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Winfrey v. Hartford Life and Accident Insurance Co.

United States District Court, D. Kansas

October 3, 2014

LARRY WINFREY, Plaintiff,
v.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY, et al., Defendants.

ORDER

JAMES P. O'HARA, Mgistrate Judge.

Defendant Hartford Life and Accident Insurance Company ("Hartford") denied a claim for long-term disability benefits ("LTD") made by the plaintiff, Larry Winfrey. The benefits were claimed by plaintiff under an Employment Retirement Income Security Act ("ERISA") plan provided by defendant Group Long Term Disability Plan for Employees of Spirit Aerosystems, Inc. (the "Plan"). Plaintiff alleges that Hartford had a dual-role conflict of interest as both the insurer and administrator of the Plan, "tainting" its denial of benefits. Accordingly, plaintiff seeks discovery targeted at Hartford's conflict of interest and how it may have impaired his claim denial. This case is before the undersigned U.S. Magistrate Judge, James P. O'Hara, on plaintiff's motion to compel (ECF doc. 31). Specifically, plaintiff moves to compel defendants to produce responsive documents to plaintiff's Request for Production No. 9. For the reasons discussed below, plaintiff's motion is granted.

I. Background

As an employee of Spirit Aerosystems, Inc., plaintiff participated in a LTD plan which was insured and administered by Hartford. The Plan provides short-term and long-term benefits in compliance with ERISA. Plaintiff became physically disabled from back pain and neuropathy and went on short-term disability in September 2012. After an unsuccessful attempt to return to work, plaintiff went on medical leave, which resulted in his separation from employment in 2013. Plaintiff submitted a claim for LTD in early 2013. Subsequently, Hartford instructed plaintiff to apply for Social Security disability. The Social Security Administration determined that plaintiff was totally and permanently disabled, and that his disability had commenced in the fall of 2012. However, Hartford denied plaintiff's claim for "own occupation" LTD benefits under the Plan. Plaintiff contends he qualifies for LTD benefits under the Plan.

On April 24, 2014, plaintiff served his first request for production of documents.[1] Defendants served their objections to plaintiff's requests on May 9, 2014.[2] In Request for Production No. 9, plaintiff asked for "Claim manuals, internal guidelines, rules and policies for the processing, investigation and determination of LTD claims." Defendants responded with several objections, but agreed to produce the table of contents and certain relevant portions of a "comprehensive manual providing technical reference tools and best practices for the administration of LTD claims (the BMS Reference Manual')"[3] subject to their objections and subject to the entry of a protective order and confidentiality agreement.

Subsequently, plaintiff sought two extensions of time to file a motion to compel with respect to defendants' responses to his first set of written discovery. The court granted plaintiff an extension until June 11, 2014, to file discovery-related motions.[4] The parties reached a discovery "compromise" on June 9, 2014.[5] With respect to Interrogatory No. 9, defendants agreed to produce the "Disability Best Practices Memos; Disability Updates; Claim Submission & Investigation; Definition of Disability; Denials and Terminations; Legal."[6] Defendants provided these responsive documents on June 13, 2014.

Plaintiff disputes the sufficiency of defendants' response because unbeknownst to him, the claim manual is an electronic reference and many sections of it offer little to no discussion. The scanned printouts of the claim manual direct the reader to a hyperlinked item called "Claims Excellence."[7] Plaintiff asserts that his counsel thoroughly conferred with defendants' counsel to settle the issue because the deadline to file motions to compel had already run when he discovered the "deficient response."[8] But, the parties could not come to a resolution on this issue.

II. Analysis

On August 25, 2014, plaintiff filed his motion to compel defendants to "provide certain Claims Excellence' materials referenced in Hartford's claim manual."[9] Plaintiff asserts that he seeks these materials because they are relevant and material to the case. And because it will "shed light on [Hartford's] reasonable policies and procedures for making benefit determinations."[10] Plaintiff admits that it would not be proper to allow him to conduct discovery directed to the factual merits of his claim; however, he insists that the court should permit limited discovery related to the alleged conflict of interest and to the policies and procedures used by Hartford to make its decision.[11]

Initially, defendants made three primary objections to the disputed discovery requests. First, defendants objected that Request for Production No. 9 seeks discovery beyond the administrative record, which is inappropriate in ERISA matters when the evaluation was limited to whether the claims administrator abused its discretion in making a factual determination related to the merits of the claim. Second, and more specifically, defendants objected that although some discovery pertaining to the alleged conflict of interest might be permissible, because of Hartford's dual role, the disputed request was not directed to that limited topic. Finally, defendants objected to producing the contents of the claims manual because it contains confidential, proprietary material. Although defendants eventually agreed to produce each of the various sections of the claims manual that plaintiff had requested, defendants assert their compliance was contingent upon it resolving all of plaintiff's issues with Request for Production No. 9.[12]

On June 22, 2014, plaintiff contacted defendants, seeking additional production. Specifically, plaintiff asked for a complete copy of "an entire confidential, internal database."[13] Defendants assert that plaintiff's basis for his additional request was that the produced materials contained cross-references to another database. According to defendants, this is true of the majority of their internal operating documents. Defendants argue that plaintiff's request for these materials is a "direct violation of Plaintiff's explicit discovery agreement, undermining the rationale of encouraging parties... to resolve discovery disputes..."[14] Nonetheless, defendants offered to produce the items if their compliance would end plaintiff's discovery requests.[15] Plaintiff responded with requests for additional materials and requirements to which defendants could not agree. Therefore, plaintiff filed the instant motion.

Defendants assert that plaintiff's motion should be denied for two reasons: (1) on the grounds of fundamental fairness per the discovery agreement; and (2) on the merits because the discovery sought is outside the administrative record and is not probative of defendants' alleged conflict of interest.

Fed. R. Civ. P. 26(b)(1) currently provides that generally the scope of discovery is limited to the parties' pleaded claims and defenses, but that "[f]or good cause, the court may order discovery of any matter relevant to the subject matter involved in the action"; on December 1, 2015, if recently proposed rules amendments go into effect, the latter sort of discovery no longer will be available. In any event, when a party files a motion to compel and asks the court to overrule objections, the objecting party must specifically show in its response to the motion how each discovery request is objectionable.[16] Objections initially raised but not supported in response to the motion to compel are deemed abandoned.[17] However, if the discovery request appears facially objectionable in that they are overly broad or seek information that does not ...


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