Moore v. Metropolitan Life Insurance Co. et al

Filing 38

MEMORANDUM OPINION AND ORDER: 1. Moore's motions to compel Southern Company to produce documents exchanged between it and Met Life concerning the claim at issue, (Doc. 25 ) and to compel Southern Company to respond to her request for admission on the basis Met Life informed her was the reason her claim was denied (Doc. 26 ) are DENIED. 2. Moore's 24 Motion to Strike the Defendants' objections to producing privilege logs and compel their overdue production, is GRANTED. By separ ate order entered prior to the date on which this opinion and order were entered, the court ordered Met Life to serve a privilege log on Moore on or before 6/27/2011. 3. Moore's motion to compel production and identification of manuals, guidelin es and other documents governing the manner in which Met Life makes claims decisions for her plan. (Doc. 20 ) is GRANTED to the extent that Met Life shall produce all written procedures, rules, guidelines or other governing documents which applied i n any way to the resolution of Moore's claim. 4. Moore's motion to compel production of documents detailing or explaining Met Life's organizational structure in which the persons who were involved in her claim pursuant to plan worked ( Doc. 22 ) is DENIED. 5. Moore's motion to compel production of application documents for her plan and documents evidencing other plans or coverages provided to her (Doc. 23 ) is DENIED. 6. Moore's motion to compel production of documents and information relevant under supreme court precedent concerning Met Life's conflict of interest (Doc. 21 ) is GRANTED as further set out in the order. In all other respects, the plaintiff's motion to compel is DENIED. It is further ORDER ED that Met Life shall comply with the provisions of this order requiring responses or production on or before 7/1/2011. It is further ORDERED that on or before 2:00 p.m., 7/1/2011, the parties shall agree upon and submit to the court a proposed prot ective order covering the documents which must be produced pursuant to this order. Signed by Honorable Judge Charles S. Coody on 6/27/2011. (dmn) [Modified on 6/27/2011 to reflect that 29 Motion for Expedited Hearing and 34 Motion for Protective Order terminated per instruction of Judge Coody.-DMN]

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF ALABAMA
NORTHERN DIVISION
JANIE MOORE,
Plaintiff,
v.
METROPOLITAN LIFE INS. CO., et al.,
Defendants.

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CIVIL ACTION NO. 2:11cv170-MHT
(WO)

MEMORANDUM OPINION AND ORDER
I. Introduction
In this ERISA action filed pursuant to 29 U.S.C. § 1132(a)(1), Janie Moore seeks
benefits allegedly due her under a group dependent benefits life insurance Plan. Moore
contends that Paul Moore was her common-law husband, and she is due benefits after his
death. After investigation Met Life concluded that no common-law marriage existed and
denied eligibility for dependent life insurance benefits. That decision led to this lawsuit.
Presently before the court are a few discovery motions:
1. Moore’s Motion to Compel Production and Identification of Manuals,
Guidelines and Other Documents Governing the Manner in Which Met Life Makes
Claims Decisions for Her Plan. (doc. # 20)
2. Moore’s Motion to Compel Production of Documents and Information Relevant
under Supreme Court Precedent Concerning Met Life's Conflict of Interest. (doc. # 21)
3. Moore’s Motion to Compel Production of Documents Detailing or Explaining

Met Life's Organizational Structure in Which the Persons Who Were Involved in Her
Claim Pursuant to Plan Worked. (doc. # 22)
4. Moore’s Motion to Compel Production of Application Documents for Her Plan
and Documents Evidencing Other Plans or Coverages Provided to Her. (doc. # 23)
5. Moore’s Motion to Strike the Defendants’ Objections to Producing Privilege
Logs and Compel Their Overdue Production (doc. # 24)
6. Moore’s Motion to Compel Southern Company to Produce Documents
Exchanged Between it and Met Life Concerning the Claim at Issue. (doc. # 25)
7. Moore’s Motion to Compel Southern Company to Respond to Her Request for
Admission on the Basis Met Life Informed Her Was the Reason Her Claim Was Denied.
(doc. # 26)
8. Metropolitan Life Ins. Co.’s Motion for Protective Order Regarding Deposition
of Marie Ruffing Noticed by Plaintiff. (doc. # 34)
The court heard oral argument on these motions and has carefully considered the
arguments and the briefs of the parties. At its heart, the central issue raised by most of
these motions is the scope of discovery in an ERISA case in which there exists a conflict
of interest. Before delving into that question, several of these motions can be disposed of
rather quickly.
II. Moore’s Motions Related to the Southern Company
There is no dispute that Metropolitan Life Insurance Company (Met Life) is both

