In a dispute governed by the Employee Retirement Income Security Act (“ERISA”), Martin v. The Guardian Life Insurance Company of America, No. CV 5:20-507-DCR, 2021 WL 1994229 (E.D. Ky. May 17, 2021), a district court recently ordered the Defendant, Guardian Life Insurance Company of America (“Guardian”), to produce two employees for deposition as well as produce discovery responses going to its reviewing doctors’ conflict of interest. If an insurance company has ever denied your claim for long-term disability (“LTD”) benefits, it likely relied on a reviewing doctor who may be financially motivated to say that you have sufficient work capacity to not qualify for benefits.
In Martin, Plaintiff William Martin moved to compel Guardian to produce two employees who were involved in his LTD claim decision for a deposition. Specifically, he wanted to depose Delondria Terry, the Group LTD Senior Case Manager who signed the first denial of his LTD claim, and Christina Moretz, the Appeals Case Manager II who signed the denial of his claim after he submitted an appeal. Guardian refused to make them available for questioning, instead arguing that producing a Rule 30(b)(6) representative would be sufficient. The court sided with Martin. It explained that courts within the district have routinely granted plaintiffs’ motions to compel depositions in ERISA cases where the depositions are limited to issues of due process violation, bias, or conflict of interest. However, the court did deny Martin’s request that Guardian be sanctioned for its refusal to produce these employees for deposition. It explained that most of the case law on the issue of ERISA discovery is unsettled and “the Court cannot say that reasonable people could not disagree on the subject.”
Martin also requested that Guardian produce statistical data and other documents going to Guardian’s and its medical reviewers’ conflict of interest. The court ordered Guardian to provide information about the number of times three medical reviewers—Dr. Jamie Lewis, Dr. Amparo Gordian, and NP Amy Gilmer—reviewed claims and opined that the claimants could work in at least a sedentary occupation or found the claimant not to be disabled. The court rejected Guardian’s argument that discovery should only be limited to the individuals who handled his most recent denial. The court also ordered Guardian to produce data going back to 2012, even though Guardian may have failed to maintain this type of information.
In addition to statistical data, the court ordered Guardian to produce information about how much it paid the medical reviewers going back to 2012, to identify the specific factors considered in awarding bonuses to employees who review benefit claims, and to disclose the training manuals used by its long-term disability department. Lastly, the court found Martin’s request for internal policies and procedures that Guardian did not specifically rely upon to decide his claim is overly broad and he is not entitled to discover that information.
If Guardian has denied your long-term disability claim, contact an experienced ERISA attorney before you handle the appeal on your own. It is important to create a strong record supporting your LTD claim before you file a lawsuit. Contact Roberts Disability Law, P.C. for a complimentary case evaluation.
*Please note that this blog is a summary of a reported legal decision and does not constitute legal advice. This blog has not been updated to note any subsequent change in status, including whether a decision is reconsidered or vacated. The case above was handled by other law firms, but if you have questions about how the developing law impacts your ERISA benefit claim, the attorneys at Roberts Disability Law, P.C. may be able to advise you so please contact us.
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