An individual receiving a pension benefit from a New York State public retirement system reemployed by New York State or political subdivision of the State must report such her reemployment and his or her earning derived from such reemployment to the retirement system

The individual [Respondent] in this action had served with the City Fire Department in various capacities for some twenty years. In May 2000 Respondent retired from the Department and after obtained a license to practice law in New York State, was reemployed by City Fire Department.

New York's Retirement and Social Security Law provides that retirees within the New York State and Local Police and Fire Retirement System [NYSLPFR]who return to employment with the State of New York or a political subdivision of the State can earn up to $30,000 per year before their retirement benefits are suspended, unless a waiver is obtained. Respondent neither reported his return to public service nor the earnings he received in excess of $30,000 to NYSLPFR. Further, Respondent did not obtain a waiver of the earnings limit. This resulted in Respondent receiving approximately $95,106 in pension benefits to which he was not entitled via wire transfer from Florida to his bank account in New York.

Respondent admitted that he "returned to public service after approximately ten years of being in retirement" but when he took the job, he did not obtain the required waiver. He further stated "[w]ell, the required waiver that would allow me to continue to receive my entire pension, and I did understand that I needed that waiver. And I just, I didn't do it." He then stated that in 2014 he "contacted the retirement system, notified them that I was receiving the benefits and to make those arrangements necessary to suspend my retirement and to start paying back the benefits I had received."

Respondent was convicted of wire fraud in violation of 18 USC §1343, which is essentially similar to the New York felony of grand larceny in the second degree, in violation of Penal Law §155.40, a Class C felony. By virtue of his felony conviction, Respondent was automatically disbarred and ceased to be an attorney pursuant to Judiciary Law §90(4)(a) and, among other penalties imposed, was directed to pay restitution to the NYSLPFR in the amount of $95,106.15, a fine of $50,000, and an assessment fee of $100.

With respect to Respondent's admission to the New York Bar, New York State's Judiciary Law, in pertinent part, provides for automatic disbarment in the event an attorney is convicted of a felony. Under this section, an offense committed in any other State, district or territory of the United States where it is classified as a felony is determined to be a felony when it would constitute a felony in this state. (see Judiciary Law, §90, subdivision 4, paragraph  e.) For purposes of this determination, the Court of Appeals has ruled that a felony in the other jurisdiction need not be a mirror image of the New York felony, precisely corresponding in every detail, but it must have essential similarity.

In response to the Grievance Committee for the Ninth Judicial District's motion to strike Respondent's name from the roll of attorneys and counselor-at-law, the Appellate Division concluded that Respondent's conviction of wire fraud in violation of 18 USC §1343 is essentially similar to the New York felony of grand larceny in the second degree, in violation of Penal Law §155.40, a Class C felony and granted the Committee's motion. The court noted that "[b]y virtue of his felony conviction, [Respondent] was automatically disbarred and ceased to be an attorney pursuant to Judiciary Law §90(4)(a)."

The decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_04704.htm

Expulsion from membership of an organization created by the New York State Legislature

Following a member [Petitioner] of a veteran's organization [Organization] created by the New York State Legislature in 1868 expulsion from the Organization.  he commenced a CPLR Article 78 proceeding seeking reinstatement. Supreme Court granted the petition to the extent of annulling Petitioner's expulsion and ordering the Organization to reinstate him as a member. Organization reinstated Petitioner's membership but then file new charges against him, which again resulted in his expulsion from membership in the Organization.

Petitioner, contending that by expelling him a second time, the Organization is in contempt of the Supreme Court's judgment asked the Appellate Division to find the Organization in civil contempt of the Supreme Court's directive.

Citing Garcia v Great Atlantic and Pacific Tea Co., 231 AD2d 401, the Appellate Division rejected Petitioner's claim. The court explained that in order to find a party in civil contempt, it must be determined that:

 [1] a lawful order of the court, clearly expressing an unequivocal mandate, was in effect;

 [2] that the party charged with contempt had notice of the order and disobeyed it; and

[3] the failure to comply with the order prejudiced the rights of a party to the litigation.

