Opinion ID: 3011590
Heading Depth: 2
Heading Rank: 2

Heading: Beneficiary

Text: Even if a letter from a lawyer on behalf of a beneficiary is sufficient to implicate S 1024(b)(4), the attorney must still write on behalf of either a participant or abeneficiary. Mr. Daniels, not Mrs. Daniels, was the participant; to invoke the protection of S 1024(b)(4), Mrs. Daniels, then, must be a beneficiary. Section 1002(8) of Title 29 defines an ERISA beneficiary as a person designated by a participant, or by the terms of an employee benefit plan, who is or may become entitled to a benefit thereunder. This requires that we resolve two issues: (1) what constitutes a relevant benefit?; and (2) when does an individual making a request for plan documents qualify as a person . . . who is or may become entitled to such a benefit?6 _________________________________________________________________ 5. See Graves v. United States Coast Guard , 692 F.2d 71, 74 (9th Cir. 1982) (The designation `attorney for Leonard Graves' [on an administrative Tort Claims Act claim] is particularly important in view of the body of case law holding that the appearance of an attorney for a party raises a presumption that the attorney has the authority to act on that party's behalf.) See also Anderson v. Flexel, Inc., 47 F.3d 243, 249 (7th Cir. 1995) (recognizing in the context of an attorney's request under S 1024(b)(4) the existence of the long-standing legal presumption that an attorney has authority to act on behalf of the person he purports to represent). 6. Mrs. Daniels brought her breach of fiduciary duty claim under 29 U.S.C. S 1132(a)(3) which provides in part that a civil action may be brought . . . by a participant, beneficiary or fiduciary . . . to obtain . . . appropriate equitable relief . . . to redress . . . violations of ERISA. T&B does not contend that Mrs. Daniels fails to qualify as a beneficiary under this section, and we thus have no occasion to address the relationship between it and section 1002(8). 17 With regard to the first of these two questions, the specific relief that Mrs. Daniels seeks in the instant case-- damages stemming from T&B's alleged breach of fiduciary duty--does not constitute a benefit within the meaning of S 1002(8). The Ninth Circuit Court of Appeals came to this same conclusion in Kuntz v. Reese, 785 F.2d 1410, 1411 (9th Cir. 1986), in which the court observed: The . . . plaintiffs do not allege that their vested benefits were improperly computed, rather they allege breach of fiduciary duty or of a duty to disclose information about benefits, thus any recoverable damages would not be benefits from the plan. Consequently, if we were to assess beneficiary status as of the time of the present appeal, Mrs. Daniels would not be a beneficiary and, therefore, would not be entitled to lodge a request for plan documents to which T&B would be legally obligated to respond. As of the time of the present appeal, Mrs. Daniels presses only a claim for damages stemming from T&B's alleged breach of fiduciary duty. Any recovery Mrs. Daniels would receive as a consequence of the present cause of action for fiduciary breach would come out of T&B's pocket (i.e., on the theory that T&B made materially misleading statements about the plan), and not out of MetLife's (i.e., on the theory that the plan's provisions entitle Mrs. Daniels to payment pursuant to its terms). We conclude, however, that ERISA beneficiary status should not be measured as of the time of the present appeal. Instead, the temporal focus of the beneficiary inquiry should be the time the request for plan documents was made. An individual who is . . . entitled to a plan benefit or who may become entitled to such a benefit, as of the time that individual makes the request of the plan administrator, thus constitutes a beneficiary. As of the time of her request, Mrs. Daniels had no reason to believe that events would happen in the future which would entitle her to a benefit, i.e., that she would become entitled at some future date. The issue for decision is thus narrowed to whether Mrs. Daniels was entitled to a plan benefit on September 29, 1994, when her request for documents was made. In order for her to be entitled, it is 18 not necessary that she establish that she had a meritorious claim; it is sufficient if she demonstrates that she had a colorable claim that . . . she will prevail in a suit for benefits. Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 117 (1989). We conclude that she had such a claim. As we have recounted, Mrs. Daniels had been told by her husband shortly before his death that he had life insurance through his employer's plan in the amount of 2.5 times his annual salary. He was in a position to have personal knowledge of this matter and had an interest in accurately advising her regarding it. As of September 29th, Mrs. Daniels knew she had received materially less than 2.5 times Mr. Daniels' salary in insurance proceeds. While her son had been shown the group insurance election form, its significance could not be reliably assessed in isolation. With this knowledge, we conclude that Mrs. Daniels had a colorable claim to additional insurance proceeds and that Congress intended that she have access to the documents necessary to determine whether she had a meritorious claim as well as a colorable one. The concept of a colorable claim necessarily encompasses situations in which the requester has a reasonable basis for believing that he or she has a meritorious claim but is in fact mistaken. If Mrs. Daniels' situation on September 29th were not one of these, we would have difficulty hypothesizing one. It is true, as T&B stresses, that the letter of Mrs. Daniels' attorney was consistent with her contemplating a breach of fiduciary duty claim.7 We do not believe, however, that one in Mrs. Daniels' position should be held to have made an election of remedies based on the precise wording of a letter seeking access to the information necessary to make an informed decision regarding available remedies. If an administrator has concerns about whether someone _________________________________________________________________ 7. One paragraph of the letter reads as follows: We are representing the family on their claims for damages concerning the actions of Thomas & Betts, and its employees, resulting in the denial of life insurance benefit payments on life insurance benefits that were provided to Mr. Daniels prior to his death. App. at 69. 19 requesting access lacks a colorable claim, it is free to ask for the facts upon which a claim to a benefit is being made. If, like T&B, it fails to do so, it proceeds at its own risk.