mr. Ruttenberg's assertion, U.S. Life did not adopt in its statement of facts the position that he could not work more than thirty hours on the floor and that he worked the required hours in preparing for trades. U.S. Life's statement of facts listed the text of a letter received from Mr. Ruttenberg's attorney only to support the fact that the letter was received, not the letter's contents. Indeed, aside from assertions that he obviously worked more than thirty hours per week preparing for trades, he submitted no evidence that such was the case, for example, through affidavits from himself or associates. He was aware before the administrative record closed that U.S. Life questioned his eligibility under the full-time requirement, but failed to supplement the record. Thus, Mr. Ruttenberg presented insufficient evidence that he actually worked more than thirty hours per week. On this record, therefore, any relief Mr. Ruttenberg may be granted must be found through contractual ambiguity. 56 Turning to the ambiguity question, other courts' interpretations of the term full-time in other contracts do not control the present inquiry. Rather, we must determine what the term means in this insurance contract. 57 In interpreting a contractual term, we cannot give meaning to a word standing alone. Rather, we must take into account its placement in the text and discern its proper relationship to the text in which it is placed. Here, given the ambiguity in the term employee, it is not clear from the contract that the full-time requirement applies to noncommon law classes of employees like independent traders. Indeed, in defining full-time, the policy simply refers back to the ambiguous term employee: FULL-TIME means active work on the Participating Employer's [SMW's] regular work schedule for the class of employees to which you belong. R.36-1 at 298. If, as we have determined, the term employee is itself ambiguous as applied to Mr. Ruttenberg, then the policy is equally ambiguous about the application of the full-time requirement to his class of worker. 58 Moreover, the full-time provision is ambiguous even apart from the lack of clarity in the term employee. Independent traders like Mr. Ruttenberg do not work according to a work schedule established by SMW; independent traders clear their trades through SMW but the company does not control the details of their work schedules. Similarly, to qualify as a full-time worker, the employee must render active work, defined as performing each duty of your job for full pay. Id. It is not clear how full pay is measured for independent traders who do not draw a salary from SMW and simply clear their trades through the company. The inclusion of independent traders as employees under the eligibility clause cannot be reconciled with a definition of full-time that such workers cannot meet. 18 One of the provisions must take precedence, and arguably this means that the full-time requirement does not apply to the class of eligible employees that includes Mr. Ruttenberg. 59 Mr. Ruttenberg's proposed interpretation, that the full-time requirement does not apply to his category of eligible employee, is at least as plausible as U.S. Life's. The term cannot be said to be unambiguous, and the district court erred in dismissing his claim on that ground. Given the error, we remand to the district court for further proceedings. 19 60 Apart from the ambiguity questions, Mr. Ruttenberg and U.S. Life each argue that they are entitled to summary judgment on the merits of their respective claims. U.S. Life asserts that Mr. Ruttenberg is not disabled; for his part Mr. Ruttenberg contends that U.S. Life's own expert in fact found him to be disabled. The merits of Mr. Ruttenberg's claim, whether he is disabled and therefore entitled to the policy benefits, is a matter properly reserved to the district court on remand.