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Mote v. Aetna Life Insurance Co.

November 3, 2006

BRENDA MOTE,*FN1 PLAINTIFF,
v.
AETNA LIFE INSURANCE COMPANY, ET AL., DEFENDANTS.



The opinion of the court was delivered by: Milton I. Shadur Senior United States District Judge

MEMORANDUM OPINION AND ORDER

Brenda Mote ("Mote") brings this action under a provision of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §1132(a)(1)(B).*fn2 Mote seeks reinstatement of disability payments under that ERISA section pursuant to the Arthur Andersen LLP Group Long Term Disability Insurance Plan ("Plan"), as underwritten by Aetna Life Insurance Company ("Aetna"). Although Mote has named both the Plan and Aetna as defendants, Aetna is not a proper party under Blickenstaff v. R.R. Donnelley & Sons Co. Short Term Disability Plan, 378 F.3d 669, 674 (7th Cir. 2004), which held that a claim for ERISA benefits "generally is limited to a suit against the Plan." To be sure, Aetna collected all of Mote's medical information, made all of the determinations about her medical condition and communicated those decisions to Mote, but it did so as agent for and on behalf of the Plan. Hence this Court is obligated to attribute Aetna's decision-making process to the Plan (see Blickenstaff, 378 F.3d at 672 n.1). Mote's claim against Aetna is therefore dismissed.*fn3

As between Mote and the Plan, each has now moved for summary judgment under Fed. R. Civ. P. ("Rule") 56 and has relatedly complied with this District Court's LR 56.1.*fn4 Their cross-motions are fully briefed and ready for decision. For the reasons stated in this memorandum opinion and order, the Plan's motion is granted, Mote's motion is denied and this action is dismissed.

Summary Judgment Standard

Every Rule 56 movant bears the burden on her or its Rule 56 motion of establishing the absence of any genuine issue of material fact (Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986)). For that purpose courts consider evidentiary records in the light most favorable to nonmovants and draw all reasonable inferences in their favor (Lesch v. Crown Cork & Seal Co., 282 F.3d 467, 471 (7th Cir.2002)).

As this Court has said in Coles v. LaSalle Partners Inc.

Disability Plan, 287 F.Supp.2d 896, 900 (N.D. Ill. 2003):

Those requirements often present an insurmountable hurdle when applied to cross-motions for summary judgment.

No such insurmountable hurdle exists here, even though this review of the Plan in the summary judgment context under the requisite deferential standard creates a unique situation, for it requires a determination of the reasonableness of the Plan's decision even while all reasonable inferences are drawn in Mote's favor.

Statement of Facts*fn5

Mote worked as a Human Resource Generalist with Arthur Andersen until April 10, 1998, when she ceased working because she became incapable of performing her job due to back pain and physical complications, including fibromyalgia, stemming from an accident she had suffered in August 1997 (M. App. at 1, 6). Based on a period of eligibility beginning on April 11, she began to receive long-term disability benefits on July 10, 1998 under the Arthur Andersen Long-Term Disability ("LTD") Plan, on the premise that she was totally disabled due to severe back pain and fibromyalgia (id. at 1).

On December 8, 2003 the Plan notified Mote that it had recently reevaluated her claim and, upon reviewing the information in her file, had determined that she no longer met the Plan requirements for total disability (M. App. at 1). Under the Plan "total disability" has a two-tiered definition that means (AP. Ex.1 at 1206):

For Active Regular Employees with a job class below manager, that solely because of an illness, pregnancy or accidental bodily ...


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