Case Summaries

ERISA

[02/01] Muto v. CBS Corp.
In a putative class action complaint brought in New York by Pennsylvania residents against the plaintiffs' former employer and the employer's pension plan for benefits alleged to be due under ERISA, the district court's dismissal of the complaint as time-barred is affirmed, where: 1) the district court was correct in applying New York's borrowing statute directing it to look to Pennsylvania law for the applicable statute of limitations; and 2) plaintiffs' claims were untimely under Pennsylvania law.

[01/26] The DIRECTV Group, Inc. v. US
In a case involving the calculation and payment of segment closing adjustments associated with a corporation's sale of certain business units that included the transfer of defined benefit pension plans, the decision of the United States Court of Federal Claims granting summary judgment in favor of the corporation is affirmed, where: 1) the Claims Court did not err by calculating segment closing adjustments based on the assets and liabilities of the entire segment, rather than only the assets and liabilities that the corporation retained; and 2) the Claims Court correctly determined that the corporation's segment closing obligations could be satisfied by the cost savings realized by the government in the successor contracts.

[01/23] Leeson v. Transamerica Disability Income Plan
In an action under ERISA challenging the termination of the plaintiff's long-term disability benefits that was dismissed by the district court for lack of standing to pursue an ERISA claim and thus lack of federal subject matter jurisdiction, the dismissal is vacated and the case remanded, as the plaintiff's status as a participant for purposes of ERISA was a substantive element of his claim, not a prerequisite for subject matter jurisdiction.

[01/11] Scibelli v. Prudential Insurance Company
In an appeal from an order of the district court dismissing, on summary judgment, plaintiff's ERISA claim, 29 U.S.C. section 1132, order is vacated where based on the relevant evidence, the Group Policy language, and the unexplained inconsistency in the Plan Administrator's award of benefits, the deceased beneficiary was "totally disabled" under the terms of subject Group Policy when he stopped working, and therefore, his estate is entitled to the proceeds of a group life insurance policy.

[01/11] Fortier v. Principal Life Insurance Co.
In an appeal from an order of the district court dismissing, on summary judgment, plaintiff's ERISA complaint for further benefits under a group disability policy, judgment is affirmed where the plan administrator reasonably interpreted the policy so that plaintiff's claim of certain extraordinary expenses as deductions on his federal income tax returns made such expenses ordinary and necessary and thus were deductible from his gross predisability earnings.

[12/23] Milgram v. The Orthopedic Associates Defined Contribution Pension Plan
In a suit under ERISA seeking to recover funds that were erroneously removed from an individual's defined contribution pension fund account and credited to that of his former wife, the district court's judgment against the plan is affirmed, where: 1) ERISA’s anti-alienation provision and other provisions of federal and state law do not prohibit enforcement of the judgment; and 2) the inclusion of accumulated earnings and prejudgment interest in the award was permitted by the plan contract.

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Elder Law

[01/27] Hutcherson v. Arizona Health Care Cost Containment System Administration
In a declaratory judgment action seeking a declaration that Arizona's Medicaid agency had no right at all to recover from an annuity purchased by a husband so that his institutionalized wife could obtain Medicaid coverage or, alternatively, had no right to recover for any costs incurred for the wife's care after the husband's death, the district court's grant of the defendant's motion for summary judgment is affirmed, where: 1) the federal Medicaid Act allows states to reach a deceased community spouse's annuity for costs incurred on behalf of an institutionalized spouse; and 2) nothing in the language of the Act was inconsistent with permitting the state agency to recover from the annuity expenses incurred after the husband's death.

[10/20] NY Coalition for Quality Assisted Living, Inc. v. MFY Legal Services, Inc.
In an appeal from a judgment of the appellate division reversing a trial court order enjoining defendants from violating an assisted living facilities' visitor access guidelines, judgment is affirmed where the guidelines impermissibly restrict advocate access to facility residents, and violate 18 NYCRR 485.14 and the DOH's interpretation of that regulation.

[09/21] In re: Lemington Home for the Aged
In an appeal from a judgment of the district court granting summary judgment in favor of defendants on the grounds that the business judgment rule and the doctrine of in pari delicto bar plaintiff's action for breach of fiduciary duty, judgment is reversed where there are genuine disputes of material facts.

