Crox v. Unum Group Corporation

Filing 34

ORDER accepting and adopting 31 Report and Recommendations; denying 18 Motion for Judgment; overruling 32 OBJECTION to Magistrate Judge Order. Plaintiff's Complaint (Doc. 1) is hereby DISMISSED WITH PREJUDICE.Signed by District Judge Harry S Mattice, Jr on 9/1/2015. (BJL, )

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF TENNESSEE
at CHATTANOOGA
MONICA L. CROX,
Plaintiff,
v.
UNUM GROUP CORPORATION
Defendant.

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Case No. 1:14-cv-254
Judge Mattice
Magistrate Judge Steger

ORDER
On July 29, 2015, United States Magistrate Judge William B. Carter filed his
Report and Recommendation (Doc. 31) pursuant to 28 U.S.C. § 636(b)(1), and Fed. R.
Civ. P. 72(b).

Magistrate Judge Carter recommended that Plaintiff’s Motion for

Judgment (Doc. 18) be denied, and that judgment be entered in favor of Defendant.
(Doc. 31 at 1).
Plaintiff has filed timely objections to the Magistrate Judge’s Report and
Recommendation. (Doc. 32). Plaintiff’s objections reiterate arguments already raised in
her Motion for Judgment. Specifically, Plaintiff objects to: “(1) certain factual findings
and omissions;1 (2) the application of an arbitrary and capricious standard of review;
and (3) the failure to adequately consider any applicable conflict of interest.” (Id. at 1).
For the reasons stated herein, the Court will OVERRULE Plaintiff’s objections
(Doc. 32), and will ACCEPT and ADOPT Magistrate Judge Carter’s Report and
Recommendation (Doc. 31). Accordingly, Plaintiff’s Motion for Judgment (Doc. 18) will
The Court notes that while Plaintiff objects to “certain factual findings and omissions” in the
introduction of her Objection, she does not specifically address any factual findings or omissions in detail
in the argument section of her brief. See Doc. 32. Accordingly, the Court will construe this objection as an
objection to the factual findings and omissions relating to her objections to the standard of review and
consideration of any applicable conflict of interest.

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be DENIED, and Plaintiff’s Complaint (Doc. 1) will be DISMISSED WITH
PREJUDICE.
I.

ANALYSIS
The Court has conducted a de novo review of the record and the Report and

Recommendation, specifically reviewing those portions to which Plaintiff has objected,
and it agrees with Magistrate Judge Carter’s well-reasoned conclusions regarding
factual findings and the applicable standard of review. Specifically, the Court finds, as
Plaintiff concedes in her brief, (Doc. 32 at 2), that the welfare benefit plan at issue
unambiguously grants Unum Group Corporation (“Unum”) discretionary authority to
make benefit determinations, thus establishing an arbitrary and capricious standard of
review. See Sanford v. Harvard Indus., Inc., 262 F.3d 590, 595 (6th Cir. 2001). Plaintiff
argues that this authority is limited by phrases indicating that the determination must
be “reasonable,” and that on appeal, “the Court will determine the standard of review.”
(Doc. 32 at 2–3). These arguments, however, merely restate those set forth in Plaintiff’s
Motion for Judgment, which were fully addressed in Magistrate Judge Carter’s Report
and Recommendation. (Cf. Doc. 18 at 5–6 with Doc. 32 at 2–3; see Doc. 31 at 14–16).
The Court has conducted a review of the Report and Recommendation, as well as the
record, and it agrees with Magistrate Judge Carter’s well-reasoned conclusions.
Accordingly, Plaintiff’s objection as to the applicable standard of review will be
OVERRULED.
Finally, Plaintiff correctly states that Magistrate Judge Carter’s Report and
Recommendation fails to consider any applicable conflict of interest. Where “the entity
that administers the plan . . . both determines whether an employee is eligible for
benefits and pays benefits out of its own pocket,” a conflict of interest arises. Metro. Life

Ins. Co. v. Glenn, 554 U.S. 105, 108 (2008). “[A] reviewing court should consider that
conflict as a factor in determining whether the plan administrator has abused its
discretion in denying benefits; and . . . the significance of the factor will depend upon
the circumstances of the particular case.” Id.
It is undisputed that Unum has such a conflict of interest. Despite this conflict,
however, the Court finds that given the particular circumstances of this case, Unum’s
decision to deny Plaintiff’s benefits claim was neither arbitrary nor capricious. As
discussed at length in Magistrate Judge Carter’s Report and Recommendation, Unum
based its decision upon the opinions of seven physicians who stated that the Plaintiff
was capable of working full-time in a sedentary capacity, and two physicians who opined
that Plaintiff’s disability was caused by a mental illness. (Doc. 31 at 8–11). In contrast,
neither the record nor Plaintiff’s briefs identify even a single physician who is of the
opinion that Plaintiff cannot work full-time in a sedentary capacity.2 Plaintiff further
asserts that Unum acted improperly in considering the opinions of its own doctors.
(Doc. 32 at 4–5). This act, however, “prove[s] less important . . . where the
administrator has taken active steps to reduce potential bias and to promote accuracy.”
Glenn, 554 U.S. at 117. Specifically, Unum contacted all of Plaintiff’s physicians, not just
those employed by Unum, to inquire about Plaintiff’s ability to work. As stated above,
none of these physicians opined that Plaintiff was incapable of working full-time in a
sedentary capacity. Even considering Unum’s conflict of interest, the Court finds that,
given the dearth of evidence in Plaintiff’s favor, Unum’s decision to deny Plaintiff

2 Plaintiff argues that the Social Security Administration (“SSA”) found that she could not perform
sedentary work and was therefore disabled. (Doc. 32 at 6). ERISA administrators, however, are not bound
by the SSA’s decision. Whitaker v. Hartford Life and Accident Ins. Co., 404 f.3d 947, 949 (6th Cir. 2005).
At any rate, in this case Unum considered the SSA award and reasonably reached a different conclusion
based on information in the administrative record that was not presented to the SSA. (Doc. 31 at 17).

benefits was reasonable, and thus was neither arbitrary nor capricious. See Price v. Bd.
of Trs. of Indiana Laborer’s Pension Fund, 632 F.3d 288, 295 (6th Cir. 2011) (“Under
[the arbitrary and capricious] standard of review, we must uphold the administrator’s
decision if the administrator’s interpretation of the Plan’s provisions is reasonable.”)
(internal quotation marks omitted). Accordingly, Plaintiff’s objection that Unum’s
decision was arbitrary and capricious based on its conflict of interest will be
OVERRULED.
II.

CONCLUSION
For the reasons stated herein, Plaintiff’s objections (Doc. 32) are hereby

OVERRULED, and the Court hereby ACCEPTS and ADOPTS Magistrate Judge
Carter’s Report and Recommendation (Doc. 31). Accordingly, Plaintiff’s Motion for
Judgment (Doc. 18) is hereby DENIED, and Plaintiff’s Complaint (Doc. 1) is hereby
DISMISSED WITH PREJUDICE.

SO ORDERED this 1st day of September, 2015.

/s/ Harry S. Mattice, Jr._______
HARRY S. MATTICE, JR.
UNITED STATES DISTRICT JUDGE