Cady v. Hartford Life & Accident Insurance Company
Filing
76
ORDER denying 64 Motion for Summary Judgment; granting 70 Motion for Summary Judgment. Plaintiff's claims pursuant to 29 U.S.C. § 1132(a)(1)(B) are dismissed with prejudice. Signed by Judge Edward J. Lodge. (caused to be mailed to non Registered Participants at the addresses listed on the Notice of Electronic Filing (NEF) by (dmc)
UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF IDAHO
NICOLE L. (PIPER) CADY,
Case No. 3:10-CV-00276-EJL
Plaintiff,
MEMORANDUM DECISION
AND ORDER
v.
HARTFORD LIFE & ACCIDENTAL
INSURANCE COMPANY,
Defendant.
Plaintiff Nicole Cady brings this action against Defendant Hartford Life and
Accident Insurance Company claiming wrongful denial of accidental death benefits under
29 U.S.C. 1132(a)(1)(B). The parties have filed cross motions for summary judgment.
The issues have been fully briefed and are ripe for the Court’s consideration.
Having fully reviewed the record herein, the Court finds that the facts and legal
arguments are adequately presented in the briefs and record. Accordingly, in the interest
of avoiding further delay, and because the Court conclusively finds that the decisional
process would not be significantly aided by oral argument, this motion shall be decided on
the record before this Court without a hearing.
MEMORANDUM DECISION AND ORDER - 1
FACTUAL AND PROCEDURAL BACKGROUND
This is an Employment Retirement Income Security Act (“ERISA”) case.
Hartford Life and Accident Insurance Company (“Hartford”) issued a group Accidental
Death and Dismemberment insurance policy to Alliant Techsystems, Inc. (“ATK”),
number ADD-S05459, for the benefit of eligible employees. (Dkt. 62, p. 2.) Decedent
Matthew Marsh, an eligible ATK employee under the Hartford Policy, died on May 28,
2008. (Id., p. 3.) Plaintiff Nicole Cady (“Cady”) is the former girlfriend of Mr. Marsh
and was Mr. Marsh’s named beneficiary under the Hartford Policy. (Dkt. 29-1, HCF
116.)
Cady completed a Beneficiary Statement and Claimant’s Statement of Accidental
Death on July 10, 2008, indicating that Mr. Marsh’s death was due to an “overdose of
prescription and non-prescription drugs.” (Id., HCF 121.) 1 On July 18, 2008, Cady
mailed the Statement of Accidental Death and the Certificate of Death for Mr. Marsh to
Hartford. (Id., HCF 80.) The Certificate of Death listed Mr. Marsh’s cause of death as
an “overdose of prescription and non-prescription drugs.” (Id., HCF 118.)
Hartford approved Cady’s claim for life insurance benefits on August 12, 2008, and
thereafter paid Cady $42,000, plus interest in the amount of $109.32. (Dkt. 62, p. 3.) In
order to review Cady’s claim for accidental death benefits in the amount of $140,000,
1 Most of Hartford’s Claim File (designated herein as “HCF”) was filed under seal
pursuant to a Protective Order.
MEMORANDUM DECISION AND ORDER - 2
Hartford stated it would need the Coroner’s Report, the Toxicology Report and a
prescription list from the pharmacies used by Mr. Marsh between January 2008 and May
2008. (Dkt. 29-1, HCF 58-59.) Hartford notified Cady that it had requested a vendor to
obtain the Coroner’s Report and Toxicology Report, but asked that Cady submit Mr.
Marsh’s prescription lists. (Id.)
Hartford received the Toxicology Report on September 11, 2008 and the Coroner’s
Report on October 20, 2008. (Dkt. 70-9, p. 4.) The Toxicology Report indicated that Mr.
Marsh’s blood tested positive for Alprazolam (an anti-anxiety drug more commonly
known as Xanax), Duloxetine (an anti-depressant known as Cymbalta), Olanzapine (an
anti-psychotic with the trade name Zyprexa), Methadone, and Cannabinoids (THC).
(Dkt. 70-4, HCF 136-38.) The Coroner’s Report concluded that Mr. Marsh’s death
appeared to have been caused by an “accidental overdose.” (Dkt. 29-1, HCF 52-53.) The
Coroner’s Report suggested that Mr. Marsh’s consumption of Xanax alone was four times
the therapeutic range for Xanax. (Dkt. 70-6, HCF 144.) In the course of its review,
Hartford also obtained copies of records from Dr. Michael Baldeck, Mr. Marsh’s treating
physician. (Dkt. 70-1, HCF 125-26.) Dr. Baldeck’s records indicate that Mr. Marsh was
being treated for anxiety and depression, and that Dr. Baldeck had prescribed Mr. Marsh
Xanax, Cymbalta and Zyprexa. (Id.) Dr. Baldeck’s records do not show that Mr. Marsh
had a prescription for Methadone or that he was being treated by any other medical
professional. (Id.)
MEMORANDUM DECISION AND ORDER - 3
Hartford did not receive Mr. Marsh’s prescription list until January 10, 2011, over
three years after Hartford initially requested the prescription list from Cady in August,
2008.2 (Dkt. 70-9, p. 6.) Much of the factual history of this case involves the parties’
dispute over their respective responsibility for obtaining, or, more accurately, failing to
obtain, Mr. Marsh’s prescription list from Walmart.3 Cady maintains that she was unable
to initially acquire the prescription list because she was not a family member, that she made
consistent and repeated attempts to procure the prescription list over several years, that she
was ultimately forced to file a lawsuit in order to obtain the records from Walmart through
use of the federal subpoena power, and that Hartford, by contrast, could have easily
obtained the prescription list through its power under the Policy to conduct an investigation
“without consent of the insured or the insured’s family.” (Dkt. 66, pp. 5-6.) Hartford
counters that it left unanswered messages for Cady stating it needed the pharmacy records
2 During the course of the parties’ argument over responsibility for obtaining the
prescription list, Cady initially filed suit in Idaho state court on April 27, 2010. (Dkt. 65,
p. 2.) Hartford removed the case to this Court on June 1, 2010. (Dkt. 1.) On April 12,
2011, after Cady had provided Hartford with the Walmart prescription list, this Court
granted Hartford’s Motion to Stay the case so that Hartford could complete administrative
review of Cady’s claim. (Dkt. 56.) After the review, Hartford denied the claim. (Dkt.
