Smith v. Continental Casualty Co.

289 F. Supp. 2d 706, 2003 U.S. Dist. LEXIS 19945, 2003 WL 22532851
Procedural entryThis page is a short order in Smith v. Continental Casualty Co.. Read the opinion of the Court — 276 F. Supp. 2d 447
District Court, D. Maryland·Decided October 27, 2003·No. CIV. WDQ-02-3049·Published

Opinion

MEMORANDUM OPINION AND ORDER

QUARLES, District Judge.

BACKGROUND

The Plaintiff, Neal Smith (“Mr.Smith”), sued the Defendant, Continental Casualty Company (“Continental”), for wrongful denial of his claim for long-term disability benefits, pursuant to the Employee Retirement Income Security Act of 1974 (“ERISA”). 1 In a Memorandum Opinion dated August 4, 2003, the Court granted in *708 part Mr. Smith’s motion for summary judgment. Smith v. Cont’l Cas. Co., 276 F.Supp.2d 447 (D.Md.2003). The Court concluded that Continental abused its discretion when it discredited Mr. Smith’s self-reports of pain without substantial evidence that he was exaggerating, and denied his claim for disability benefits. Smith, 276 F.Supp.2d at 453-54.

Because the Court determined that Continental abused its discretion when it denied Mr. Smith’s claim, Mr. Smith seeks an award of attorney’s fees and costs, authorized by ERISA § 1132(g). Pl.’s Mot. for Att’ys Fees & Costs 2. Section 1132(g)(1) provides “[i]n any action under this title ... by a participant, beneficiary, or fiduciary, the court in its discretion may allow a reasonable attorney’s fee and costs of action to either party.” 29 U.S.C. § 1132(g)(1) (2003).

Continental argues that Mr. Smith is not entitled to recover attorney’s fees, or that if fees are awarded, they should be less than the amount Mr. Smith requested. See generally, Def.’s Opp’n to Pl.’s Mot. for Att’ys Fees & Costs. In replying to this argument, Mr. Smith asked the Court to require Continental to submit its billing records for this case into evidence, in order to demonstrate that the fees charged by Mr. Smith’s attorney are reasonable in comparison. Pl.’s Reply 8. Continental’s counsel then filed a motion for leave to file a surreply so that it could respond to Mr. Smith’s request. Def.’s Mot. for Leave to File Surreply 2. Pending are Mr. Smith’s motion for attorney’s fees and Continental’s motion for leave to file a surreply.

I.Whether to Award Attorney’s Fees

A. The Five Factor Test

In Reinking v. Philadelphia American Life Insurance Company, 2 , the Fourth Circuit adopted a five factor test for the District Court to use in determining whether to grant a request for attorneys’ fees. The five factors are:

1. degree of opposing parties’ culpability or bad faith;
2. ability of opposing parties to satisfy an award of attorneys’ fees;
3. whether an award of attorneys’ fees against the opposing parties would deter other persons acting under similar circumstances;
4. whether the parties requesting attorneys’ fees sought to benefit all participants and beneficiaries of an ERISA plan or to resolve a significant legal question regarding ERISA itself; and
5. the relative merits of the parties’ positions.

Id. at 1218 (citing Iron Workers Local No. 272 v. Bowen, 624 F.2d 1255, 1266 (5th Cir.1980)).

The factors do not constitute a rigid test, but “rather provide[ ] general guidelines for the district court in determining whether to grant a request for attorneys’ fees.” Quesinberry v. Life Ins. Co. of N. Am., 987 F.2d 1017, 1029 (4th Cir.1993) (citing Gray v. New England Tel. & Tel. Co., 792 F.2d 251, 258 (1st Cir.1986)). No one factor is necessarily determinative, and some may not apply in a particular case, but together they are the “nuclei of concerns that a court should address” when applying ERISA § 1132(g). Id. (citing Bowen, 624 F.2d at 1266).

B. Applying the Five Factors

Mr. Smith contends that Continental showed bad faith in denying his claims for disability benefits by ignoring his self-reports of intolerable pain, recommendations from his treating physicians that he refrain from working, results of a functional capacity evaluation indicating that he was *709 not capable of performing even sedentary work, and the Social Security Administration’s determination that he was disabled. Pl.’s Mot. for Att’ys Fees & Costs 3-4. Continental failed to properly review Mr. Smith’s disability claim when it “noted but finally disregarded” some of the evidence and “utterly ignored” much of the rest. Smith, 276 F.Supp.2d at 454.

Ignoring the voluminous evidence supporting Mr. Smith’s claim, Continental refused to acknowledge his disability and instead had him secretly videotaped to verify his disability status. Id. at 455-56. The videotape surveillance was inconclusive, however, because the investigator was only able to record images of Mr. Smith traveling to and from a doctor’s appointment and walking with the aid of a cane. Id.

Finally Continental sent Mr. Smith’s disability file for an independent medical review. Id. at 450-51. The reviewing physician discredited Mr. Smith’s representations about his condition and concluded that because diagnostic tests were unable to substantiate the level of pain Mr. Smith reported, that he was not disabled or entitled to benefits. Id. at 459-60.

Continental acted in bad faith when it refused to credit Mr. Smith’s self-reported pain symptoms, particularly in light of the abundance of medical and occupational reports supporting his claim. See Hines v. Unum Life Ins. Co. of Am., 110 F.Supp.2d 458 (W.D.Va.2000) (finding bad faith when insurance company ignored treating physician’s assessment of claimant’s disability and “readily jumped to secretly videotape” his activities in an attempt to show that he was not disabled).

Once a sufficient finding of bad faith has been made, consideration of the remaining four factors necessarily follows. Id. (citing O’Bryhim v. Reliance Standard Life Ins. Co., 1999 WL 617891, 1999 U.S.App. LEXIS 19232 (4th Cir. Aug. 16, 1999)). The Court further finds that: (1) Continental has the ability to pay Mr. Smith’s attorney’s fees; 3 (2) granting attorney’s fees is likely to deter other insurers from engaging in similar bad faith conduct; (3) Mr. Smith’s success in establishing that the insured’s subjective pain reports should be credited in the absence of substantial evidence to the contrary has resolved a significant legal question with regards to ERISA; and (4) Mr. Smith’s claim, relative to Continental’s defense, had much greater merit. Accordingly, Mr. Smith is entitled to an award of reasonable attorney’s fees.

II. Determining Reasonable Attorney’s Fees

A. The Lodestar Figure

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Smith v. Continental Casualty Co., 289 F. Supp. 2d 706, 2003 U.S. Dist. LEXIS 19945, 2003 WL 22532851 (D. Md. 2003).

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