Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-4_13-cv-01789/USCOURTS-alnd-4_13-cv-01789-0/pdf.json

Parties Involved:
Sharon Blair
Plaintiff
Metropolitan Life Insurance Company
Defendant

Document Text:

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ALABAMA

MIDDLE DIVISION

SHARON BLAIR,

Plaintiff,

v.

METROPOLITAN LIFE

INSURANCE COMPANY,

Defendant.

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Case No.: 4:13-CV-1789-VEH

 

MEMORANDUM OPINION

I. Introduction and Procedural History

On August 22, 2013, Plaintiff Sharon Blair (“Ms. Blair”) initiated this longtermdisabilitybenefits case against Defendant Metropolitan Life Insurance Company

(“MetLife”) in the Circuit Court of Etowah County. (Doc. 1-1 at 2-4; Doc. 29-1 at 2-

4).1 MetLife removed Ms. Blair’s state court action to this court on September 26,

2013, on the basis of federal preemption under the Employee Retirement Income

Security Act of 1974 (“ERISA”). (Doc. 1; id. at 2-3 ¶¶ 5-6).

Prior to that, on April 3, 2012, Ms. Blair had filed an essentially

indistinguishable long-term disability benefits case against MetLife in Etowah

1 All page references to Doc. 1-1 and Doc. 29-1 correspond with the court’s CM/ECF

numbering system.

FILED

 2016 Mar-02 PM 04:49

U.S. DISTRICT COURT

N.D. OF ALABAMA

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 1 of 21
County, which action MetLife similarly removed to federal court (“Blair I”)2

on May

3, 2012. (Doc. 1; Doc. 1-1 at 3-4).3 On May 12, 2014, this case (“Blair II”) wasstayed

and administratively closed (Doc. 20) while the Eleventh Circuit considered the

merits of an appeal in Blair I (Doc. 37) filed by Ms. Blair on July 23, 2013. 

The Eleventh Circuit decided Blair I in favor of MetLife in an unpublished

opinion–Blair v. Metlife, 569 F. App’x 827 (11th Cir. 2014), cert. denied, 135 S. Ct.

1414, 191 L. Ed. 2d 364 (2015)–issued initially on June 23, 2014, by the Eleventh

Circuit (see Blair II, Doc. 29-2 at 2)

4

and subsequently entered as a mandate in Blair

I (Doc. 40 at 2) on November 3, 2014. On June 16, 2015, the court lifted the stay and

reinstated Blair II (Doc. 27) in light of Ms. Blair’s unwillingness to accept the

outcome in Blair I as dispositive of her long-term disability claim in Blair II. (Doc.

26). 

Currently pending before the court are the following four motions:

! Ms. Blair’s Motion To Allow Amended Complaint (Doc. 28) (the “Amend

Motion”) on filed June 17, 2015;

! MetLife’s Renewed Motion To Dismiss (Doc. 29) (the “Dismissal Motion”)

filed on June 29, 2015;

2

 The CM/ECF district court case number for Blair I is 4:12-CV-1776-JEO.

3 All page references to Doc. 1-1 of Blair I correspond with the court’s CM/ECF numbering

system.

4 All page references to Doc. 29-2 correspond with the court’s CM/ECF numbering system.

2

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 2 of 21
! Ms. Blair’s Motion To Allow Sur Reply (Doc. 36) (the “Sur Reply Motion”)

filed on July 31, 2015; and

! Ms. Blair’s Motion To Compel (Doc. 37) (the “Compel Motion”) filed on

August 21, 2015.

For the reasons stated below, the court finds that MetLife’s Dismissal Motion

is due to be granted in part and otherwise denied, Ms. Blair’s Amend Motion is due

to be denied as futile, and the remaining two motions are due to be termed as moot

or, alternatively, denied.

II. Standards

A. Rule 12(b)(6)

A Rule 12(b)(6) motion attacksthe legalsufficiency of the complaint. See FED.

