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Burnham v. Guardian Life Ins. Co.

Burnham v. Guardian Life Ins. Co.

United States Court of Appeals for the First Circuit

May 3, 1989

No. 88-2115

Opinion

 [*487]  SELYA, Circuit Judge.

This is a hard case - hard not in the sense that it is legally difficult or tough to crack, but in the sense that it requires us, like the court below, to deny relief to a plaintiff for whom we have considerable sympathy. We do what we must, for "it is the duty of all courts of justice to take care, for the general good of the community, that hard cases do not make bad law." United States v. Clark, 96 U.S. 37, 49, 24 L. Ed. 696 (1877) (Harlan, J., dissenting) (quoting Lord Campbell in East Indian Co. v. Paul, 7 Moo. P.C.C. 111).

Plaintiff-appellant Joan C. Burnham is the duly appointed administratrix of the estate of her late husband, Gordon C. Burnham, Jr. (Burnham). The decedent was a long-time employee [**2]  of Caribou Fisheries, Inc. (Caribou), a national distributor of frozen fish and other food products. By October of 1979, 2 he had become Caribou's Operations Manager. On the twentieth of that month, Burnham was hospitalized to receive radiation therapy for a malignant cancer. On November 8, he was discharged to his home, where he remained for roughly three weeks. On November 29, he was admitted to another hospital. He died there in early December.

On November 1, defendant-appellee Guardian Life Insurance Company (Guardian) added Caribou as an additional insured  [*488]  under a group life insurance policy (Policy), effective that date. The Policy covered eligible Caribou employees as of November 1. The parties agree that, had Burnham been working in Caribou's office full time on November 1, he would have been covered. But, he was then hospitalized, and the Policy's coverage embraced only "full-time Employee[s]," defining the phrase as follows:

A full-time Employee means an Employee who regularly works at least the number of hours in the normal work week established by his Participating Employer, but [**3]  in no event shall an Employee be considered a full-time Employee unless he regularly works at least 30 hours per week performing the duties of his occupation at his Participating Employer's business establishment or other location to which his Participating Employer's business requires him to travel.

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873 F.2d 486 *; 1989 U.S. App. LEXIS 6032 **

JOAN C. BURNHAM, ETC., Plaintiff, Appellant, v. THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, Defendant, Appellee

Prior History:  [**1]  APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MASSACHUSETTS, Hon. John J. McNaught, U.S. District Judge.

CORE TERMS

full-time, district court

Civil Procedure, Appeals, Standards of Review, Governments, Fiduciaries, Pensions & Benefits Law, Judicial Review, Standards of Review, Arbitrary & Capricious Review, De Novo Review, ERISA, Civil Litigation, General Overview, Fiduciaries, Handling of Claims, De Novo Standard of Review, Conflict of Interest Analysis, Causes of Action, Suits to Recover Plan Benefits, Civil Litigation, Insurance Law, Industry Practices, Federal Regulations, Preliminary Considerations, Federal & State Interrelationships, Federal Common Law, Contracts Law, Contract Interpretation, Claim, Contract & Practice Issues, Policy Interpretation, Plain Language, Group Policies, Defenses, Ambiguities & Mistakes, Ordinary & Usual Meanings