Guest-Marcotte v. Life Insurance Company Of North America et al

Filing 42

ORDER Overruling Plaintiff's 41 Objections, Adopting the 40 Report and Recommendation, Granting in Part and Denying in Part Plaintiff's 35 Motion to Amend, Denying Plaintiff's 27 Procedural Challenge, and Confirming Standard of Review as Arbitrary and Capricious. Signed by District Judge Thomas L. Ludington. (Sian, M)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MICHIGAN
NORTHERN DIVISION
KIMBERLY J. GUEST-MARCOTTE,
Plaintiff,
v

Case No. 15-cv-10738
Honorable Thomas L. Ludington
Magistrate Judge Patricia T. Morris

METALDYNE POWERTRAIN
COMPONENTS, Inc., et al.,
Defendants.
__________________________________________/
ORDER OVERRULING PLAINTIFF’S OBJECTIONS, ADOPTING THE REPORT
AND RECOMMENDATION, GRANTING IN PART AND DENYING IN PART
PLAINTIFF’S MOTION TO AMEND, DENYING PLAINTIFF’S PROCEDURAL
CHALLENGE, AND CONFIRMING STANDARD OF REVIEW AS
ARBITRARY AND CAPRICIOUS
Plaintiff Kimberly J. Guest-Marcotte initiated this case by filing her two-count complaint
on February 27, 2015. Complaint, ECF No. 1. Plaintiff alleges that Defendants violated her
rights under the Employee Retirement Income Security Act, 29 U.S.C. § 1132(a)(1)(B) and
(a)(2) (“ERISA”) in denying her request for short term disability benefits, and her rights under
Michigan’s Persons with Disabilities Civil Rights Act (“PWDCRA”) in subsequently terminating
her employment. After her state law claim was dismissed, Plaintiff filed a procedural challenge
seeking discovery. ECF No. 27. When the subsequent briefing led to confusion about the
applicable plan and related documents, Plaintiff filed a motion for leave to file an amended
complaint. ECF No. 35.
Magistrate Judge Patricia T. Morris issued her report and recommendation on February
17, 2016. ECF No. 40. The magistrate judge concluded that the appropriate standard of review
was arbitrary and capricious. She also recommended granting in part and denying in part

Plaintiff’s motion for leave to file an amended complaint, and denying Plaintiff’s procedural
challenge. Plaintiff timely filed objections to the magistrate judge’s report and recommendation,
which will now be overruled for the reasons stated below. ECF No. 41. The magistrate judge’s
report and recommendation will be adopted.
I.
Plaintiff Kimberly J. Guest-Marcotte is an individual currently residing in Sanford,
Michigan. Compl. ¶ 1. Defendant Metaldyne Powertrain Components, Inc. (“Metaldyne
Powertrain”) is a subsidiary of Metaldyne, LLC, with its principal place of business in Delaware.
Id. ¶¶ 4, 17. In her complaint, Plaintiff Guest-Marcotte alleges that she was an employee of
Defendant Metaldyne Powertrain and a participant in Defendant Metaldyne Salary Continuation
Plan. Compl. ¶ 18. Plaintiff alleges that the Metaldyne Salary Continuation Plan is an employee
welfare benefits plan under 29 U.S.C. § 1002(1), and therefore governed by ERISA. Compl. ¶
19. Plaintiff further alleges that Defendant Life Insurance Company of North America, under the
service mark CIGNA Group Insurance (“CIGNA”) is the administrator and fiduciary of the
Metaldyne Salary Continuation Plan. Id. ¶ 20.
A.
After taking a disability leave of absence for a medical condition called Ehlers-Danlos
syndrome1 on June 6, 2013, Plaintiff applied for short-term disability benefits under the
Metaldyne Salary Continuation Plan. Compl. ¶¶ 25-29. In her application Plaintiff attached
documentation from her primary care physician, Dr. Phillip Kadaj, M.D., and from an Ehlers

1

Ehlers-Danlos syndrome refers to “any one of a rare group of inherited (autosomal dominant or autosomal
recessive) disorders of the connective tissue involving abnormal or deficient collagen, the protein that gives the body
tissues strength.” OXFORD CONCISE MEDICAL DICTIONARY (9th ed. 2015). It is often marked by elastic, yet fragile
skin that bruises easily and scars poorly, as well as mobile joints prone to dislocation. Id.

