Kruk v. Metropolitan Life Insurance

267 F.R.D. 435, 2010 U.S. Dist. LEXIS 52311, 2010 WL 2169645
CourtDistrict Court, D. Connecticut
DecidedMay 27, 2010
DocketNo. 3:07-CV-01533(CSH)
StatusPublished

This text of 267 F.R.D. 435 (Kruk v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kruk v. Metropolitan Life Insurance, 267 F.R.D. 435, 2010 U.S. Dist. LEXIS 52311, 2010 WL 2169645 (D. Conn. 2010).

Opinion

RULING AND ORDER ON PLAINTIFF’S SUPPLEMENTAL MOTION TO COMPEL [doc. #45]

HAIGHT, Senior District Judge:

I. Background

The factual background of this case is described in the Court’s previous ruling on plaintiff Rita Kruk’s original motion to compel. See Memorandum Opinion and Order [doc. # 38], 46 Employee Benefits Cas. 2777, [437]*4372009 WL 1481543, 2009 U.S. Dist. LEXIS 46454 (D.Conn. May 26, 2009) [hereinafter “Discovery Ruling”]. Familiarity with the Discovery Ruling is presumed.

The Court is now called upon to interpret the meaning of the Discovery Ruling with respect to the production of MetLife’s internal operating guidelines—the guidelines that set procedures for appeals of coverage under defendant Pechiney’s disability plan. Because the discussion contained in my previous ruling is germane here, I repeat it for convenience:

MetLife has cited several district court cases from other judicial circuits to show that “[t]he legal proposition that claim manuals must always be produced as part of the Administrative Record has been squarely rejected.” I am not convinced by these cases.
The plain language of the statute on the issue of relevancy is inescapable: “A document, record, or other information shall be considered ‘relevant’ to a claimant’s claim if such document, record, or other information ... (iv)[i]n the case of a ... plan providing disability benefits, constitutes a statement of ... guidance with respect to the plan concerning the denied treatment option or benefit for the claimant’s diagnosis, ivithout regard to whether such advice or statement was relied upon in making the benefit determination.” 29 C.F.R. § 2560.503-l(m)(8) (emphases added).

2009 WL 1481543 at *5, 2009 U.S. Dist. LEXIS 46454 at *18-19 (citation omitted). I ordered MetLife to produce any such statements.1

But I also ruled that Kruk’s discovery requests had been overbroad. Kruk had requested “ ‘[a]ll internal operating procedures, guidelines and documents concerning the manner in which the Company undertakes review of appeals of claims for long term disability insurance.’ ” 2009 WL 1481543 at *6, 2009 U.S. Dist. LEXIS 46454 at *20-21 (emphasis in original) (quoting Pl.’s Mem. ex. G [doc. # 23-8] at 4). That request could be construed to embrace a wide-ranging inquiry into all of MetLife’s procedures for administering the various disability plans of its various clients, regardless of whether those procedures could have applied in her ease.

II. Discussion

During the deposition of Sharon Muldrow, the MetLife employee who administered Kruk’s long-term-disability appeal, plaintiff “learned that MetLife has a manual which sets forth practices for handling long term disability claims and appeals. MetLife never previously identified the existence of this document and has only recently acknowledged its existence.” Pis.’ Reply [doc. # 50] at 2.

MetLife claims that the manual, which it calls the “Claims Management Guidelines” or “CMG,” is not responsive to plaintiffs discovery requests or to the Court’s previous Order. It claims this is so, even though it does not deny that the manual prescribes procedures for handling claims like Kruk’s. Met-Life’s argument against the responsiveness of its manual turns on the key phrases of limitation contained in my previous Discovery Ruling, taken from 29 C.F.R. § 2560.503-l(m)(8): “with respect to the plan,” and “concerning the denied treatment option or benefit for the claimant’s diagnosis.”

In this renewed motion to compel, Kruk argues that these key phrases embrace the manual that MetLife refuses to produce.

MetLife, in turn, relies on the limiting scope of the key phrases, arguing that it has “twice confirmed through sworn testimony that it does not maintain any statement of policy or guidance with respect to the disability plan at issue in this case.” Opp’n Br. [doc. # 48] at 2. In other words, under Met-Life’s interpretation, in order to be responsive in this case, the manual would have to explicitly refer to both her employer’s disability plan and the particular treatment option or benefit she sought.

[438]*438This interpretation is confirmed by the Supplemental Affidavit of Timothy Suter, attached to MetLife’s opposition brief. Suter is a Litigation Specialist at MetLife who claims to have personal knowledge of the claim at issue in this case. Supp. Aff. ¶ 4, MetLife Opp’n ex. 5 [doc. #48-2 at 23], Suter further avers:

7. MetLife’s Claim Management Guidelines (“CMG”) are not tailored to any particular plan or type of plan and are therefore not a statement of policy or guidance with respect to the plan governing Ms. Kruk’s claim. MetLife does not possess, and I am not aware of the existence of any statement of policy or guidance with respect to the plan governing Ms. Kruk’s claim, with the exception of the applicable summary plan description (“SPD”).
8. The CMG also do not contain any statement of policy or guidance regarding long term disability claims made by claimants diagnosed with lupus or mixed connective tissue disease, and I am not aware of the existence of any statement of policy or guidance regarding long term disability claims made by claimants diagnosed with lupus or mixed connective tissue disease.

Id. ¶¶ 7-8.

In my previous ruling, I thought that the plain language of § 2650 clearly provided for the type of discovery that plaintiff was seeking. By focusing on certain words of limitation, MetLife argues that none of its Claims Management Guidelines is “relevant” within the plain language of the regulation. In short, MetLife argues that the regulation is ambiguous, and that the ambiguity favors nondisclosure.

Assuming for the purposes of argument that the regulatory language is ambiguous, I nevertheless conclude that it should be construed to provide the discovery that Kruk seeks. I reach that conclusion after examining the history behind the regulation, and the intent that motivated its adoption.

A. Regulatory History behind 29 C.F.R. § 2560

When the Department of Labor adopted the current version of 29 C.F.R. § 2560, the regulation that compelled the result of my previous opinion, the Department explained the revised regulation in a lengthy memorandum. ERISA; Rules and Regulations for Administration and Enforcement; Claims Procedure, 65 Fed.Reg. 70,246, at 70,252 (Nov. 21, 2000) [hereinafter “Announcement Memo”]. That discussion, reproduced in the margin,2 does not directly define the key [439]*439phrase, “statement of policy or guidance with [440]

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Bluebook (online)
267 F.R.D. 435, 2010 U.S. Dist. LEXIS 52311, 2010 WL 2169645, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kruk-v-metropolitan-life-insurance-ctd-2010.