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the Plan administrator and also funds the Plan. It appears from the language of the Plan
that Met Life has discretionary authority to determine eligibility for benefits under the
Plan. Moore’s motions to compel Southern Company to produce documents exchanged
between it and Met Life concerning the claim at issue, (doc. # 25) and to compel Southern
Company to respond to her request for admission on the basis Met Life informed her was
the reason her claim was denied (doc. # 26), therefore, are due to be denied.
F ED.R.C IV.P. 26(b)(1) provides that “[p]arties may obtain discovery regarding any
nonprivileged matter that is relevant to any party’s claim or defense . . . ” The
information sought by Moore in these two motions to compel is plainly not relevant to
any claim she makes because those claims focus solely on the decision of the Plan
administrator, Met Life. At oral argument Moore’s counsel conceded as much.
III. Privilege Logs
Moore’s motion to strike the defendants’ objections to producing privilege logs
and compel their overdue production, (doc. # 24) is due to be granted. In its responses to
Moore’s discovery requests, Met Life made the following objection:
MetLife objects to each discovery request to the extent that it
may be interpreted to call for the production of documents
prepared in anticipation of litigation pursuant to Fed. R. Civ.
P. 26 or privileged documents or information, including
documents or information protected by the attorney client
privilege or the "work product" doctrine. MetLife will
provide a privilege log if privileged documents exist that
pre-date the filing of this lawsuit.
This objection is improper. It is wholly inconsistent with the requirements of F ED
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R. C IV. P. 26(b)(5)(A) which provides as follows:
When a party withholds information otherwise discoverable by claiming
that the information is privileged or subject to protection as trial-preparation
material, the party must:
(I) expressly make the claim; and
(ii) describe the nature of the documents, communications, or
tangible things not produced or disclosed--and do so in a manner
that, without revealing information itself privileged or protected, will
enable other parties to assess the claim.
Met Life’s blanket objection which fails to specify what information is privileged
or protected is simply not an express assertion of the claim within the meaning of the
Rule. “A blanket claim of privilege which does not specify what information is protected
will not suffice.” United States v. White, 970 F.2d 328, 334 (7th Cir.1992). See also In re
Grand Jury Subpoena, 831 F.2d at 226 (“Blanket assertions of [the attorney-client]
privilege before a district court are usually unacceptable.”).
Moreover, F ED R. C IV. P. 26(b)(5)(A)(ii) does not say that the so-called privilege
log can be provided at a later date. By its terms, the Rule contemplates that the log will
be provided at the time the privilege or protection is asserted so that the claim can be
assessed.
At oral argument, the court noted the deficiencies and informed Met Life’s counsel
that the court would order production of a log in compliance with F ED R. C IV. P.
26(b)(5)(A)(ii) within seven days. The court will so order.

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IV. Scope of Discovery in an ERISA Action
In Williams v. BellSouth Telecomms., Inc., 373 F.3d 1132, 1138 (11th Cir.2004),
the Eleventh Circuit established a sequential, six-step analysis to guide review of a plan
administrator's benefits determination: (1) Apply the de novo standard to determine
whether the claim administrator's benefits-denial decision is “wrong” (i.e., the court
disagrees with the administrator's decision); if it is not, then end the inquiry and affirm the
decision; (2) If the administrator's decision in fact is “de novo wrong,” then determine
whether the administrator was vested with discretion in reviewing claims; if not, end
judicial inquiry and reverse the decision; (3) If the administrator's decision is “de novo
wrong” and he was vested with discretion in reviewing claims, then determine whether
“reasonable” grounds supported it (hence, review his decision under the more deferential
arbitrary and capricious standard); (4) If no reasonable grounds exist, then end the
inquiry and reverse the administrator's decision; if reasonable grounds do exist, then
determine if he operated under a conflict of interest; (5) If there is no conflict, then end
the inquiry and affirm the decision; and (6) If there is a conflict of interest, then apply
heightened arbitrary and capricious review to the decision to affirm or deny it.1
After the Supreme Court’s decision in Met. Life Ins. Co. v. Glenn, 554 U.S. 105

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This analytical approach derives from Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 109,
(1989), in which the Court established three distinct standards for reviewing an ERISA plan
administrator's decision: (1) de novo where the plan does not grant the administrator discretion; (2)
arbitrary and capricious where the plan grants the administrator discretion; and (3) heightened arbitrary
and capricious where the plan grants the administrator discretion and the administrator has a conflict of
interest.