70-4, HCF 136-38.) Cady appealed and Hartford affirmed its denial. (Dkt. 70-5, HCF
140-42.) Cady thereafter filed a motion to re-open this case, which the Court granted on
December 1, 2011. (Dkt. 61.)
3 Dr. Baldeck’s records indicated that Mr. Marsh filled his prescriptions at Walmart.
(Dkt. 70-1, HCF 125-26.) Neither party knows if Mr. Marsh filled prescriptions at any
other pharmacy, and no pharmacy records other than that from Walmart were obtained
during the course of Hartford’s administrative review. During Hartford’s review, Cady’s
attorney confirmed that he had no documentary evidence to confirm that Mr. Marsh had a
prescription for Methadone. (Dkt. 70-3, HCF 133.)
MEMORANDUM DECISION AND ORDER - 4
for nearly a year, that it closed the file after notifying Cady on October 2, 2009 that it could
not make a decision with respect to accidental death without the pharmacy records, that it
did not receive notice from Cady that she was having difficulty obtaining the prescription
list until January 13, 2009, that it re-opened the file to examine Cady’s claim once it
ultimately received the prescription list on January 10, 2011, and that Hartford, like Cady,
did not have the power to compel production of pharmaceutical records without a
subpoena.4 (Dkt. 70-9, pp. 4-6; Dkt. 75, p. 7.) Once it was ultimately obtained by Cady,
Mr. Marsh’s prescription list revealed that he did not have a prescription for Methadone
with Walmart. (Dkt. 71-1, HCF 131.)
Once the prescription list was secured, Hartford completed its review, determined
that the evidence did not establish a covered loss under the terms of the Policy, and denied
Cady’s claim. (Dkt. 70-4, HCF 136-38.) Hartford’s May 6, 2011 denial letter (“Initial
Denial”) explained that Mr. Marsh’s death did not meet the definition of “Injury” required
for purposes of accidental death coverage under the Policy. Specifically, the Policy
defines “Injury” as:
…bodily injury resulting directly from accident and independently of all other
causes which occurs while the Covered Person is covered under the policy. Loss
resulting from: a) a sickness of disease, except a pus-forming infection which
occurs through an accidental wound; or b) medical or surgical treatment of a
sickness or disease; is not considered as resulting from injury.
4 Cady also claims Hartford could have potentially accessed material information with
respect to Mr. Marsh’s prescriptions through Idaho and Washington’s prescription drug
monitoring programs, thereby eliminating the burden Hartford placed upon her to obtain
Mr. Marsh’s prescriptions. (Dkt. 73, p. 9.) Hartford maintains that it cannot access
prescription drug monitoring databases without a court order. (Dkt. 75, p. 7.)
MEMORANDUM DECISION AND ORDER - 5
(Id., HCF 136.)
Hartford concluded that, to the extent Mr. Marsh’s fatal overdose resulted from
taking Xanax, Cymbalta and Zyprexa, the medicines prescribed to treat his ongoing
depression and anxiety, such loss was a result of “medical or surgical treatment of a
sickness or disease,” and thus did not meet the definition of Injury required for covered
losses under the Policy. (Id., HCF 138.) In addition, Hartford explained that, to the
extent Mr. Marsh’s death was caused by Methadone, a drug for which he presumably had
no prescription, Mr. Marsh’s death was excluded from coverage under the Policy
Exclusion providing:
The Policy does not cover any loss resulting from…6) Injury sustained while
voluntarily taking drugs which federal law prohibits dispensing without
prescription, including sedatives, narcotics, barbiturates, amphetamines, or
hallucinogens, unless the drug is taken as prescribed or administered by a licensed
physician.5
(Id., HCF 136-37.)
In its Initial Denial, Hartford encouraged Cady to submit any additional information
she believed would support her claim, and suggested such information would include
“documentation that confirms a prescription was written for Methadone, the medical
records that establish the basis for the Methadone prescription, and any evidence…that Mr.
Marsh took Methadone as prescribed by a physician.” (Id., HCF 138.) The Initial Denial
also instructed Cady that she had a right to appeal the decision, and gave her directions on
perfecting an appeal. (Id.)
5 Methadone legally requires a prescription. (Dkt. 70-9, p. 4.)
MEMORANDUM DECISION AND ORDER - 6
Cady appealed the Initial Denial on June 20, 2011. (Dkt. 70-5, HCF 140-42.)
Cady’s appeal letter contended that Hartford had failed to adequately investigate Mr.
Marsh’s death, had failed to meet its burden in establishing the non-prescription drug
exclusion, had failed to provide a scientific or clinical judgment for its determination, and,
through such failures, had deprived Cady of an opportunity to offer expert opinions
regarding the evidence upon which Hartford relied. (Id.) However, Cady did not submit
any additional evidence or expert analysis with her appeal. Hartford thereafter referred
Cady’s claim to its Appeal Unit to conduct an independent review. (Dkt. 70-6, HCF
143-45.)
After independent review, Hartford re-affirmed its denial of Cady’s claim. In its
September 8, 2011 denial letter (“Final Denial”), Hartford again explained that Mr.
Marsh’s death was not a covered loss under the Policy, due to both the definition of
“Injury” required for a covered loss and the non-prescription drug exclusion. (Id.) The
Final Denial further explained:
Please note that the Policy requires that a benefit will be paid if an accidental injury
occurs. We do not interpret the word “accident” to include circumstances where it
is reasonably foreseeable that death will occur. Accidents by nature are
unforeseeable events. It is a well-known fact that if [sic] consuming four (4) times
the therapeutic dose of Xanax and also ingesting Methadone can cause serious
bodily injury or death. It is our opinion that Mr. Marsh should have reasonably
foreseen that such actions would result in severe injury or death, even if death was
not intended. The assumption of a known risk by the insured does not constitute an
“accident” and the result of that assumption, death in this circumstance, does not
constitute a covered injury under the terms of the Policy.
(Id., HCF 145.)
MEMORANDUM DECISION AND ORDER - 7
Cady sued under 29 U.S.C. § 1132(a)(1)(B), the provision of ERISA allowing for
civil actions to recover benefits under an ERISA plan. (Dkt. 62.) The parties have filed
cross-motions for summary judgment. (Dkt. 64; Dkt. 70.)
STANDARD FOR SUMMARY JUDGMENT
Summary judgment is properly granted when no genuine and disputed issues of
material fact remain, and when, viewing the evidence in a light most favorable to the
non-moving party, the movant is clearly entitled to prevail as a matter of law.
