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Greene v. Hartford Life & Accident Ins. Co.

United States District Court, E.D. Pennsylvania

February 6, 2015

JEFFREY A. GREENE, Plaintiff,
v.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY, Defendant

For JEFFREY A. GREENE, Plaintiff: WILL ROSENZWEIG, LEAD ATTORNEY, BLANK ROME LLP, PHILADELPHIA, PA.

For HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY, Defendant: JOSHUA BACHRACH, LEAD ATTORNEY, WILSON ELSER MOSKOWITZ EDELMAN & DICKER LLP, PHILADELPHIA, PA.

MEMORANDUM OPINION

MITCHELL S. GOLDBERG, Judge.

Plaintiff Jeffrey A. Greene brings this Employee Retirement Income Security Program (" BRISA") action seeking life insurance benefits from Defendant Hartford Life and Accident Insurance Company (" Hartford"). He alleges that Defendant wrongfully denied these benefits following the death of his wife, Anita Greene. Before me is Plaintiff's request to obtain fact discovery from Defendant as well as Ms. Greene's employer.

I. Procedural and Factual History

Ms. Greene held a life insurance policy administered and funded by Hartford through her employer, TD Bank (" TD"). The policy grants Hartford the discretionary authority to determine a policyholder's eligibility for coverage. Ms. Greene began her employment TD as a loan officer on October 29, 2012. On November 20, 2012, Ms. Greene was diagnosed with a recurrence of breast cancer and passed away on December 6, 2012. Plaintiff alleges that during the time between her diagnosis and passing, Ms. Greene continued to work using a company-issued laptop and remote connection device.

Following her death, TD submitted a claim for life insurance benefits to Hartford on Plaintiff's behalf. On the initial claim form, TD listed Ms. Greene's " actual last day physically at work" as December 5, 2012. Two weeks later, on January 7, 2013, TD submitted a revised claim form, with the December 5, 2012 date crossed out and November 19, 2012 written in its place. Hartford denied the claim on the basis that Ms. Greene had not provided the requisite one month of " continuous service" to be eligible for benefits under the policy because she stopped working on November 19, 2012. The denial of benefits was affirmed on appeal.

Plaintiff contends that Ms. Greene's job could be performed away from the office and that she continued to work while hospitalized, with TD's knowledge. Accordingly, Plaintiff claims that Ms. Greene provided the one month of continuous service necessary for eligibility.

Plaintiff filed a complaint for declaratory relief (Count I); damages in the full amount due under the policy pursuant to 29 U.S.C. § 1132(a)(1)(B) (Count II); and breach of fiduciary duty under 1132(a)(3) (Count III). On September 10, 2014, Hartford's motion to dismiss Count III was granted.

While the motion to dismiss was pending, Plaintiff served Hartford with interrogatories and requests for documents and TD with a subpoena for Ms. Greene's employment records. Hartford objected to both requests on the basis that discovery was premature and that any factual discovery in this ERISA matter is prohibited.

Following a status conference on October 15, 2014, I permitted Plaintiff to obtain written discovery from TD and directed the parties to submit letter briefs regarding Plaintiff's additional discovery requests after TD produced certain records. After receiving these records, Plaintiff proposed additional expansive discovery. The parties have submitted letter briefs outlining their positions regarding the proper scope of discovery in this matter.

II. The Parties' Positions

Plaintiff argues further discovery is appropriate at this juncture because 1) it was " impossible" for Plaintiff to obtain discovery during the administrative process and fairness and justice require that he be allowed to obtain discovery now, and 2) Hartford harbored a conflict of interest and such conflicts are a basis for granting discovery outside of the administrative record. Plaintiff asserts that he has a good faith basis for alleging that Hartford harbored a conflict of interest because Hartford both administers and funds the plan and the altered claim form suggests a procedural irregularity.

Hartford counters that the mere assertion of a structural conflict -- i.e. that an entity both administers and funds a plan -- is not a sufficient showing to warrant discovery in an BRISA case. Regarding the altered claim form, Hartford contends that a TD employee initially entered December 5, 2012 based on information " from a computer" and later obtained the " real" date -- November 19, 2012 -- from Ms. Greene's manager. According to Hartford, these events do not suggest a procedural irregularity because it was not possible that Ms. Greene was continuing to render service on December 5, 2012 as she was in hospice care as of December 3, 2012. Therefore, ...


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