Here, however, the Appellate Division determined that although the Supreme Court's judgment mandated Petitioner's reinstatement, it did not address any future charges and nor did it hold that Petitioner could never be discharged from the Organization. In the words of the court, "[t]he sole mandate of the judgment, which was based exclusively on the first charges brought against [Petitioner], was for [the Organization] to reinstate Petitioner. As the Organization admittedly complied with that mandate, there was no violation such that a finding of contempt would be appropriate.

The Appellate Division also noted Petitioner's argument that he is entitled to [1] a determination as to his allegations of fraudulent conduct by other members of the Organization and [2] whether Organization followed proper procedure in expelling him a second time.

However, ruled the Appellate Division, as Petitioner's initial petition did not seek such determinations in his initial petition and only sought a determination involving the first set of charges brought against him by Organization, the Supreme Court's determination concerning that matter was fully disposed of by the court.

The decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_04101.htm

Determining the timeliness of an appeal of an administrative decision to an administrative appellate body within the agency

The critical lesson set out in this decision by the Appellate Division is that a request to reconsider a "final administrative determination" does not toll the running of the statute of limitations for initiating litigation challenging the decision.

The Appellate Division said it agreed with the Supreme Court's determination that the commencement of a proceeding pursuant to CPLR Article 78 was untimely as the retiree [Petitioner] did not file the action within four months of receiving the Retirement Systems determination informing her of the effective date of her retirement. Although Petitioner's subsequent asked the Retirement System to reconsider its determination regarding the effective date of her retirement, requests for "administrative reconsideration" do not extend or toll the running of the statute of limitations.

A related question concerns the timeliness of filing an administrative appeal of an agency's determination concerning a matter when a statute authorizes an individual to file an appeal from an administrative determination by mail. Is the controlling date the date the appeal was mailed to the agency's administrative appellate body or the date on which the appeal was received by the administrative appellate body?

In McLaughlin v Saga Corp., NYS Appellate Division, 242 A.D.2d 393, the Appellate Division overturned the traditional view was that the notice of appeal is untimely if it physically received by the appellate body after the Statute of Limitations had passed.

Rather, decided the Appellate Division, if the party is able to submit "proof of mailing within the limitations period," the application or appeal is timely.

The case arose under a provision of the Workers' Compensation Law that allowed a party to "serve" its appeal on the WCB by mailing it to the Board within 30 days. However, the Board took the position that unless it received the application for review on or before the last day of the 30-day limitations period, it was untimely. In Saga's case, although mailed within the 30-day period allowed for filing the application, WCB did not physically receive it until eight days after the statute of limitations had expired.

The rationale underlying the revised ruling is clear. If a person has a statutory right to make a decision, which may be then filed by mail, this period would necessarily be shortened if the appellate body could insist that it physically receive the mailed notice no later than the last day of the period of limitation.

In effect the Appellate Division concluded that the method of service of a notice of appeal, mail or personal delivery, should not determine the time period available to the party to decided whether or not to appeal an administrative ruling.

However, it appears that such a final action must be reduced to writing in order to start the running of the statute of limitations. In McCoy v San Francisco, City and County, 14 F.3d 28 , theU.S. Court of Appeals, 9th Circuit, ruled that a public employee's civil rights suit against his employer accrued when the appointing authority issued a  written statement suspending him from work, rather than from the date of a hearing held earlier at which time McCoy was orally told he was suspended from his position.

The Retirement System decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_04177.htm

The McLaughlin v Saga decision is posted on the Internet at:

https://casetext.com/case/matter-of-mclaughlin-v-saga-corporation-1

The McCoy v San Francisco decision is posted on the Internet at:

https://www.leagle.com/decision/19944214f3d28130

School District held not a party to the long-term disability insurance policy issued by the insurer covering certain District employees

Arroyo v Central Islip UFSD

2019 NY Slip Op 04669

Decided on June 12, 2019

Appellate Division, Second Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

This opinion is uncorrected and subject to revision before publication in the Official Reports.

