United States District Court, D. Maryland
MEMORANDUM OPINION & ORDER
Xinis, United States District Judge
Reidy (Plaintiff) brought this suit against Unum Life
Insurance Company of America and The Squire Patton Boggs
Group Long Term Disability Plan (Defendants), seeking a
declaration of entitlement to disability benefits, payment of
back-benefits plus interest, and costs pursuant to the
Employee Retirement Income Security Act, 29 U.S.C. §
1001, et seq. (ERISA). On May 19, 2017, Plaintiff moved to
compel discovery, ECF No. 26. The issues are fully briefed
and the Court now rules pursuant to Local Rule 105.6 because
no hearing is necessary. For the reasons set forth below,
Plaintiff's Motion to Compel Discovery (ECF No. 26) is
is a former employee of Squire Patton Boggs where she served
as the Director of Professional Development and Retention.
ECF No. 1 at ¶ 11. Plaintiff was a plan participant
under a group benefits plan established by Defendant Squire
Patton Group Long Term Disability Plan. ECF No. 1 at ¶
6; see also ECF No. 8. Defendant Unum Life Insurance
Company of America (“Unum”) is the claims
administrator and insurer of Plaintiff's disability
insurance. ECF No. 1 at ¶ 7; see also ECF No.
avers that she became disabled on or around March 27, 2014
and sought disability benefits. Id. at ¶ 12.
Defendants denied Plaintiff's claim on July 30, 2015.
Id. at ¶ 13. Plaintiff appealed Unum's
decision and Unum denied the appeal on March 21, 2016.
Id. at ¶¶ 14-15. Plaintiff then filed this
action against the plan under § 502(a)(1)(B) of the
Employment Retirement Income Security Act of 1974
(“ERISA”), requesting that this Court declare her
entitled to benefits under the plan. ECF No. 1.
filing the Complaint, Plaintiff propounded interrogatories
and requests for production of documents on Defendants
regarding the doctors that reviewed Plaintiff's claim,
Dr. Kletti and Dr. Shipko. See ECF Nos. 22 &
26-2. Plaintiff more particularly requested Defendants
produce evidence regarding (1) the total number of ERISA
disability claims referred to Dr. Kletti and how many of
these claims were approved; (2) the total number of ERISA
disability claims referred to Dr. Shipko and how many of
these claims were approved; (3) the number of times Drs.
Kletti and Shipko reviewed the same claim from 2014 to
present; and (4) all monies paid to Drs. Kletti and Shipko
from 2014 to present under the Unum Management Incentive
Compensation Plan (MCIP) or other bonus plans. Plaintiff
asserts that this information is necessary to determine if
Dr. Kletti and Dr. Shipko's denial is somehow tied to
Unum's compensation structure. ECF No. 26-1 at 6-8.
Defendants object to Plaintiff's requests as moot,
immaterial, and disproportionate to the needs of the case
under Fed.R.Civ.P. 26(b)(1). ECF No. 27.
19, 2017, Plaintiff moved to compel the above-described
discovery. ECF No. 26. On June 7, 2017, Unum opposed,
principally arguing that Plaintiff is not entitled to the
discovery because the administrative record is sufficient for
the Court to determine whether and the extent to which
Unum's conflict of interest improperly influenced
Plaintiff's benefits decision. Id. For the
following reasons, the Court agrees with Unum.
“the administration of ERISA plans should be left to
plan fiduciaries, not federal courts, ” judicial review
of plan administrator decisions is generally limited to the
evidence presented to the plan administrator at the time of
decision. Helton v. AT & T Inc., 709 F.3d 343,
352 (4th Cir. 2013); Clark v. Unum Life Ins. Co. of
Am., 799 F.Supp.2d 527, 531 (D. Md. 2011) (noting it is
“settled law in this circuit that a district court
reviewing a plan administrator's decision under a
deferential standard may consider only the evidence before
the administrator at the time of decision.”).
Accordingly, when a plaintiff requests extra-record discovery
into a defendant's alleged conflict of interest, the
court must determine “at the outset . . . whether or
not the administrative record contains enough information to
allow the court to properly weigh [the] [d]efendant's
admitted conflict of interest.” Clark, 799
F.Supp.2d at 533. The plaintiff bears the burden of
“provid[ing] a basis for the court to determine whether
such discovery would fill gaps in the record, and
demonstrat[ing] that such discovery is necessary to determine
the weight of administrator's conflict.”
