Bartel v. Sun Life Assurance Co. of Canada

536 F. Supp. 2d 623, 2008 U.S. Dist. LEXIS 23564
CourtDistrict Court, D. Maryland
DecidedMarch 6, 2008
DocketCivil Action CCB-07-659
StatusPublished
Cited by3 cases

This text of 536 F. Supp. 2d 623 (Bartel v. Sun Life Assurance Co. of Canada) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bartel v. Sun Life Assurance Co. of Canada, 536 F. Supp. 2d 623, 2008 U.S. Dist. LEXIS 23564 (D. Md. 2008).

Opinion

MEMORANDUM

CATHERINE C. BLAKE, District Judge.

Now pending before the court is a motion for partial summary judgment and motion to compel filed by plaintiff Charles W. Bartel against defendant Sun Life Assurance Company of Canada (“Sun Life”), and Sun Life’s cross motion for partial summary judgment. Pursuant to the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. §§ 1001, et seq., Bartel is suing Sun Life for denial of long term disability benefits related to a stroke Bartel suffered while employed by Adel-berg, Rudow, Dorf & Hendler, LLC (“ARD & H”). Bartel and Sun Life each seek partial summary judgment on the proper standard of review that will govern this case. Bartel further moves to compel discovery beyond the disclosed administrative record. The issues in these motions have been fully briefed and no hearing is necessary. For the reasons stated below, Bartel’s motions will be denied and Sun Life’s cross motion granted.

BACKGROUND

Bartel served as the Director of Administration at the law firm of ARD & H from January 30, 1987 until December 17, 2004. In that capacity, Bartel was responsible for overseeing the administrative needs of more than twenty attorneys and forty support personnel. According to Bartel, he was in charge of financial planning, personnel-staffing, physical facilities, long range planning, insurance, and compensation and profit distribution. (Pl.’s Sum. J. Mem. at 2.) Through his employment at ARD & H, Bartel became a participant in the firm’s Sun Life Disability Plan (the “Plan”) funded through an employee group benefits policy. The parties to this dispute do not contest that, while employed by ARD & H, Bartel suffered a stroke that ultimately led him to stop working on December 17, 2004. 1

The factual underpinning of Bartel’s lawsuit against Sun Life centers on Sun Life’s denial of his claim for long term disability benefits based on his stroke. *626 According to the terms of the Plan, Sun Life agreed to provide disability benefits to ARD & H employees, who suffered a total or partial disability due to an injury or sickness. (Id.) More relevant to the pending motions concerning standard of review and discovery, however, are terms in the Plan that may indicate whether Sun Life has been delegated discretionary authority to determine employee eligibility for benefits or to construe the terms of the Plan. First, in the section concerning the level of proof required to submit a valid claim, the Plan states that “[p]roof must be satisfactory to Sun Life.” (Id. at Ex. A, The Plan at 47.) Second, in the section entitled “Insurer’s Authority,” the Plan states that:

The Plan administrator has delegated to Sun Life its entire discretionary authority to make all determinations regarding claims for benefits under the benefit plan insured by this Policy. This discretionary authority includes, but is not limited to, the determination of eligibility for benefits, based upon enrollment information provided by the Policyholder, and the amount of any benefits due, and to construe the terms of this Policy. (Id.)

According to Bartel; these two provisions do not clearly and unambiguously grant Sun Life discretionary authority to interpret and apply the Plan; Bartel thus concludes that the court should apply a de novo standard of review when reviewing Sun Life’s claim denial. Bartel further argues that Sun Life is collaterally es-topped by a decision from a California district court, Green v. Sun Life Assurance Co. of Canada, 383 F.Supp.2d 1224 (C.D.Cal.2005), from suggesting that an abuse of discretion standard should apply in this case. Finally, Bartel asserts that under either a de novo or abuse of discretion standard, he is entitled to discovery beyond the administrative record.

In response, Sun Life filed a cross motion for summary judgment arguing that the Plan clearly delegates discretionary authority to Sun Life, thereby requiring this court to apply an abuse of discretion standard. Stating that it is not collaterally estopped from making such an argument, Sun Life further concludes that discovery beyond the administrative record is precluded under an abuse of-discretion standard and granted only under exceptional circumstances with a de novo review. As will be discussed, the court agrees.

ANALYSIS

Rule 56(c) of the Federal Rules of Civil Procedure provides that summary judgment:

shall be rendered forthwith if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.

The Supreme Court has clarified this does not mean that any factual dispute will defeat the motion:

By its very terms, this standard provides that the mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported motion for summary judgment; the requirement is that there be no genuine issue of material fact.

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986) (emphasis in original).

“The party opposing a properly supported motion for summary judgment ‘may not rest upon the mere allegations or denials of [his] pleadings,’ but rather must ‘set forth specific facts showing that there is a *627 genuine issue for trial.’ ” Bouchat v. Baltimore Ravens Football Club, Inc., 346 F.3d 514, 525 (4th Cir.2003) (alteration in original) (quoting Fed.R.Civ.P. 56(e)). The court must “view the evidence in the light most favorable to ... the nonmovant, and draw all reasonable inferences in her favor without weighing the evidence or assessing the witness’ credibility,” Dennis v. Columbia Colleton Med. Ctr., Inc., 290 F.3d 639, 644-45 (4th Cir.2002), but the court also must abide by the “affirmative obligation of the trial judge to prevent factually unsupported claims and defenses from proceeding to trial.” Bouchat, 346 F.3d at 526 (internal quotation marks omitted) (quoting Drewitt v. Pratt, 999 F.2d 774, 778-79 (4th Cir.1993), and citing Celotex Corp. v. Catrett, 477 U.S. 317, 323-24, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986)).

In reviewing a claim under 29 U.S.C.

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Bluebook (online)
536 F. Supp. 2d 623, 2008 U.S. Dist. LEXIS 23564, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bartel-v-sun-life-assurance-co-of-canada-mdd-2008.