R. CIV. P. 12(b)(6) (“[A] party may assert the following defenses by motion: (6)

failure to state a claim upon which relief can be granted[.]”). The Federal Rules of

Civil Procedure require only that the complaint provide “‘a short and plain statement

of the claim’ that will give the defendant fair notice of what the plaintiff’s claim is

and the grounds upon which it rests.” Conley v. Gibson, 355 U.S. 41, 47, 78 S. Ct. 99,

103, 2 L. Ed. 2d 80 (1957) (footnote omitted) (quoting FED. R. CIV. P. 8(a)(2)),

abrogated by Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 556, 127 S. Ct. 1955,

1965, 167 L. Ed. 2d 929 (2007); see also FED. R. CIV. P. 8(a) (setting forth general

pleading requirements for a complaint including providing “a short and plain

3

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 3 of 21
statement of the claim showing that the pleader is entitled to relief”). 

While a plaintiff must provide the grounds of his entitlement to relief, Rule 8

does not mandate the inclusion of “detailed factual allegations” within a complaint.

Twombly, 550 U.S. at 555, 127 S. Ct. at 1964 (quoting Conley, 355 U.S. at 47, 78 S.

Ct. at 103). However, at the same time, “it demands more than an unadorned,

the-defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662,

678, 129 S. Ct. 1937, 1949, 173 L. Ed. 2d 868 (2009). “[O]nce a claim has been

stated adequately, it may be supported by showing any set of facts consistent with the

allegations in the complaint.” Twombly, 550 U.S. at 563, 127 S. Ct. at 1969. 

“[A] court considering a motion to dismiss can choose to begin by identifying

pleadings that, because they are no more than conclusions, are not entitled to the

assumption of truth.” Iqbal, 556 U.S. at 679, 129 S. Ct. at 1950. “While legal

conclusions can provide the framework of a complaint, they must be supported by

factual allegations.” Id. “When there are well-pleaded factual allegations, a court

should assume their veracity and then determine whether they plausibly give rise to

an entitlement to relief.” Id. (emphasis added). “Under Twombly’s construction of

Rule 8 . . . [a plaintiff’s] complaint [must] ‘nudge[] [any] claims’ . . . ‘across the line

from conceivable to plausible.’ Ibid.” Iqbal, 556 U.S. at 680, 129 S. Ct. at 1950-51. 

A claim is plausible on its face “when the plaintiff pleads factual content that

4

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 4 of 21
allows the court to draw the reasonable inference that the defendant is liable for the

misconduct alleged.” Iqbal, 556 U.S. at 678, 129 S. Ct. at 1949. “The plausibility

standard is not akin to a ‘probability requirement,’ but it asks for more than a sheer

possibility that a defendant has acted unlawfully.” Id. (quoting Twombly, 550 U.S. at

556, 127 S. Ct. at 1965). 

B. Futility

“When a district court denies the plaintiff leave to amend a complaint due to

futility, the court is making the legal conclusion that the complaint, as amended,

would necessary fail.” St. Charles Foods, Inc. v. America’s Favorite Chicken Co.,

198 F.3d 815, 822-23 (11th Cir. 1999). The futility standard is comparable to that

applicable to a motion to dismiss. See B.D. Stephenson Trucking, L.L.C. v.

Riverbrooke Capital, No. 5:06-CV-0343-WS, 2006 WL 2772673, at *6 (S.D. Ala.

2006) (“The futility threshold is akin to that for a motion to dismiss; thus, if the

amended complaint could not survive Rule 12(b)(6) scrutiny, then the amendment is

futile and leave to amend is properly denied.” (citing Burger King Corp. v. Weaver,

169 F.3d 1310, 1320 (11th Cir. 1999))); see also Florida Power & Light Co. v. Allis

Chalmers Corp., 85 F.3d 1514, 1520 (11th Cir. 1996) (affirming district court’s

denial of amendment as futile because purported cause of action “would not

withstand a motion to dismiss”).

5

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 5 of 21
III. Analysis

A. MetLife’s Dismissal Motion

1. Blair I Background and Holdings

In November 2007, Ms. Blair made a long-term disability claim (the “LTD

Claim”) under the Progressive Corporation Group Long Term Disability Plan (the 

“Plan”). MetLife is the claims administrator for the Plan. Initially, MetLife approved

Ms. Blair’s LTD Claim. However, in November 2008, MetLife denied it, finding that

Ms. Blair had failed to provide supporting evidence of her continued disabled status

under the Plan.