[08/23] Estate of Dito
In a probate petition alleging financial elder abuse, judgment of the trial court dismissing complaint without leave to amend on the ground that it is barred by res judicata is reversed as modified, where the petition is not barred as a matter of law on the basis of an earlier dispute because the issues as presented differ .

[08/12] Carter v. Prime Healthcare Paradise Valley
In a tort and injury action alleging elder abuse, willful misconduct, and wrongful death, judgment of the trial court dismissing action is affirmed because plaintiffs had not alleged conduct that qualified as elder abuse, as distinguished from negligence, and where the willful misconduct and wrongful death claims were untimely.

[06/28] Hartley v. Superior Court (Monex Deposit Co.)
In a petition for a writ of mandate to overturn the trial court's order compelling petitioner to arbitrate her claims against real parties in interest, order is vacated where trial court erred by finding the parties' arbitration agreement clearly and unmistakably gives the arbitrator the exclusive authority to decide the gateway issue of unconscionability, or arbitrability.

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Government Benefits

[02/03] Sauer v. Dep't of Education
In a suit by a California state agency seeking review of an arbitration award that made it liable to a blind vendor for failing to sue the federal General Services Administration (GSA) to vindicate the rights of the vendor to conduct business on federal property, the district court's judgment affirming the award is reversed, where: 1) the arbitration panel committed a legal error when it interpreted the Randolph-Sheppard Vending Stand Act as requiring the state agency to bring an action against GSA, and that the agency's failure to do so made it liable for compensatory damages; and 2) because the arbitration panel's ruling was not in accordance with law, it had to be set aside under the Administrative Procedure Act.

[01/31] Fowlkes v. Thomas
On a prisoner's postjudgment motion for an order directing the Social Security Administration (SSA) to re-tender a check for retroactive supplemental Social Security benefits that he was owed, the district court’s denial of the motion is affirmed, as: 1) the No Social Security Benefits for Prisoners Act bars the SSA from making any payment to an incarcerated individual covered by the Act, regardless of when the underlying obligation to pay the individual arose; and 2) the Act is not impermissibly retroactive, because it alters only the procedure and timing by which certain individuals receive their retroactive Social Security benefit payments, and does not affect their substantive right to those benefits.

[01/27] Hutcherson v. Arizona Health Care Cost Containment System Administration
In a declaratory judgment action seeking a declaration that Arizona's Medicaid agency had no right at all to recover from an annuity purchased by a husband so that his institutionalized wife could obtain Medicaid coverage or, alternatively, had no right to recover for any costs incurred for the wife's care after the husband's death, the district court's grant of the defendant's motion for summary judgment is affirmed, where: 1) the federal Medicaid Act allows states to reach a deceased community spouse's annuity for costs incurred on behalf of an institutionalized spouse; and 2) nothing in the language of the Act was inconsistent with permitting the state agency to recover from the annuity expenses incurred after the husband's death.

[01/20] National Organization of Veterans' Advocates, Inc. v. Secretary of Veterans Affairs
In a challenge to a rule issued by the Secretary of Veterans Affairs with respect to claims for service-connected disability benefits for posttraumatic stress disorder, a petition to review the final rule is denied where, under a Chevron analysis: 1) no existing statute or regulation specifically addresses the issue raised in the rule so as to create a conflict or contradiction; 2) the court could not say that the rationale behind the rule is without a logical basis, or is otherwise arbitrary and capricious.

[01/17] US v. Aguasvivas-Castillo
On appeal by an owner of a supermarket chain convicted for food stamp fraud and money laundering, the district court's application of sentence enhancements and its forfeiture order are affirmed, where: 1) the district court correctly determined that under the totality of the circumstances, the appellant was clearly engaged in the business of laundering funds; 2) the evidence established the appellant's supervisory role in the conspiracy; and 3) the forfeiture was not grossly disproportional to the gravity of the appellant's offense and thus not unconstitutional under the Excessive Fines Clause of the Eighth Amendment.

[01/11] Pacific Operators Offshore, LLP v. Valladolid
In an appeal from a judgment of the appeals court vacating an administrative dismissal of respondent's Outer Continental Shelf Lands Act (OCSLA) claim for benefits as a surviving spouse, judgment is affirmed where a claimant seeking benefits under the OCSLA must establish a substantial nexus between the injury and extractive operations on the shelf.

