Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_07-cv-00049/USCOURTS-caed-2_07-cv-00049-0/pdf.json

Nature of Suit Code: 110
Nature of Suit: Insurance
Cause of Action: 28:1337 Sherman-Clayton Act

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28 This matter was determined to be suitable for decision without *

oral argument. L.R. 78-230(h).

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

KERRY L. LEICK, )

) 2:07-cv-49-GEB-DAD

Plaintiff, )

)

v. ) ORDER*

)

HARTFORD LIFE AND ACCIDENT )

INSURANCE COMPANY aka THE )

HARTFORD, )

)

Defendant. )

)

On April 11, 2007, Plaintiff filed a motion for discovery in

this ERISA action, arguing she is entitled to the following discovery

outside the administrative record: the identity of Defendant’s

personnel who handled the administrative record or claim file; the

identity of individuals Defendant consulted or who provided input to

the determination of non coverage; any and all of Defendant’s

administrative and claims procedures governing the determination of

coverage; any and all policy language used by Defendant in disability

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Plaintiff also argued, for the first time in her Reply brief, 1

that she is entitled to discovery on the issue of whether the

administrative record is valid; however, this argument is disregarded

because new matters should not be raised in the Reply brief. (Reply at

4:7-8; see Stewart v. Wachowski, 2004 WL 2980783, at *11 (C.D. Cal.

Sept. 28, 2004) (“Courts decline to consider arguments that are raised

for the first time in reply.”).) This ruling moots Defendant’s motion

to strike the new arguments raised in Plaintiff’s Reply brief. 

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policies insuring persons covered by the Ace Hardware Corporation

policy; any and all materials demonstrating a conflict of interest

possessed by Defendant in the determination of coverage due to its

dual role of funding and administering the plan; and the depositions

of all identified persons who were instrumental in forming the

determination of non coverage made by Defendant or who provided

information instrumental in making that determination. (Mot. for 1

Disc. (“Mot.”) at 3:6-19.) Defendant opposes the motion, arguing that

“the Court’s review is limited to the administrative record.” (Opp’n

at 1:7-8.) 

BACKGROUND

Plaintiff purchased a disability policy from Defendant in

August 1991. (Mot. at 2:3-4.) Later that same year, Plaintiff became

disabled due to illness. (Id. at 2:6.) Plaintiff received disability

payments from Defendant from April 1992 through November 17, 2005. 

(Id. at 2:6-9.) Defendant terminated its payments to Plaintiff on

November 17, 2005, claiming that she was no longer disabled. (Id. at

2:8-10.) 

ANALYSIS

Both parties agree that the de novo standard of review

applies to this action. (See Opp’n at 3:6-7; Reply at 2:14-15.) 

“Discovery outside the administrative record under the de novo

standard is limited to unusual cases.” Steiner v. Hartford Life &

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Accident Ins., 2004 WL 2271599, at *2 (N.D. Cal. June 4, 2004). Such

discovery is allowed “‘only when circumstances clearly establish that

additional evidence is necessary to conduct an adequate de novo review

of the benefit decision.’” Van Gerwen v. Guarantee Mut. Life Co., 214

F.3d 1041, 1047-48 (9th Cir. 2000) (quoting Mongeluzo v. Baxter

Travenol Long Term Disability Benefit Plan, 46 F.3d 938, 944 (9th Cir.

1995)). “In a few instances when courts have permitted discovery

outside [the administrative] record, it has been for the purpose of

justifying a shift to a heightened standard of review, from abuse of

discretion to de novo review. [Plaintiff] has already stipulated that

de novo review is appropriate in this case, so extra-record discovery

[for that purpose] is not necessary.” Steiner, 2004 WL 2271599, at

*2; Grosz-Salomon v. Paul Revere Life Ins. Co., 237 F.3d 1154, 1162

n.34 (9th Cir. 2001) (stating where “de novo review applies,

[Plaintiff’s] contention that she should have been allowed further

discovery to show a conflict of interest [need not be addressed],

since the point of showing a conflict of interest is to obtain a more

demanding standard of review than abuse of discretion.”). 

Here, Plaintiff’s mere articulation of the discovery she

seeks does not establish that this is the type of case in which

discovery outside the administrative record is necessary to an

adequate de novo review. Nor does Plaintiff’s bare argument that this

discovery will aid Plaintiff in “her effort to determine whether [a]

structural conflict of interest in the review of [her] claim

influenced the decision[]” satisfy the standard, since it does not

evince that the administrative record itself is inadequate for her to

challenge the benefit decision. (Mot. at 3:26-27.)

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CONCLUSION

For the reasons stated, Plaintiff’s request for discovery

outside the administrative record is denied. 

 

IT IS SO ORDERED.

Dated: June 27, 2007

 

GARLAND E. BURRELL, JR.

United States District Judge

 

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