District Court Grants Plaintiff Limited Discovery Upon Allegation of Insurer Bias In ERISA Benefits Action

In Dotson v. Metropolitan Life Insurance Company, No. CR 5:23-178-DCR, 2024 WL 532301 (E.D. Ky. Feb. 9, 2024), Kentucky Eastern District Chief Judge Danny C. Reeves granted Plaintiff’s motion to compel, finding that Plaintiff sufficiently alleged the existence of bias to warrant limited discovery outside the “administrative record” in this ERISA action seeking long-term disability benefits.

In 2021, Plaintiff submitted a claim for long-term disability benefits under a group LTD policy insured by MetLife. MetLife paid benefits for a period of time due to symptoms of the COVID-19 virus before terminating benefits in July 2022. MetLife upheld its decision on appeal. In the ensuing litigation, MetLife objected to Plaintiff’s written interrogatories and requests for production of documents arguing that Plaintiff was not entitled to obtain discovery outside of the administrative record.

On Plaintiff’s motion to compel, the Court noted that, notwithstanding the broad restriction on discovery in ERISA matters, limited discovery is available if the claimant makes a satisfactory allegation of a violation of due process or bias by the plan administrator. The Court analyzed the applicable law within the Sixth Circuit, noting first that in MetLife Ins. Co. v. Glenn, 554 U.S. 105, 117 (2008), the Supreme Court held that there is a per se conflict of interest when a plan administrator is responsible for both evaluating and paying benefits on a claim. The Glenn court counseled that a reviewing court should consider this inherent conflict as a factor in determining whether the plan administrator abused its discretion in denying benefits, and that “the significance of the factor will depend upon the circumstances of the particular case.” The Court next analyzed ensuing Sixth Circuit decisions which interpreted Glenn to mean that threshold evidentiary showings are not required for discovery in ERISA cases. See Johnson v. Conn. Gen. Life Ins. Co., 324 F. App’x 459, 466 (6th Cir. 2009). The Court noted, however, that the Sixth Circuit expressly declined to conclude that discovery would automatically be available any time the defendant was the administrator and payor under an ERISA plan and found that the district courts were “well equipped” to evaluate and determine to what extent limited discovery is appropriate.

In opposition, MetLife pointed out that subsequent Sixth Circuit decisions have provided additional guidance requiring that a claimant provide more than just a mere allegation of bias to justify prehearing discovery. In Collins v. Unum Life Insurance Co. of America, 682 F. App’x 381 (6th Cir. 2017), the Sixth Circuit affirmed the denial of discovery noting that a claimant “must put forth a factual foundation to establish that he has done more than merely allege bias.” The Court reasoned that while Collins appeared to suggest that the existence of an inherent conflict of interest is not “evidence of bias,” the Collins court did not explain how imposing an evidentiary threshold complies with Glenn or Johnson. In granting Plaintiff’s motion to compel, the Court adhered to the position that an inherent conflict of interest is, in and of itself, some evidence of bias. It further reasoned that there is no practical way to determine the extent of an administrator’s conflict of interest without looking beyond the administrative record.

If MetLife or your insurance company has denied or terminated your disability claim, contact us for assistance.