United States District Court, M.D. Pennsylvania
MATTHEW W. BRANN, District Judge.
Before the Court is Defendant Liberty Life Assurance Company of Boston's Motion for a Protective Order to Prohibit Conducting Depositions Requested by Plaintiff and a Brief in Support of that Motion (ECF Nos. 21, 22). The Motion seeks to prohibit Plaintiff Scott Cipriani from conducting two depositions the Defendant asserts are beyond the scope of appropriate discovery for this action. The Plaintiff filed a Brief in Opposition to the Motion (ECF No. 24) and the Defendant filed a Reply Brief (ECF No. 25).
For the following reasons, the Motion is granted in part and denied in part.
This action concerns a claim asserted by Plaintiff Scott Cirpriani seeking long term disability benefits filed pursuant to the Employee Retirement Income Security Act (ERISA), §502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B). Liberty Life Assurance Company of Boston ("Defendant" or "Liberty Life") is the insurer for benefits under the long term disability plan provided by Plaintiff's employer, The Turner Corporation ("Turner"). Liberty Life provides long term disability insurance to Turner employees under a group disability income policy ("Turner LTD Policy"). Cipriani was covered under the Turner LTD Policy as a result of his employment as a Project Superintendent for Turner.
Cipriani commenced disability leave from his position at Turner on February 23, 2009, following a motor vehicle accident in which he was injured. Cirpriani received benefits under a Turner Short Term Disability plan until the maximum 90-day period expired. On May 25, 2009, Cipriani began to receive long term disability benefits under the Tuner LTD Plan.
Under the policy, persons in Cipriani's employment class were eligible to receive benefits for a 24-month period if their medical conditions prevented them from performing the material duties of their occupations. After benefits were paid for the 24-month period, a person was eligible to continue receiving benefits if his medical condition prevents him from performing the material duties of any occupation.
Cipriani received benefits under the Turner LTD Policy from May 25, 2009 through November 17, 2011 when benefits were discontinued due to Liberty Life changing Cipriani's disability status to an "any occupation" definition. Liberty Life asserted that the discontinuance of benefits was based upon its determination that Cipriani's physical conditions did not prevent him from returning to any alternative occupations identified during the administrative review process. Cipriani pursued an administrative appeal that was denied on June 11, 2012. Cipriani then filed the instant action.
In support of his claims, Cipriani seeks to take two depositions subject to the instant motion that Liberty Life desires to prevent: depositions of Stephanie Berry ("Berry") and Dr. Ronald Disimone (Dr. Disimone). Berry is the Liberty Life claim representative principally responsible for Liberty Life's final administrative decisions. Dr. Disimone was one of Plaintiff's treating physicians consulted in the review process. Liberty Life objects because it asserts these depositions are directed solely to the merits of Liberty Life's administrative decision, which is not appropriate discovery in an ERISA action in this posture.
A. ERISA Discovery
ERISA empowers a person denied benefits under an employee benefit plan to challenge that denial in federal court. 29 U.S.C. § 1132(a)(1)(B). The conflicting values at issue in the Motion sub judice are the general limitation on discovery in ERISA actions and the strain of cases recognizing that limited discovery is appropriate in a narrow set of circumstances. A fundamental goal of ERISA is to provide "a method for workers and beneficiaries to resolve disputes over benefits inexpensively and expeditiously." Accord Semien v. Life Ins. Co. of N. Am. , 436 F.3d 805, 815 (7th Cir. 2006) (quoting Perry v. Simplicity Eng'g , 900 F.2d 963, 967 (6th Cir. 1990)) (internal quotations omitted). Consequently, discovery is often limited in ERISA actions; in some cases, depending on the court's applicable standard of review, discovery beyond the administrative record is inappropriate.
The United States Supreme Court articulated the appropriate standard of review for this species of ERISA action, stating that "a denial of benefits challenged under § 1132(a)(1)(B) is to be reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan." Firestone Tire & Rubber Co. v. Bruch , 489 U.S. 101, 115 (1989). When the challenged plan grants the administrator discretionary authority by its terms, the applicable standard of review is "arbitrary and capricious." Estate of Kevin Schwing v. Lilly Health Plan , 562 F.3d 522, 525 (3d Cir. 2009). Under this standard, an administrator's interpretation of the plan "will not be disturbed if reasonable." Id. at 114; see also Mitchell v. Eastman Kodak Co. , 113 F.3d 433, 437 (3d Cir. 1997). "To be insulated from de novo review, a plan must communicate the idea that the administrator not only has broad-ranging authority to assess compliance with pre-existing criteria, but also has the power to interpret the rules, to implement the rules, and even to change them entirely." Viera v. Life Ins. Co. of N. Am. , 642 F.3d 407, 417 (3d Cir. 2011) (internal quotations and citations omitted).
The policy in this case vests Liberty Life with the authority and discretion to construe the terms of the policy and to determine benefit eligibility. Both the construction and determinations have conclusive and binding effect. Specifically, the policy states:
Liberty shall possess the authority, in its sole discretion, to construe the terms of this policy and to determine benefit eligibility hereunder. Liberty's decisions regarding construction of the terms of this policy ...