Although couched in a ruling on a motion to
reconsider an order compelling MetLife to
respond to plaintiff's discovery requests, a
recent thoughtful opinion in Hogan-Cross
v. Metropolitan Life Ins.Co., 2008
U.S.Dist.LEXIS 58027 (S.D.N.Y. July 31), a
disability benefit dispute, explains the
paradigm shift in ERISA litigation created
by a recent Supreme Court ruling. Judge
Lewis Kaplan explores the overall impact of
Metropolitan Life Ins. Co. v. Glenn,
128 S.Ct. 2343 (2008), and how the impact of
that ruling on the scope of judicial claim
review goes beyond the Supreme Court's
primary conclusion finding insurers that
both administer benefit claims and pay
claims out of their own funds are
conflicted. Prior to Glenn, courts
almost universally denied discovery and
limited judicial review to the so-called
''administrative'' record. Kaplan announced
a new regime, though.
''MetLife's notion that
discovery is inappropriate in this case
because 'there is no evidence in the
administrative record of any actual
conflict,' a dubious proposition to begin
with before Glenn, is misguided,''
Kaplan wrote. ''The question here, as in all
cases, is whether the discovery sought is
relevant in itself or 'appears reasonably
calculated to lead to the discovery of
admissible evidence.' ''
The court then turned its
attention to the specific discovery
requests. For example, the court noted the
requests were focused on the approval/denial
rate of claims submitted by IBM employees
and statistics regarding MetLife's benefit
termination rate. While the court
acknowledged that high denial rates may
simply be due to a high proportion of
non-meritorious claims or that high rates of
terminations could be accounted for by
claimants' recovery from serious illness or
injury, the court nonetheless refused to
deny discovery under the relevance standard
set forth in Rule 26 of the Federal Rules of
Civil Procedure, finding: ''Evidence of high
rates of benefit denials or terminations
reasonably could lead to further inquiry as
to the reasons for those actions, which
might prove either benign or malignant.''
The court took a similar
position with respect to discovery aimed at
compensation paid to consultants and
employees involved in benefit terminations.
Again, the court found that such evidence
may not prove much of anything; however, the
court pointed out: ''It could matter a great
deal, for example, if an outside reviewer
derived all or most of his or her income
from MetLife, particularly if that reviewer
frequently recommended denial or termination
of benefits.''
Despite the contrary
finding in Abromitis v. Continental
Casualty Co. , 261 F. Supp. 2d 388 (W.D.N.C.
2003), aff'd without consideration of the
point, 114 Fed. App'x. 57 (4th Cir. 2004),
that the compensation of an outside
consultant was irrelevant, the court
rejected MetLife's citation of that case
because it was issued pre-Glenn and
because Judge Kaplan found the opinion
unpersuasive.
The court explained: ''…
the existence, nature, extent, and effect of
any conflict of interest are relevant
considerations. A consultant may be
compensated in a manner and/or to an extent
that creates a motive to recommend against
the payment of benefits because such
recommendations are believed to serve the
interests of the plan administrator. If a
decision maker knowingly were to rely on
advice from such a consultant, it would be
only common sense to say that the decision
would command less deference than one made
on the basis of unbiased advice or in
ignorance of the bias.''
The court added that the
viewpoint expressed in Abromitis ''is
blind to potentially important information
that, at least in some cases, may be
critical to the fair and informed review of
benefit claims.'' Moreover, the court found
that whatever rationale may have supported
Abromitis was eviscerated by
Glenn, which ''abrogated the limitations
on discovery unique to ERISA cases that were
imposed or applied by such cases as
Abromitis.''
The court also
highlighted the guidance offered by Glenn
with respect to how a court is to
evaluate a conflict. Because the effect of
conflict may play a greater role in the
claim adjudication, the court determined:
''Information bearing on the manner in which
a conflicted plan administrator compensates
outside consultants could be highly
pertinent. Maintenance of compensation
arrangements that create economic incentives
for consultants to recommend denial or
termination of benefits would have a
material bearing on the likelihood that the
administrator's conflict affects its benefit
determinations.''
Finally, while
acknowledging the expense of discovery,
Kaplan emphasized the countervailing, but
paramount considerations inherent in ERISA
litigation.
''No one denies that
speedy, simple, and inexpensive
determination of actions seeking review of
benefit determinations is desirable,''
Kaplan wrote. ''Eliminating or sharply
limiting discovery would serve that goal.
But that is not the only goal. Congress
enacted ERISA to provide unsuccessful
claimants with a federal forum for the fair
determination of their claims. Pretrial
discovery is a part of the process for which
Congress opted.''
Anticipating criticism,
the court then assuaged fears that ERISA
litigation would spin out of control,
reminding litigants that judges retain the
power to limit discovery. Thus, the amount
of discovery allowed will be tailored to fit
the circumstances of individual cases, but
''Blunderbuss attempts to cut off discovery
on the ground that it never or rarely should
be permitted in these cases, whatever their
merits before Glenn, no longer have
merit.''
Clearly, Kaplan
recognizes the importance of the Glenn
ruling, the underlying purpose of the
ERISA law, and its future impact on ERISA
litigation.