Fraley v. General Motors, LLC
OPINION AND ORDER DENYING 8 MOTION to Remand to Supplement the Administrative Record. (TELEPHONIC Status Conference set for 1/17/2018 11:30 AM before District Judge Terrence G. Berg) Signed by District Judge Terrence G. Berg. (AChu)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MICHIGAN
Case No. 16-14465
Hon. Terrence G. Berg
GENERAL MOTORS LLC,
OPINION AND ORDER DENYING PLAINTIFF’S
MOTION FOR REMAND TO SUPPLEMENT THE
ADMINISTRATIVE RECORD (Dkt. 8)
Charles Fraley, a former GM engineer who went on disability
in April 2012, has brought a lawsuit against GM challenging the
denial of certain benefits pursuant to the Employee Retirement Income Security Act (“ERISA”). Plaintiff filed claims with Defendant
for company-paid Basic Life Insurance, company-paid Health Care
Coverage, and COBRA Continuation coverage. Dkt. 8, Pg. ID 3. Defendant allegedly issued a final denial of Plaintiff’s claims on January 11, 2016, and Plaintiff maintains he has since exhausted his
internal appeals. Dkt. 8, Pg. ID 3. Plaintiff now moves for a remand
to the plan administrator in order to supplement the administrative
record. For the reasons outlined below, Plaintiff’s Motion for Remand to Supplement the Administrative Record is DENIED.
Fraley worked as a GM engineer from September 1997 until
April 20, 2012. Dkt. 8, Pg. ID 2. Defendant acknowledges that
Plaintiff was approved for a Total and Permanent Disability Retirement, which Plaintiff maintains was due to lupus, Reynaud’s syndrome, and chronic obstructive pulmonary disease. Dkt. 4, Pg. ID
23; Dkt. 1, Pg. ID 2.
The Parties disagree on various issues surrounding the
type(s) of coverage to which Plaintiff is entitled and Plaintiff’s coverage history. For the purposes of the motion before the Court, however, the only issue is whether there is cause to remand the case to
the plan administrator in order to supplement the record. Dkt. 6.
III. Standard of Review
When reviewing an administrator’s decision denying benefits,
a district court conducts a review “based solely on the administrative record.” Wilkins v. Baptist Healthcare Sys., Inc., 150 F.3d 609,
610 (6th Cir. 1998). “The only exception to the . . . principle of not
receiving new evidence at the district court level arises when consideration of that evidence is necessary to resolve an ERISA claimant’s procedural challenge to the administrator’s decision, such as
an alleged lack of due process afforded by the administrator or alleged bias on its part.” Id. at 618.
The Sixth Circuit has found that remand to an ERISA plan
administrator is appropriate in a variety of circumstances when the
plan administrator erroneously denies benefits, particularly where
the plan administrator’s decision suffers from a procedural defect
or the administrative record is factually incomplete. See Shelby
County Health Care Corp. v. Majestic Star Casino, 581 F.3d 355,
373 (6th Cir. 2009) (internal citations omitted). However, with regard to alleged factually incomplete administrative records, the
Sixth Circuit has noted that a complainant “cannot ‘simply on a
hunch’ compel [Defendant] to produce documents that either do not
exist or were not included in the administrative record in the ordinary course of [Defendant’s] business.” Likas v. Life Ins. Co. of
North America, 222 Fed. Appx. 481, 485 (6th Cir. 2007) (unpublished case) (internal citations omitted).
Plaintiff’s motion “contends the administrative record is incomplete with respect to various important records” and “requests
the Court order a remand to the administrator to supplement the
administrative record.” Dkt. 8, Pg. ID 1035, 1036. However, neither
Plaintiff’s original Complaint nor his motion to remand raises a
claim of administrator bias or a claim of procedural deficiency during the underlying administrative proceeding. See Dkts. 1, 8. Moreover, Plaintiff does not argue that the administrative record filed
by Defendant in this action, Dkt. 6, is an inaccurate or incomplete
representation of the record evidence that was reviewed by the plan
administrator in the underlying proceeding.
