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9th Cir. – Unpublished Ninth Circuit AD&D Case

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  • 9th Cir. – Unpublished Ninth Circuit AD&D Case

    Here’s a one-page opinion from the Ninth Circuit titled Petra Heng v. Metropolitan Life Insurance Company. It does not appear that comment is really necessary. The court’s ruling is as follows.

    The district court properly granted summary judgment because Heng failed to raise a genuine dispute of material fact as to whether defendant incorrectly denied AD&D benefits. See Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 962-63 (9th Cir. 2006) (en banc) (on de novo review, the district court “simply proceeds to evaluate whether the plan administrator correctly or incorrectly denied benefits;” this court reviews de novo the district court’s application of the standard of review to decisions by fiduciaries in ERISA cases, and for clear error the underlying findings of fact). As appellant conceded in district court in response to Met Life’s motion for summary judgment, her husband Thomas was “no longer co-employed by Tri Net after June 30, 2012.” Accordingly, the contract on which appellant relies no longer covered her husband, either on July 1, 2012 or July 25, 2012 when he was discovered deceased. The conversion option rights in the contract, which were never exercised, unambiguously related only to life insurance coverage, not to AD&D.
    The opinion is attached below.
    Attached Files