Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_11-cv-00170/USCOURTS-almd-2_11-cv-00170-1/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1132 E.R.I.S.A.-Employee Benefits

---

IN THE UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF ALABAMA

NORTHERN DIVISION

JANIE MOORE, )

)

Plaintiff, )

)

v. ) CIVIL ACTION NO. 2:11cv170-MHT

) (WO)

METROPOLITAN LIFE INS. CO., et al., )

)

Defendants. )

MEMORANDUM OPINION AND ORDER

Presently before the court is the plaintiff’s motion to compel production of

documents identified in Met Life's privilege log. (doc. # 39) At issue are four documents

which Met Life claims are protected from disclosure by the attorney-client privilege or

protected from disclosure by the work-product doctrine. Moore contends that these

documents are not protected by virtue of the so-called fiduciary exception to the privilege.

Met Life rebuts that contention arguing that “[o]nce a beneficiary like Moore becomes an

adversary, the fiduciary’s and the beneficiary’s interests diverge; thereafter, the fiduciary

may consult counsel without fear that the privilege may be pierced by the beneficiary.”

Pursuant to the order of the court, Met Life produced the disputed documents for

an in camera review. Based on the court’s review of the motion, Met Life’s opposition to

the motion and the disputed documents, the court concludes that the motion to compel

production of the four documents should be granted.

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 1 of 11
Under the common law fiduciary exception, the attorney-client privilege does not 1

apply with respect to communications made to certain fiduciaries who obtain legal advice

in the execution of their fiduciary obligations. The Supreme Court recently discussed the

nature of the exception but held that it did not apply to the federal government as a trustee

of Indian funds. United States v. Jicarilla Apache Nation, ___U.S. ___, 131 S.Ct. 2313

(2011). Numerous circuit courts of appeal have applied the fiduciary exception with

respect to ERISA fiduciaries. See Solis v. The Food Employers Labor Relations Ass'n.,

2

— F.3d ----, 2011 WL 1663597 (4 Cir. May 4, 2011) (collecting cases). th

What about the Eleventh Circuit? In Garner v. Wolfinbarger, 430 F.2d 1093, 1101

(5 Cir. 1970), the court did determine that shareholders suing their corporation may th

discover communications otherwise protected by the attorney-client privilege upon a

Pursuant to FED. R. EVID. 501, “the privilege of a witness ... shall be governed by the principles

1

of the common law as they may be interpreted by the courts of the United States in the light of reason

and experience.” The attorney-client privilege is “the oldest of the privileges for confidential

communications known to the common law,” United States v. Zolin, 491 U.S. 554, 562. The

attorney-client privilege applies to “confidential communications between an attorney and his client

relating to a legal matter for which the client has sought professional advice.” Miccosukee Tribe of

Indians of Florida v. United States, 516 F.3d 1235, 1262 (11 Cir. 2008). The Supreme Court has th

broadly construed this privilege in support of the underlying policy “that sound legal advice or advocacy

serves public ends and that such advice or advocacy depends upon the lawyer's being fully informed by

the client.” Upjohn Co. v. United States, 449 U.S. 383, 389 (1981). “The party invoking the

attorney-client privilege has the burden of proving that an attorney-client relationship existed and that the

particular communications were confidential.” United States v. Schaltenbrand, 930 F.2d 1554, 1562

(11th Cir.1991). To determine if a particular communication is confidential and protected by the

attorney-client privilege, the privilege holder must prove the communication was “(1) intended to remain

confidential and (2) under the circumstances was reasonably expected and understood to be

confidential.” United States v. Bell, 776 F.2d 965, 971 (11th Cir.1985).

The Third Circuit refused to apply the fiduciary exception to an ERISA fiduciary in Wachtel v.

2

Health Net, Inc., 482 F3d 225 (3 Cir. 2007), but it has not yet determined if the exception is available in rd

the circuit.

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Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 2 of 11
showing of good cause. Cox v. Administrator U.S. Steel & Carnegie, 17 F.3d 1386, 1414

(11 Cir. 1994) is sometimes cited as holding that the attorney-client privilege does not th

apply with respect to communications made to certain fiduciaries who obtain legal advice

in the execution of their fiduciary obligations. Cox concerned the question of whether the

Garner doctrine applied to a union's assertion of the attorney-client privilege against its

members, but the Cox decision does not contain any holding about the extent of the

fiduciary exception in other contexts. “Because we hold that even if the Garner doctrine

applies, it does not support an exception to the attorney-client privilege under the facts of

this case, we need not decide whether the Garner doctrine does apply to disputes between

a union and its members.” Cox, 17 F.3d at 1415. However, there is no Eleventh Circuit

opinion applying the fiduciary exception in an ERISA case. That, however, is no reason

to not apply the exception where it applies, and to that question the court now turns. 3

Solis provides a succinct explanation of the exception.

