Jennifer Collins v. UNUM Life Insurance Company ( 2017 )

UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 16-1636
JENNIFER MULLEN COLLINS,
Plaintiff - Appellant,
v.
UNUM LIFE INSURANCE COMPANY OF AMERICA,
Defendant - Appellee.
Appeal from the United States District Court for the Eastern
District of Virginia, at Norfolk. Robert G. Doumar, Senior
District Judge. (2:15-cv-00188-RGD-RJK)
Submitted: December 20, 2016 Decided: July 6, 2017
Before GREGORY, Chief Judge, and NIEMEYER, and HARRIS, Circuit
Judges.
Affirmed by unpublished per curiam opinion.
Gregory N. Stillman, Wendy C. McGraw, HUNTON & WILLIAMS LLP,
Norfolk, Virginia; Todd M. Stenerson, HUNTON & WILLIAMS, LLP,
Washington, DC, for Appellant. David E. Constine, III, Stephen
C. Piepgrass, TROUTMAN SANDERS LLP, Richmond, Virginia, for
Appellee.
Unpublished opinions are not binding precedent in this circuit.
PER CURIAM:
Former Navy SEAL David M. Collins served this country for
seventeen years, during which he was deployed to Iraq,
Afghanistan, and Kuwait. He served in dangerous and stressful
situations, many of which exposed him to enemy gunfire and
blasts from mortar fire. Upon retirement, he was diagnosed with
Post-traumatic Stress Disorder, Major Depressive Disorder,
Generalized Anxiety Disorder, and chronic traumatic
encephalopathy (CTE), a “progressive neurodegenerative disease”
caused by “repetitive brain trauma.” J.A. 719. Despite seeking
treatment, Mr. Collins was found dead in the driver’s seat of
his car with a gunshot wound to his head on March 12, 2014. The
death was ruled a suicide.
Prior to his death, Mr. Collins had been working for
Blackbird Technologies, where he participated in an employee
benefit plan that provided basic and supplemental life insurance
through group policies funded and administered by Unum Life
Insurance Company of America. When Mr. Collins died, his widow,
Jennifer Mullen Collins, applied for benefits under both
policies. Unum granted benefits under the basic policy, but
denied benefits under the supplemental policy’s suicide
exclusion. The supplemental policy had become effective in
February 2013.
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To challenge the denial, Ms. Collins filed this action
under the Employee Retirement Income Security Act. See 29
U.S.C. 1132(a)(1)(B) (2012). Both parties filed motions for
summary judgment. Applying the abuse-of-discretion standard of
review, the district court affirmed the denial of benefits and
granted summary judgment to Unum. The district court first
found the suicide exclusion valid. Then, the court ruled that
Unum reasonably interpreted the plan term “suicide” to include
sane and insane suicide and had substantial evidence to support
its conclusion that the exclusion applied.
We “review the district court’s disposition of cross-
motions for summary judgment . . . de novo, viewing the facts in
the light most favorable to the non-moving party.” Bostic v.
Schaefer, 760 F.3d 352, 370 (4th Cir. 2014). Summary judgment
requires the moving party to show that no genuine dispute of
material fact remains and that the moving party “is entitled to
judgment as a matter of law.” Fed. R. Civ. P. 56(a). A court
should grant summary judgment unless a reasonable jury could
return a verdict for the nonmoving party on the evidence
presented. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249
(1986).
Here, the cross-motions for summary judgment concerned
Unum’s use of a suicide exclusion. Plan administrators bear the
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burden of proving an exclusion applies. Jenkins v. Montgomery
Indus., 77 F.3d 740, 743 (4th Cir. 1996).
Where, as here, the plan grants an administrator discretion
to award a benefit, we “must review only for abuse of discretion
and . . . must not disturb the . . . decision if it is
reasonable, even if the court itself would have reached a
different conclusion.” Fortier v. Principal Life Ins. Co., 666
F.3d 231, 235 (4th Cir. 2012) (internal quotation marks
omitted). An “administrator’s decision is reasonable if it is
the result of a deliberate, principled reasoning process and if
it is supported by substantial evidence.” Evans v. Eaton Corp.
Long Term Disability Plan, 514 F.3d 315, 322 (4th Cir. 2008)
(internal quotation marks omitted).
Our review for reasonableness applies to both a plan
administrator’s factual findings and plan interpretations. An
administrator’s factual findings require substantial evidence,
meaning “more than a scintilla but less than a preponderance.”
Newport News Shipbuilding & Dry Dock Co. v. Cherry, 326 F.3d
449, 452 (4th Cir. 2003) (internal quotation marks omitted).
When reviewing the administrator’s findings for substantial
evidence, a court must confine its review to the administrative
record, limiting itself “to the evidence that was before the
plan administrator at the time of the decision.” Bernstein v.