Fed.R.Civ.P. 56; Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). The moving
party bears the burden of showing that there is no material factual dispute, and the court
must draw all reasonable inferences in favor of the party against whom summary judgment
is sought. Celotex, 477 U.S. at 324. Material facts which would preclude summary
judgment are those which may affect the outcome of the case. Anderson v. Liberty Lobby,
Inc., 477 U.S. 242, 248 (1986). The relevant substantive law will determine which facts
are material for purposes of summary judgment. Id.
Where, as here, both parties move for summary judgment, the summary judgment
standard does not change, and the court must evaluate each party’s motion on the merits.
Farm Bureau Ins. Co. of Idaho v. Kinsey, 234 P.3d 739, 742 (Idaho 2010) (citation
omitted); see also Nolan v. Heald College, 551 F.3d 1148, 1154 (applying traditional
summary judgment standards to cross-motions for summary judgment in ERISA benefits
MEMORANDUM DECISION AND ORDER - 8
denial case). Where the moving party does not bear the burden of proof on an issue at
trial, the moving party may discharge its burden of showing there is no genuine issue of
material fact by demonstrating an “absence of evidence to support the nonmoving party’s
case.” Celotex, 477 U.S. at 325. If the moving party establishes an absence of evidence
to support the non-moving party’s case, the burden then shifts to the opposing party to
produce “specific evidence, through affidavits or admissible discovery material, to show
that the dispute exists.” Bhan v. NME Hosp. Inc., 929 F.2d 1404, 1409 (9th Cir. 1991).
A complete failure of proof concerning an essential element of the non-moving party’s
case renders all other facts immaterial. Celotex, 477 U.S. at 323.
Where the moving party instead bears the burden of proof on an issue at trial, “it
must, in order to discharge its burden of showing that no genuine issue of material fact
remains, make a prima facie showing in support of its position on that issue. That is, the
moving party must prevent evidence that, if uncontroverted at trial, would entitle it to
prevail on that issue. Once it has done so, the non-moving party must set forth specific
facts controverting the moving party’s prima facie case.” Sabatino v. Liberty Life Assur.
Co. of Boston, 286 F.Supp.2d 1222, 1229 (N.D. Cal. 2003) (citing UA Local 343 v.
Nor-Cal Plumbing, Inc., 48 F.3d 1465, 1471 (9th Cir. 1994)).
MEMORANDUM DECISION AND ORDER - 9
ANALYSIS
1.
ERISA Standard of Review
In actions challenging denials of benefits pursuant to 29 U.S.C. § 1132(a)(1)(B), the
district court reviews de novo “unless the benefit plan gives the administrator or fiduciary
discretionary authority to determine eligibility for benefits or to construe the terms of the
plan.” Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989). If the plan
unambiguously confers discretionary authority, then the standard of review shifts to abuse
of discretion. Id.; see also Kearney v. Standard Ins. Co., 175 F.3d 1084, 1089 (9th Cir.
1999).
The first step of analysis is thus to examine whether the terms of the ERISA plan
unambiguously grant discretion to the administrator. The Hartford Policy provides, “[t]he
Plan has designated and named the Insurance Company as the claims fiduciary for benefits
provided under the Policy. The Plan has granted the Insurance Company full discretion
and authority to determine eligibility for benefits and to construe and interpret all terms and
provisions of the Policy.” (Dkt. 29-1, HCF 25.)
Cady suggests this provision is ambiguous because Defendant reserved discretion in
“specified areas” but did “not reserve discretion regarding whether it could excuse the
procedure set forth in the plan” and could not “reserve discretion regarding whether it
needs to satisfy the duties to the beneficiary of the insured.” (Dkt. 66, p. 4.) However,
the Supreme Court has counseled that a plan grants discretion if the administrator has the
“power to construe disputed or doubtful terms” in the plan. Firestone, 489 U.S. at 115
MEMORANDUM DECISION AND ORDER - 10
(noting that if a plan grants an administrator the right to determine eligibility for benefits or
to “construe the terms of the plan,” it has discretionary authority). Moreover, the Ninth
Circuit has repeatedly held that plan wording which, like the language at issue, grants the
power to interpret plan terms and to make final benefits determinations confers discretion
on the plan administrator. Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 963 (9th
Cir. 2006) (citing Bergt v. Ret. Plan for Pilots Employed by MarkAir, Inc., 293 F.3d 1139,
1142 (9th Cir. 2002) and Grosz-Salomon v. Paul Revere Life Ins. Co., 237 F.3d 1154, 1159
(9th Cir. 2001)). The Hartford Policy bestows on the administrator full discretion and
authority to both interpret all terms and provisions of the plan and to determine eligibility
for benefits. Under Ninth Circuit and Supreme Court precedent, the Policy clearly vests
discretion in the Hartford plan administrator.
After finding the plan unambiguously confers discretion, the Court would ordinarily
proceed to review of the plan decision under the deferential abuse of discretion standard of
review. An ERISA administrator abuses its discretion only if it: “(1) renders a decision
without explanation, (2) construes provisions of the plan in a way that conflicts with the
plain language of the plan, or (3) relies on clearly erroneous findings of fact.” Boyd v.
Bell, 410 F.3d 1173, 1178 (9th Cir. 2005). However in this case, a less deferential
standard is triggered because Hartford operates under a structural conflict of interest. A
structural conflict of interest exists where, as here, an insurer acts as both the administrator
MEMORANDUM DECISION AND ORDER - 11
and funding source for an ERISA plan.6 Tremain v. Bell Indus., Inc., 196 F.3d 970, 976
(9th Cir. 1999).
The Supreme Court has indicated that a structural conflict of interest, even if merely
formal and unaccompanied by any evidence of bad faith or self-dealing, should have some
effect on judicial review. Firestone, 489 U.S. at 115. In Abatie, the Ninth Circuit
clarified that Firestone requires abuse of discretion review whenever an ERISA plan grants
discretion to the plan administrator, but that such review must be “informed by the nature,
extent, and effect on the decision-making process of any conflict of interest that may
appear in the record.” Abatie, 458 F.3d at 967. The level of skepticism “with which a
court views a conflicted administrator’s decision may be low if a structural conflict of
interest is unaccompanied, for example, by any evidence of malice, of self-dealing, or of a
parsimonious claims-granting history.”
Id. at 968.