Decided on June 12, 2019 SUPREME COURT OF THE STATE OF NEW YORK Appellate Division, Second Judicial Department 
ALAN D. SCHEINKMAN, P.J. 
CHERYL E. CHAMBERS 
LEONARD B. AUSTIN 
COLLEEN D. DUFFY, JJ.

2016-09188 
(Index No. 32465/09) 

Gail Arroyo, appellant, 

v

Central Islip UFSD, et al., respondents, et al., defendants.

Law Offices of Wayne J. Schaefer, LLC, Smithtown, NY, for appellant.

Devitt Spellman Barrett, LLP, Smithtown, NY (John M. Denby of counsel), for respondents.

DECISION & ORDER*

In an action, inter alia, to recover damages for breach of contract, the plaintiff appeals from an order of the Supreme Court, Suffolk County (Joseph C. Pastoressa, J.), dated June 30, 2016. The order granted the motion of the defendants Central Islip UFSD and Central Islip Union Free School District pursuant to CPLR 3211(a)(7) to dismiss the complaint insofar as asserted against them.

ORDERED that the order is affirmed, with costs.

The plaintiff was employed as a security guard by the defendants Central Islip UFSD and Central Islip Union Free School District (hereinafter together the District). She sustained injuries in the course of her employment and sought benefits under a long-term disability insurance policy issued by the defendant Sun Life and Health Insurance Company (U.S.) (hereinafter Sun Life), which covered certain employees of the District. The named policyholder was the Trustee of the New York State Group Insurance Trust. The policy provided that a written notice of claim for long-term disability benefits had to be sent to "us," defined as Sun Life, at its home office. The policy further provided that no legal action could be commenced against Sun Life for the claim until 60 days after the filing of the notice of claim.

A handbook which Sun Life provided to employees of the District stated that as participants in an employer benefit plan, employees were entitled to rights and protections under the Employee Retirement Income Security Act of 1974 (29 § USC 1001 et seq.; hereinafter ERISA). The handbook named Sun Life as the claims fiduciary with the obligation, and the discretion, to determine claims in its sole and exclusive discretion and to construe all issues relating to eligibility for benefits. The handbook stated that benefit determinations could be appealed to a named office of Sun Life and that, while the determination was final, an employee could bring an action in federal court under section 502(a) of ERISA (29 USC § 502[a]).

The plaintiff was initially granted long-term disability benefits by Sun Life but, after receiving benefits for almost three years, the plaintiff was notified by Sun Life in a letter dated September 11, 2008, that she was no longer eligible for benefits as she was no longer totally disabled. The plaintiff was given written notice of her right to appeal to a designated Sun Life office [*2](the same one named in the handbook). She was also advised that she may have the right to bring a civil action under ERISA in the event of an adverse appeals determination. The plaintiff exercised her right to appeal the determination to Sun Life; however, her appeal was denied. The plaintiff commenced this action against Sun Life, the District, and others, alleging breach of contract and wrongful denial of benefits under ERISA. The District moved pursuant to CPLR 3211(a)(7) to dismiss the complaint insofar as asserted against it based, inter alia, on a lack of privity. In an order dated June 30, 2016, the Supreme Court granted the District's motion. The plaintiff appeals.

The plaintiff's arguments on this appeal are predicated largely upon excerpts from a Summary Plan Description which the plaintiff asserts was issued by Sun Life's predecessor as policy issuer. The Summary Plan Description identifies the District as the plan administrator and as the agent for service of legal process. The Summary Plan Description also states that any denial of benefits would be provided by the named plan administrator, which was the District, and that the claimant has 60 days after receipt of a written denial to request review. The Summary Plan Description further states that a decision would be rendered within 60 days of receipt of the request for review and that plan participants have rights under ERISA which may be enforced by a lawsuit in federal court. The Summary Plan Description states that it does not constitute a part of the insurance plan or part of the insurance policy.

