United States District Court, D. Nevada
ORDER ON MOTIONS FOR JUDGMENT ON THE ADMINISTRATIVE RECORD (Dkt. ##25, 28)
ANDREW P. GORDON, District Judge.
Kenneth Murphy was a software engineer for ICP Triplex, Inc. He suffered from a terminal illness and died while employed at ICP. Shortly before his death, Kenneth signed up for a voluntary life insurance policy ("the Voluntary Policy") from defendant Life Insurance Company of North America ("LINA").
After Kenneth died, his wife, plaintiff Linda Murphy ("Murphy"), asked LINA to pay her benefits under the Voluntary Policy. LINA denied the claim, explaining that the Voluntary Policy never went into effect. Murphy then filed this lawsuit challenging LINA's denial and seeking a bench trial on the administrative record.
I find that LINA correctly denied Murphy's claim. The Voluntary Policy could not go into effect unless Kenneth was "actively working" for ICP on the relevant enrollment date. Murphy provides scarce evidence that Kenneth was actively working on any of the relevant dates. LINA, in contrast, provides substantial evidence indicating Kenneth was unable to actively work during these periods; hospice and hospital records show that Kenneth's illness was progressing and seriously affecting his mental faculties. Judgment on the administrative record is therefore entered in LINA's favor.
I. LEGAL STANDARD: MOTION FOR JUDGMENT ON THE ADMINISTRATIVE RECORD IN AN ERISA CASE
The parties have stipulated that review of LINA's denial is in the form of a bench trial on the record that the administrator had before it. Rather than asking whether there is a genuine issue of fact under Federal Rule of Civil Procedure 56, here I decide the issues of fact. I "evaluate the persuasiveness of conflicting testimony and decide which is more likely true." I then make findings of fact and law under Rule 52(a) and determine which party prevails. I consider only the administrative record that was before LINA.
The parties agree that my review of LINA's denial is de novo.  Murphy has the burden to prove that she is entitled to benefits under the policy and that LINA improperly denied her claim.
II. FINDINGS OF FACT
Linda Murphy was Kenneth's wife. Kenneth died on November 2, 2006 of glioblastoma, an aggressive, malignant brain tumor. When he died, Kenneth was an employee if ICS Triplex.
Shortly before his death, Kenneth signed up for two life insurance policies. Early in October of 2006, he signed up for a basic term life insurance policy. Later in October, he enrolled in a Voluntary Group Universal Life Insurance Policy (the "Voluntary Policy"). LINA is the plan administrator and insurer of both policies.
After Kenneth died, Murphy requested benefits under both policies. LINA paid benefits under the basic term policy but denied Murphy's claim for benefits under the Voluntary Policy. LINA's explanation for its denial was: (1) the Voluntary Policy required Kenneth to be in "active service" before it could go into effect; and (2) LINA determined that Kenneth was not in "active service" during the relevant time periods. In 2009, Murphy filed a lawsuit challenging LINA's denial and the court remanded back to LINA.
In 2012, LINA again denied Murphy's claim. LINA determined that, based on the evidence in the administrative record, Kenneth was not in "active service" during the period in which the Voluntary Policy could have gone into effect. Thus, LINA concluded the Voluntary Policy never covered Kenneth and Murphy was not ...