The Abatie Court counseled a
conflict of interest should be weighed more heavily if, for example, the administrator
provides inconsistent reasons for denial, fails to adequately investigate a claim or ask the
plaintiff for necessary evidence, fails to credit a plaintiff’s reliable evidence, or has
6 A
conflict of interest exists in such circumstances because, while the administrator is
responsible for administering the plan so that those who deserve benefits receive them, the
administrator also “has an incentive to pay as little in benefits as possible to plan
participants because the less money the insurer pays out, the more money it retains in its
own coffers.” Abatie, 458 F.3d at 966 (citation omitted).
MEMORANDUM DECISION AND ORDER - 12
repeatedly denied benefits to deserving participants by interpreting plan terms incorrectly
or by making decisions against the weight of evidence in the record.7 Id.
In order to weigh a conflict of interest more heavily, the beneficiary must provide
“material, probing evidence beyond the mere fact of the apparent conflict, that tends to
show that the administrator’s self-interest caused a breach of the administrator’s fiduciary
obligations to the beneficiary.” Sabatino, 286 F.Supp.2d at 1230. If the beneficiary
meets this threshold burden, then a rebuttable presumption is created that the plan’s
decision was a dereliction of its fiduciary responsibilities. Id. The plan then bears the
burden of rebutting this presumption by producing evidence that the conflict of interest did
not affect its decision to deny benefit. Id. If the plan fails to carry this burden, then the
Court will review the denial of benefits de novo.8 Id.; see also Tremain v. Bell Indus., 196
F.3d at 976.
Cady devotes much of her briefing to establishing Hartford’s conflict of interest
improperly affected its denial of benefits. Specifically, Cady maintains that Hartford
7 As the Abatie Court noted, “when a plan administrator’s actions fall so far outside the
strictures of ERISA that it cannot be said that the administrator exercised the discretion that
ERISA and the ERISA plan grant, no deference is warranted.” Id. at 972.
8 If Cady presents probative evidence that Hartford’s self-interest caused a breach of
fiduciary duties, and if Hartford fails to rebut this presumption, the burden of proof with
respect to entitlement of benefits does not, as Cady suggests, shift to Hartford to establish
its decision was not the result of a dereliction of fiduciary duties. (Dkt. 73, p. 4.) Rather,
such evidence would instead simply alter the standard of review—from abuse of discretion
to de novo. Cady still has the burden of proving coverage under the plan even if Hartford
fails to rebut the presumption that it acted under a conflict of interest.
MEMORANDUM DECISION AND ORDER - 13
provided inconsistent reasons for denial, failed to adequately investigate Cady’s claim,
ignored Cady’s offer to participate in the review process, and interpreted two exceptions
found within the Policy in such a manner as to frustrate the very purpose of the contract.
a.
Inconsistent reasons for denial
Cady maintains Hartford’s Initial Denial did not deny benefits on the grounds that
the death was not accidental, but rather on the grounds that the death was either not an
“injury” under the Policy or was not covered under exclusion six of its policy. (Dkt. 72, p.
3.) Cady argues that Hartford’s Motion for Summary Judgment added a new argument
that Mr. Marsh’s death was not “accidental” under the policy, and that this represents an
inconsistent reason for denial. Cady’s argument is unavailing. The Hartford Policy
clearly states that coverage applies only to “injury,” and defines “injury” as “bodily injury
resulting directly from accident and independently of all other causes which occurs while
the Covered Person is covered under the policy. Loss resulting from…medical or surgical
treatment of sickness or disease…is not considered as resulting from Injury.” (Dkt. 29-1,
HCF 19-20.) Thus, in order to be considered a covered loss under the accidental death
policy, Mr. Marsh’s death must have been (1) caused by an “accident” and (2) have
resulted independently from medical treatment of sickness or disease.
Both Hartford’s
Initial Denial and Final Denial explain that Mr. Marsh’s death did not meet the definition
of “injury” required for accidental death coverage. As such, both denials were necessarily
premised on a finding that the death was not an accident, as the definition of “injury” in the
MEMORANDUM DECISION AND ORDER - 14
policy establishes what loss is covered as accidental.
Hartford has not offered
inconsistent reasons for denial.
b.
Failure to adequately investigate
Cady claims Hartford failed to adequately investigate her claim and instead
gathered only enough information needed to support its denial, and then placed the burden
on Cady to provide any other evidence. (Dkt. 72, p. 4.) When considering a claim for
benefits, ERISA administrators have a duty to adequately investigate the claim. Booton v.
Lockheed Medical Ben. Plan, 110 F.3d 1461, 1463 (9th Cir. 1997). This requires that the
plan administrator engage in “meaningful dialogue” with the beneficiary. Id. If the
administrator “believes more information is needed to make a reasoned decision, they must
ask for it.” Id.
When investigating Cady’s claim, Hartford obtained the Death Certificate, the
Coroner’s Report, the Toxicology Report, the records from Mr. Marsh’s only known
treating physician, and the Statement of Coverage. Each of these documents, including
Cady’s own assertions in the Statement of Coverage, supported the conclusion that Mr.
Marsh’s death was the result of an overdose. Dr. Baldeck’s records established that Mr.
Marsh had prescriptions for Xanax, Cymbalta and Zyprexa. Because it did not have
evidence of a prescription for Methadone, Hartford asked Cady to provide Mr. Marsh’s
prescription records, as well as any other evidence to establish Mr. Marsh had such a
prescription.
(Dkt. 70-4, HCF 136-38.)
MEMORANDUM DECISION AND ORDER - 15
Hartford also invited Cady to submit any
additional evidence which would assist it with evaluating her claim. (Id.) Although she
submitted Mr. Marsh’s prescription list, Cady declined to submit any additional
information.
This Court finds Hartford conducted a sufficiently thorough investigation to justify
its decision to deny benefits. All the information Hartford had when making its decision
was compatible with a finding of death by overdose of prescription and non-prescription
drugs. There was no evidence of any cause of death other than an overdose of prescription
and non-prescription drugs.
Hartford also asked Cady for additional evidence—the
prescription list—it felt was needed to make a decision. Although Cady claims it was
abusive for Hartford to place the burden of obtaining the prescription list upon her, there is
no evidence that Hartford had any greater access to or knowledge of Mr. Marsh’s
prescriptions. Indeed, as Mr. Marsh’s former girlfriend, Cady was in a better position to
know both where Mr. Marsh filled his prescriptions and whether he took non-prescription
drugs than was Hartford. As the Fifth Circuit explained in Vega v. Nat’l Life Ins. Servs.,
Inc., 188 F.3d 287, 298 (5th Cir. 1999) (en banc), “[t]here is no justifiable basis for placing
the burden solely on the administrator to generate evidence relevant to deciding the claim,
which may or may not be available to it, or which may be more readily available to the
claimant.”
