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Black v. Hartford Life Insurance Co.

United States District Court, D. Oregon

August 14, 2018

DAVID BLACK, Plaintiff,

          Megan E. Glor John C. Shaw Megan E. Glor, Attorneys at Law, PC Attorneys for Plaintiff

          Russell S. Buhite Ogletree, Deakins, Nash, Smoak & Stewart, P.C. Attorney for Defendant

          OPINION & ORDER


         Before the Court is Plaintiff David Black's Motion to Compel Production [15]. Plaintiff brought this action against Defendant Hartford Life & Accident Insurance Company (“Hartford”), alleging that it wrongfully terminated his long term disability (“LTD”) benefits claim in violation of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq. Plaintiff seeks a Court order compelling Defendant to produce three categories of documents by responding to Requests for Production 1-3, 6-9, and 12-16. See Mot. to Compel 2, ECF 15.

         The Motion is GRANTED in part.


         Plaintiff was employed by DMX Music as a Lead Customer Service Representative. Compl. ¶¶ 4-8, ECF 1. Plaintiff was diagnosed with Atypical Parkinson's Disease and obtained LTD benefits beginning in December of 2005. Id. at ¶¶ 9-11. Plaintiff's LTD policy is insured by Hartford, which is responsible for determining Plaintiff's eligibility for benefits and for paying benefit awards. Id. at ¶¶ 1, 8; Glor Decl. Ex. B, at 1, ECF 16. Plaintiff was granted an initial twenty-four months of LTD benefits based on his inability to perform material duties of his “own occupation.” Compl. ¶ 12; Glor Decl. Ex. B, at 69. After the twenty-four month period ended, Plaintiff continued to receive benefits under the more stringent “any occupation” standard. Compl. at ¶ 13; Glor Decl. Ex. B, at 69. Plaintiff received LTD benefits for approximately nine years under the “any occupation” standard. Glor Decl. Ex. B, at 66-72.

         From the outset of Plaintiff's LTD claim, Defendant directed Plaintiff to apply for Social Security Disability Income (“SSDI”) benefits. Id. at 75-76. Plaintiff applied for SSDI benefits. In 2009, the Social Security Administration (“SSA”) determined that he was “unable to perform any work existing in significant numbers in the national economy.” Id. at 78. SSA determined that Plaintiff was disabled as of February 1, 2006, and it awarded him benefits he should have received since that date. Id. Plaintiff's retroactive SSDI benefits award offset Defendant's prior LTD benefit payments to Plaintiff. Id. at 81. As a result, Plaintiff's monthly LTD payments were roughly cut in half and Plaintiff paid Defendant $24, 780 out of the SSDI award to cover Defendant's overpayment. Id. In the seven years following SSA's determination, the nature of Plaintiff's disabling condition was regularly confirmed by physicians and Defendant. Id. at 82- 97.

         On November 20, 2015, Defendant's Special Investigation Unit (“SIU”) proactively began investigation Plaintiff's LTD claim based on online information that Plaintiff had started a business. Id. at 98. Defendant hired a third-party vendor to conduct surveillance of Plaintiff. Id. at 101-105. The video surveillance showed Plaintiff walking with a cane, using public transportation, going to the bank, getting his hair cut, shopping, and carrying groceries. Id. Defendant also found an online YouTube video of Plaintiff playing in a band in May of 2014. SIU scheduled an interview with Plaintiff which was conducted on March 17, 2016. Id. at 123. Regarding his purported business, Plaintiff explained that he had registered a business but that he never derived any income from it and continued paying to maintain the corporate license to keep alive his hope of someday working again. Id. at 142-43. Moreover, Defendant hired neurologist Dr. Robert Egan, who examined Plaintiff on June 14, 2016. Based on Dr. Egan's examination and review of Defendant's surveillance footage, he concluded that Plaintiff did not have Atypical Parkinson's disease. Id. at 156.

         On August 31, 2016, Defendant wrote a letter to Plaintiff informing him that his LTD benefits claim had been terminated. Id. at 157-69. Plaintiff appealed the decision, proffering additional medical reports and explaining that in the YouTube video, he could clearly be seen sitting the back playing drums, not out front playing guitar. Id. at 173-76. Defendant denied Plaintiff's appeal. Plaintiff then filed this lawsuit alleging that Defendant abused its discretion under ERISA when it decided to terminate his LTD benefits claim. Plaintiff filed a Motion to Compel Production, seeking three categories of documents responsive to Plaintiff's first requests for production. Defendant opposes the motion.


         Under Rule 26 of the Federal Rules of Civil Procedure, parties “may obtain discovery regarding any nonprivileged matter that is relevant to any party's claim or defense and proportional to the needs of the case . . . .” Fed.R.Civ.P. 26(b)(1). In ERISA cases, discovery may be limited because the statute's primary goal is to provide inexpensive and expeditious resolution to employee benefits claims. Boyd v. Bert Bell/Pete Rozelle NFL Players Retirement Plan, 410 F.3d 1173, 1178 (9th Cir. 2005) (citing Taft v. Equitable Life Assurance Soc'y, 9 F.3d 1469, 1472 (9th Cir. 1993). District courts are generally limited to the administrative record unless a so-called structural conflict of interest exists. Montour v. Hartford Life & Acc. Ins. Co., 588 F.3d 623, 630 (9th Cir. 2009). A conflict of interest exists where the “the entity that administers the plan, such as an employer or an insurance company, both determines whether an employee is eligible for benefits and pays benefits out of its own pocket.” Metro. Life Ins. Co. v. Glenn, 554 U.S. 105, 108 (2008). Where this conflict of interest exists, the plaintiff may be entitled to discovery outside of the administrative record to determine the “nature, extent, and effect” the conflict may have had on the decision-making process. Burke v. Pitney Bowes Inc. Long-Term Disability Plan, 544 F.3d 1016, 1028 (9th Cir. 2008) (quoting Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 970 (9th Cir. 2006)).


         Plaintiff seeks production of three categories of documents, the first two he refers to ...

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