NEBESNY-FENDER v. American Airlines, Inc.

818 F. Supp. 2d 1319, 2011 U.S. Dist. LEXIS 63001, 2011 WL 2452382
CourtDistrict Court, S.D. Florida
DecidedJanuary 11, 2011
DocketCase 08-61858-CIV-JORDAN
StatusPublished
Cited by3 cases

This text of 818 F. Supp. 2d 1319 (NEBESNY-FENDER v. American Airlines, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
NEBESNY-FENDER v. American Airlines, Inc., 818 F. Supp. 2d 1319, 2011 U.S. Dist. LEXIS 63001, 2011 WL 2452382 (S.D. Fla. 2011).

Opinion

Findings op Fact and Conclusions op Law

ADALBERTO JORDAN, District Judge.

After considering the arguments of counsel, the stipulations of the parties, and the evidence presented at the bench trial held in this ease, I make the following findings of fact and conclusions of law pursuant to Rule 52(a)(1) of the Federal Rules of Civil Procedure.

I. The Evidence Properly Considered

This case, brought under the Employee Retirement Income Security Act, 29 U.S.C. §§ 1001 et seq., concerns American Airlines’ denial of Anna Nebesny-Fender’s request to re-enroll in the prefunding plan for retiree medical coverage with credit for previous years of enrollment. The plan administrator ruled against Ms. NebesnyFender, finding that, by not returning to American her refund of prefunding plan contributions within 90 days of her return to work, she had forfeited her right to re-enroll in the prefunding plan with credit.

In December of 2009, I denied the parties’ motions for summary judgment because there were material issues of fact as to whether Ms. Neb’esny-Fender received notice about relevant changes to the prefunding plan, and reserved ruling on whether evidence outside the administrative record would be considered at trial. *1323 See Order Denying Motions for Summary Judgment [D.E. 58] at 7-8 (Dec. 8, 2009). At trial, I allowed the parties to introduce evidence that was not in the administrative record, but again reserved ruling on whether such evidence was admissible. I now conclude, for the reasons which follow, that my review in this case is confined to the administrative record.

Ms. Nebesny-Fender and American agree that the plan gives the administrator discretion to interpret and apply its terms. They also agree that, under governing ERISA principles, see, e.g., Conkright v. Frommert, - U.S. -, 130 S.Ct. 1640, 1646, 176 L.Ed.2d 469 (2010), the administrator’s decision in this matter should be reviewed under the arbitrary and capricious standard. 1

Under that standard, the task of a district court is to determine whether there is a “reasonable basis for the [administrator’s] decision based upon the facts as known to the administrator at the time the decision was made.” See, e.g., Glazer v. Reliance Standard Ins., 524 F.3d 1241, 1246 (11th Cir.2008); Jett v. Blue Cross & Blue Shield of Ala., 890 F.2d 1137, 1139 (11th Cir.1989). The same standard applies to both factual findings and legal conclusions by the administrator. See Paramore, 129 F.3d at 1451.

If that is how the standard operates, then it would seem inappropriate to consider evidence outside the administrative record. In fact, the Eleventh Circuit has noted, in an unpublished opinion, that when applying the arbitrary and capricious standard in an ERISA action a district court “sits more as an appellate tribunal than as a trial court. It does not take evidence, but, rather, evaluates the reasonableness of an administrator’s determination in light of the record compiled before the plan fiduciary.” See Curran v. Kemper Nat’l Servs., No. 04-14097, 2005 WL 894840, *7 (11th Cir.2005) (per curiam). Unlike a typical summary judgment scenario, the district court’s job in a case like this one is not to determine whether there are material issues of fact, but rather whether the administrator’s findings are reasonable. See Glazer, 524 F.3d at 1246 (“Glazer argues that the district court erred when it granted summary judgment because there were factual disputes about whether [she] was disabled, but this argument misunderstands our standard of review. Our review of a denial of benefits is whether the decision of the administrator was arbitrary and capricious.”).

These principles, which seem relatively straightforward, would seem to call for review to be limited to the administrative record compiled below. But things are not as simple as they seem.

First, in a number of ERISA cases applying the arbitrary and capricious standard, the Eleventh Circuit has reversed grants of summary judgment and remanded for trial at which the district court was to make independent findings of fact. See, e.g., Tippitt v. Reliance Standard Life Ins., 457 F.3d 1227, 1237 (11th Cir.2006) (Tippitt I) (remanding to district court, in case involving “heightened” arbitrary and capricious review, for findings about employee’s ability to perform certain duties *1324 even though administrator had found that employee could carry out duties of his occupation); 2 Merritt v. Fed. Express Corp., 185 Fed.Appx. 891, 892-95 (11th Cir.2006) (per curiam) (reversing grant of summary judgment in favor of administrator in case involving “heightened” arbitrary and capricious review and remanding for factual findings as to when employee received benefit information packet, even though administrator had found that employee did not receive package in November of 2003, as he had claimed). Although it is unclear whether the Eleventh Circuit intended for the district courts in Tippitt I and Memtt to consider evidence outside the administrative record on remand, simply making new factual findings would seem to cut against the notion that arbitrary and capricious review focuses on the findings and conclusions of the administrator based on the record before it.

Second, in other ERISA cases applying the arbitrary and capricious standard, the Eleventh Circuit has said that a district court can consider an administrator’s “post-hoc explanation” for denial of benefits. See, e.g., Marecek v. BellSouth Telecomms., 49 F.3d 702, 707 (11th Cir.1995); Tippitt v. Reliance Standard Life Ins., 276 Fed.Appx. 912, 915-16 (11th Cir.2008) (Tippitt II). A post-hoc explanation, however, by definition is not part of the administrative record. Thus, cases like Marecelc and Tippitt II are in some tension with the notion that review in a case like this one is limited to the administrative record. See also Orndorf v. Paul Revere Life Ins. Co., 404 F.3d 510, 520 (1st Cir.2005) (“There may be times when it is appropriate for courts to hear new evidence. Where the challenge is not to the merits of the decision to deny benefits, but to the procedure used to reach the decision, outside evidence may be of relevance.”).

On balance, I conclude that I should generally limit my review concerning historical facts to the administrative record. For starters, the earliest Eleventh Circuit opinion on the issue, Jett, 890 F.2d at 1139, holds that review is “limit[ed] ... to ...

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818 F. Supp. 2d 1319, 2011 U.S. Dist. LEXIS 63001, 2011 WL 2452382, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nebesny-fender-v-american-airlines-inc-flsd-2011.