MEMORANDUM DECISION AND ORDER - 16
c. Failure to allow participation in the claims process
Cady contends Hartford failed to consider the expert opinion of Dr. Carl Wigren,
M.D., a toxicologist, when conducting its review, and that such failure constituted an abuse
of Hartford’s fiduciary duty. During Hartford’s review, Cady raised the issue of the need
for an expert toxicologist, and suggested her expert called into doubt the validity of the
Toxicology Report for Mr. Marsh. Cady’s attorney invited Hartford to depose Cady’s
expert, and represented portions of the expert’s opinion in various letters to Hartford
during the review process. However, Cady’s attorney failed to ever name Dr. Wigren,
failed to submit an expert report, and failed to submit any evidence to Hartford to show that
Mr. Marsh’s death was the result of anything other than an overdose of prescription and
non-prescription drugs.9
ERISA administrators may not “shut their eyes to readily available information
when the evidence in the record suggests that the information might confirm the
beneficiary’s theory of entitlement.”
Rodgers v. Metropolitan Life Ins. Co., 655
F.Supp.2d 1081, 1087 (N.D. Cal. 2009) (citations omitted). However, if a plan participant
fails to bring evidence to the attention of the administrator, the participant cannot complain
of the administrator’s failure to consider such evidence. Sandoval v. Aetna Life and Cas.
Ins. Co., 967 F.2d 377, 381 (10th Cir. 1992). The Initial Denial notified Cady that
Hartford was relying, at least in part, on the Coroner’s Report and the Toxicology Report.
9 In fact, the expert report submitted to the Court is dated November 23, 2011. (Dkt.
67-1, Ex. D.) The report was thus not prepared until after Hartford completed its review,
as well as two months after Hartford’s September 8, 2011 Final Denial.
MEMORANDUM DECISION AND ORDER - 17
Cady thus had notice that evidence which would undermine the Toxicology Report would
be relevant to Hartford’s benefit determination. Hartford also invited Cady, who was
represented by counsel throughout the review process, to submit any additional evidence
which would support her claim. Cady could have submitted her expert report at any stage
of the review, but declined to do so. Hartford cannot be found to have breached its
fiduciary duty by failing to consider an expert report that was never before it.10 Id.; see
also Davidson v. Prudential Ins. Co. of America, 953 F.2d 1093, 1095 (8th Cir. 1992)
(finding claimant was required to submit evidence he believed was necessary to make a
proper benefits determination to the administrator, and could not attempt to later challenge
the administrator’s decision by submitting such evidence to the court).
d.
Policy interpretation
Finally, Cady maintains that Hartford’s interpretation of the Policy combined “two
discrete provisions to exclude coverage in a host of scenarios where a person of average
intelligence and experience would consider themselves covered.”
(Dkt. 66, p. 9.)
Specifically, Hartford concluded that the drugs found in Mr. Marsh’s system were either
taken pursuant to medical treatment of a sickness or disease or were not being taken in
accordance with a prescription. If the drugs were being taken in accordance with medical
treatment, then Mr. Marsh’s death was not an “injury” under the Policy. However, if Mr.
Marsh did not have a prescription for the drugs in his system, then his death was not a
covered loss due to the Policy exclusion for “injury” sustained while voluntarily taking
MEMORANDUM DECISION AND ORDER - 18
prescription drugs without a prescription. Cady claims Hartford thus used two discrete
Policy provisions to exclude coverage any time a person is found to have had prescription
and non-prescription drugs in their system, even if they died due to a totally unrelated
accident. (Dkt. 66, pp. 9-10.)
When considering questions of insurance policy interpretation under ERISA,
federal courts apply federal common law. Padfield v. AIG Life Ins. Co., 290 F.3d 1121,
1125 (9th Cir. 2002). Under the federal common law of ERISA, federal courts “interpret
terms in ERISA insurance policies in an ordinary and popular sense, as would a person of
average intelligence and experience.” Id. The interpretation of an insurance policy is a
question of law, and any ambiguities in the plan are construed against the insurer. Evans
v. Safeco Life Ins. Co., 916 F.2d 1437, 1441 (9th Cir. 1990); Kunin v. Benefit Trust Life Ins.
Co, 910 F.2d 534, 539 (9th Cir. 1990). Cady assigns fault to Hartford’s reliance on the
definition of “injury,” when construed in conjunction with the Policy exclusion for use of
drugs without a prescription.
The Court will accordingly consider whether such
provisions are ambiguous when interpreted to exclude coverage.
As previously mentioned, the Hartford Policy provides coverage for death resulting
from “injury.” (Dkt. 29-1, HCF 19.) “Injury” is defined as “bodily injury resulting
directly from accident and independently of all other causes which occurs while the
Covered Person is covered under the policy. Loss resulting from…medical or surgical
treatment of a sickness or disease is not considered as resulting from Injury.” (Id.) The
Policy does not define medical treatment of sickness or disease. When a term is not
MEMORANDUM DECISION AND ORDER - 19
defined, the Courts will look to the normal usage and definition of that term. Evans, 916
F.2d at 1441.
The term “treatment” means a “broad term covering all the steps taken to affect a
cure of an injury or disease; including examination and diagnosis as well as application of
remedies.” Black’s Law Dictionary, 1502 (6th ed. 1990). This Court and other courts
have previously held that the administration of prescription medications is considered
medical care or treatment. Cole v. Delaplain, 2010 WL 4909586 (1:08-CV-00476)
(discussing prisoner claims regarding alleged withholding of prescription medications as
medical treatment); see also Wilson v. Business Men’s Assur. Co., 181 F.2d 88, 89 (9th Cir.
1950) (medical treatment extended to drug prescribed for treating insured’s ailment);
Pickard v. Transamerica Occidental Life Ins. Co., 663 F.Supp. 126, 127 (E.D. Mich. 1987)
(death due to drinking wrong solution in preparation for colonoscopy was medical
treatment under accidental death policy); Reid v. Aetna Life Ins. Co., 440 F. Supp. 1182,
1183-84 (S.D. Ill. 1977) (accidental injection of lethal drug considered death caused by
medical and surgical treatment).
