Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_06-cv-00486/USCOURTS-casd-3_06-cv-00486-1/pdf.json

Nature of Suit Code: 110
Nature of Suit: Insurance
Cause of Action: 29:1001 E.R.I.S.A.: Employee Retirement

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

DAVID ORDWAY,

Plaintiff,

CASE NO. 06cv486-L (WMc)

ORDER GRANTING IN PART AND

DENYING IN PART PLAINTIFF’S

APPLICATION TO ADD TO THE

ADMINISTRATIVE RECORD

vs.

METROPOLITAN LIFE INSURANCE

COMPANY,

Defendant.

On May 18, 2007, the Court held a hearing, on the record, regarding discovery. 

Participating were James Warner, Esq. (counsel for plaintiff), Rob Renner, Esq.(counsel for

defendant), and Sara Maunder, Esq.(counsel for defendant). The two issues addressed at the

hearing were: 1) Whether the plaintiff is entitled to supplement the Administrative Record; 2)

Whether the plaintiff is entitled to conduct conflict-of-interest discovery regarding defendant’s

structural conflict of interest and defendant’s use of a physician consultant from Elite Physicians,

Ltd. After hearing from counsel of record and based upon its oral ruling, which is fully

incorporated herein, the Court issues the following Order:

1. The controlling Ninth Circuit authority of the issues presented is Abati v. Alta

Health & Life Insurance, 458 F.3d 955 (9th Cir. 2006). Under Abati if procedural

irregularities are alleged or exist the Court may add to, or look outside, the

Administrative Record to determine the degree of scrutiny it will use when

Case 3:06-cv-00486-L-WMC Document 36 Filed 06/07/07 Page 1 of 3
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applying the abuse of discretion standard. In this case, the plaintiff did not

establish the existence of procedural irregularities under Abatie so grave or flagrant

as to constitute a failure by Defendant to exercise discretion. Therefore, plaintiff’s

request to conduct additional discovery on the structural conflict of interest issue is

DENIED.

2. Plaintiff asserts that defendant took videotape footage which allegedly

demonstrates plaintiff’s ability to walk for extended periods of time. Plaintiff

argues that he has never seen the videtape. Further, despite his requests for a copy

of the videotape, he has never received a copy. It is undisputed that (a) the

videotape was not made a part of the Administrative Record, (b) Defendant did use

and rely on a surveillance report by its investigator who made the videotape and (c)

that report is included in the Administrative Record. Plaintiff claims that the

failure to include the videotape in the Administrative Record unfairly skews the

record in Defendant’s favor. Plaintiff argues that the videotape covers only a short

period of time that plaintiff was seen walking and does not show him walking for

an extended period of time. In an effort to rebut the videotape, Plaintiff obtained a

letter from witness Jack Collins who was present at the time the videotape was

taken and who could testify that plaintiff walked only for a very short period of

time. Finally, Defendant admits the videotape still exists. The videotape is more

direct and competent evidence than the investigative report which purports to

describe it. Furthermore, there is no prejudice to Defendant in producing the

videotape since Defendant has implicitly relied on the videotape by directly relying

on the investigation report. Furthermore, the failure to originally include the

videotape in the Administrative Record is reason to allow the inclusion of the

explanatory letter from Jack Collins. Finally, under Abatie the Defendant’s failure

to produce the videotape and to the consider the allegedly exculpatory letter from

Jack Collins may be factors the District Judge will consider in determining the

level of scrutiny to apply to the facts of this case. Therefore, plaintiff’s request to

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supplement the Administrative Record with the full copy of the investigative

videotape and the explanatory letter from witness Jack Collins is GRANTED.

3. Plaintiff contends that defendant improperly relied on a conclusory statement made

by plaintiff’s employer, Craig Joyner, indicating that plaintiff’s job was sedentary. 

Plaintiff argues that Mr. Joyner had previously stated during a deposition plaintiff’s

job was not sedentary. Although excerpts from Mr. Joyner’s deposition were made

part of the Administrative Record, the entire deposition testimony was not made a

part of the Administrative Record. Plaintiff has asserted that the excerpts, taken out

of context, may potentially unfairly and unintentionally slant the excerpts (and

related evidence) in Defendant’s favor. There is no prejudice to the Defendant

since Defendant was present at the deposition through counsel and has relied on

excerpts of the same deposition to support its conclusion. Finally, placing the

entire deposition transcript into the Administrative Record will provide a more

compete context for Mr. Joyner’s statements and may provide guidance for the trial

court in determining the level of scrutiny it should apply to the case. For these

reasons, plaintiff’s request to supplement the Administrative Record with Mr.

Joyner’s complete deposition transcript is GRANTED.

IT IS SO ORDERED.

DATED: June 7, 2007

Hon. William McCurine, Jr.

U.S. Magistrate Judge

United States District Court

cc: HONORABLE JAMES LORENZ

 UNITED STATES DISTRICT JUDGE

 ALL COUNSEL AND PARTIES OF RECORD

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