CapitalCare, Inc., 70 F.3d 783, 788 (4th Cir. 1995). When an
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administrator interprets a plan’s terms, the court does not
construe ambiguities against the insurer who drafted the terms.
See Carden v. Aetna Life Ins. Co., 559 F.3d 256, 261 (4th Cir.
2009).
Judicial review for reasonableness also finds aid in a
nonexhaustive list of factors this court set forth in Booth v.
Wal-Mart Stores, Inc. Assocs. Health & Welfare Plan, 201 F.3d
335, 342-43 (4th Cir. 2000). The Booth factors include:
(1) the language of the plan; (2) the purposes and
goals of the plan; (3) the adequacy of the materials
considered to make the decision and the degree to
which they support it; (4) whether the fiduciary’s
interpretation was consistent with other provisions in
the plan and with earlier interpretations of the plan;
(5) whether the decision making process was reasoned
and principled; (6) whether the decision was
consistent with the procedural and substantive
requirements of ERISA; (7) any external standard
relevant to the exercise of discretion; and (8) the
fiduciary’s motives and any conflict of interest it
may have.
Id.
On appeal, Ms. Collins argues that the district court erred
for three reasons, but our review of the record reveals no
reversible error. First, Ms. Collins argues that the exclusion
violates Va. Code § 38.2-3106 (2014), which prohibits insurers
from using suicide as a defense to the payment of life insurance
benefits unless the insurer includes “[a]n express provision
. . . limiting the liability of the insurer to an insured who,
whether sane or insane, dies by his own act within two years
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from the date of the policy.” Ms. Collins argues that the
absence of the phrase “whether sane or insane” in Unum’s suicide
exclusion nullifies the exclusion.
We conclude, however, that Unum’s exclusion sufficiently
complies with Virginia law because a policy only needs to
provide sufficient notice of an exclusion and its limit of two
years to comply with the statute. See New England Mut. Life
Ins. Co. v. Mitchell, 118 F.2d 414, 417 (4th Cir. 1941) (ruling
that a valid suicide exclusion does not need to use any “magic”
words to comply with statute that governs such exclusions). *
Second, Ms. Collins argues that Unum unreasonably
interpreted “suicide” to mean any non-accidental, self-inflicted
death. She contends that, because the suicide exclusion did not
include a clause specifying that suicide could be “sane or
insane,” the exclusion does not apply to suicides committed by
insane persons. Under the abuse-of-discretion standard,
however, Unum only has to offer a reasonable, and not the most
reasonable, interpretation of a plan term. See McCorkle v.
Metro. Life Ins. Co., 757 F.3d 452, 459 (5th Cir. 2014)
(explaining that abuse-of-discretion standard prohibits a court
* Because we conclude that the suicide exclusion complies
with Virginia law we need not resolve the parties’ dispute
regarding whether Unum should be allowed to alternatively
assert, for the first time on appeal, that the exclusion should
be found valid under Maine law.
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from “substituting [its] own, narrower interpretation of the
term [“suicide”] in place of [the administrator’s] reasonable,
yet broader, interpretation”) (internal quotation marks
omitted). Because people could reasonably understand the term
“suicide” to include any non-accidental, self-inflicted death
regardless of mental state, we defer to Unum’s interpretation.
Moreover, courts have upheld plan administrators’
interpretations of “suicide” to include sane and insane suicide
even though the phrase “sane and insane” did not appear in the
exclusions. McCorkle, 757 F.3d at 459; Riggs v. Metro. Life
Ins. Co., 940 F. Supp. 2d 172, 184–85 (D.N.J. 2013).
Third, under Ms. Collins’ interpretation of “suicide,” she
argues the administrative record lacks substantial evidence to
show that Mr. Collins was sane when he died. She contends that,
during Mr. Collins’ military service, he experienced sub-
concussive blasts that injured his brain and impaired his
ability to resist the impulse to kill himself. Thus, she
contends that Mr. Collins was not sane under Fourth Circuit law.
See Reinking v. Philadelphia Am. Life Ins. Co., 910 F.2d 1210,
1215 (4th Cir. 1990) (defining insanity to include someone who
suffers from “an ‘insane’ impulse that so overwhelms the will or
rational thought that the individual is unable to resist”).
Because we hold that Unum reasonably interpreted the
suicide exclusion to encompass insane suicide, Mr. Collins’
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sanity at death has no bearing on the outcome. Moreover, we
find substantial evidence in the administrative record to
support Unum’s conclusion that the suicide exclusion applied.
Accordingly, we affirm the district court’s order granting
summary judgment to Unum and denying summary judgment to Ms.
Collins. We dispense with oral argument because the facts and
legal contentions are adequately presented in the materials
before this court and argument would not aid the decisional
process.
AFFIRMED
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