Instead, the motion argues that “[i]n the experience of plaintiff’s attorney, and probably in the court’s experience” administrative records in ERISA cases like this “routinely” contain evidence
that is not present in the administrative record filed by Defendant
here. Dkt. 8, Pg. ID 1042. Plaintiff maintains that certain “ordinary
and important records” such as “telephone records and logs of conversations with the claimant,” are normally included but that here,
“the administrative record has no documentation of any telephone
communications . . . [and further that t]he administrative record
has no written indication that plaintiff’s COBRA claim was denied.”
Id. at 1041, 1042.
In reply, Defendant argues there is no basis to allow discovery
or to remand to the plan administrator for consideration of additional evidence. Dkt. 12, Pg. ID 1060. Because Plaintiff’s Complaint
(Dkt. 1) and Motion to Remand (Dkt. 8) do not raise a claim of administrator bias or procedural deficiency, they do not require remand to the plan administrator to consider additional evidence.
Dkt 12, Pg. ID 1061-62; see also Wilkins, 150 F.3d at 610. Defendant’s position is correct. Because Plaintiff’s complaint does not allege facts amounting to a denial of procedural due process in connection with the plan administrator’s decision, the Court finds that
its review in this matter may be correctly based solely on the administrative record, and remand to the administrator for the consideration of additional evidence is not warranted. See Wilkins, 150
F.3d at 610; see also Fendler v. CAN Group Life Assur. Co., 247 Fed.
Appx. 754, 757-58 (6th Cir. 2007) (unpublished case) (denying a
plaintiff’s request to supplement the administrative record, in part,
for plaintiff’s failure to assert a procedural challenge to the administrator’s decision in his complaint).
Regarding Plaintiff’s claim that remand is necessary because
the administrative record is allegedly incomplete, Defendant argues, “[p]laintiff’s belief that the filed administrative record is incomplete has no factual support. Defendant cannot supplement the
administrative records with documents or materials that do not exist or were not maintained by Defendant in its ordinary course of
business.” Dkt. 12, Pg. ID 1063 (citing Likas, 222 Fed. Appx. at 485
(unpublished case)). While Plaintiff’s counsel suggests that certain
kinds of evidence are normally found in other ERISA administrative records, Plaintiff has not presented any evidence to suggest
that such documents or materials exist in this case that were improperly omitted from the administrative record filed with the
In response to this motion, Defendant searched for records responsive to Plaintiff’s requests and discovered an additional correspondence dated June 20, 2014 to Plaintiff from Metropolitan Life
Insurance and two recordings of telephone conversations between
Plaintiff’s former counsel and GM Benefits & Services Center. Dkt.
12, Pg. ID 1064. According to Defendant, these materials were not
included in the administrative record filed with the Court because
they were “not considered by any administrator in connection with
the issues raised in Plaintiff’s Complaint.” Id. However, Defendant
informed Plaintiff of its willingness to supplement the filed administrative record to include these materials. Id. (citing Dkt. 12-1, Pg.
ID 1067). As it appears that both parties support including these
documents in the record before this Court, Defendant is hereby directed to supplement the record by filing them.
Other than these additional records, however, Defendant
maintains that whatever other kinds of information Plaintiff believes may “typically” be found in other ERISA cases, they apparently are not available here. Dkt. 12, Pg. IDs 1063-64. The speculation of counsel is not a sufficient reason to require a remand to the
plan administrator. Consequently, Plaintiff’s motion will be denied.
For the foregoing reasons, Plaintiff’s Motion for Remand to
Supplement the Administrative Record, Dkt. 8, is DENIED.
On September 13, 2017, this Court vacated the remaining
deadlines set forth in the governing Case Management Scheduling
Order, Dkt. 5, until after this Court ruled on Plaintiff’s pending motion. The Court hereby ORDERS both parties to appear by telephone on Wednesday January 17, 2018 at 11:30 a.m. to discuss
the remaining scheduling order deadlines. Counsel for Plaintiff
shall initiate the call and include the Court when all parties are
present by dialing (313) 234-2640.
Dated: January 9, 2018
s/Terrence G. Berg
TERRENCE G. BERG
UNITED STATES DISTRICT JUDGE
Certificate of Service
I hereby certify that this Order was electronically filed, and the
parties and/or counsel of record were served on January 9, 2018.
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