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Danlos syndrome specialist, Dr. Bradley Tinkle, stating that Plaintiff was indefinitely disabled
from employment. Compl. ¶ 30; Compl. Exs. 10, 11.
CIGNA denied Plaintiff’s request by a letter dated August 2, 2013. Compl. Ex. 1. In
denying Plaintiff’s claim, Plaintiff alleges that LICNA/CIGNA used an incorrect definition of
“disability” under the plan. Specifically, while the plan summary states in relevant part that
“[y]ou are considered Disabled if, solely because of Injury or Sickness you are: Unable to
perform the material duties of your Regular Occupation; and Unable to earn 80% or more of
your Covered Earnings from working in your Regular Occupation.” Compl. Ex. 2 § 6. In
contrast, the letter denying Plaintiff’s request for benefits states that under her employer’s plan,
“An employee is Totally Disabled if, because of Injury or Sickness, he or she is unable to
perform all the substantial and material duties of his or her regular occupation, or solely due to
Injury or Sickness, is unable to earn more than 80% of his or her Indexed Covered Earnings.”
Compl. Ex. 1 (emphasis added).
After the denial, Plaintiff attempted to send supplementary medical documentation to
support her claim.

However, on August 4, 2013, August 20, 2013, and August 23, 2013

Defendant CIGNA reaffirmed its decision to deny Plaintiff’s claim. See Compl. Exs. 4-6.
Plaintiff then filed a second stage appeal with additional medical information on September 25,
2013. CIGNA denied her appeal in a letter dated November 21, 2013. See Compl. Ex. 7. In
upholding its decision, CIGNA again referenced the “incorrect” definition of disability, and
explained that “[t]here were no significant clinical findings identified to support a loss of
function. The medical information on file reviewed does not demonstrate you would be unable
to perform your job duties as a Senior Risk Analyst.” Id.

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While the plan administrator, Defendant CIGNA, did not find that Plaintiff was unable to
perform her job duties, her employer, Defendant Metaldyne Powertrain, reached the opposite
conclusion. On November 22, 2013, the day after Plaintiff’s appeal was denied, Metaldyne
Powertrain terminated Plaintiff’s employment. Compl. Ex. 8. Metaldyne Powertrain explained
that Plaintiff had been on leave since June 6, 2013, that her 12 week allotment of leave under the
Family and Medical Leave Act had expired on August 28, 2013, and that she had been unable to
return to work after the expiration of her FMLA leave. Id. Metaldyne Powertrain primarily relied
on documentation from Doctor Kadaj, which indicated that Plaintiff remained unable to perform
the essential functions of her position with or without a reasonable accommodation, and that
Plaintiff was unlikely to recover sufficiently to perform the functions of her position. Id. In light
of the denial of her appeal for short-term disability benefits, “the unknown nature of your ability
to perform your job functions in the future, and the unknown timing of your ability to return to
work, your employment with Metaldyne will end November 22, 2013.” Id.
On July 30, 2014, Plaintiff timely filed her final internal appeal to CIGNA. Plaintiff
again submitted medical documentation from both Dr. Kadaj and Dr. Tinkle. Compl. ¶¶ 47-50.
CIGNA again denied Plaintiff’s appeal on October 22, 2014, using the same definition of
disability as it had previously. Compl. Ex. 12. The final denial explained that, “[w]hile we
understand your client has Ehlers-Danlos syndrome, the clinical findings and test results do not
document her physical impairments. There was no clinical evidence that would demonstrate a
functional loss and inability to perform her sedentary occupation beginning 6/6/13.” Id.
B.
Plaintiff filed suit on February 27, 2015, claiming that Defendants’ violated her rights
under ERISA 29 U.S.C. § 1132(a)(1)(B) and (a)(2) in denying her request for short term

