Frank v. Liberty Life Assurance Co.

149 F. Supp. 3d 566, 2015 WL 7871335, 2015 U.S. Dist. LEXIS 163014
CourtDistrict Court, D. Maryland
DecidedDecember 3, 2015
DocketCase No.: GJH-15-124
StatusPublished
Cited by2 cases

This text of 149 F. Supp. 3d 566 (Frank v. Liberty Life Assurance Co.) 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
Frank v. Liberty Life Assurance Co., 149 F. Supp. 3d 566, 2015 WL 7871335, 2015 U.S. Dist. LEXIS 163014 (D. Md. 2015).

Opinion

MEMORANDUM OPINION

GEORGE J. HAZEL, United States District Judge

Plaintiff Noreen Frank brings this case against Liberty Life Assurance Company of Boston (“Liberty”), Sodexo, Inc. (“So-dexo”), and Sodexo Long Term Disability Plan (“Sodexo Plan”). Frank’s claims for relief arise under the Employee Retirement Income Security Act of 1974, as amended (“ERISA”). 29 U.S.C. § 1132(a)(1) and (3). ECF No. 1 at ¶1. Plaintiff alleges wrongful denial of benefits and breach of Fiduciary duty stemming from Liberty’s termination of Frank’s long-term disability (“LTD”) benefits,

This Memorandum Opinion and accompanying Order address Defendants Sodexo Plan and Sodexo’s Motion to Dismiss the Complaint .(ECF No. 14), Frank’s Motion for Partial Summary Judgment, to Set a Scheduling Order, and to Permit Discovery (ECF No. 31), and Liberty’s Motion to Seal Exhibits to Affidavit of Paula J. McGee (ECF No. 36). The issues are adequately briefed and no hearing is necessary. See Local Rule 105.6 (D. Md. 2014). For the reasons stated below, Defendant Sodexo and Sodexo Plan’s Motion to Dismiss is GRANTED, Plaintiffs Motion for Partial Summary Judgment is GRANTED against Defendant Liberty and DENIED against Defendants Sodexo and Sodexo Plan, Plaintiffs Motion to Set a Scheduling [569]*569Order and Motion to Permit Discovery are DENIED as moot, and Defendant -Liberty’s Motion to Seal Exhibits is GRANTED.

I. BACKGROUND1

At all times relevant to. this ■ matter, Frank has been a participant of the So-dexo Plan. ECF No. 1 at ¶3. Defendant Sodexo employed Frank as a Human Resources Director. Id. at ¶¶ 3, 9.

Defendant Sodexo Plan is an employee welfare benefit plan organized and operating under the provisions of ERISA. Id. at ¶ 3. The - Summary Plan Description (“SPD”) designated the Corporate Benefits Department of Sodexo as the plan administrator and plan fiduciary of the Sodexo Plan. Id. at ¶ 4. Sodexo Operations,LLC, to whom the policy was issued, is a wholly owned subsidiary of Sodexo. Id.

Defendant Liberty issued policy number GD3/GF3-810-252576-01 (“Liberty Policy”) to Sodexo Operations, LLC, under which the Sodexo Plan provides LTD benefits. Id. at ¶ 5. Liberty “was insurer and decision maker for [the Sodexo] Plan, and is legally hable for providing the LTD benefits sought [in the Complaint].” Id.

Frank is disabled by severe pain in her lower back, which radiates into her legs, and other condition, Id. at ¶ 10. Throughout the course of her claim,.Frank complied with the requirements of the Sodexo Policy, submitting medical evidence demonstrating the cause of her pain and proof that she was entitled to LTD benefits. Id. On December 6, 2012, Frank submitted to Liberty an “Activities Questionnaire” that explained her physical limitations. Id. at ¶11. On December 17, 2012. Liberty informed Frank that she was eligible to receive LTD benefits and began paying LTD benefits to her effective December 9, 2012. Id. at ¶ 12. During the course of her claim, Liberty caused Frank to be secretly observed eighteen times in eight-hour intervals from March 26, 2013 to September 14, 2013. Id. at ¶ 13. On October 23, 2013, Frank submitted another activities questionnaire to Liberty. Id..si ¶ 14,.

