Santos v. Quebecor World Long Term Disability Plan

254 F.R.D. 643, 2009 U.S. Dist. LEXIS 5348, 2009 WL 111910
District Court, E.D. California·Decided January 16, 2009·No. No. 1:08-cv-00565 AWI GSA·Published·Cited by 6 cases

Opinion

ORDER RE: MOTION TO PERMIT DISCOVERY

GARY S. AUSTIN, United States Magistrate Judge.

Plaintiff Guadalupe Santos (“Plaintiff’) filed the instant motion to permit discovery on October 10, 2008. Defendant Quebecor World Long Term Disability Plan (“Defendant”) opposed Plaintiffs motion. This court considered the motion on the record and without oral argument on the now vacated November 21, 2008 hearing. As discussed more fully below, the motion is GRANTED IN PART and DENIED IN PART.

PROCEDURAL BACKGROUND

On April 23, 2008, Plaintiff filed this action, contending that she is entitled to long-term [647] disability benefits under an employee welfare benefit plan governed by the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq. Plaintiff seeks a declaratory judgment for the payment of long-term disability benefits, along with attorney fees and costs. Defendant filed an answer to the complaint on June 9, 2008.

On July 24, 2008, the Court entered a scheduling order in this matter. The order set a briefing schedule on the issue of whether, and to what extent, Plaintiff was permitted to conduct discovery in this matter. (Doc. 13). Pursuant to the stipulation of the parties, the Court’s scheduling order was modified on August 27, 2008. The modified scheduling order provided that Plaintiff must file a motion for leave to conduct discovery on or before October 10, 2008. (Doc. 15).

In accordance with the Court’s order, Plaintiff filed the instant motion for discovery on October 10, 2008. Plaintiff is seeking discovery outside the administrative record regarding defendant’s alleged conflict of interest in administering Plaintiffs claim for long term disability benefits. Plaintiff contends that she is entitled to certain requested discovery, including depositions of insurance company employees and reviewing doctors. Defendant counters that Plaintiffs requests are excessive and are not narrowly tailored to the issue of conflict of interest.

FACTUAL BACKGROUND

According to her complaint, Plaintiff was employed by Quebeeor World as a Supervisor and was a participant in the Quebeeor World Long Term Disability Plan (“Plan”). The Plan is insured by Hartford Life Group Insurance Company and provides long term disability benefits to Quebeeor World employees meeting the Plan’s definition of total disability.

Plaintiff alleges that she is totally disabled and completely ceased work on December 19, 2005. She was granted long-term disability benefits under the Plan by letter dated August 31, 2006. Thereafter, Plaintiffs benefits under the Plan were terminated by letter dated July 30, 2007. On January 23, 2008, Plaintiff appealed the termination. Plaintiffs appeal was denied and she exhausted her administrative remedies.

Plaintiff asserts that the denial of long-term disability benefits was arbitrary and capricious and that she continues to be disabled under the terms of the Plan. She desires a judicial determination of her rights, along with a declaration that the Plan is obligated to pay her long-term disability benefits. See generally Complaint.

PLAINTIFF’S REQUESTED DISCOVERY

Plaintiff seeks the following discovery: (1) a Rule 30(b)(6) deposition of Hartford, the insurance company which paid claims and determined whether claimants were eligible for benefits; (2) if necessary, 30(b)(6) depositions of the services—Reed Review Service, MES Solutions—which provided reviewing doctors to Hartford; and (3) if necessary, depositions of the three reviewing doctors— Dr. Gary Nudell, Dr. Kelly Clark and Dr. Mark Burns. Plaintiff argues that the discovery sought is directed to Hartford’s “conflict of interest in evaluating that conflict of interest for the purpose of evaluating the propriety of its action terminating [Plaintiffs] benefits.” Plaintiffs Points and Authorities in Support of Motion to Permit Discovery, p. 1.

Defendant counters that the proposed discovery is “outrageously excessive.” Defendant’s Opposition to Plaintiffs Motion to Permit Discovery, p. 7.

DISCUSSION

A. Motion for Discovery

1. Discovery in ERISA Actions

The discovery allowed in ERISA actions challenging the denial of benefits, if any, is directly related to the standard of review employed by the Court. While the default standard of review is de novo, the Court will review the decision for abuse of discretion where an ERISA plan grants discretion to the plan administrator. Abatie v. Alta Health & Life Insurance Co., 458 F.3d 955, 967 (9th Cir.2006) (en banc). In this instance, neither party appears to contend [648] that the standard of review is de novo. Accordingly, Abatie provides that an abuse of discretion review is limited to the administrative record. Id. at 970. However, a district court may, in its discretion, consider evidence outside the administrative record to decide the nature, extent and effect on the decision-making process of any conflict of interest; the decision on the merits, though must rest on the administrative record once the conflict (if any) has been established, by extrinsic evidence or otherwise. Id. at 970.

The United States Supreme Court confirmed in Metropolitan Life Insurance Co. v. Glenn, — U.S. -, 128 S.Ct. 2343, 171 L.Ed.2d 299 (2008) that a conflict of interest “should prove more important (perhaps of great importance) where circumstances suggest a higher likelihood that it affected the benefits decision, including, but not limited to, cases where an insurance company administrator has a history of biased claims administration.” Id. at 2351. The Court held that a district court could consider evidence of an administrator’s actions taken in an effort “to reduce potential bias and to promote accuracy,” such as “walling off claims administrators from those interested in firm finances,” or “imposing management cheeks that penalize inaccurate decisionmaking irrespective of whom the inaccuracy benefits.” Id.

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Santos v. Quebecor World Long Term Disability Plan, 254 F.R.D. 643, 2009 U.S. Dist. LEXIS 5348, 2009 WL 111910 (E.D. Cal. 2009).

254 F.R.D. 643 (Santos v. Quebecor World Long Term Disability Plan) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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