Opinion
No. C 08-1575.
April 1, 2010
ORDER DENYING MOTIONS FOR SUMMARY JUDGMENT WITHOUT PREJUDICE; AFFORDING PLAINTIFF OPPORTUNITY TO CONDUCT DISCOVERY; DIRECTIONS TO PARTIES
Before the Court are (1) plaintiff Louis J. Vela's motion for summary judgment, filed February 24, 2009 and (2) defendant AT T Umbrella Benefit Plan's cross-motion for summary judgment, filed March 20, 2009, each brought pursuant to Rule 56 of the Federal Rules of Civil Procedure. Also before the Court are the parties' supplemental briefings on the issues raised by the Court as to (1) whether the term "Benefits Payable" under plaintiff's Disability Income Plan ("DIP") refers to plaintiff's gross or net benefits, (2) whether any estoppel exists based on statements made by defendant to plaintiff's wife, and (3) the appropriate remedy if liability is established. Having considered the parties' respective submissions, the Court, as discussed below, will deny both motions without prejudice.
In the course of the supplemental briefing, defendant sought to offer a declaration by Tonya Warner ("Warner") for the purpose of showing the claims administrator has consistently interpreted the phrase "Benefits Payable" in the subject DIP to refer to gross benefits. (See Warner Decl. at ¶¶ 7-12.) Plaintiff objects to the Court's consideration of the Declaration on the grounds that it constitutes evidence outside the administrative record and because discovery has closed.
To the extent plaintiff may be arguing the Declaration is untimely, the Court finds to the contrary. The Declaration was submitted solely in connection with the first of the above-referenced three issues on which supplemental briefing was allowed, which issue was not raised until the Court asked the parties to address it at the Case Management Conference held on December 18, 2009.
The scope of the evidence a district court may consider in reviewing a decision to deny a claim under ERISA depends on whether the standard of review is abuse of discretion or de novo.See Abatie v. Alta Health Life Ins. Co., 458 F.3d 955, 970 (9th Cir. 2006). In the instant case, the parties dispute the proper standard under which the decision at issue should be reviewed, and further, if the standard is deemed to be abuse of discretion, the degree of skepticism with which the Court should review said decision. (See Pl.'s MSJ Reply at 2:17-21; see also Def.'s MSJ Reply at 7:5-10.)
Under either standard of review, however, the Court finds, on the record before it, the Declaration is relevant and admissible.See McDaniel v. Chevron Corp., 203 F.3d 1099, 1113 (9th Cir. 2000) (holding "consistent pattern of interpretation is significant evidence" as to reasonableness of plan interpretation) (internal quotation and citation omitted);Abatie, 458 F.3d at 968-70 (holding, under abuse of discretion standard, a "district court may . . . consider evidence outside the administrative record to decide the nature, extent, and effect on the decision-making process of any conflict of interest"; in determining Court's degree of skepticism "[a] Court may weigh a conflict more heavily if . . . the administrator provides inconsistent reasons for denial . . . or has repeatedly denied benefits to deserving participants by interpreting plan terms incorrectly"); Jebian v. Hewlett Packard, 349 F.3d 1098, 1110 (9th Cir. 2002) (holding, under de novo review, trial court may admit additional evidence, beyond the record before the claims administrator, to "enable the full exercise of informed and independent judgment").
Nonetheless, as plaintiff points out, the documents on which Warner relies have not been submitted in connection with the Declaration and plaintiff has not had an opportunity to conduct discovery with respect to any such additional evidence. Under the circumstances, the Court will deny both motions for summary judgment without prejudice and will afford plaintiff the opportunity to seek discovery with respect to defendant's newly proffered evidence.
Accordingly, for the reasons stated above:
1. The parties' pending motions for summary judgment are hereby DENIED without prejudice.
2. Plaintiff may conduct limited discovery relevant to defendant's additional evidence; upon completion of such discovery, the parties shall renotice their motions for summary judgment, and, if appropriate, submit in connection therewith a stipulated schedule for additional supplemental briefing.