Bunger v. Unum Life Insurance Co. of America

196 F. Supp. 3d 1175, 2016 U.S. Dist. LEXIS 94842, 2016 WL 3912986
CourtDistrict Court, W.D. Washington
DecidedJuly 20, 2016
DocketCase No. 2:15-cv-01050-RAJ
StatusPublished
Cited by5 cases

This text of 196 F. Supp. 3d 1175 (Bunger v. Unum Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bunger v. Unum Life Insurance Co. of America, 196 F. Supp. 3d 1175, 2016 U.S. Dist. LEXIS 94842, 2016 WL 3912986 (W.D. Wash. 2016).

Opinion

The Honorable Richard A. Jones, United States District Judge

I. INTRODUCTION

This matter comes before the Court on Cross Motions filed by Plaintiff Chris Bun-ger and Defendant Unum Life Insurance Company of America, seeking a final judgment from this Court under Federal Rule of Civil Procedure 52 based on an administrative record created in an underlying Employee Retirement Income Security Act (“ERISA”) dispute. Dkt. ## 13 and 14. Plaintiff brings this action under ERISA, 29 U.S.C. § 1001 et seq. to recover short-term disability benefits and long-term disability benefits under the Costco Employee Benefits Program’s — Voluntary Short Term Disability Plan and the Costco Employee Benefits Program’s — Long Term Disability ■ Plan. Mr. Bunger, who worked as a Web Content Specialist for Costco Wholesale Corporation, argues that he is totally disabled under the terms of both plans due to chronic fatigue syndrome, Lyme disease, or an unspecified illness which causes extreme fatigue and inability to concentrate. Unum argues that Mr. Bunger has no properly diagnosed conditions, and has not shown that he is unable to perform his job functions. For the reasons set forth below, the Court denies both motions and remands to Unum to further develop the record.

II. PROCEDURAL ISSUES

Before turning to the merits of the parties’ arguments, the Court must determine whether it is appropriate to resolve this case on the parties’ cross motions for judgment under Rule 52 (Dkt. -## 13 and 14) as opposed to summary judgment under Rule 56. The answer depends on what standard of review the court applies. See Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 109, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989) (“ERISA does not set out the appropriate standard of review for actions under § 1132(a)(1)(B) challenging benefit eligibility determinations.”). The parties here have simplified the matter by stipulating to de novo review. Dkt. ## 13 at 15; 14 at 9. The Court accepts the parties’ stipulation and reviews the record de novo. See Rorabaugh v. Cont’l Cas. Co., 321 Fed.Appx. 708, 709 (9th Cir.2009) (unpublished) (court may accept parties’ stipulation to de novo review).

Where review is under the de novo standard, the Ninth Circuit has not definitively stated the appropriate vehicle for resolution of an ERISA benefits claim. The de novo standard requires the court to make findings of fact and weigh the evidence. See Walker v. Am. Home Shield Long Term Disability Plan, 180 F.3d 1065, 1069 (9th Cir.1999) (de novo review applies to plan administrator’s factual findings as well as plan interpretation). Typically, a request to reach judgment prior to trial would be made under a Rule 56 motion for summary judgment, however under such a motion the court is forbidden to [1178]*1178make factual findings or weigh evidence. T.W. Elec. Serv., Inc. v. Pac. Elec. Contractors Ass’n, 809 F.2d 626, 630 (9th Cir.1987). Instead, the parties here propose the Court conduct a trial on the administrative record under Rule 52.

This procedure is outlined in Kearney v. Standard Ins. Co., 175 F.3d 1084, 1095 (9th Cir.1999) (noting that “the district court may try the case on the record that the administrator had before it”). In a trial on the administrative record:

The district judge will be asking a different question as he reads the evidence, not whether there is a genuine issue of material fact, but instead whether [the plaintiff] is disabled within the terms of the policy. In a trial on the record, but not on summary judgment, the judge can evaluate the persuasiveness of conflicting testimony and decide which is more likely true.

Id. Thus, when applying the de novo standard in an ERISA benefits case, a trial on the administrative record, which permits the court to make factual findings, evaluate credibility, and weigh evidence, appears to be the appropriate proceeding to resolve the dispute. See Casey v. Uddeholm Corp., 32 F.3d 1094, 1099 (7th Cir.1994) (on de novo review of an ERISA benefits claim, the “appropriate proceeding[ ] ... is a bench trial and not the disposition of a summary judgment motion”); Lee v. Kaiser Found. Health Plan Long Term Disability Plan, 812 F.Supp.2d 1027, 1032 n. 2 (N.D.Cal.2011) (“De novo review on ERISA benefits claims is typically conducted as a bench trial under Rule 52”); but see Orndorf v. Paul Revere Life Ins. Co., 404 F.3d 510, 517 (1st Cir.2005) (“When there is no dispute over plan interpretation, the use of summary judgment ... is proper regardless of whether our review of the ERISA decision maker’s decision is de novo or deferential”).

Given the above law, and the clear intent of the parties, the Court elects to resolve the parties’ dispute in a bench trial on the administrative record rather than on summary judgment. Therefore, the court issues the following findings and conclusions, pursuant to Rule 52.

III. FINDINGS OF FACT

1. Plaintiff Chris Bunger began working for Costco Wholesale Corporation in 2000. LTD-5. In 2014, when Mr. Bunger became ill, he was working as a Web Content Specialist. LTD-368. This job required “[ejxcellent written and verbal communication skills, ... [sjtrong organizational and analytical skills, and attention to detail,” as well as the ability to multi-task and perform a variety of complex tasks. LTD-368, 370.

2. Mr. Bunger was offered Short Term Disability (“STD”) and Long Term Disability (“LTD”) benefits through plans administered by Unum Life Insurance Company of America. STD-378; LTD-450.

3. Under the STD Plan, benefits are awarded if an employee is “limited from performing the material and substantial duties of [his] own job ... due to ... sickness or injury; and [he] ha[s] a 20% or more loss in weekly earnings.” STD-367. These benefits are only available for a short term: 26 weeks. STD-371.

4. Under the LTD Plan, benefits are awarded beyond the 26-week window. LTD-434. For the first nine months of LTD coverage, “disabled” is defined in the same way for LTD benefits as it is for STD benefits. LTD-428. However, after nine months, an employee must show that he is disabled from “any gainful occupation” as opposed to just his “own job.” Id.

[1179]*11795. On January 6, 2014, Mr. Bunger visited his primary care physician, Traci Tag-gart, N.D. LTD 72-74. Dr. Taggart is a naturopath. Id. At this visit, Mr. Bunger described an episode that occurred the previous Friday. LTD-74. While driving home from work, Mr. Bunger had started feeling lightheaded, cloudy, weak, and faint. Id. The feeling lasted for about one minute. Id. Mr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
196 F. Supp. 3d 1175, 2016 U.S. Dist. LEXIS 94842, 2016 WL 3912986, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bunger-v-unum-life-insurance-co-of-america-wawd-2016.