Analogizing the ERISA fiduciary's role to the role of the trustee at common

law, these courts have relied on one of two related rationales. Applying the

reasoning of the Fifth Circuit in Garner, some courts have concluded that

the ERISA fiduciary's duty to act in the exclusive interest of beneficiaries

supersedes the fiduciary's right to assert attorney-client privilege. Other

courts, however, have reasoned that the ERISA fiduciary, as a

representative of the beneficiaries, is not the real client in obtaining advice

As one district court put it, “Defendant maintains that this Court should not apply the fiduciary

3

exception here because the Eleventh Circuit has never applied the fiduciary exception in the context of an

ERISA case. Defendant provides no legal or factual explanation of why this Court should not apply this

doctrine, however. Indeed, application of this doctrine to ERISA actions finds significant support in

federal case law.” Maltby v. Absolut Spirits Co., Inc., — F.Supp.2d ----, 2009 WL 800142, *4 (S.D. Fla

March 25, 2009).

3

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regarding plan administration and “thus never enjoyed the privilege in the

first place.” Under either rationale, “where an ERISA trustee seeks an

attorney's advice on a matter of plan administration and where the advice

clearly does not implicate the trustee in any personal capacity, the trustee

cannot invoke the attorney-client privilege against the plan beneficiaries.” 

Solis, ___ F.3d at ___, 2011 WL 1663597, 4 (citations and footnote omitted) (quoting

United States v. Mett, 178 F.3d 1058, 1064 (9 Cir. 1999). th

Thus, a fiduciary of an ERISA plan “must make available to the beneficiary, upon

request, any communications with an attorney that are intended to assist in the

administration of the plan.” In re Long Island Lighting Co., 129 F.3d 268, 272 (2nd

Cir.1997). The exact nature of what constitutes plan administration may be difficult to

discern. For example, the Supreme Court has held that “making intentional

representations about the future of plan benefits in . . . [certain] context[s] is an act of

plan administration.” Varity Corp. v. Howe, 516 U.S. 489, 505 (1996). But, decisions

relating to a plan's amendment or termination are not fiduciary decisions. See Hughes

Aircraft Co. v. Jacobsen, 525 U.S. 432, 443-44 (1999) (when employers adopt, modify, or

terminate welfare plans, “they do not act as fiduciaries, but are analogous to the settlors of

a trust.”).

Under the Mett approach, “where an ERISA trustee seeks an attorney's advice on a

matter of plan administration and where the advice clearly does not implicate the trustee

in any personal capacity,” the exception applies. Mett, 178 F.3d at 1064. But, “where a

plan fiduciary retains counsel in order to defend herself against the plan beneficiary,” the

4

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 4 of 11
exception does not apply. Id.

The general test is that “when the interests of the ERISA plan fiduciary and

the plan beneficiaries have diverged sufficiently such that the fiduciary ...

[is acting] in its own interest to defend itself against the plan beneficiaries,

then the attorney-client privilege remains intact.” Tatum v. R.J. Reynolds

Tobacco Co., 247 F.R.D. 488, 497 (M.D.N.C.2008) (emphasis added). The

interests of plan participants and plan administrators undoubtedly diverge

sufficiently upon the final denial of an administrative claim or upon the

initiation of litigation. See, e.g., Geissal v. Moore Medical Corp., 192

F.R.D. 620, 625-26 (E.D.Mo. 2000) (ruling post-administrative claim denial

advice privileged).

Allen v. Honeywell Retirement Earnings Plan, 698 F.Supp.2d 1197, 1201 (D. Ariz. 2010).

Met Life argues that with respect to the four documents to which they claim

privilege, their interests and the interests of the plaintiff had sufficiently diverged so that

the fiduciary exception does not obviate their protected status. The court will address that

argument after setting forth some facts necessary for resolution of the question.

Moore is an employee of Southern Company Services, Inc., and has lived in

Alabama since at least 1996. In 2003 she enrolled in a group life insurance plan for

benefits for her common-law husband, Jamie Moore. In 2009, Jamie Moore died of lung

cancer. Moore applied for benefits under the plan. 