The plaintiff acknowledges that ERISA is not applicable to the subject Sun Life plan as it constitutes a governmental plan exempt from ERISA (see 29 USC §§ 1002[32]; 1003[b][1]; Lyndaker v Board of Educ. of W. Can. Val. Cent. Sch. Dist., 129 AD3d 1561, 1562-1563). Nevertheless, the plaintiff contends that, based on the language of portions of the Summary Plan Description, the District subjected itself to ERISA's statutory scheme governing appeals from denials of claims. We disagree.

An insurance policy is a contract to which standard provisions of contract interpretation apply (see Universal Am. Corp. v National Union Fire Ins. Co. of Pittsburgh, Pa., 25 NY3d 675, 680; Omanoff v Rohde, 129 AD3d 510, 510). "Liability for breach of contract does not lie absent proof of a contractual relationship or privity between the parties" (Hamlet at Willow Cr. Dev. Co., LLC v Northeast Land Dev. Corp., 64 AD3d 85, 104; see Siskin v Cassar, 122 AD3d 714, 717; CDJ Bldrs. Corp. v Hudson Group Constr. Corp., 67 AD3d 720, 722). "One cannot be held liable under a contract to which he or she is not a party" (Victory State Bank v EMBA Hylan, LLC, 169 AD3d 963, 965; see Maki v Travelers Cos., Inc., 145 AD3d 1228, 1230; 1911 Richmond Ave. Assoc., LLC v G.L.G. Capitol, LLC, 90 AD3d 627, 627).

Here, the District was not a party to the long-term disability policy issued by Sun Life to a different named policyholder. Even assuming the authenticity of the Summary Plan Description excerpts relied upon by the plaintiff, nothing in the record reflects that the District authored, published, or agreed to be bound by the Summary Plan Description, which, by its terms, did not form part of the insurance policy. Nor do the terms of the insurance policy incorporate the provisions of ERISA (cf. Advanced Refractory Tech. v Power Auth. of State of N.Y., 81 NY2d 670, 678). While portions of the handbook, distributed to District employees by Sun Life, assert the applicability of ERISA to those employees, the record does not indicate that the District issued or agreed to be bound by the provisions of the handbook. Further, the record indicates that the plaintiff followed the claims review and appeal procedures set forth by Sun Life and that the determinations were made by Sun Life without the involvement of the District. The plaintiff's lack of privity with the District is fatal to her breach of contract cause of action against the District (see Siskin v Cassar, 122 AD3d at 717; 1911 Richmond Ave. Assoc., LLC v G.L.G. Capitol, LLC, 90 AD3d at 627).

Additionally, the plaintiff failed to timely serve a notice of claim on the District, which is a condition precedent to the commencement of an action against a school district (see Education Law § 3813[1]; Matter of Zelin v Blind Brook-Rye Union Free Sch. Dist., 164 AD3d 1352, 1352; Santostefano v Middle Country Cent. Sch. Dist., 156 AD3d 926, 927). The plaintiff contends that the District waived the notice of claim requirements by agreeing to an ERISA-based appeal procedure as outlined in Sun Life's September 11, 2008, letter. This argument is without merit as the letter was issued by Sun Life, not by the District (cf. Matter of Geneseo Cent. School [*3][Perfetto & Whalen Constr. Corp.], 53 NY2d 306, 311).

Accordingly, we agree with the Supreme Court's determination granting the District's motion to dismiss the complaint insofar as asserted against it.

In light of this determination, we need not address the parties' remaining contentions.

SCHEINKMAN, P.J., CHAMBERS, AUSTIN and DUFFY, JJ., concur.

ENTER:

Aprilanne Agostino

Clerk of the Court

The decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_04669.htm

* N.B. See, also, Matter of Gail Arroyo v Central Islip UFSD, et al., posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_04688.htm