Liberty obtained an “occupational analysis/vocational review” dated November 18, 2013 by Ellen Levine, who described Frank’s occupation as “most often sedentary and light in physical demand.” Id. at ¶ 15. Liberty also obtained a medical re-yiew from Dr. Gayle G. Brown, Jr., dated December 10, 2013, which “concluded that there was no medical support for restrictions, and limitations precluding full time sedentary and light physical work, purportedly relying in part on the surveillance film as supporting Frank’s ability to perform work at the sedentary and light physical demand levels.” Id. at ¶ 16. Dr. Brown also summarized her opinion in a December 12, 2013 letter to Dr. Mohsin Sheikh, one of Frank’s treating physicians. Dr. Sheikh responded to Dr. Brown’s letter by noting his conclusion that Ms. Frank cannot perform full time sedentary work due to chronic pain that does not allow her to sit. Id. at ¶ 18. Dr, Sheikh also explained that Frank has difficulty concentrating due to the chronic pain and the side effects from medications which'she needs. Id. Dr. Brown provided a supplemental report dated January 27, 2014, concluding that she remained of the opinion that Frank can perform “full time sedentary work, including the essential duties of her occupation, with allowance for position change [sit/stand/sit] as needed” but that “given the difference in opinion between Dr. Sheikh.and this reviewer you may wish to consider an independent medical evaluation.” Id. at ¶ 20.

[570]*570On January 20,2014, Liberty terminated Plaintiffs LTD benefits effective December 31, 2013, but invited Plaintiff to appeal that decision. Id. at ¶ 19. On July 14, 2014. Plaintiff appealed the termination of her LTD benefits. Id. at ¶22. Liberty denied Frank’s appeal on'October 28, 2014, Id. at ¶24. .

The Liberty Policy that Sodexo distributed to Frank does not mention or reference any requirement for “Objective evidence” or “clinical evidence” to support a claim, except to state that “Proof’ may include a claim form submitted’ by the claimant, an attending physician’s statement submitted by the claimant’s ■ physician, and “standard diagnosis, chart notes, lab findings, test results, x-rays, and/or other forms of objective medical evidence in support of a claim for benefits.” Id. at ¶ 28 (emphasis added). The plan document itself, as amended and restated effective January 1, 2012, requires proof of claim “satisfactory to the insurer/’ including information regarding the date, cause, and degree of disability. Id.

The SPD repeatedly mentions objective evidence, stating that (1) to receive LTD benefits “you must provide objective clinical evidence satisfactory to the insurance company to support your inability to perform the regular duties of your job”; (2) in order for the claimant to continue receiving benefits, the claimant’s physician must be “able to provide objective evidence regarding progress towards recovery”; (3) benefits will end if the claimant receives benefits, “through the normal recovery time for your condition and you do not provide objective clinical evidence to support your continued absence-from work” or the claimant or their “doctor does not provide required medical information that supports physical or mental impairment that is demonstrated by clinical and laboratory evidence”; and, (4) “Periods of Disability lasting longer than the normal period of recuperation must be supported by objective clinical and laboratory evidence.” Id. \ see also EOF No, 14. ex. 3 at 9, 10, 17. Also of note, the Liberty Policy “contains a clause that purports to reserve sole discretion to Liberty to interpret it.” Id. at ¶ 37.E (emphasis added).

II. DEFENDANTS SODEXO AND SO-DEXO PLAN’S MOTION TO DISMISS

A. Standard of. Review

Federal Rule of Civil Procedure

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149 F. Supp. 3d 566, 2015 WL 7871335, 2015 U.S. Dist. LEXIS 163014, Counsel Stack Legal Research, https://law.counselstack.com/opinion/frank-v-liberty-life-assurance-co-mdd-2015.