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disability benefits. Compl. ¶¶ 54-56. Plaintiff also alleged that Defendant Metaldyne Powertrain
discriminated against her in violation of Michigan’s PWDCRA, by terminating her employment.
See Compl. ¶¶ 57-67. The matter was referred to Magistrate Judge Patricia T. Morris on April 1,
2015 for hearing and determination of any pretrial matters. ECF No. 9.
On April 24, 2015 all Defendants filed a motion to dismiss Plaintiff’s claim under the
PWDCRA. Mot. to Dismiss, ECF No. 11. Defendants alleged that, because Plaintiff admitted
her disability was related to her ability to perform the duties of her job, Plaintiff could not
establish a prima facie case under the PWDCRA. Id. Pursuant to that motion, the Court
dismissed Plaintiff’s PWDCRA claim on August 5, 2015. ECF No. 28.
i.
Also on April 5, 2015, Plaintiff filed a statement of procedural challenge. ECF No. 27. In
her challenge, Plaintiff sought discovery outside the administrative record under Metropolitan
Life Ins. Co. v. Glenn, 554 U.S. 105 (2008). Plaintiff alleged that there was a potential CIGNA
acted with bias and conflict in denying her claim. In support of this allegation, Plaintiff argued
that CIGNA had ignored substantial medical evidence in support of Plaintiff’s claim, cherry
picked medical evidence in support of its determination, and used the incorrect definition of
“disability.” ECF No. 27. Plaintiff therefore sought to discover information related to bias and
conflict of interest. Id.
In response, Defendants argued that discovery outside the administrative record “both
unnecessary and unauthorized” in a majority of cases. ECF No. 34. See also Wilkins v. Baptist
Healthcare Sys., 150 F.3d 609, 618 (6th Cir. 1998). Defendants noted the narrow exception to
the general rule that discovery is not permitted: where discovery is necessary to resolve a
procedural challenge that includes an alleged lack of due process afforded by the administrator or

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alleged bias on the part of the administrator. Id. at 618. Defendants argued that this narrow
exception did not apply because Plaintiff’s conclusory allegations of bias were insufficient to
obtain discovery without any actual evidence of bias. See Bennetts v. AT & T Umbrella Plan
Case No. 12- 14640, *2 (E.D. Mich. Aug. 9, 2013).
On October 7, 2015 the magistrate judge issued an order requesting supplemental
briefing as to the correct standard of review. ECF No. 30. In her supplemental brief, Plaintiff
argued that a de novo standard of review should apply for two reasons: (1) Defendants had used
a definition of “disability” that differed from the summary plan definition; and (2) Michigan law
requires de novo review. In contrast, Defendants argued in their supplemental brief that the
usual arbitrary and capricious standard should apply, since Metaldyne’s short term disability plan
granted the plan administrator, CIGNA, discretionary authority to interpret the plan terms. ECF
No. 31. In support of their arguments, Defendants attached as exhibits (1) Metaldyne, LLC’s
Short Term Disability Income Plan, effective January 1, 2012 (“STDIP”), and (2) a summary
plan description of Metaldyne, LLC’s STDIP. ECF No. 31 Exs. 1-2.
In responding to Defendants, Plaintiff took issue with the two Metaldyne STDIP
documents attached to Defendants’ supplemental brief. ECF No. 34. Plaintiff argued that those
plan documents had never been provided to her, despite the fact that she had requested “a copy
of all plan documents related to her Short Term Disability Claim” in January of 2015, and that
Defendants had only provided her with documents related to the Metaldyne Salary Continuation
Plan. Id. Plaintiff alleged that Metaldyne Powertrain’s failure to produce the documents related
to Metaldyne’s STDIP constituted a violation of ERISA § 104(b), which requires plan
administrators to provide various documents to a requesting participant.
ii.

