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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1 2 3 UNITED STATES DISTRICT COURT 4 NORTHERN DISTRICT OF CALIFORNIA 5 6 7 GARY E. AFFONSO, 8 Plaintiff, 9 ORDER GRANTING MOTION FOR RECONSIDERATION METROPOLITAN LIFE INSURANCE COMPANY, et al., 11 For the Northern District of California United States District Court 10 v. No. C 10-5054 PJH 12 13 Defendants. _______________________________/ Now before the court is plaintiff’s motion for reconsideration of that portion of the 14 July 6, 2011 order applying the abuse of discretion standard of review to this matter. 15 Plaintiff contends that Morgan Stanley denies the existence of the plan document by which 16 its life insurance plans were created, leaving only the insurance policy to serve as the plan 17 document. To the extent that plaintiff seeks relief on the ground that the summary plan 18 description is not the plan document, the court denies any relief because the court has 19 already held that the plan document is the same document that serves as the summary 20 plan description. Doc. no. 78. 21 Plaintiff further argues that because the insurance policy does not grant discretion to 22 the plan administrator, the denial of benefits must be reviewed de novo. Doc. no. 96. The 23 court has determined that the SPD expressly refers to the insurance contract. Doc. no. 78 24 (citing Braun Decl., Ex. 1 at Morgan Stanley 000175 (“benefits provided by each of the 25 Plans are limited to the coverage of the insurance contract”)). Defendant MetLife contends 26 that the Plan document defers to the insurance policy only when there is a conflict as to the 27 benefits insured by those policies, yet defendant has not addressed the apparent conflict 28 raised by plaintiff in that the insurance policy lacks a grant of discretion to MetLife, whereas 1 the plan document does grant discretion. Based on the newly produced insurance policy 2 documents that have been presented on plaintiff’s motion for reconsideration, which were 3 not presented to the court on defendants’ motion for abuse of discretion review, the court 4 concludes that reconsideration is proper under Civil Local Rule 7-9 and that defendants 5 have not met their burden to show that the abuse of discretion standard of review is 6 applicable under Grosz-Salomon v. Paul Revere Life Ins. Co., 237 F.3d 1154, 1161-62 (9th 7 Cir. 2001). withdrawn to the extent that it established the standard of review, and the de novo standard 10 of review will be applied. See Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 964 (9th 11 For the Northern District of California The order granting defendants’ motion for abuse of discretion review is hereby 9 United States District Court 8 Cir. 2006) (en banc). 12 IT IS SO ORDERED. 13 14 Dated: October 13, 2011 ______________________________ PHYLLIS J. HAMILTON United States District Judge 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2

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