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Insurance Law

[02/03] Pennsylvania National Mutual Casualty Insurance Co. v. Roberts
In a suit brought by an insurer seeking a declaratory judgment that it was required to indemnify its insured for no more than 40 percent of a state court judgment because it had covered its insured for no more than 40 percent of the time in which the state court plaintiff was exposed to lead poisoning, the district court's judgment is: 1) affirmed in part, where it was correct in allocating the insurer's liability using the pro-rata time on-the-risk, and its decision to use the plaintiff's date of birth as the starting point for the period in which she was exposed to lead poisoning was sound; and 2) reversed in part, where the district court erred in holding the insurer liable for 24 months of coverage rather than 22, since under the insurance contract, coverage ended when the property was sold.

[02/03] Scandinavian Reinsurance Co. Ltd. v. Saint Paul Fire and Marine Insurance Co.
The district court's grant of a petition to vacate an arbitral award is reversed, and on remand the district court is instructed to grant a cross-petition to confirm the award, where there was insufficient evidence before the district court on which to base a finding of "evident partiality" within the meaning of the Federal Arbitration Act despite the failure of two arbitrators to disclose their concurrent service as arbitrators in another, arguably similar, arbitration.

[01/30] M & F Fishing, Inc. v. Sea-Pac Insurance Managers, Inc.
In an action by owners and operators of commercial fishing companies alleging violations of the Unfair Competition Law predicated on violations of the Insurance Code, the judgment in favor of the plaintiffs is reversed and the matter is remanded, where: 1) the plaintiffs were not entitled to restitution for insurance lawfully placed from admitted carriers; 2) the plaintiffs were not entitled to restitution of premiums paid for nonadmitted coverage; 3) the plaintiffs were barred from recovering restitution of any broker fees based on a violation of Insurance Code section 1764.1 occurring more than four years before they filed suit; 4) the trial court should have granted one defendant's motion for nonsuit for lack of an agency relationship; 5) the trial court properly exercised its discretion when it denied the plaintiffs' motions to amend to add additional parties; and 6) the plaintiffs' entitlement to prejudgment interest was subject to the discretion of the trial court.

[01/27] Hutcherson v. Arizona Health Care Cost Containment System Administration
In a declaratory judgment action seeking a declaration that Arizona's Medicaid agency had no right at all to recover from an annuity purchased by a husband so that his institutionalized wife could obtain Medicaid coverage or, alternatively, had no right to recover for any costs incurred for the wife's care after the husband's death, the district court's grant of the defendant's motion for summary judgment is affirmed, where: 1) the federal Medicaid Act allows states to reach a deceased community spouse's annuity for costs incurred on behalf of an institutionalized spouse; and 2) nothing in the language of the Act was inconsistent with permitting the state agency to recover from the annuity expenses incurred after the husband's death.

[01/26] Lopez & Medina Corp. v. Marsh USA, Inc.
On appeal of a rejected cross-motion for summary judgment that argued that an insurance policy's coverage expressly applied to an airline's underlying claims for damages arising from the insured's failure to provide air transportation, as contractually required, to the airline's passengers, the district court's order denying the motion is affirmed, as the phrase "legally obligated to pay as damages" in a commercial general liability policy, which usually covers only tort claims, does not also provide coverage for claims in an underlying action arising out of and related to a contract between the parties.

[01/26] Fortin v. Titcomb
In a case in which a federal jury awarded the appellant $125,000 in damages against a police officer after finding that the officer negligently used force in arresting the appellant, which award the district court reduced to $10,000, the maximum set by the Maine Tort Claims Act (MTCA) for the personal liability of government employees, the following questions are certified to the Maine Supreme Judicial Court: 1) where an insurance policy is available to cover a judgment against a government employee sued in his or her personal capacity, is the limit on the award of damages $10,000 as set by the MTCA at section 8104-D or is the limit set by reference to sections 8105(1) and 8116?; and 2) which interpretive principles should be applied to construe an insurance policy, procured by a governmental body to cover itself or its employees for MTCA damages liability, that contains an ambiguity affecting the scope of coverage?

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