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Thereafter, on November 20, 2015 Plaintiff filed a motion for leave to file a first
amended complaint. ECF No. 35. In her motion Plaintiff seeks to elimiate her PWDCRA claim
(which has already been dismissed by this Court), add five new exhibits, add Defendant
Metaldyne STDIP to her first Count, and add a claim that Defendants violated 29 U.S.C. §§
1132(c)(1) and 1024(b)(4) by failing to provide her with all required plan documents upon her
request.
In their response, Defendants argue that the STDIP plan documents were mistakenly
attached to their supplemental brief. ECF No. 36. They argue that in her January 22, 2015
requests for documents, Plaintiff addressed the requests only to Defendant Metaldyne Salary
Continuation Plan and Defendant CIGNA, and that Defendant CIGNA then provided Plaintiff a
copy of, among other things, the Metaldyne Salary Continuation Plan Summary Plan
Description. Defendants further argue that Plaintiff herself attached a copy of the Metaldyne
Salary Continuation Plan to her original complaint and named the Metaldyne Salary
Continuation Plan as a defendant in this action. Id. Defendants also argue that, because the
STDIP documents were created by CIGNA not Metaldyne Powertrain, they do not constitute
summary plan descriptions. Finally, Defendants argue that in any event the Metaldyne Salary
Continuation Plan supersedes that Metaldyne STDIP documents, making them irrelevant to
Plaintiff’s claims.
In their response Defendants conclude that Plaintiff’s proposed claim that Defendants
violated 29 U.S.C. §§ 1132(c)(1) and 1024(b)(4) by failing to provide her with all required plan
documents would be futile because she received all relevant plan documents. Defendants also
conclude that Plaintiff’s claim would be moot because she eventually received the Metaldyne
STDIP documents through Defendants’ October 22, 2015 supplemental brief.

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Finally,

Defendants conclude that Plaintiff’s proposed claim is futile with respect to any entity other than
the Plan Administrator under Caffey v. Unum Life Ins. Co., 302 F.3d 576, 584 (6th Cir. 2002),
and that Metaldyne, LLC – not a party to this action – is the Plan Administrator of Metaldyne
STDIP.
After receiving a reply and sur-reply from the parties, the magistrate judge issued her
report and recommendation. ECF No. 40. The magistrate judge recommended that the standard
of review should be “arbitrary and capricious”. In so doing, the magistrate judge rejected
Plaintiff’s argument that the different definition of “disability” required a different standard of
review. She also rejected Plaintiff’s argument that Michigan law required de novo review,
finding Michigan Administrative Code Rule 500.2201.-02 inapplicable because the plans at issue
are self-funded and therefore preempted by ERISA.

The magistrate judge concluded that

Plaintiff’s motion for leave to file a first amended complaint should be granted in part and denied
in part, and that Plaintiff’s request for discovery should be denied. Id. Plaintiff timely filed two
objections to these recommendations. ECF No. 41. Having reviewed both of Plaintiff’s
objections de novo, the objections will be overruled, and the report and recommendation will be
adopted.
II.
Pursuant to Federal Rule of Civil Procedure 72, a party may object to and seek review of
a Magistrate Judge’s report and recommendation. See Fed. R. Civ. P. 72(b)(2). Objections must
be stated with specificity. Thomas v. Arn, 474 U.S. 140, 151 (1985) (citation omitted). If
objections are made, “[t]he district judge must determine de novo any part of the magistrate
judge’s disposition that has been properly objected to.” Fed. R. Civ. P. 72(b)(3). De novo review
requires at least a review of the evidence before the Magistrate Judge; the Court may not act

