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Leonora Glunt v. Life Insurance Company of North America

March 15, 2012

LEONORA GLUNT, PLAINTIFF,
v.
LIFE INSURANCE COMPANY OF NORTH AMERICA,
DEFENDANT.



The opinion of the court was delivered by: Schiller, J.

MEMORANDUM

In this Employee Retirement Income Security Act ("ERISA") case, Leonora Glunt seeks short-term disability benefits under a policy that she had through her employer, which was which was administered by the Life Insurance Company of North America ("LINA"). On January 24, 2012, following oral argument, the Court found that Glunt produced satisfactory evidence that she qualifies as disabled under the policy and granted Glunt's motion for summary judgment and denied LINA's motion for summary judgment. Pending before the Court is Glunt's motion for attorneys' fees. For the reasons that follow, the Court will grant Glunt's motion.

I. BACKGROUND

Glunt was a phlebotomist at Quest Diagnostics. LINA provided short-term disability ("STD") coverage for Quest employees. Due to a panic disorder, Glunt stopped working at Quest on April 27, 2010. She filed a claim with LINA for STD benefits on May 3, 2010, which her treating physician Dr. Sisbarro supported with office visit notes and a behavioral health questionnaire claim form. On May 25, 2010, LINA reviewed Glunt's claim and concluded that the record did not support a finding that Glunt was disabled. On June 2, 2010, Glunt appealed LINA's denial of benefits, and her doctors submitted additional information in support of her claim. On August 23, 2010, LINA reviewed Glunt's record and again found insufficient clinical information to support Glunt's claim for benefits. On August 25, 2010, LINA affirmed its previous decision to deny benefits.

On April 22, 2011, Glunt filed a Complaint in the Lancaster County Court of Common Pleas, which LINA removed to this Court on May 12, 2011. The parties filed cross-motions for summary judgment. The Court granted Glunt's motion for summary judgment after finding sufficient evidence that Glunt satisfied the definition of "disabled" under the policy. Glunt now seeks attorneys' fees and costs.

II. STANDARD OF REVIEW

A district court has discretion to award a "reasonable attorney's fee and costs of action" under ERISA. 29 U.S.C. § 1132(g)(1). However, fees may only be awarded to a claimant who achieves "some degree of success on the merits." Hardt v. Reliance Standard Life Ins. Co., __ U.S. __, 130 S. Ct. 2149, 2158 (2010). This standard requires more than "trivial success on the merits" or a "purely procedural victory." Id. at 2158.

III. DISCUSSION

A. Glunt Satisfies the "Some Degree of Success" Standard

Glunt has clearly achieved success on the merits of her claim as the Court granted summary judgment in her favor. The Court determined that: (1) Glunt produced evidence satisfactory to show that she was disabled under LINA's policy; (2) LINA's insistence on a statement of severity, intensity, duration, and frequency of Glunt's symptoms to demonstrate functional incapacity added an additional hurdle not required by the policy, and regardless, Glunt's doctors provided such information; (3) LINA's decision to forego an independent medical examination of Glunt, given the subjective nature of her anxiety and its resulting limitations, further limited its ability to evaluate contrary medical evidence; (4) LINA accepted Glunt's doctors' diagnoses but impermissibly refused to accept their prognosis of her resulting limitations; (5) LINA selectively read Glunt's medical records to justify its denial of her claims; and (6) LINA had no reasonable basis to conclude that Glunt could safely and reliably perform as a phlebotomist given her medical condition. Glunt has achieved far more than trivial success on the merits or a purely procedural victory.

B. The Ursic Factors Tip in Favor of Glunt

Prior to the Supreme Court's decision in Hardt, courts in the Third Circuit applied a five factor test to determine whether to award attorneys' fees in ERISA cases. Ursic v. Bethlehem Mines, 719 F.2d 670, 673 (3d Cir. 1983). In Hardt, the Supreme Court held that while not required, after meeting the "some degree of success" test, a court may still consider the five factor test to determine whether to award attorneys' fees. Hardt, 130 S. Ct. at 2158 n.8 ("We do not foreclose the possibility that once a claimant has satisfied this requirement, and thus becomes eligible for a fees award under § 1132(g)(1), a court may consider the five factors adopted by the Court of Appeals in deciding whether to award attorney's fees.") (citing Fourth Circuit's five factor test set out in Quesinberry v. Life Ins. Co. of North Am., 987 F.2d 1017, 1029 (4th Cir. 1993)). District courts throughout this Circuit have tended to continue to apply the Ursic factors after determining the success on the merits. See, e.g., Templin v. Independence Blue Cross, Civ. A. No. 09-4092, 2011 WL 3664427, at *4 (E.D. Pa. Aug. 19, 2011) (applying Ursic factors); Howley v. Mellon Fin. Corp., Civ. A. No. 06-5992, 2011 WL 2600664, at *1 (D.N.J. Jun 27, 2011) (noting that Ursic factors are not required and bear no relationship to 1132(g)(1) test but applying the factors nonetheless).

Since both Plaintiff and Defendant addressed the Ursic factors in their briefs, and because the Court finds them helpful in guiding its discretion, the Court will evaluate the Ursic factors here. However, the factors are flexible guidelines, and no single factor is determinative. Trucking Emps. of N. Jersey Welfare Fund, Inc. v. Brockway Fast Motor Freight Co., 130 F.R.D. 314, 325 (D.N.J. 1989).

The five Ursic factors are: "(1) the offending parties' culpability or bad faith; (2) the ability of the offending parties to satisfy an award of attorneys' fees; (3) the deterrent effect of an award of attorneys' fees against the offending parties; (4) the benefit conferred on members of the pension plan as a whole; and (5) the relative merits of the parties' position." Ursic, 719 F.2d at 673. There is no presumption that a successful plaintiff in an ERISA lawsuit recovers attorneys' fees in the absence of exceptional circumstances, nor is there a presumption that exceptional circumstances are required for prevailing plaintiffs to be entitled to attorneys' fees. Tomasko v. Weinstock, 255 F. App'x 676, 680 (3d Cir. 2007) (citing McPherson v. Emps.' Pension Plan of Am. Re-Ins. Co., 33 F.3d 253, 254 (3d Cir. 1994)). Rather, "the defendant in an ERISA action usually bears the burden of attorney's fees for the prevailing plaintiff or plaintiff class, thus encourag[ing] private enforcement of the statutory substantive ...


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