Mulligan v. Provident Life & Accident Insurance

271 F.R.D. 584, 2011 U.S. Dist. LEXIS 1851, 2011 WL 52549
CourtDistrict Court, E.D. Tennessee
DecidedJanuary 7, 2011
DocketNo. 1:10-CV-31
StatusPublished
Cited by4 cases

This text of 271 F.R.D. 584 (Mulligan v. Provident Life & Accident Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mulligan v. Provident Life & Accident Insurance, 271 F.R.D. 584, 2011 U.S. Dist. LEXIS 1851, 2011 WL 52549 (E.D. Tenn. 2011).

Opinion

ORDER

SUSAN K. LEE, United States Magistrate Judge.

Before the Court is Plaintiffs motion to compel responses to certain interrogatories and requests for production of documents in this ERISA1 disability benefits case [Doc. 22]. Plaintiff seeks evidence to support his contention that his benefits were denied because of Defendants’ financial conflict of interest. Defendants do not disagree that some discovery is appropriate; they argue instead that Plaintiffs requests go too far. For the reasons stated below, Plaintiffs motion to compel [Doe. 22] will be GRANTED IN PART and DENIED IN PART.

I. BACKGROUND

In his complaint, Plaintiff alleges the ERISA plan administrator both evaluates and pays claims [Doc. 1 at ¶¶ 19, 20]. This allegation does not appear to be contested and, if true, it means a structural conflict of interest exists that must be weighed in determining whether the administrator met the arbitrary and capricious standard. Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105, 117, 128 S.Ct. 2343, 171 L.Ed.2d 299 (2008). Plaintiff further alleges that the administrator’s “concern over its own funds ... influence[d] its decision-making” and that Defendants violated their fiduciary duty to Plaintiff of a decisionmaking process “free of influence by self-interest.” [Doc. 1 at1Hl 21, 32-33].2 Defendants deny these allegations [Doc. 15 ¶¶ 19-21], although they do not dispute for purposes of this motion that the same entity both evaluated and paid claims [Doc. 28 at 3].

In his brief supporting the motion to compel, Plaintiff expands on his theories of bias. First, he argues the ERISA plan administrator’s “incentive system ... rewards employees, including those working on claims, based, in part, on company profitability____” [Doc. 29 at 7]. Second, he argues the administrator “has engaged in an ongoing, company-wide, top-to-bottom program to save money by denying or reducing the payments on claims.” [Doc. 29 at 8]. Last, Plaintiff argues the administrator’s history of biased claims administration show that the denial in this case was based on self interest [Doe. 29 at 8]. Plaintiff seeks discovery to support these theories, and his discovery requests are discussed in detail below.

II. ANALYSIS

A. Availability of Discovery in ERISA Cases

1. Generally

As a general rule, an ERISA claimant may not seek discovery of matters outside the administrative record. See Wilkins v. Baptist Healthcare Sys., Inc., 150 F.3d 609, 618 (6th Cir.1998) (Gilman, J., concurring) (noting that a district court may not ordinarily consider new evidence). This gener[588]*588al prohibition is founded on two separate principles: First, the reviewing court’s role, ordinarily, is not to determine whether a claimant is eligible for benefits, but merely to determine whether the administrator’s decision was defensible based on the administrative record. See Perry v. Simplicity Eng’g, 900 F.2d 963, 966 (6th Cir.1990) (holding that under either “de novo” or “arbitrary and capricious” standard, court’s review is limited to the record). Second, the prohibition of discovery effectuates ERISA’s “primary” goal — the “inexpensive!] and expeditious!]” resolution of disputes. Id. at 966— 67.

(3,4] When a claimant makes a “procedural challenge” to the administrator’s decision, however, “such as an alleged lack of due process ... or alleged bias,” limited discovery is permitted in spite of the general prohibition. Johnson v. Conn. Gen. Life Ins. Co., 324 Fed.Appx. 459, 466 (6th Cir.2009) (quoting Judge Gilman’s concurrence in Wilkins, 150 F.3d at 619). In such a case, the first rationale for prohibiting discovery is inapplicable; the court is not prohibited from looking outside the administrative record and must instead consider circumstances affecting the administrator’s conflict of interest. Glenn, 554 U.S. at 117, 128 S.Ct. 2343.3 For the same reason, however, any discovery must be strictly confined to the procedural challenge by which it is justified. Johnson, 324 Fed.Appx. at 466; Moore v. LaFayette Life Ins. Co., 458 F.3d 416, 430 (6th Cir.2006). Moreover, the second rationale for prohibiting discovery remains applicable, and discovery therefore must also be tailored to facilitate the prompt and inexpensive resolution of disputes. See Price v. Hartford Life and Acc. Ins. Co., 746 F.Supp.2d 860, 865-66, 2010 WL 3998039, at *5 (E.D.Mich. Oct. 12, 2010) (courts should account for the “interests of economy, efficiency, accuracy, and fairness” when addressing scope of discovery issues).

2. Types of discovery relating to an alleged conflict of interest

As in all civil cases, the permissible scope of discovery is drawn by reference to the parties’ pleadings.4 See Fed.R.Civ.P. 26(b) (tying the relevance inquiry to the parties’ claims or defenses or, for good cause, to the subject matter); Wilkins, 150 F.3d at 618 (Gilman, J., concurring) (additional evidence may be necessary to explore “alleged lack of due process” or “alleged bias”) (emphases added). Relevant discovery may be had with respect to matters “reasonably calculated to lead to the discovery of admissible evidence.” Fed.R.Civ.P. 26(b). As explained above, evidence outside the ERISA record may be considered only inasmuch as it relates to a procedural challenge (here, the alleged conflict of interest or bias), so discovery is similarly limited to those issues. Moore, 458 F.3d at 430.5

[589]*589Whether to allow discovery relating to an alleged conflict of interest is a decision entrusted to the trial court’s discretion. See Bell v. Ameritech Sickness and Accident Disability Benefit Plan, 399 Fed.Appx. 991, 998, 2010 WL 4244126, at *6 (6th Cir.2010) (unpublished) (“Discovery may be appropriate to determine the weight to accord to a conflict of interest, ... but the district court retains discretion to decide when to allow such discovery.”); Johnson, 324 Fed.Appx. at 467 (noting that discovery will not be “automatically” available in every case where there is a conflict of interest). A court may deny discovery, even when relevant to the plaintiffs allegations, when it is cumulative, unnecessary, or unduly burdensome. Fed. R.Civ.P. 26(b), (c) (discovery must be limited where its burden outweighs its likely benefit and may be limited where its burden is “undue”). See also Bell, 2010 WL 4244126, at *6 (approving the trial court’s denial of discovery when it would not have aided the court’s review); Murphy, 619 F.3d at 1163; Hughes v.

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
271 F.R.D. 584, 2011 U.S. Dist. LEXIS 1851, 2011 WL 52549, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mulligan-v-provident-life-accident-insurance-tned-2011.