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solely on the basis of a Magistrate Judge’s report and recommendation. See Hill v. Duriron Co.,
656 F.2d 1208, 1215 (6th Cir. 1981). After reviewing the evidence, the Court is free to accept,
reject, or modify the findings or recommendations of the Magistrate Judge. See Lardie v. Birkett,
221 F. Supp. 2d 806, 807 (E.D. Mich. 2002).
Only those objections that are specific are entitled to a de novo review under the statute.
Mira v. Marshall, 806 F.2d 636, 637 (6th Cir. 1986). “The parties have the duty to pinpoint those
portions of the magistrate’s report that the district court must specially consider.” Id. (internal
quotation marks and citation omitted). A general objection, or one that merely restates the
arguments previously presented, does not sufficiently identify alleged errors on the part of the
magistrate judge. See VanDiver v. Martin, 304 F.Supp.2d 934, 937 (E.D.Mich.2004). An
“objection” that does nothing more than disagree with a magistrate judge’s determination,
“without explaining the source of the error,” is not considered a valid objection. Howard v. Sec’y
of Health and Human Servs., 932 F.2d 505, 509 (6th Cir. 1991). Without specific objections,
“[t]he functions of the district court are effectively duplicated as both the magistrate and the
district court perform identical tasks. This duplication of time and effort wastes judicial resources
rather than saving them, and runs contrary to the purposes of the Magistrate’s Act.” Id. Plaintiff
now objects to both of the magistrate judge’s recommendations.
A.
Plaintiff first objects to the magistrate judge’s conclusion that Plaintiff’s motion to amend
should be granted in part and denied in part. In her report the magistrate judge recommended
granting Plaintiff’s motion to amend to remove her dismissed PWDCRA claim and her proposed
joinder of Defendant Metaldyne STDIP to her first Claim. ECF No. 40. However, the magistrate
judge recommended denying Plaintiff’s motion to amend to the extent she sought to add a claim

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that Defendants violated 29 U.S.C. §§ 1132(c)(1) and 1024(b)(4) by failing to provide her with
all required plan documents upon her request. In reaching this conclusion, the magistrate judge
accepted Defendants’ argument that the proposed amendment was futile with regard to any entity
other than the plan administrator under Caffey, 302 F.3d 576, at 584. The magistrate judge
concluded that because non-party Metaldyne, LLC was the plan administrator of Metaldyne
STDIP, the proposed claim would be futile as to all Defendants in this action.
i.
Under Federal Rule of Civil Procedure 15, a court should “freely give leave” to amend
“when justice so requires.” FED. R. CIV. P. 15(a)(2). “[T]he thrust of Rule 15 is to reinforce the
principle that cases should be tried on their merits rather than the technicalities of pleadings.”
Moore v. City of Paducah, 790 F.2d 557, 559 (6th Cir. 1986) (internal citations and quotations
omitted). Factors that courts should consider when determining whether to grant leave to amend
include “[u]ndue delay in filing, lack of notice to the opposing party, bad faith by the moving
party, repeated failure to cure deficiencies by previous amendments, undue prejudice to the
opposing party, and futility of amendment….” Hageman v. Signal L.P. Gas, Inc., 486 F.2d 479,
484 (6th Cir. 1973). “Decisions as to when justice requires amendment are left to the sound
discretion of the trial judge[.]” Robinson v. Michigan Consol. Gas Co. Inc., 918 F.2d 579, 591
(6th Cir. 1990).
The magistrate judge determined that Plaintiff’s proposed claim under 29 U.S.C.
1132(c)(1) would be futile. “A proposed amendment is futile if the amendment could not
withstand a Rule 12(b)(6) motion to dismiss.” Riverview Health Inst. LLC v. Med. Mut. of Ohio,
601 F.3d 505, 512 (6th Cir. 2010) (internal citation and quotation marks omitted). A pleading
fails to state a claim under Rule 12(b)(6) if it does not contain allegations that support recovery