In Barkerding v. Aetna Life Ins. Co., the Fifth Circuit explained “[m]edical and
surgical treatment mean what is done by a physician…in diagnosing a bodily ailment and
seeking to alleviate or cure it. It includes the things done by the patient to carry out
specific directions given for these ends by a physician.” 82 F.2d 358, 359 (5th Cir. 1936).
Dr. Baldeck’s prescription of Xanax, Cymbalta and Zyprexa to alleviate Mr. Marsh’s
MEMORANDUM DECISION AND ORDER - 20
depression and anxiety constituted medical treatment under the clear meaning of the
Hartford Policy.
The terms “sickness” and “disease” are also not defined in the Policy. However, in
giving these terms their ordinary meaning, bi-polar disease and depression can be
considered sickness or disease. The Ninth Circuit has determined the term “disease”
includes an “ailment or disorder of an established or settled character to which the insured
is subject,” as opposed to a more “temporary” or “slight” ailment. Chale v. Allstate Life
Ins. Co., 353 F.3d 742, 749 (9th Cir. 2003). The Diagnostic and Statistical Manual of
Mental Disorders IV describes bipolar disorder and depression as potentially lasting an
entire lifetime, with a significant number of persons never receiving relief through
treatment. Diagnostic and Statistical Manual of Mental Disorders IV-TR 296 (4th Ed.
2000). Moreover, federal courts have determined depression constitutes a “sickness.”
Heffernan v. UNUM Life Ins. Co. of Am. 101 Fed Appx. 99, 108 (6th Cir. 2004) (finding
insured suffered from a “sickness” when examining physicians found that the insured
suffered from depression); Paul Revere Life Ins. Co. v. Forester, 32 F.Supp.2d 352, 354
(W.D.N.C. 1998) (insured suffered from depression, which qualified as a “sickness”).
Mr. Marsh’s on-going depression constituted a “sickness” or “disease” under the plain
meaning of the Hartford Policy.
The Hartford prescription drug exclusion provided “[t]he policy does not cover any
loss resulting from…Injury sustained while voluntarily taking drugs which federal law
prohibits dispensing without a prescription, including sedatives, narcotics, barbiturates,
MEMORANDUM DECISION AND ORDER - 21
amphetamines, or hallucinogens, unless the drug is taken as prescribed or administered by
a licensed physician.” (Dkt. 29-1, HCF 20.) Cady argues this exclusion, when read in
conjunction with the definition of “injury,” constituted an absurd policy interpretation
which would exclude coverage in a host of scenarios where death should be covered as
accidental. However, as the Court explained when considering essentially identical
provisions in Grobe v. Vantage Credit Union, 679 F.Supp.2d 1020 (E.D. MO. 2010),
Hartford’s interpretation of “injury” in conjunction with the prescription drug exclusion is
neither ambiguous nor absurd.
As the Grobe Court held, the prescription drug exclusion is not rendered moot by
the Policy’s definition of injury:
[I]magine two individuals covered under [the] policy each broke a bone in an
accident. To deal with the pain from the break and surgery, both individuals then
took a drug that, under federal law, cannot be dispensed without a prescription.
Individual One went to the doctor to get the prescription. Individual Two took the
medication from her friend, who had been prescribed the medication from a former
accident. If both individuals died of overdoses, Individual One would be covered
by [the] policy, and Individual Two would not. Both individuals suffered a loss
under the definition of injury in the policy because they were taking the medication
because of an accident, and not as ‘medical or surgical treatment of a sickness or
disease.’ The prescription drug exclusion is triggered because both individuals
took regulated drugs, and suffered an injury while doing so. Individual Two
cannot collect on the policy because her injury was ‘sustained while voluntarily
taking drugs’ and she did not have a prescription. Individual One can collect,
however, because, unlike Individual Two, she received a prescription for her drugs
because of the original accident.
Id. at 1033.
MEMORANDUM DECISION AND ORDER - 22
The Grobe Court went on to explain the distinction between losses resulting from
drug use prescribed as treatment for a sickness or disease and those resulting from use of
drugs without a prescription is based:
… it seems, on the difference between a death that is ‘foreseeable’ or in some way
related to an assumed risk, and one that is not. AD&D policies are intended to
cover accidental deaths and losses, not all deaths and losses. The medical
treatment exclusion is intended to exclude coverage for those individuals who have
assumed the risks of medical treatment, including the possibility of death. Courts
have consistently held that a medical treatment exclusion applies to accidental death
caused by an overdose of drugs prescribed by a doctor in the course of a treatment
for a sickness or disease. Death caused by sickness or disease, and the medical
treatment sought for such, is not unforeseeable. The prescription drug language
further excludes those losses that occur when an individual takes regulated drugs
without a prescription. Taking regulated drugs without a prescription is the sort of
assumed-risk behavior that could make a loss foreseeable….The exception to the
prescription drug exclusion, for when an individual is prescribed a regulated drug
by a physician for something unrelated to disease or sickness, and suffers a loss
while taking that drug, recognizes the difference between taking drugs illegally and
taking them legally. This exception to the exclusion does not, however, modify the
definition of ‘injury’ found at the beginning of the policy, which specifies that
losses resulting from medical treatment of a sickness or disease are not injuries.
The two provisions do not conflict, and the insurance policy is not ambiguous.
Id.
Under the Hartford Policy, the initial question is whether there was a covered
“injury.” If a drug is taken by an individual in the course of medical treatment or disease,
and a loss result from that drug use, there is no injury and the inquiry ends. Id. at 1033.
Thus, to the extent Mr. Marsh’s death was caused by a combination of Xanax, Cymbalta
and Zyprexa, his death was not a covered “injury” under the Policy. However, if a drug
was taken for a reason unrelated to sickness or disease, then the prescription drug provision
is triggered, and the source of the drug must be examined. Id. To the extent Mr. Marsh’s
MEMORANDUM DECISION AND ORDER - 23
death was caused by Methadone, a drug for which he presumably had no prescription, his
death does not constitute an accidental loss under the prescription drug exclusion.
Although they dispute the exact drug or combination of drugs which caused Mr. Marsh’s
death, the parties do not dispute that Mr. Marsh’s death was caused by an accidental
overdose.
Whether Mr. Marsh’s overdose was the result of medical treatment for
depression or the result of his use of Methadone without a prescription, his loss was not
covered as an accidental death under the unambiguous terms of the Policy.11
In sum, the Court determines Cady has not presented material probative evidence
that Hartford’s decision was influenced by its conflict of interest.
