United States District Court, W.D. Missouri, Western Division
Johnston, Plaintiff, represented by Benjamin F. Easter &
Kelly C. Tobin.
Commerce Bancshares, Inc., Defendant, represented by
Christopher M. McHugh, Seigfreid Bingham, P.C., Jordan Leigh
May, Seigfreid Bingham, P.C., Richard J. Pautler, Thompson
Coburn LLP & Shannon Dawn Johnson, Seigfreid Bingham, P.C..
Prudential Insurance Company of America, Defendant,
represented by Richard J. Pautler, Thompson Coburn LLP, Ada
W. Dolph, Seyfarth Shaw LLP, pro hac vice & Alexius C.
O'Malley, Seyfarth Shaw LLP, pro hac vice.
ORDER GRANTING IN PART MOTION FOR ADDITIONAL
KAYS, Chief District Judge.
ERISA action arises from Defendant Prudential Insurance
Company of America's ("Prudential") termination
of Plaintiff's long-term disability benefits.
before the Court is Plaintiff's motion to allow discovery
beyond the administrative record (Doc 34). Because Plaintiff
has shown good cause to conduct some limited discovery
outside of the administrative record, the motion is GRANTED
may discover: (1) internal communications from Prudential
related to the reason his particular file was brought up for
review; and (2) Standard Operating Procedures
("SOP") used by Prudential to determine when to
review and terminate benefits, including SOP outlining any
criteria used for triggering a review. This discovery is
limited to requests for production of documents and things,
and it excludes taking any depositions.
Commerce Bancshares, Inc. ("Commerce"), employed
Plaintiff as a senior computer programmer. As part of his
compensation, it provided him with long-term disability
insurance purchased from Prudential. Under the policy,
Prudential operated as both the claims administrator and the
plan administrator who owed a fiduciary duty to the plan
participants. As such, an inherent conflict of interest
existed. Metro. Life Ins. Co. v. Glenn, 554 U.S.
105, 112, 114 (2008).
2013, doctors found Plaintiff had a colloid cyst resulting in
hydrocephalus, a condition which caused fluid buildup in his
brain. Plaintiff had brain surgery to correct the problem,
but apparently the procedure was not totally successful: the
Social Security Administration declared Plaintiff totally
disabled, and in November of 2013, Prudential determined he
qualified for long-term disability benefits under the policy.
January 2014, Commerce selected a new insurance company to
provide disability insurance benefits, thus Prudential would
not receive any premium payments for new policies.
(Plaintiff, of course, retained any right to benefits he may
have had under Prudential's policy.) Two months later,
Prudential began reviewing Plaintiff's continued
eligibility for benefits. On October 2, 2014, Prudential
terminated Plaintiff's benefits retroactively, effective
August 31, 2014.
subsequently sued Defendants under ERISA.
and Plaintiff hotly dispute the reasons why Prudential began
reviewing his claim. Prudential contends that after it
approved Plaintiff's claim it received additional medical
records from Plaintiff's doctors that led it to question
whether he was eligible for benefits. At least one of the
reviewing doctors who examined these records questioned
whether Plaintiff fully exerted himself in the testing.
Plaintiff argues that the timing of events suggests that
after Commerce terminated its relationship with Prudential,
Prudential acted in its own self-interest to clear its books
of a long-term financial liability in violation of its
fiducial duty to Plaintiff as a plan participant.
now moves to conduct discovery outside of the administrative