Met Life denied the claim on November 25, 2009, on the basis that the State of

Wisconsin, the state in which the common-law marriage was established, does not

recognize common-law marriages. Met Life also informed Moore of her appeal rights.

In response, Moore sent a letter “in regard to . . . [her] claim.” (Pl. Evid.

Submission, doc. # 28-13) On December 18, 2009, a Met Life representative

5

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 5 of 11
acknowledged receipt of the letter which was characterized as an appeal. “Her appeal to

our denial outlines that in Alabama . . . acknowledges common law marriage . . .” (Pl.

Evid. Submission, doc. # 28-14)

In a letter inexplicably dated August 12, 2009, Moore was informed that her appeal

received on December 14, 2009, was considered and rejected. “After additional review

of the claim file, we must uphold the denial of our claim . . .” The basis of the denial

was again that Wisconsin does not recognize the validity of a common-law marriage. (Pl.

Evid. Submission, doc. # 28-15)

Moore retained counsel who sent to Met Life a letter requesting plan documents

and Moore’s file. On August 11, 2010, counsel wrote a letter to Met Life, inter alia

requesting a reconsideration of the denial of her claim. (Pl. Evid. Submission, doc. # 28-

18) On August 17, 2010, Met Life representatives exchanged email messages in which it

was suggested that counsel’s letter be reviewed to determine whether Met Life’s denial

decision should be changed. On September 10, 2010, a Met Life representative wrote

Moore’s counsel requesting specific documentation “[i]n order for use to consider your

client’s claim further . . .” (Pl. Evid. Submission, doc. # 28-20)

On October 18, 2010, Moore’s counsel wrote to Met Life stating that if no

response was received to the August 11, 2010, letter, Moore would consider that to be a

de facto denial. (Pl. Evid. Submission, doc. # 28-21) Then, on December 2, 2010,

Moore’s counsel again wrote Met Life.

6

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 6 of 11
On November 22, 2010 we received a letter from MetLife dated November

17, 2010. The letter is unsigned and does not even identify the author of the

correspondence. The letter blindly asks for additional information

supporting the establishment of a common law marriage relationship when

we are presently in the appellate remedy stage of an ERISA claim where the

Insurance company and/or claims administrator and/or Plan administrator

have denied the claim based upon the fact that Wisconsin law docs not

recognize common law marriages.

Let me be very frank: We have spent more than a year trying to obtain the

basic document production and then deal with what is without a doubt one

of the silliest denials we have seen (even for an ERISA claim.) In order for

us to proceed back to the administrative remedy phase we would have to

first recognize that the insurance company is setting aside (as a result of our

appeal) their initial denial of the claim.

So, if someone would like to finally rule upon Mrs. Moore's appeal we can

then proceed to the next step in this matter. In order for a formal ruling to

occur, either the company needs to uphold its initial decision or it needs to

set aside its initial decision (granting her appellate remedy) and reopen the

administrative functions of this case.

Under the Department of Labor standards there is a time period for which

these appeals must be decided. We arc going to operate as though there is a

de novo denial and proceed with the next remedy available to Mrs. Moore if

we do not hear from you on or before December 10, 2010.

We have spent a year trying to get the basic document production and trying

to have the insurance company and/or Plan administrator and/or claims

administrator recognize how damaging and ill-conceived this denial was

and remains. For someone to fire off an unsigned letter that doesn’t even

identify the author asking for additional documentation at this stage is

ridiculous. As a practical matter, whoever sent this letter would first have to

recognize that Alabama law applies to the claim which would require

setting aside of the initial claims decision. Unless that happens, this request

is nothing marc than a request for additional documentation that is

irrelevant based upon the present rationale for denying the claim.

We have had enough, you should have paid these insurance benefits a year

ago. You need to send a check payable for the full amount of benefits plus

7

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 7 of 11
interest to this office payable to Mrs. Janie Moore and her attorneys at

SinclairWilliams, LLC.

(Pl. Evid. Submission, doc. # 28-22)

On December 20, 2010, Met Life responded to Moore’s counsel.

We are writing in regard to the above referenced claim for Group Life

insurance benefits. Please accept Our sincere condolences at this time.

We are not considering any further requests for administrative review. By

letter dated November 25.2006, we initially denied your claim for benefits

under the Plan. By letter dated August 12, 2009, we upheld the denial of

your claim after considering your request for an administrative review. As

indicated in that letter, your administrative remedies under the Plan have

been exhausted. Accordingly, no further appeals will be considered.