The Court will
accordingly review Hartford’s denial for abuse of discretion, with a “low level of
skepticism” given to Hartford’s structural conflict of interest. Abatie, 458 F.3d at 968.
2.
Evidence outside the record
In support of her Motion for Summary Judgment, Cady submitted the report of Dr.
Carl Wigren, a purported expert forensic pathologist. (Dkt. 67-1, Ex. D.)
Hartford
seeks to strike Dr. Wigren’s report because Cady could have, but failed to submit the report
during Hartford’s review of Cady’s claim.
(Dkt. 69, p. 4.)
In general, a plan
administrator’s decision may be challenged by seeking judicial review of only the record
11 Cady
claims Hartford’s interpretation would wrongfully exclude accidental death
coverage for an engineer who accidently takes his wife’s estrogen medication before going
for an evening run and then, unrelated to the effects of that drug, is struck by a car while in
a cross-walk, or for an attorney who smokes marijuana before boarding a plane and is then
killed when the plane crashes shortly before landing. (Dkt. 66, pp. 9-10.) Unlike in these
examples, there is no evidence in this case of any accident independent from drug use
pursuant to medical treatment or without a prescription which caused Mr. Marsh’s death.
MEMORANDUM DECISION AND ORDER - 24
developed during the administration of the claim. Kearney v. Standard Ins. Co., 175 F.3d
1084, 1091 (9th Cir. 1999). This Court has previously determined that, regardless of the
appropriate standard or review, a court “may not take additional evidence merely because
someone at a later time comes up with evidence that was not presented to the plan
administrator.” Podolan v. Aetna Life Ins. Co., 909 F.Supp. 1385, 1386 (D. Idaho 1995)
(citing Mongeluzo v. Baxter Long Term Disability Plan, 46 F.3d 938, 940 (9th Cir. 1995).
Cady argues her expert report suggests several critical errors in the Coroner’s
processing of Mr. Marsh’s death. (Dkt. 66, pp. 7-8.) However, as previously mentioned,
both Hartford’s Initial Denial and Final Denial rested, in part, on the Coroner’s Report and
the Toxicology Report. Cady thus had notice that any evidence, including expert analysis,
which called into question the validity of either the Coroner’s Report or the Toxicology
Report would undermine Hartford’s denial of benefits. Hartford also continually invited
Cady to submit any additional evidence which would support her claim. Although Cady
claims she made Hartford “multiple offers to provide expert analysis supporting her
claim,” Cady does not dispute that she never actually provided Hartford with Dr. Wigren’s
report. (Dkt. 72, p. 4.) As other courts have noted, “‘Congress intended plan fiduciaries,
not the federal courts, to have the primary responsibility for claims processing.’
Claimants must present their strongest available case to the plan administrator, because the
primary decision is made at that point.” Duhon v. Texaco Inc., 15 F.3d 1302, 1309 (5th
Cir. 1994) (citing Makar v. Health Care Corp., 872 F.2d 80, 83 (4th Cir. 1989)) (emphasis
in original).
MEMORANDUM DECISION AND ORDER - 25
If Cady believed Dr. Wigren’s analysis was necessary for Hartford to make a proper
determination, Cady should have submitted it to Hartford. Having failed to do so, Cady’s
offer of additional evidence at this point “amounts to nothing more than a last-gasp attempt
to quarrel with” Hartford’s determination. Davidson v. Prudential Ins. Co. of Am., 953
F.2d 1093, 1095 (8th Cir. 1992); see also Sandoval v. Aetna Life and Cas. Ins. Co., 967
F.2d 377, 381 (“In effect, a curtain falls when the fiduciary completes its review, and for
purposes of determining if substantial evidence supported the decision, the district court
must evaluate the record as it was at the time of the decision.”). The Court accordingly
grants Hartford’s motion to strike Dr. Wigren’s report.
3. Coverage under the Policy
Under an “abuse of discretion” standard of review, even when tempered with low
skepticism given Hartford’s structural conflict of interest, Hartford prevails.
This
standard requires that the Court uphold the administrator’s decision “if it is based upon a
reasonable interpretation of the plan’s terms and was made in good faith.” Estate of
Shockley v. Alyeska Pipeline Ser. Co., 130 F.3d 403, 405 (9th Cir. 1997). Both of these
conditions are met here. As explained, supra, Hartford did not misinterpret the terms of
the Policy, afforded Cady the full and fair review of her claims required by ERISA, and had
an abundance of evidence favoring its determination. Hartford cannot be found to have
MEMORANDUM DECISION AND ORDER - 26
abused its discretion in denying benefits under such circumstances.12 Bartholomew v.
Unum life Ins. Co. of America, 588 F.Supp.2d 1262, 1273 (W.D. Wash. 2008).
Moreover, Hartford’s review and denial of Cady’s claim must also be considered in
light of Cady’s failure to meet her burden of proof with respect to establishing coverage in
the first place. Cady has the initial burden of establishing—by a preponderance of the
evidence—that Hartford’s conclusions were legally and/or factually wrong, and that Mr.
Marsh’s death fell within the terms of the policy. 13
Mers v. Marriott Int’l Group
Accidental Death and Dismemberment Plan, 949 F.Supp. 1323, 1329 (N.D.Ill. 1996)
(“Mers”); see also Muniz v. Amec Const. Management, Inc., 623 F.3d 1290, 1295-96 (9th
Cir. 2010) (plaintiff suing under 29 U.S.C. § 1132(a)(B)(1) bears the burden of proving
entitlement to benefits).
Again, the Policy defines “injury” as “bodily injury resulting directly from accident
and independently of all other causes which occurs while the Covered Person is covered
under the policy. Loss resulting from…medical or surgical treatment of a sickness or
disease is not considered as resulting from Injury.” (Dkt. 29-1, HCF 19.) Thus, “to
12 In Bartholomew, the court noted that where the decision to grant or deny ERISA
benefits is reviewed for abuse of discretion, a motion for summary judgment is merely the
conduit to bring the legal question of whether discretion has been abused before the district
court and the usual tests of summary judgment, such as whether a genuine dispute of
material fact exists, do not apply. Id., at 1266 (citing Bendixen v. Standard Ins. Co., 185
F.3d 939, 942 (9th Cir. 1999).
13 Cady would first have the burden of proof with respect to establishing coverage even if
this Court credited Cady’s claims of conflict of interest and reviewed Hartford’s denial of
benefits de novo. Id.
