Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-4_06-cv-03746/USCOURTS-cand-4_06-cv-03746-0/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1104 Recovery of Benefits to Employee

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United States District Court

For the Northern District of California

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United States District Court

For the Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

JOEL R. FRIEDMAN

Plaintiff, No. C 06-3746 PJH

v. ORDER GRANTING DISCRETIONARY

STANDARD OF REVIEW

METROPOLITAN LIFE INSURANCE 

COMPANY,

Defendant.

_______________________________/

Defendant’s motion to determine the standard of review came on for hearing before

this court on December 13, 2006. Plaintiff, Joel R. Friedman (“Friedman”), appeared pro

se. Defendant, Metropolitan Life Insurance Company (“Met Life”), appeared through its

counsel, Rebecca A. Hull. Having read all the parties’ papers and carefully considered the

parties’ arguments and the relevant legal authority, and good cause appearing, the court

hereby GRANTS defendant’s motion for application of a discretionary standard of review,

for the reasons stated at the hearing, and summarized as follows.

1. Discretionary review is mandated here, pursuant to Abatie v. Alta Health &

Life Ins. Co., 458 F.3d 955 (9th Cir. 2006). Under Abatie, Met Life’s plan language – which

states in part that “the Plan administrator and other Plan fiduciaries...” shall have

“discretionary authority to interpret the terms of the Plan and to determine eligibility for and

entitlement to Plan benefits” – constitutes a clear grant of discretionary authority on the

Plan administrator and Plan fiduciaries, such that discretionary review is warranted. See

ADMIN 0026; see also Abatie, 458 F. 3d at 963. This conclusion is not altered by plaintiff’s

assertion that a structural conflict of interest and/or procedural errors exists here, as Abatie

Case 4:06-cv-03746-PJH Document 28 Filed 01/09/07 Page 1 of 3
United States District Court

For the Northern District of California

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also states that abuse of discretion review is required “whenever an ERISA Plan grants

discretion to the Plan administrator” – even, for example, where a structural conflict of

interest exists. Id..at 967. To the extent any such conflict exists, the court shall weigh any

and all evidence of that conflict in connection with its application of the abuse of discretion

standard in determining the merits of plaintiff’s claim – i.e., in determining whether Met

Life’s denial of benefits was proper.

2. To the extent that plaintiff seeks general open-ended discovery, plaintiff’s

request is DENIED. Once again, Abatie is instructive. Abatie reiterated the principle that

where abuse of discretion review is applied – as here – the court is limited to matters in the

administrative record only, and discovery is not generally permissible. See 458 F.3d at

970. No other Ninth Circuit authority has held differently. However, two important

qualifications to this principle apply: first, with respect to any purported conflict of interest,

the court may, in its discretion, consider evidence “outside the administrative record to

decide the nature, extent, and effect on the decision-making process of any conflict of

interest...”. Second, with respect to procedural errors that have “affected the administrative

review,” claimants should be given the opportunity to submit additional evidence

demonstrating the effect of the administrator’s procedural error. See Abatie, 458 F.3d at

972-73. Accordingly, the court applies these qualifications here, as follows: 

The denial of plaintiff’s discovery request is without prejudice to plaintiff’s right to

seek discovery again. Specifically, if plaintiff becomes aware of material outside the

administrative record that would shed light on the existence of any structural conflict or

qualifying procedural errors, plaintiff may submit a request to the court setting forth the

specifically identifiable evidence that plaintiff seeks to discover, and specifically setting forth

the reasons why plaintiff believes the particular evidence will shed light on the above

issues. Prior to making any such discovery request before the court, however, plaintiff

must first submit his request to defendant, so that defendant has an opportunity to stipulate

to admission of the evidence in question. 

Case 4:06-cv-03746-PJH Document 28 Filed 01/09/07 Page 2 of 3
United States District Court

For the Northern District of California

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Any discovery request made by plaintiff in the manner just described must be made

no later than January 12, 2007. 

3. Any cross-motions for summary judgment that the parties wish to file shall be

filed no later than May 30, 2007.

IT IS SO ORDERED.

Dated: January 9, 2007 ______________________________

PHYLLIS J. HAMILTON

United States District Judge

Case 4:06-cv-03746-PJH Document 28 Filed 01/09/07 Page 3 of 3