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(2008), the Eleventh Circuit modified the sixth step, eliminating the heightened standard
of review. Doyle v. Liberty Life Assur. Co. of Boston, 542 F.3d 1352, 1360 (11th
Cir.2008). Now, a conflict of interest, which arises when the administrator both
determines eligibility under the plan and pays the claim from its own general assets, is
merely “a factor for the district court to take into account when determining whether an
administrator's decision was arbitrary and capricious.” Id. This requires an individualized
inquiry into the conflict of interest in a particular case, because a benefits decision can
relate to conflicts in many different ways and the conflicts “will themselves vary in kind
and in degree of seriousness.” Glenn 554 U.S. at 116. See also Capone v. Aetna Life Ins.
Co., 592 F.3d 1189, 1195 (11th Cir.2010).
In Brown v. Blue Cross & Blue Shield of Ala., Inc., 898 F.2d 1556 (11th
Cir.1990), the court held that “that when a plan beneficiary demonstrates a substantial
conflict of interest on the part of the fiduciary responsible for benefits determinations, the
burden shifts to the fiduciary to prove that its interpretation of plan provisions committed
to its discretion was not tainted by self-interest.” Id. at 1566. However, after Glenn, the
Eleventh Circuit concluded that “the burden remains on the plaintiff to show the decision
was arbitrary; it is not the defendant's burden to prove its decision was not tainted by
self-interest.” Doyle, 542 F.3d at 1360.
This leads the court, then, to consider what is the proper scope of discovery in this
case. The answer to this question is first informed by the following discussion in Glenn.

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The conflict of interest at issue here, for example, 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. See Langbein, supra, at 1317–1321 (detailing
such a history for one large insurer). It should prove less important (perhaps
to the vanishing point) where the administrator has taken active steps to
reduce potential bias and to promote accuracy, for example, by walling off
claims administrators from those interested in firm finances, or by imposing
management checks that penalize inaccurate decision making irrespective
of whom the inaccuracy benefits. See Herzel & Colling, The Chinese Wall
and Conflict of Interest in Banks, 34 Bus. Law 73, 114 (1978)
(recommending interdepartmental information walls to reduce bank
conflicts); Brief for Blue Cross and Blue Shield Association as Amicus
Curiae 15 (suggesting that insurers have incentives to reward claims
processors for their accuracy); cf. generally J. Mashaw, Bureaucratic Justice
(1983) (discussing internal controls as a sound method of producing
administrative accuracy).
Glenn, 554 U.S. at 117–118.
Most recently, Judge Hopkins in the Northern District of Alabama, noting the
existence of a divergence of opinion among the circuits 2 about the scope of discovery in
ERISA cases after Glenn, concluded that
the plaintiff should not be limited to the Plan's assertion that any such
conflict did not affect the claim decision. Without such discovery, the
existence of a conflict of interest would be analyzed in a vacuum, which
would be at odds with Glenn's holding that “... the significance of the
(conflict of interest) factor will depend upon the circumstances of the
particular case.” Glenn, supra, 554 U.S. at 108 (emphasis supplied). It
would be reasonable to permit Harvey to attempt to ascertain the
circumstances surrounding the conflict of interest . . .

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See Elizabeth J. Bondurant, Standard of Review and Discovery after Glenn: the Effect of the
Glenn Standard of Review on the Role of Discovery in Cases Involving Conflicts of Interest, 77 Def.
Couns. J. 120 (2010) (Discussing varied approaches of the circuits).

