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11th Cir. – Approved While Claim is Moot

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  • 11th Cir. – Approved While Claim is Moot

    Here’s a new case out of the Eleventh Circuit, unpublished, entitled Theresa E. Peer v. Liberty Life Assurance Company of Boston. In this matter, the plaintiff’s waiver of premium claim was denied, but then after the lawsuit was filed, Liberty was rolled over and approved it. Plaintiff then filed a second suit again claiming a benefits claim, but also requesting that the court approve future benefits. The court finds for the defendant on all matters.

    We first address the denial of Peer’s Waiver of Premium claim. Peer states in her complaint—and reiterates on appeal—that she seeks a determination of life-insurance coverage pursuant to the plan’s Waiver of Premium provision. But as the district court correctly held, the claim is moot because Liberty reversed its initial adverse benefits determination and reinstated Peer’s coverage. Accordingly, Peer has already received the relief that she seeks, and “there is no further relief that the Court can award [Peer] on her claim for an award of the Waiver of Premium benefit.” See Pakovich v. Verizon LTD Plan, 653 F.3d 488, 492 (7th Cir. 2011) (holding that “[Plaintiff’s] benefit claim became moot when the Plan paid it in full”). The district court did not err in denying Peer’s Waiver of Premium claim; she had already received the benefit retroactively without a gap in coverage.

    Peer next contends that the district court improperly dismissed—as failing to present a live case or controversy—her request for a declaration of future benefits under 29 U.S.C. § 1132(a)(1)(B) (providing that a beneficiary may bring a civil action “to clarify [her] rights to future benefits”). She contends that Lamuth v. Hartford Life & Accident Insurance Co. supports the position that receipt of plan benefits does not moot a claim for a declaration of future benefits. 30 F. Supp. 3d 1036 (W.D. Wash. 2014). In Lamuth, the plaintiff sought “a declaration as to when she was first disabled … so as to avoid further conflict with regard to the Pre-existing Conditions Limitation.” Id. at 1047. Peer’s argument is different; rather than seeking a post-administrative-review determination of when past coverage was triggered, however, Peer requests a declaration as to her future eligibility. Before that claim ripens, Peer must first be deemed not “Totally Disabled” and that decision must then be administratively reviewed by Liberty. See Heimeshoff v. Hartford Life Acc. Ins. Co., 571 U.S. 99, 105 (2013) (“A participant’s cause of action under ERISA … does not accrue until the plan issues a final denial.”). Absent an adverse benefits determination, there is no ripe claim before us. As the district court observed, we “fail[] to see … how the Court may adjudicate [Peer’s] disability status in the future.”

    Finally, Peer asserts that “[t]he district court abused its discretion in failing to apply judicial estoppel” to bar Liberty’s contention that the case-or-controversy requirement precludes declaratory relief under 29 U.S.C. § 1132(a)(1)(B). “[D]istrict court[s] may apply judicial estoppel when a two-part test is satisfied.” Slater v. United States Steel Corp., 871 F.3d 1174, 1180 (11th Cir. 2017) (en banc). Specifically, judicial estoppel may be appropriate when the party against whom the doctrine is applied (1) has taken an inconsistent position from one staked out in a separate proceeding and (2) “intended to make a mockery of the judicial system.” Id. In Sand-Smith v. Liberty Life Assurance Co. of Boston, Peer claims, Liberty removed a case from state to federal court when the claimant sought a judicial declaration regarding an ERISA plan on the ground that the suit presented a federal question over which the federal court had jurisdiction. See 2017 WL 4169430, at *2 (D. Mont. Sept. 20, 2017). Liberty’s acknowledgment that a declaratory judgment regarding the ERISA plan in that case presented a justiciable controversy does not trigger judicial estoppel here. Liberty has never contended that all requests for judicial declarations are justiciable. Rather, it has consistently argued that declarations are proper under ERISA so long as there is a live case or Moreover, and in any event, we find no indication that Liberty is intending to make a mockery of the judicial system. Peer’s judicial estoppel claim fails on both prongs.
    The opinion is attached below.
    Attached Files