(Pl. Evid. Submission, doc. # 28-23)

Approximately five months later on May 17, 2011, and slightly more than two

months after this lawsuit was filed, a senior claim examiner of Met Life wrote Moore’s

counsel again. In pertinent part, the letter states as follows:

We write in response to your letter of December 2, 2010 and further to our

letter of December 20, 2010. In light of your correspondence, we have

conducted a further administrative review. We have examined the entire

claim file, including any additional material and information provided with

your request for review. For the reasons detailed below, we must again

uphold the denial of your client's claim.

* * * *

On November 25, 2009, MetLife denied your client's claim for dependent

benefits on the ground that the State of Wisconsin does not recognize

common-law marriages, and, therefore, the Decedent was not a Dependent

under the terms of the plan. On December 28, 2009, we upheld the denial of

your client's claim. (Note that the letter is incorrectly dated August 12,

2009.) In a letter dated August 11, 2010, you explained that, although your

client and the Decedent lived in Wisconsin at one point, at all times relevant

to this claim they resided in Alabama. Therefore, you stated that Alabama

8

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 8 of 11
law governs whether your client and the Decedent were common-law

spouses.

MetLife agrees that Alabama law, not Wisconsin law, governs the issue

whether a common-law marriage existed. Although we never explicitly

withdrew our initial denial, which was erroneously based on Wisconsin law,

in letters to you dated September 10 and November 17, 2010, we agreed to

reopen the record and consider “any additional documents that you feel

would help us in our review of the common-law marriage relationship”

under Alabama law. Despite our repeated requests, your client has provided

no additional documentation. As a result, there is insufficient evidence in

the record to substantiate the existence of a common-law marriage under

Alabama law. Because Ms. Moore has not established that the Decedent

was an eligible dependent under the Plan, dependent life benefits are not

payable.

Consequently, we must again uphold our denial of your client's claim.

Your client is entitled to receive, upon request and free of charge,

reasonable access to, and copies of, all documents, records, and other

information relevant to the claim for benefits. You have the right to bring a

civil action under Section 502(a) of ERISA.

Notwithstanding the above and the fact that the claim is now in litigation,

MetLife will be pleased to consider any documentation your client might

wish to submit to support her assertion that she and the Decedent had a

valid common-law marriage under Alabama law.

(Pl. Evid. Submission, doc. # 28-25)

One of the documents at issue presents an easy call. It is a memo written on

September 9, 2010, well before this action commenced. Even though Moore had retained

counsel by the time this document was authored, that fact alone is insufficient to

demonstrate that the interests of Moore and Met Life had diverged. See Asuncion v.

Metropolitan Life Insurance Co., 493 F.Supp.2d 716, 722 (S.D. New York 2007). The

9

Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 9 of 11
document itself addresses questions which are plainly about administration of the Plan. 

This document shall be produced.

The remaining three documents present a more difficult question. All of them

were written after this lawsuit commenced on March 11, 2011. It is tempting to take the

easy path devoid of analysis and use the filing date as a date on which the interests of Met

Life and Moore diverged such that the fiduciary exception does not apply. However, the

facts of this case, especially the actions of Met Life, make the easy path unacceptable.

Met Life’s May 17, 2011, letter set forth above (Pl. Evid. Submission, doc. # 28-

25) shows that even after litigation commenced Met Life still was considering

administratively Moore’s claim for benefits. “We have examined the entire claim file,

including any additional material and information provided with your request for review.

For the reasons detailed below, we must again uphold the denial of your client's claim.”

Id. “[A] plan administrator engages in a fiduciary act when making a discretionary

determination about whether a claimant is entitled to benefits under the terms of the plan

documents.” Varity Corp., 516 U.S. at 511. The letter shows on its face that even after

litigation commenced, Met Life was making a determination about Moore’s entitlement

to benefits. That is a fiduciary act. Moreover, the contents of the three documents show

that they are concerned with the benefit determination decision embodied in the May 17,

2011, letter. There is nothing in the three documents indicating that the concern of the

authors’ was the fiduciary in any personal capacity. The advice sought was on a matter

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Case 2:11-cv-00170-MHT-CSC Document 54 Filed 07/13/11 Page 10 of 11
of plan administration. Thus, the remaining three documents listed on the privilege log

shall be produced. Accordingly, it is

ORDERED that the motion to compel (doc. # 39) be and is hereby GRANTED and

that on or before July 18, 2011, Met Life shall produce to the plaintiff the four documents

listed on the privilege log.

Done this 13 day of July, 2011. th

 /s/Charles S. Coody 

CHARLES S. COODY

UNITED STATES MAGISTRATE JUDGE

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