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Harvey v. Standard Ins. Co., ---- F.Supp.2d -----, -----, 2011 WL 2050752, *5
(N.D.Ala.,2011).
In short, the court concludes that it is appropriate to permit discovery related to the
conflict of interest because if it is necessary for the court to consider that factor, the court
must weigh the varying circumstances of its existence and extent. See Self v. The
Prudential Ins. Co. of America, ---- F.Supp.2d, ----, 2010 WL 996503 (N.D.Fla. 2010).
As will be reflected below, this does not mean unlimited discovery. With that established,
the court will turn to the remaining individual motions to compel.
1. Moore’s motion to compel production and identification of manuals, guidelines
and other documents governing the manner in which met life makes claims decisions for
her plan. (doc. # 20) The undisputed facts show that Met Life first denied Moore’s claim
based on Wisconsin law but later retreated from that position agreeing that Alabama law
governed the resolution of this claim. Met Life has agreed to produce, subject to a
protective order, any claim guidelines relating to common law marriage. However, the
court agrees that some more limited discovery is appropriate, especially in light of Met
Life’s statement that it “did not specifically rely on any other guidelines or manuals . . .”
That statement, of course, begs that question about what Met Life generally relied upon.
Accordingly, the court will order that Met Life produce all written procedures, rules,
guidelines or other governing documents which applied in any way to the resolution of
Moore’s claim. The court will also order the parties to reach agreement on a protective
order.

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2. Moore’s motion to compel production of documents detailing or explaining Met
Life's organizational structure in which the persons who were involved in her claim
pursuant to plan worked (doc. # 22) is due to be denied. Moore argues that neither it nor
the court should “take Met Life’s word for it” when Met Life states that its claims
personnel are separated from it financial affairs personnel. Moore speculates that it is
possible other departments do have influence over the claims process. First, Met Life’s
responses were made under oath and do constitute evidence upon which the parties and
the court can rely. Secondly, documents showing the organizational structure of Met Life
are not related to the questions for which Moore seeks answers. In other words, the
formal structure of an organization will not show whether there exists influences between
and among divisions within an organization. As noted at oral argument, the court will
permit the deposition of Marie Ruffing by telephone, and this subject is a legitimate area
of inquiry.
3. Moore’s motion to compel production of application documents for her plan
and documents evidencing other plans or coverages provided to her (doc. # 23) is due to
be denied. Met Life has produced the claim file. Other than requesting these documents,
Moore makes no showing as to how they are relevant to her claim in this case.
4. Moore’s motion to compel production of documents and information relevant
under supreme court precedent concerning Met Life's conflict of interest (doc. # 21) has
several distinct aspects which must be discussed separately. Moore’s requests for

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production 5 through 7 relate to documents showing financial bonuses, incentives, stock
options, honors, awards, remuneration (whether financial or not) or any other type of
compensation or program for “company personnel working with the departments directly
responsible for the adjudication or assessment of the Plaintiff’s claims,” for persons who
supervised employees who handle the Plan’s claims, and for employees who handled the
plaintiff’s claims.
Obviously, the requests for this information relate to the conflict of interest issue in
this case. In response, Met Life stated the following:
MetLife’s Claims Associates, including both Claims Specialists and
Appeals Specialists, are evaluated base upon the quality, accuracy, and
timeliness of their claims evaluations and determinations. MetLife assesses
whether Claims Associates evaluated and determined claims pursuant to the
applicable plan documents. MetLife does not consider the number of claims
that resulted in either an adverse or non-adverse determination during the
performance reviews of its Claims Associates, and the number of claims
that resulted in either an adverse or non-adverse determination does not
affect the performance review or compensation decisions relating to that
employee. MetLife’s Claims Associates do not receive benefits, bonuses,
commissions, promotions, or any other incentives, financial or otherwise,
based on the number of claims that, based on their claims evaluations and
determinations, are or are not payable. MetLife evaluates each claim based
upon the particular plan provisions and information before the administrator
at the time of the determination in accordance with its fiduciary obligations.
Claims Associates do not have access to reserve information, and do not
report up to Finance Department employees. The compensation of Claims
Associates is not related to whether claims that individual reviewed resulted
in adverse or non-adverse determinations. As such, the requested
information is neither relevant nor reasonably calculated to lead to the
discovery of admissible evidence.
Moore’s motion to compel recites all of Met Life’s boilerplate objections but fails

