Anderson v. Hartford Life & Accident Insurance

668 F. Supp. 2d 1129, 2009 U.S. Dist. LEXIS 109056
CourtDistrict Court, S.D. Indiana
DecidedOctober 30, 2009
DocketCause 2:08-cv-471-WTL-WGH
StatusPublished
Cited by3 cases

This text of 668 F. Supp. 2d 1129 (Anderson v. Hartford Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Anderson v. Hartford Life & Accident Insurance, 668 F. Supp. 2d 1129, 2009 U.S. Dist. LEXIS 109056 (S.D. Ind. 2009).

Opinion

ENTRY ON PLAINTIFF’S OBJECTION TO MAGISTRATE JUDGE’S ORDER

WILLIAM T. LAWRENCE, District Judge.

This cause is before the Court on the Plaintiffs objection to an order of the Magistrate Judge assigned to this case granting the Defendants’ motion for protective order, thereby denying the Plaintiff the ability to conduct discovery in this case at this time. Mindful of the “clearly erroneous or contrary to law” standard for considering such objections, see 28 U.S.C. § 636(b)(1)(A), the Court, being duly advised, RECONSIDERS the Magistrate Judge’s ruling and DENIES the Defendants’ motion for protective order for the reasons set forth below.

This cases arises under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001. The Plaintiff alleges that Defendant Hartford Life and Accident Insurance Company (“Hartford”) improperly denied her application for long-term disability benefits. The Defendants allege that the ERISA Plan at issue gave Hartford discretionary authority to determine benefit eligibility and/or to construe the terms of the plan and therefore this Court’s review is limited to determining whether the decision to deny benefits was arbitrary and capricious. For purposes of this Entry, the Court will assume this is correct.

Prior to the Supreme Court’s decision in Metropolitan Life Ins. Co. v. Glenn, — U.S. -, 128 S.Ct. 2343, 171 L.Ed.2d 299 (2008), the law was clear in the Seventh Circuit that in ERISA cases in which the arbitrary and capricious standard applied, discovery was appropriate only in the “exceptional case” in which the plaintiff satisfied two factors: “First, a claimant must identify a specific conflict of interest or instance of misconduct. Second, a claimant must make a prima facie showing that there is good cause to believe limited discovery will reveal a procedural defect in the plan administrator’s determination.” Semien v. Life Ins. Co. of North America, 436 F.3d 805, 815 (7th Cir.2006). This standard created a “high bar” for plaintiffs and permitted discovery “into the motivations of a plan administrator or into the motivations of ‘independent’ physicians only where the claimant has made a prima facie showing of misconduct or conflict of interest.” Id. The Plaintiff — relying heavily on decisions by Chief Judge Hamilton, Magistrate Judge Baker, and Magistrate Judge Magnus-Stinson of this district— argues that Glenn effectively abrogated the standard set forth in Semien and that the holding of Glenn suggests that conflict-of-interest discovery should be the rule rather than the exception in ERISA cases. The Court agrees.

In Glenn, the Supreme Court held that when the administrator of an ERISA plan “both determines whether an employee is eligible for benefits and pays benefits out of its own pocket,” this “dual role creates a conflict of interest” as a matter of law. Glenn, 128 S.Ct. at 2346. *1131 The Court had previously held that if an ERISA plan gives discretion to a plan administrator who is operating under a conflict of interest, “that conflict must be weighed as a factor in determining whether there is an abuse of discretion.” Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). In Glenn, the Court reaffirmed this holding and examined the question of how the dual-role conflict should be taken into account on judicial review of an ERISA plan’s decision to deny benefits. The Court warned that it did not “believe it necessary or desirable for courts to create special burden-of-proof rules, or other special procedural or evidentiary rules, focused narrowly upon the evaluator/payor conflict.”

In principle, as we have said, conflicts are but one factor among many that a reviewing judge must take into account. Benefits decisions arise in too many contexts, concern too many circumstances, and can relate in too many different ways to conflicts — which themselves vary in kind and in degree of seriousness — for us to come up with a one-size-fits-all procedural system that is likely to promote fair and accurate review. Indeed, special procedural rules would create further complexity, adding time and expense to a process that may already be too costly for many of those who seek redress.

Glenn, 128 S.Ct. at 2351. Acknowledging that it was declining to provide a “detailed set of instructions,” the Court expressed its faith in the ability of reviewing courts to take into account and appropriately weigh various “factors” in making a decision:

We believe that Firestone means what the word “factor” implies, namely, that when judges review the lawfulness of benefit denials, they will often take account of several different considerations of which a conflict of interest is one. This kind of review is no stranger to the judicial system. Not only trust law, but also administrative law, can ask judges to determine lawfulness by taking account of several different, often case-specific, factors, reaching a result by weighing all together.

Id. The Court did give some guidance to reviewing courts, however, noting the following:

[A]ny one factor will act as a tiebreaker when the other factors are closely balanced, the degree of closeness necessary depending upon the tiebreaking factor’s inherent or case-specific importance. The conflict of interest at issue here, for example, should prove more important (perhaps of great importance) where circumstances suggest a higher likelihood that it affected the benefits decision, including, but not limited to, cases where an insurance company administrator has a history of biased claims administration. It should prove less important (perhaps to the vanishing point) where the administrator has taken active steps to reduce potential bias and to promote accuracy, for example, by walling off claims administrators from those interested in firm finances, or by imposing management checks that penalize inaccurate decisionmaking irrespective of whom the inaccuracy benefits.

Id. (internal citation omitted).

Glenn was not a case about the propriety of discovery, and indeed discovery was not even mentioned in the decision. However, it seems clear that in order for the record to contain any evidence relevant to the appropriate weight to be given the conflict of interest in a given case, discovery regarding that issue will be necessary. For example, it will be impossible for a reviewing court to follow the mandate of Glenn and determine how much importance to give the conflict of *1132

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Cite This Page — Counsel Stack

Bluebook (online)
668 F. Supp. 2d 1129, 2009 U.S. Dist. LEXIS 109056, Counsel Stack Legal Research, https://law.counselstack.com/opinion/anderson-v-hartford-life-accident-insurance-insd-2009.