Montoya v. Reliance Standard Life Insurance Company et al

Filing 103

JUDGMENT. Signed by Judge William H. Orrick on 02/02/2017. (jmdS, COURT STAFF) (Filed on 2/2/2017)

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UNITED STATES DISTRICT COURT
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NORTHERN DISTRICT OF CALIFORNIA
MARLON MONTOYA,
) CASE NO. 3:14-cv-02740-WHO
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Plaintiff,
) JUDGMENT
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v.
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RELIANCE STANDARD LIFE
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INSURANCE COMPANY, THE RSL
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GROUP AND BLANKET TRUST,
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Defendants
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)

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On February 4, 2015, this Court heard motions for partial summary judgment and held at

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that hearing that Reliance Standard Life Insurance Company (“Reliance Standard”) was entitled

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to an IME, and the parties were directed to meet and confer in an attempt to reach an agreement

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as to a physician who was qualified to conduct the IME and willing to allow plaintiff’s counsel

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to attend. The parties reached an agreement and the IME was performed.

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On March 2, 2015, this Court issued its Order Denying Plaintiff’s Motion for Partial

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Summary Judgment, and its Order Denying Defendants’ Motion for Summary Judgment. These

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motions concerned the right of Reliance Standard to conduct an IME during an administrative

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appeal, and the right of Montoya to review medical reviews done by Reliance Standard during

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the administrative appeal prior to its making a decision on that administrative appeal, and

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whether or not Montoya had exhausted his administrative remedies.
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On September 27, 2016, this Court issued its Order on Cross-Motions for Summary

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Judgment, holding under a de novo standard of review that Reliance Standard erred and

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determined that Montoya was entitled to long term disability benefits and it granted Montoya’s

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motion for summary judgment, and denied Reliance Standard’s motion for summary judgment.

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Because this Court found that neither side adequately addressed the issue of the appropriate

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remedy at that time, the Court ordered the parties to meet and confer on a proposed form of

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judgment. The parties were unable to agree on the terms of the judgment, and after appropriate

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briefing on the disputed issues, on December 19, 2016 this Court issued its Order on Disputes re

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Final Judgment, which resolved the disputes over the appropriate remedy. This Court then again

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directed the parties to meet and confer and propose a form of judgment, which they have done,

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and which the Court now adopts. Any portion of this judgment which is not based upon findings

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of the Court is based upon the agreement of the parties.

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Accordingly, the Court enters judgment as follows:

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1.

The Court finds that defendant, Reliance Standard, erred in denying long term

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disability benefits to plaintiff, Marlon Montoya, and it orders Reliance Standard Life Insurance

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Company to pay back benefits to Marlon Montoya for the time period of September 24, 2012

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through September 23, 2014 (the “own occupation” period) in the amount of $35,435.95, plus

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prejudgment interest in the amount of $785.70, calculated on stipulation of the parties following

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the Court's determination of the appropriate rate in the Court's order on December 19, 2016,

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docket 95, pp. 3-4.

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2.

The definition of disability changes from “own occupation” to “any occupation”

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on September 24, 2014. Accordingly, the Court remands this case to Reliance Standard Life

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Insurance Company to determine whether or not Marlon Montoya is entitled to additional

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benefits beginning September 24, 2014. Reliance Standard Life Insurance Company may, within

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20 days of the entry of this judgment, provide a new proof of claim form to be completed by Mr.

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Montoya, if it so desires.

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requested by Reliance Standard Life Insurance Company, or such information as desired by Mr.

Commencing upon submission of such information as may be

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Montoya, Reliance Standard Life Insurance Company shall adjudicate the claim for further

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benefits in accordance with 29 C. F. R. 2560.503-1, including an administrative appeal.

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3.

Plaintiff may seek costs and fees under F. R. C. P., Rule 54. The time to file any

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motion for fees is extended from fourteen days following entry of judgment until 30 days

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following entry of judgment.

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Date: February 2, 2017

HONORABLE WILLIAM H. ORRICK
UNITED STATED DISTRICT JUDGE

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By:

Approved as to form:

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Dated: February 2, 2017

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LAW OFFICES OF LAURENCE F. PADWAY
By: /s/Laurence F. Padway
LAURENCE F. PADWAY
Attorneys for Plaintiff
MARLON MONTOYA

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Dated: February 2, 2017

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WILSON, ELSER, MOSKOWITZ,
EDELMAN & DICKER LLP
By: /s/Dennis J. Rhodes
DENNIS J. RHODES
Attorneys for Defendants
RELIANCE STANDARD LIFE
INSURANCE COMPANY and THE RSL
GROUP AND BLANKET TRUST

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