Miller Dismissed Again (revised)

Miller Dismissed Again
The Third Circuit U.S. Court of Appeals upheld the district courts decision in the case of Paul Miller v. Fortis Benefits Insurance Company and Resorts International Hotel, reconfirming that Fortis Benefits Insurance Company was not liable to pay an upward adjustment to Miller’s benefit checks.
Circuit judges Fuentes, Fisher, and McKay concluded that the cause of action accrued in 1987 when appellant Miller received his first benefit check. Due to the fact Miller did not file his claim within the applicable statutory period of six years, the court upheld the decision of the District Court, according to Fuentes.
Miller became disabled on October 6, 1986 after undergoing heart surgery. Prior to his surgery Miller was employed by Resorts International as a casino floor worker making $690 a week. Immediately before becoming disabled Miller worked as an outside marketing salesman earning $768 a week.
Under Resort’s Long Term Disability (LTD) plan Miller was entitled to 60 percent of his current salary until he reached the age of 65. However, Resorts accidentally reported Miller’s old salary earnings of $690 a week to Mutual Benefit, according to Miller. Beginning in April 1987 Miller began receiving disability checks based on his former salary of $690 a week, according to Fuentes.
It was not until 2002, 15 years after Miller began receiving disability checks, that he noticed he was being paid incorrectly. After consulting with an accountant Miller sent a letter to Fortis Benefits Insurance, which took over Mutual Benefit, seeking an adjustment to reflect his salary prior to becoming disabled. After investigating the matter Fortis informed Miller that the pay records that they needed to prove Miller’s claim were no longer accessible. Fortis only keeps pay records for a period of seven years. Because they did not have Miller’s records they could not adjust his payments, according to Fuentes.
In August 2003 Miller filed a complaint against Fortis and Resorts in the New Jersey Superior Court which was later moved to the District Court of New Jersey. Miller accused Fortis and Resorts of unlawfully denying him disability benefits and claimed that they breached a fiduciary duty to him by misrepresenting his proper salary and failing to thoroughly investigate his claim for adjustment, according to Fuentes.
Randi F. Knepper and Joshua A Zielenski of McElroy, Deuthsch, Mulvancy and Carpenter represented Resorts and Fortis. They moved to dismiss Miller’s complaint on the grounds that Miller failed to state a claim within the six-year statue of limitations, according to Fuentes.
According to the “Proof of Loss” section in the LTD plan, Resorts begins making payments after the insured person is totally disabled for six months. Because Miller was disabled on October 6, 1986 Fortis would become liable for payments on March or April of 1987. The policy goes on to say that it is from this time, when Fortis becomes liable, that the proof of loss must be sent in within 90 days.
Therefore, if Fortis became liable in March or April of 1987 Miller needed to provide written proof of loss in June or July of 1987. It is from June or July of 1987 that Miller had six years to file a claim, according to Fuentes.
Miller agreed that the six-year limitations period did apply to his case; however, he disagreed about the start date. Fortis cited the six-year statue of limitations according to the LTD plan; on the other hand Miller referenced the six-year period set forth in the N.J.S.A. However, because there was no discrepancy of the length of the limitations period between parties the source did not need to be determined. As a result the lower court sided with Resorts and Fortis and dismissed Miller’s case, according to Fuentes.
Miller appealed the case to the Third Circuit. Here the federal “discovery rule” was used to try and pinpoint the accrual date for Miller’s federal claim. Under this rule, the statute of limitations begins to run when a plaintiff discovers, or should have discovered, the injury that forms the basis for his or her claim. The time that a plaintiff should have discovered the miscalculation should be when he received his first benefit reward.
Because Miller did not make a claim within the six year statue of limitations, beginning on the first day he received a benefit reward, April 1987, his case was dismissed. If there was not a length of time attached to the statute of limitations then it would not be a limitation at all, according to Fuentes.
After numerous attempts to contact Miller’s lawyer, Robert P. Merenich of Gemmel, Todd and Merenich, he had no comment regarding Miller’s case.
The statutes of limitations are in place to encourage resolution to disputes in a timely fashion as well as repose for defendants and to avoid litigation where there is lost or distorted evidence. It ensures that evidence is kept and that claims are efficiently ruled upon, according to Fuentes.