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under any recognizable legal theory. Ashcroft v. Iqbal, 556 U.S. 662, 678, (2009). In considering
a Rule 12(b)(6) motion, the Court construes the pleading in the non-movant’s favor and accepts
the allegations of facts therein as true. See Lambert, 517 F.3d at 439. The pleader need not have
provided “detailed factual allegations” to survive dismissal, but the “obligation to provide the
‘grounds’ of his ‘entitle[ment] to relief’ requires more than labels and conclusions, and a
formulaic recitation of the elements of a cause of action will not do.” Bell Atlantic Corp. v.
Twombly, 550 U.S. 544, 555 (2007). In essence, the pleading “must contain sufficient factual
matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Iqbal, 556 U.S. at
678, (quoting Twombly, 550 U.S. at 570).
ii.
Plaintiff does not raise any specific objections to the magistrate judge’s determination
that Plaintiff’s proposed claim would be futile as to any entity other than the plan administrator.
Instead, despite conceding that Metaldyne LLC is the plan administrator, Plaintiff argues
generally that “the discussion by the Magistrate insufficiently addresses the prejudicial effect” of
Defendants’ conduct. Plaintiff essentially argues that because she did not pursue her benefits
claims under Metaldyne’s STDIP, and because that decision was not brought to her attention
until Defendant inadvertently attached the Metaldyne STDIP documents to its supplemental
brief, this Court should ignore Sixth Circuit precedent that “only plan administrators are liable
for statutory penalties under § 1132(c).” Caffey, 302 F.3d at 584. Plaintiff’s objection is not
persuasive and will be overruled. 2
B.

2

Plaintiff’s request for permission to amend her complaint to add a claim against the plan administrator, Metaldyne
LLC will not be addressed. As explained in this Court’s policies and procedures, “under no circumstances may a
motion be included within the text or footnotes of another motion.”

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Plaintiff next objects to the magistrate judge’s conclusion that Plaintiff has not stated a
colorable procedural challenge. The magistrate judge determined that discovery was unavailable
in this case because the law generally disallows discovery in actions for benefits under ERISA,
and because Plaintiff’s procedural challenge consisted only of substantive challenges to the
benefit denial and conclusory allegations of bias. The magistrate judge specifically rejected
Plaintiff’s claim that a per se conflict of interest existed because “an insurance company that is
retained to review disability claims has an incentive to find no disability in order to save money
for the employer and to preserve their own contractual arrangement with the employer.” The
magistrate judge found this allegation to be conclusory, unsupported by any factual allegations,
and therefore insufficient to warrant discovery.
Plaintiff does not make any specific objection to the report and recommendation. Instead,
Plaintiff merely restates arguments previously presented to and rejected by the magistrate judge,
and expresses general disagreement with the magistrate judge’s determination. This objection is
therefore improper and will be overruled. See VanDiver, 304 F.Supp.2d at 937; Howard, 932
F.2d at 509.
III.
Accordingly, it is ORDERED that Plaintiff Guest-Marcotte’s objections, ECF No. 41,
are OVERRULED.
It is further ORDERED that the report and recommendation, ECF No. 40, is
ADOPTED.
It is further ORDERED that the standard of review is ARBITRARY AND
CAPRICIOUS.

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It is further ORDERED that Plaintiff Guest-Marcotte’s procedural challenge, ECF No.
27, is DENIED.
It is further ORDERED that Plaintiff Guest-Marcotte’s motion for leave to file a first
amended complaint, ECF No. 35, is GRANTED IN PART AND REJECTED IN PART.
It is further ORDERED that Plaintiff Guest-Marcotte is GRANTED LEAVE to add
Defendant Short Term Disability Income Plan of Metaldyne, LLC, as a Defendant, to attach any
new exhibits related to the amended Count I, and to remove Count II.

s/Thomas L. Ludington
THOMAS L. LUDINGTON
United States District Judge
Dated: March 15, 2016

PROOF OF SERVICE
The undersigned certifies that a copy of the foregoing order was served
upon each attorney or party of record herein by electronic means or first
class U.S. mail on March 15, 2016.
s/Michael A. Sian
MICHAEL A. SIAN, Case Manager

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