United States District Court, D. Connecticut
ANNUZIATA GERMANA, EXECUTRIX OF THE ESTATE OF DOMINIC ACQUARULO, and JOKER'S WILD ENTERTAINMENT, LLC, Plaintiffs,
RELIANCE STANDARD LIFE INSURANCE COMPANY, Defendant.
RULING AND ORDER ON MOTION TO DISMISS
A. BOLDEN UNITED STATES DISTRICT JUDGE.
the death of Dominic Acquarulo, Plaintiffs - Annunziata
Germana, Mr. Acquarulo's widow and executrix of his
estate, and Joker's Wild Entertainment, LLC, his former
employer - filed an Amended Complaint to address his
disability insurance and related benefits. They allege, on
behalf of his estate, that Reliance Standard Life Insurance
Company (“Reliance”) breached the terms of its
insurance policy. See Am. Compl., ECF No. 22.
now moves to dismiss the Amended Complaint. See Def.
Mot. to Dismiss, ECF No. 24.
reasons stated below, the motion to dismiss the Amended
Complaint, ECF No. 24, is GRANTED in part
and DENIED in part.
FACTUAL AND PROCEDURAL BACKGROUND
Acquarulo, a Connecticut resident, worked for Joker's
Wild Entertainment, LLC, a Connecticut limited liability
corporation. Compl. ¶ 1, ECF No. 1-1. Annunziata
Germana, also a resident of Connecticut; became Executrix of
the estate of her husband, Dominic Acquarulo, on August 9,
2018. Amend. Compl. ¶ 2, ECF No. 22. Reliance Standard
Life Insurance (“Reliance”) is an insurance
company allegedly doing business in Connecticut. Amend.
Compl. ¶ 2.
issued an insurance policy to Joker's Wild Entertainment,
LLC, which provided Joker's Wild's employees with
benefits for loss of time due to disability from sickness or
injury.” Policy at 8.0, Def. Mot. to Dismiss, Ex. A,
ECF No. 11-2).
policy provided “Weekly Income Benefits, ” if an
individual “is disabled due to Sickness or
Injury” and “becomes disabled while insured by
this Policy.” Id. “[D]isabled”
meant being “unable to do the material duties of
his/her job, ” as well as “not doing any work for
payment [and] under the regular care of a physician.”
Id. at 2.0.
to the terms of the plan:
LEGAL ACTIONS: No legal action may be brought against us to
recover on this Policy within sixty (60) days after written
proof of loss has been given as required by this Policy. No
action may be brought after three (3) years (Kansas, five (5)
years; South Carolina, six (6) years) from the time written
proof of loss is required to be given.
Id. at 6.0.
allegedly provided Mr. Acquarulo with disability insurance
and related benefits and, in exchange, he paid the insurance
company a premium. Amend. Compl. ¶ 2.
August, 2014, Mr. Acquarulo submitted a claim for short term
disability benefits under the Joker's Wild policy.
See Letter from Asha Davis, STD Claims Department,
to Dominic Acquarulo (“Denial Letter”) (January
12, 2015), Def. Mot. to Dismiss, Ex. B, ECF No. 11-3. He had
been diagnosed with “glioblastoma multiforme IV,
” symptoms that first appeared in June 2014.
denied that claim. See Denial Letter at 5. The
denial letter stated that to be covered individuals had to be
“actively at work, ” which means “the
person [is] actually performing on a full-time basis each and
every duty pertaining to his/her job in the place where and
the manner in which the job is normally performed.”
Id. at 3.
rejecting the claim, Reliance also stated:
During the course of our investigation, we have also received
information that during part of the period in which you were
not working, that you were, in fact, incarcerated. We have
learned that you were incarcerated on January 15, 2013 and
were released from prison on April 9, 2014. During a recent
telephone call, we were informed that you were actually
released from prison sometime in January 2014, due to a
It is our contention that your Individual Insurance possibly
terminated as early as January 2012, when you ceased full
time work, but most certainly as late as January 15, 2013,
the date of your incarceration. According to the contract,
your Individual Insurance will be reinstated provided you
return to Active Work within the period of time shown on the
Schedule of Benefits.
According to the Schedule of Benefits, the Waiting Period for
future employees is 90 days of continuous employment. The
Individual Effective date is the first of the month
coinciding with or next following completion of the Waiting
Period. The policy requires that should you return to work
more than 6 months after your Individual Insurance
terminates, you would have to satisfy the Eligibility
Requirements of the policy again.
Therefore, since the information that we have documents that
you were released from prison on April 9, 2014, assuming you
returned to work sometime in April, you would have satisfied
the Service Waiting Period in July 2014. Therefore, your
Effective Date of Individual Insurance would be August 1,
2014, which is prior to your claimed period of disability.
Id. at 4.
noted, however, that it appeared Mr. Acquarulo had worked
until September 2014. Ultimately “[s]ince you have
continued to work and since we have not received the
previously requested documentation, we are unable to complete
the processing of your claim and determine whether benefits