Ferguson ex rel. Estate of Ferguson v. United Omaha Life
Ins. Co., No. ELH-12-1035, 2012 WL 6649192, at *2;
see also Griffin v. Hartford Life & Accident Ins.
Co., No. 16-24, 2016 WL 8795570 at *2 (W. D. Va. Sept.
27, 2016). Put differently, extra record discovery is
permitted only where the moving party plausibly alleges a
conflict of interest specific to the plaintiff's claim;
it is not warranted where the plaintiff's sole contention
rests on “alleged general unfairness” in a
defendant's business practices. Clark, 799
F.Supp. 2d. at 533-34. See also Griffin, 2016 WL
8795570 at *3; Lockard v. Unum Life Ins. Co. of Am.,
No. 15-21, 2015 WL 4730089 at *3-*4 (N. D. W.Va. Aug. 10,
2015). Thus, “the relevance and necessity of
[Plaintiff's] proposed extra-record discovery depends on
‘whether or not the administrative record contains
enough information to allow the court to properly weigh
Defendant's admitted conflict of interest.'”
Griffin, 2016 WL 8794470 at *3 (quoting
Clark, 799 F.Supp.2d at 533).
Plaintiff argues that additional discovery is necessary
because Unum's “Annual Incentive Plan, ” -
the yearly bonus plan for Unum employees that includes awards
of common stock based upon company performance -
impermissibly incentivized the reviewing physicians to deny
legitimate disability claims. See, e.g., ECF No.
26-1 at 8. Plaintiff argues that incentives based on company
performance, “especially where director-physicians are
required to hold company stock, serve to
produce a very troubling conflict of interest which
encourages claim denials.” Id. (emphasis in
original). In support, Plaintiff points to earlier cases and
government reports documenting Defendant Unum's biased
claims investigation practices. See, e.g., ECF No.
26-1 at 9.
acknowledges its inherent structural conflict of interest as
the plan's insurers and claims administrator. However,
Unum rightfully point out that the mere existence of its
Annual Incentive Plan is insufficient to transform a
generalized conflict into one affecting Unum's denial of
Plaintiff's claims. See ECF No. 27 at 14-32.
Unum further argues that the 7, 436 page administrative
record, which includes Unum's detailed claim
investigation and analysis, is sufficient for the Court to
determine the extent to which Unum's conflicting
interests influenced Plaintiff's benefits decision, if at
all. See ECF No. 27. Defendant contends that this is
especially true because it provided to Plaintiff Unum's
Annual Incentive Plan, Stock Incentive Plan of 2012, and 2015
Proxy Statement. See ECF No. 27-6. The Court agrees.
critical flaw in Plaintiff's Motion is her failure to
assert particularized facts that render extra-record
discovery necessary to explore Unum's conflict of
interest in adjudication of her particular claim.
Instead, Plaintiff broadly characterizes “Unum's
sordid history from unfair claims handling evidence”
and “the poor financial performance of Unum which has
compelled its conduct in denying disability cases to stem
losses and improve company profitability.” ECF No. 29
at 7-8. None of these statements, even if true, speak
specifically to Plaintiff's claim or to any
“gaps” in the administrative record that the
requested discovery would supplement. Accord Clark,
799 F.Supp.2d at 536 (D. Md. 2011) and Rickaby v.
Hartford Life & Accident Ins. Co., No.
WYD-NYW-16-813, 2016 WL 1597589 at *3-*4 (D. Co. Apr. 21,
2016) (“a simple tally of the number of grants and
denials would lack meaning”).
Plaintiff undercuts the need for the requested discovery by
noting that the administrative record demonstrates “a
selective review of the evidence followed by a naked
conclusion bereft of any reasoning, ” and characterizes
Drs. Kletti and Shipko's failure to conduct a personal
interview with the claimant as “unethical per
se.” ECF Nos. 26 at 11 & 29 at 14. If
Plaintiff's assertions regarding the administrative
record are true, then the record as it stands is sufficient
for the Court to assess to what extent Unum's conflict of
interest affected its review of Plaintiff's claims.
the requested discovery does not meet the requirements of
Federal Rule of Civil Procedure ...