Hughes v. Hartford Life and Accident Insurance Company

District Court, D. Connecticut·Decided May 22, 2020·No. 3:19-cv-01611·Unknown

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT

Patricia Hughes,

Plaintiff, Civil No. 3:19-cv-01611-JAM

v.

Hartford Life and Accident Insurance Co., May 22, 2020

Defendant.

RULING ON PLAINTIFF’S MOTION TO COMPEL [ECF NO. 30] AND DEFENDANT’S MOTION FOR PROTECTIVE ORDER [ECF NO. 36]

This is an ERISA disability benefits case. The plaintiff, Patricia Hughes, has moved the Court for an order compelling the defendant, Hartford Life and Accident Insurance Company (“Hartford”), to comply with thirteen requests for production and nine interrogatories. (Mot. to Compel, ECF No. 33.) Her discovery requests fall into four principal groups; they seek to explore (1) the completeness of Hartford’s administrative record; (2) Hartford’s conflict of interest; (3) alleged bias on the part of Hartford’s medical consultants; and (4) Hartford’s compliance with Department of Labor regulations governing employee benefit plans. Hughes also asks the Court to order an in camera review of one document that Hartford excluded from the record under a claim of attorney-client privilege. (Id. at 18-22.) Finally, Hartford seeks a protective order quashing three document subpoenas that Hughes served on its medical consultants. (ECF No. 36.) In an ERISA case, the Court’s review is ordinarily limited to the administrative record that was before the plan administrator when it made its benefit determination. Halo v. Yale Health Plan, 819 F.3d 42, 60 (2d Cir. 2016). The Court may go outside the record, but first it must identify a “good cause” to do so. Id. These limitations often spawn discovery disputes, because the administrator frequently contends that they render anything outside the record irrelevant and undiscoverable, while the claimant often argues that they control only admissibility and not discoverability. This case is an example of a dispute between an ERISA claimant and administrator over the standard for discoverability of extra-record information. The Court holds – as many other courts in the Second Circuit have done, and consistent

with how Judge Meyer decided a discovery dispute in the parties’ earlier case – that an ERISA plaintiff can obtain extra-record discovery to the extent that she shows, through facts and not conclusory allegations, a “reasonable chance” that the particular discovery request will yield a “good cause” for expanding the record at summary judgment or trial. E.g., Pretty v. Prudential Life Ins. Co. of Am., 696 F. Supp. 2d 170, 184 (D. Conn. 2010); Benjamin v. Oxford Health Ins., Inc., No. 3:16-cv-00408 (AWT) (SALM), 2017 WL 772328, at *2 (D. Conn. Feb. 28, 2017); see discussion, Section II.A infra. Applying this standard to the first three groups of discovery requests, the Court finds that Hughes has (1) supported one of her requests directed to the completeness of the administrative record, but not the others; (2) has not supported her requests

for discovery into Hartford’s conflict; and (3) has partially supported one of her requests directed to the alleged bias of Hartford’s medical consultants, but not the others. With respect to group (4) – the requests directed to Hartford’s compliance with DOL regulations – the Court holds that the regulations at 29 C.F.R. §§ 2560.503-1(j)(3) and –(m)(8) command production of some, but not all, of the requested documents. The Court also accepts Hughes’s principal argument about the allegedly privileged document, and it will order Hartford to produce it for in camera review. Hughes’s motion to compel is therefore granted in part and denied in part, as further detailed in Sections II and III below. Hartford’s motion for protective order is addressed in Sections II.C and III. I. BACKGROUND Hughes was an employee of Children’s Healthcare of Atlanta and a beneficiary of its long- term disability benefit plan. (See Plan, ECF No. 1-2.) In 2011 she began experiencing symptoms of vestibular disorders and other maladies, and in 2012 she submitted a disability claim to the plan’s insurer and claims administrator, Hartford. (Compl., ECF No. 1 ¶¶ 26-32.) Hartford paid

disability benefits for nearly four years, but it stopped paying after concluding that Hughes allegedly “did not provide adequate proof of disability beyond October 5, 2016.” (Memo. of L., Mot. for Prot. Order, ECF No. 36-1, at 3.) Hughes sued, and her case was assigned to Judge Meyer. Hughes v. Hartford Life & Acc. Ins. Co., No. 3:17-cv-01561 (JAM) (D. Conn.) (“Hughes I”). In that case, as in this one, Hughes sought discovery beyond the administrative record. (Mot. for Discovery, Hughes I, ECF No. 30.) Judge Meyer denied the motion “for substantially the reasons set forth in [Hartford’s] opposition,” and also because Hughes failed “to show an adequate basis in this record for her claim to need discovery.” (Order Denying Pl.’s Mot. for Discovery, Hughes I, ECF No. 36.)

The case then proceeded to a bench trial. Judge Meyer ruled in Hughes’s favor, holding that Hartford had not provided her with the “full and fair review” required by Department of Labor regulations. (Order on Mots., Hughes I, ECF No. 72, at 1.) He remanded the case to Hartford “to conduct a full and fair review.” (Id.) In the course of its remand review, Hartford engaged Exam Coordinators Network (“ECN”), which it describes as “a third-party vendor that has contracted . . . to provide qualified physicians and health care professionals to serve as independent medical consultants.” (Memo. of L., Mot. for Prot. Order, ECF No. 36-1, at 4.) ECN in turn engaged a neuro-otologist, Dr. Eric Slattery, to review Hughes’s case. (Id. at 4-5.) It also engaged a neurologist, Dr. Arousiak Varpetian Maraian. (Id. at 5.) In reports dated July 23, 2019, Drs. Slattery and Maraian disagreed with Hughes’s doctors about the source of her complaints and the extent of her limitations. Hartford says that it provided their reports to Hughes’s counsel on August 1, 2019 and invited a response. (Id. at 6-7.) Events picked up speed in August 2019 because Hartford’s period for conducting its

remand review was set to expire on September 1st. In a letter dated August 15th, Hughes’s counsel criticized the Slattery and Maraian reports. Hartford sent the criticisms to the two doctors and asked them to respond. Hartford received the responses on August 26th and conveyed them to Hughes’s counsel on August 28th. Hartford says that counsel telephoned on August 30th – the last day of the review period – to say that he wished to reply to the responses on September 3rd, but that he would not agree to extend the claim deadline by enough time to permit an evaluation of that reply. (Id. at 10.) Hartford alleges that, with no extension agreed upon, it was constrained to make a claims decision on August 30th. It says that it “issued its decision on appeal on Friday, August 30, 2019

(the last business day before the September 1, 2019 deadline), based upon the information contained in the Administrative Record as of August 27, 2019,” and it “determined that its decision to terminate Plaintiff’s claim was correct.” (Id. at 10.) Hughes sees things differently. She contends that, in affirming its benefit denial before her counsel could reply to the doctors’ responses, Hartford has committed exactly the same misconduct that Judge Meyer held to be a denial of “full and fair review” in Hughes I. She says that on remand, as in Hughes I, Hartford “unilaterally terminated the administrative process” and refused to allow her “a response to late-arriving medical opinions.” (Compl., ECF No.

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