United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER
RICHARD WEBBER SENIOR UNITED STATES DISTRICT JUDGE
matter comes before the Court on Plaintiff's Motion for
Limited Discovery [ECF No. 24].
case arises under the Employee Income Security Act
(“ERISA”), 29 U.S.C. § 1001 et seq., to
attempt to recover benefits under an employee welfare benefit
plan and insurance program. Defendants Ascension Health
Alliance and Sedgwick Claims Management Services,
Incorporated (“Defendants”) denied
Plaintiff's claim for ongoing disability benefits.
Plaintiff asks the Court to order Defendants to continue
paying her disability benefits. In her motion, Plaintiff asks
the Court to allow her to conduct limited discovery outside
of the administrative record including: (1) production of
Ascension's Administrative Services Agreement; (2) a
deposition of Ascension's corporate representative about
any conflict of interests between Ascension and Sedgwick; and
(3) issuance of a subpoena to Dane Street, a third-party
vendor, for documents and a deposition of a corporate
representative to explore an alleged procedural irregularity
in Dane Street's process of obtaining and reviewing
reports from independent medical professionals relied upon in
denying Plaintiff's claim.
deferential standard of review of the denial of benefits may
be applied in cases where a claimant has presented
“material, probative evidence demonstrating that (1) a
palpable conflict of interest or a serious procedural
irregularity existed, which (2) caused a serious breach of
the plan administrator's fiduciary duty.” Woo
v. Deluxe Corp., 144 F.3d 1157, 1160 (8th Cir. 1998).
The United States Supreme Court held a conflict of interest
exists when the entity that administers the plan “both
determines whether an employee is eligible for benefits and
pays benefits out of its own pocket.” Metropolitan Life
Ins. Co. v. Glenn, 554 U.S. 105, 108 (2008). However, Glenn
made it clear that the presence of a conflict of interest
does not entitle the claimant to de novo review. Wakkinen
v. UNUM Life Ins. Co. of America, 531 F.3d 575, 581 (8th
Cir. 2008); see also Chronister v. Unum Life Ins. Co. of
America, 563 F.3d 773, 775 (8th Cir. 2009) (abuse of
discretion standard remains the appropriate standard for
evaluating plan administrator's decision).
have varied in their assessment of Glenn's impact on
discovery in ERISA cases. Before Glenn, discovery was not
permitted in cases reviewed for abuse of discretion.
Following Glenn, courts in this district have permitted some
discovery in ERISA cases. See, e.g., Sampson v.
Prudential Life Ins. Co. of America, No. 4:08CV1290 CDP,
2009 WL 882407 (E.D.Mo. Mar. 26, 2009); Winterbauer v.
Life Ins. Co. of No. America, No. 4:07CV1026 DDN, 2008
WL 4643942 (E.D.Mo. Oct. 27, 2008). The scope of that
discovery, however, has been limited to determining whether a
conflict of interest or procedural irregularity exists.
See, e.g., T.D.E. v. Life Ins. Co. of No. America,
No. 4:07CV1387 CDP, 2009 WL 367701 *4 (E.D.Mo. Feb. 11, 2009)
(“Discovery is required to explore the nature and
extent of the purported conflict or irregularity at
issue.”); Winterbauer, 2008 WL 4643492 at *5-6
(stating “it seems logical to allow some discovery on
issues related to” the Glenn factors).
have agreed to production of the Administrative Services
Agreement if the Court permits Defendants to redact any
dollar amounts contained in the agreement. Plaintiff did not
respond to Defendants' request for redaction in her
reply. The Court will permit the redaction and require
Defendants to supply the Administrative Services Agreement to
Plaintiff within five days of this order.
Court will also require production of the internal claims
handling guidelines. See Ennis v. Prudential Ins. Co. of
America, No. 4:12CV00432 SNLJ, 2013 WL 203293 at *2
(E.D. Mo. Jan. 17, 2013) (holding the internal claims
handling manuals are discoverable when discerning whether the
administrator followed its own internal procedures.).
However, the Court will not permit Plaintiff to take a
deposition of a corporate representative of Ascension. A
deposition of a corporate representative requires significant
time and resources and Plaintiff has not established a
deposition is needed to establish a conflict of interest in
this case. See Westbrook v. Georgia-Pacific Corp.,
No. 4:05-CV-01331 GTE, 2006 WL 2772822 at *4 (E.D. Ark. Sept.
26, 2006) (“It is incumbent on ERISA plaintiffs seeking
limited discovery to specifically demonstrate to the court
why the discovery is necessary to prove their particular
theory and . . . is more than a fishing expedition.”).
addition to the documents and deposition requested from
Ascension, Plaintiff asks the Court to allow a subpoena be
issued to Dane Street, a third-party vendor from which
Defendants obtain independent medical reviews, for numerous
documents and a deposition of a corporate representative.
Plaintiff asserts the additional discovery is needed to
establish a procedural irregularity in the decision to deny
Plaintiff benefits. In support of this argument, Plaintiff
states the four physicians' reports, relied upon by
Defendants to deny Plaintiff's claim, contain nearly
identical language in each report creating doubts about their
Court finds the similarity in language between the four
physicians' reports to be concerning and may indicate
evidence of a procedural irregularity. However, the discovery
Plaintiff seeks from Dane Street is excessive, especially in
an ERISA case where discovery is limited. The Court will
allow discovery of the following documents requested by
Plaintiff: (1) the contract or agreement between Defendant(s)
and Dane Street pursuant to which Dane Street provided
medical review services to Defendant(s); (2) any directions
provided by Dane Street to the reviewing physicians; and (3)
the number of reviews the physicians have performed for Dane
Street on behalf of Defendants. The remaining documents
Plaintiff seeks do not have any relevance to the
irregularities Plaintiff asserts. The Court will not allow
Plaintiff to take a deposition of a corporate representative
of Dane Street. Plaintiff has not provided sufficient
evidence to support such discovery in this matter.
IT IS HEREBY ORDERED that Plaintiffs Motion for Limited
Discovery [ECF No. 24] is ...