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to point out the specific response set forth above. Given Met Life’s response, any
information about financial awards or incentives would not be relevant to the conflict of
interest issue unless it could be shown that the award or incentive was in some way tied to
denial of claims. The court will order some very limited discovery and permit Moore to
make inquiry about this issue during the Ruffing deposition.
The remaining issues relate to interrogatories which ask for the identity of and
information about each person who was involved in determining plaintiff’s claim and also
information about any awards, bonuses or recognition received for job performance. The
court understands that Met Life has already produced the identity of each person who
worked on the plaintiff’s claim. Notwithstanding the previous statement by Met Life
about awards, bonuses or other recognition, the court notes that Met Life’s statements
were general. Thus, the court will require Met Life to respond specifically as set forth
below. In all other respects the motion to compel will be denied.
5. Met Life’s motion for protective order regarding deposition of Marie Ruffing
noticed by plaintiff (doc. # 34) is due to be denied. The court has concluded that the
plaintiff should be allowed to make an individualized inquiry into the conflict of interest
in a particular case, because a benefits decision can relate to conflicts in many different
ways and the conflicts “will themselves vary in kind and in degree of seriousness ” Glenn
554 U.S. at 116. As indicated at oral argument, the deposition shall be limited to two
hours and shall be taken by telephone or other appropriate electronic means.

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In its response to the motion to compel Met Life argues that no discovery should
take place until the court first decides whether Met Life’s denial of benefits decision was
right. See Williams v. BellSouth Telecomms., Inc., 373 F.3d 1132, 1138 (11th Cir.2004)
as modified by Doyle v. Liberty Life Assur. Co. of Boston, 542 F.3d 1352, 1360 (11th
Cir.2008). There is no need for the court to address this issue which is framed as a
question of law. The parties have had two conferences with the District Judge assigned to
this case. Following those conferences, the court entered an order with the agreement of
the parties that allowed the parties “until July 5, 2011, to complete discovery and the
depositions of all persons whose testimony will be made part of the evidentiary record.”
Met Life will not now be allowed to protest discovery.
V. Conclusion
In accordance with the foregoing opinion, it is
ORDERED as follows:
1. Moore’s motions to compel Southern Company to produce documents
exchanged between it and Met Life concerning the claim at issue, (doc. # 25) and to
compel Southern Company to respond to her request for admission on the basis Met Life
informed her was the reason her claim was denied (doc. # 26) are DENIED.
2. Moore’s motion to strike the defendants’ objections to producing privilege logs
and compel their overdue production, (doc. # 24) is GRANTED. By separate order
entered prior to the date on which this opinion and order were entered, the court ordered

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Met Life to serve a privilege log on Moore on or before June 27, 2011.
3. Moore’s motion to compel production and identification of manuals, guidelines
and other documents governing the manner in which met life makes claims decisions for
her plan. (doc. # 20) is GRANTED to the extent that Met Life shall produce all written
procedures, rules, guidelines or other governing documents which applied in any way to
the resolution of Moore’s claim.
4. Moore’s motion to compel production of documents detailing or explaining met
life's organizational structure in which the persons who were involved in her claim
pursuant to plan worked (doc. # 22) is DENIED.
5. Moore’s motion to compel production of application documents for her plan
and documents evidencing other plans or coverages provided to her (doc. # 23) is
DENIED.
6. Moore’s motion to compel production of documents and information relevant
under supreme court precedent concerning Met Life's conflict of interest (doc. # 21) is
GRANTED as follows:
a. With respect to Moore’s requests for production 5 through 7 Met Life
shall produce any document which on its face shows that there exists any connection
between claim denial and financial bonuses, incentives, stock options, honors, awards,
remuneration (whether financial or not) or any other type of compensation or program.
Moore is granted leave to inquire about this issue during the deposition of Ruffing.

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b. With respect to interrogatories 3 and 4, Met Life shall answer with
specificity with respect to each employee who working on plaintiff’s claim and state
whether any of those employees have ever received any awards, bonuses or recognition
based on the nature of any decision they made on any claim for benefits.
c. In all other respects, the plaintiff’s motion to compel is DENIED.
It is further
ORDERED that Met Life shall comply with the provisions of this order requiring
responses or production on or before July 1, 2011. it is further
ORDERED that on or before 2:00 p.m., July 1, 2011, the parties shall agree upon
and submit to the court a proposed protective order covering the documents which must
be produced pursuant to this order.
Done this 27th day of June, 2011.

/s/Charles S. Coody
CHARLES S. COODY
UNITED STATES MAGISTRATE JUDGE

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