Affonso v. Metropolitan Life Insurance Company et al

Filing 106

ORDER by Judge Hamilton Granting 96 Motion for Reconsideration (pjhlc2, COURT STAFF) (Filed on 10/13/2011)

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UNITED STATES DISTRICT COURT

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NORTHERN DISTRICT OF CALIFORNIA

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GARY E. AFFONSO,

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Plaintiff,

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ORDER GRANTING MOTION FOR
RECONSIDERATION

METROPOLITAN LIFE INSURANCE
COMPANY, et al.,

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For the Northern District of California

United States District Court

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v.

No. C 10-5054 PJH

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Defendants.
_______________________________/
Now before the court is plaintiff’s motion for reconsideration of that portion of the

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July 6, 2011 order applying the abuse of discretion standard of review to this matter.

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Plaintiff contends that Morgan Stanley denies the existence of the plan document by which

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its life insurance plans were created, leaving only the insurance policy to serve as the plan

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document. To the extent that plaintiff seeks relief on the ground that the summary plan

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description is not the plan document, the court denies any relief because the court has

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already held that the plan document is the same document that serves as the summary

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plan description. Doc. no. 78.

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Plaintiff further argues that because the insurance policy does not grant discretion to

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the plan administrator, the denial of benefits must be reviewed de novo. Doc. no. 96. The

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court has determined that the SPD expressly refers to the insurance contract. Doc. no. 78

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(citing Braun Decl., Ex. 1 at Morgan Stanley 000175 (“benefits provided by each of the

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Plans are limited to the coverage of the insurance contract”)). Defendant MetLife contends

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that the Plan document defers to the insurance policy only when there is a conflict as to the

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benefits insured by those policies, yet defendant has not addressed the apparent conflict

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raised by plaintiff in that the insurance policy lacks a grant of discretion to MetLife, whereas

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the plan document does grant discretion. Based on the newly produced insurance policy

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documents that have been presented on plaintiff’s motion for reconsideration, which were

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not presented to the court on defendants’ motion for abuse of discretion review, the court

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concludes that reconsideration is proper under Civil Local Rule 7-9 and that defendants

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have not met their burden to show that the abuse of discretion standard of review is

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applicable under Grosz-Salomon v. Paul Revere Life Ins. Co., 237 F.3d 1154, 1161-62 (9th

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Cir. 2001).

withdrawn to the extent that it established the standard of review, and the de novo standard

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of review will be applied. See Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 964 (9th

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For the Northern District of California

The order granting defendants’ motion for abuse of discretion review is hereby

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United States District Court

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Cir. 2006) (en banc).

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IT IS SO ORDERED.

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Dated: October 13, 2011
______________________________
PHYLLIS J. HAMILTON
United States District Judge

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