MEMORANDUM DECISION AND ORDER - 27
mount even a credible challenge” to Hartford’s denial of benefits, Cady must, “at a
minimum,” satisfy her burden of showing that Mr. Marsh’s death was (1) caused by an
“accident,” (2) resulted “directly and independently from all other causes,” and (3) was not
caused by and did not result from treatment of a sickness or disease. Mers, 949 F.Supp. at
1330.
Cady has not presented any admissible evidence, let alone a preponderance of
evidence, to establish that Mr. Marsh’s death was caused by “an accident,”14 that this
accident resulted “directly and independently” from all other causes, or that the death was
not caused by and did not result from treatment of Mr. Marsh’s depression. By contrast,
Hartford relied upon substantial evidence, including the Proof of Loss, the Certified Death
Certificate from the State of Idaho, the Nez Perce County Coroner’s Report, the
Toxicological Laboratory Report, medical records from Dr. Baldeck, prescription history
records, and review of the claim file by Hartford’s Clinical Case Manager, Kathleen Bell,
to determine Mr. Marsh’s death was not a covered loss under the Policy. (Dkt. 70-4, HCF
137.) Substantial evidence supports Hartford’s determination that Mr. Marsh’s death was
not a covered loss.
14 Under Idaho law, an accident is an event that is not readily foreseeable, is unexpected,
extraordinary, unlooked-for, or which cannot be prevented. Estate of Dumoulin v. CUNA
Mut. Group, 248 P.3d 1252, 1255 (Idaho 2011) (citations omitted); see also Padfield v.
AIG Life Ins. Co., 290 F.3d 1121, 1126 (9th Cir. 2002) (a death may be deemed accidental
under an ERISA group policy if the death was unexpected or unintentional). Mr. Marsh’s
death due to taking substantially more than his prescribed level of Xanax, combined with
Cymbalta, Zyprexa, Methadone and Marijuana, cannot be considered “unexpected”,
“unforeseeable” or “extraordinary.”
MEMORANDUM DECISION AND ORDER - 28
Cady incorrectly asserts throughout her briefing that Hartford instead has the
burden of proof because it based its denial upon two exclusions. (Dkt. 72, p. 8; Dkt. 73, p.
5.) While it is true that Hartford must “carry the burden of proving the applicability of any
plan coverage exclusion it seeks to invoke,” such as the prescription drug exclusion, the
definition of “injury” is tied to the benefits section of the policy, rather than to the
exclusions section. Farley v. Benefit Trust Life Ins. Co., 979 F.2d 653, 658 (8th Cir.
1992).
As such, the definition of “injury” as not including medical treatment is not an
exclusion, but is a clarifying definition associated with benefits. Id. Cady thus has the
burden of proving Mr. Marsh’s death was an “injury” under the meaning of the Policy. Id.
(plaintiff had burden of proving coverage for “medically necessary care” where such
language was tied to the benefits section of the policy, rather than to exclusions); see also
Sabatino v. Liberty Life Assur. Co. of Boston, 286 F.Supp.2d 1222, 1232 (N.D. Cal. 2003)
(finding plaintiff had the burden of proving she was disabled under the meaning of the plan
in order to make a prima facie showing of coverage, and, once coverage was established,
defendant had the burden of proving the applicability of coverage exclusion); Lincoln Nat’l
Life Ins. Co., v. Evans, 943 F.Supp. 564, 567 (D. Md. 1996) (ERISA supports placing the
burden of proving that death was a result of accidental injury upon the claimant). To the
extent Mr. Marsh’s death was caused by consumption of drugs he obtained pursuant to
medical treatment, it did not result “directly and independently from all other causes” and
was not covered under the Policy. Cady thus has not, and cannot, meet her burden of
proving Mr. Marsh’s death was covered under the Policy.
MEMORANDUM DECISION AND ORDER - 29
Finally, Hartford has met its burden of establishing the prescription drug exclusion
applies to the extent Mr. Marsh’s death was caused by his use of Methadone. During the
course of its review, Hartford obtained the medical records for Dr. Baldeck, Mr. Marsh’s
only known treating physician. Dr. Baldeck’s records indicated both that Dr. Baldeck had
not prescribed Methadone and that Mr. Marsh was not being treated by any other
physicians.
(Dkt. 70-1, HCF 125-26.)
Mr. Marsh’s Walmart prescription list also
revealed that Mr. Marsh did not have a prescription for Methadone. (Dkt. 71-1, HCF
131.) Since it did not have any evidence of a prescription for Methadone with any other
pharmacy or from any other physician, Hartford advised Cady that it would consider any
documentation that confirmed a prescription was written for Methadone, or any other
evidence that Mr. Marsh took Methadone as prescribed by a physician. (Dkt. 70-4, HCF
138.)
Prior to Hartford’s Final Denial, Cady’s attorney confirmed that he had no
documentary evidence to confirm Mr. Marsh had a prescription for Methadone. (Dkt.
70-3, HCF 132-35.) Because substantial evidence supports Hartford’s conclusion that
Mr. Marsh did not have a prescription for Methadone, and because there is no evidence to
suggest Mr. Marsh did have a prescription for Methadone, Hartford has met its burden of
establishing Mr. Marsh’s death was excluded from coverage to the extent it resulted from
his use of Methadone.
In order to recover under the Policy, Cady had the burden of proving by a
preponderance of the evidence that Mr. Marsh’s death was caused directly and
independently of all other causes, and that his death did not result from medical treatment
MEMORANDUM DECISION AND ORDER - 30
of sickness or disease. Even under a less deferential abuse of discretion standard of
review that accounts for Hartford’s inherent conflict of interest, this Court concludes, as a
matter of law, that Hartford’s determinations (1) that Mr. Marsh’s death was caused by
drugs taken pursuant to medical treatment and drugs taken without a prescription and (2)
that, consequently, his death was not covered by the Policy, were reasonable and
appropriate in light of the evidence, the largely undisputed facts, and the relevant judicial
precedent. Consequently, summary judgment should be granted in favor of Hartford and
against Cady.
ORDER
Now, therefore, it is hereby ordered that Hartford’s Motion for Summary Judgment
(Dkt. 70) is GRANTED, and Cady’s Motion for Summary Judgment (Dkt. 64) is
DENIED.
Accordingly, Cady’s claims pursuant to 29 U.S.C. § 1132(a)(1)(B) are
dismissed with prejudice.
DATED: March 13, 2013
_________________________
Edward J. Lodge
United States District Judge
MEMORANDUM DECISION AND ORDER - 31
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