Ms. Blair administratively appealed the subsequent denial of her LTD Claim.

MetLife (i) conducted an appeal review, (ii) concluded on January 30, 2009, that she

was not disabled as defined by the LTD Plan, and (iii) advised Ms. Blair that she had

exhausted her administrative remedies. Thus, January 30, 2009, is the date on which

MetLife issued its final denial of Ms. Blair’s LTD Claim. 

Through her counsel (who is the same lawyer who has represented her

throughout Blair I and Blair II), Ms. Blair, in June 2009, requested that MetLife

conduct a second review of her LTD Claim. Even though the Plan provides for only

one administrative review, MetLife agreed to undergo a second, courtesy review of

Ms. Blair’s LTD Claim. While this courtesy review was pending, Ms. Blair submitted

6

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 6 of 21
additional recordsto MetLife in support of her LTD Claim. Ms. Blair filed her appeal

in Blair I before MetLife gave her a decision on its courtesy review.

In Blair I, the Eleventh Circuit rejected Ms. Blair’s contention that MetLife

violated ERISA by not considering certain evidence which she submitted as part of

her so-called “second appeal” to MetLife:

First, there was no “second appeal.” MetLife was not required under the

Plan to review extra materials after it had denied her first appeal. Blair

not only received a timely decision on her initial claim but also a full

administrative appellate review of her claim in accordance with the

terms of the Plan. At that point, Blair wasfree to file suit in federal court

because she had exhausted her administrative remedies. Yet, she

requested MetLife to conduct an additional administrative review of her

claim, which MetLife was not contractually bound, but voluntarily

agreed, to do. Moreover, our case law is clear that we are limited to only

those documents that were before the administrator at the time the

decision was made. See Jett v. Blue Cross & Blue Shield of Ala., Inc.,

890 F.2d 1137, 1139 (11th Cir. 1989) (noting that a review of the

administrator’s determination is “based upon the facts as known to the

administrator at the time the decision was made”); Turner v. Delta

Family–Care Disability & Survivorship Plan, 291 F.3d 1270, 1273

(11th Cir. 2002) (per curiam) (stating that the court's review is “based

on the evidence of record”). The documents Blair sent to MetLife over

the two years following the denial of her administrative appeal were not

part of the record considered when determining whether to deny Blair’s

LTD benefits. Accordingly, the district court is affirmed asto this issue.

569 F. App’x at 832 (emphasis added).

7

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 7 of 21
2. The Eleventh Circuit’s opinion in Blair I means

that Ms. Blair’s LTD Claim asserted in Blair II is

not plausible under ERISA.

While the allegations vary slightly, Blair I and Blair II are substantively

identical ERISA lawsuits. For example, Blair I and Blair II both seek redress from

MetLife’s final denial of Ms. Blair’s LTD Claim under the Plan on January 30, 2009.

(Compare Blair I, Doc. 1-1 at 3 ¶ 4 (“Plaintiff filed a written appeal and Defendant

issued a final denial on January 30, 2009.”), with Blair II, Doc. 1-1 at 2 ¶ 4 (“MetLife

denied LTD benefits and MetLife deniedBlair’s administrative appeal on 1/30/09.”)). 

More specifically, both cases urge that MetLife had an ERISA-driven

obligation to reconsider Ms. Blair’s LTD Claim in conjunction with those additional

documents that she submitted to MetLife after its final denial in January 2009.

(Compare BlairI, Doc. 1-1 at 3 ¶¶ 6-7 (referencing new submissions made to MetLife

after its final denial of Ms. Blair’s LTD Claim), with Blair II, Doc. 1-1 at 2 ¶¶ 5-8

(same)); (compare also BlairI, Doc. 1-1 at 3 ¶ 8 (“Defendant has exceeded the 45 day

deadline.”), with Blair II, Doc. 1-1 at 3 ¶ 12 (“Defendant has never issued a decision

on Plaintiff’s second appeal.”)). Blair I and Blair II also seek identical relief.

(Compare Blair I, Doc. 1-1 at 3 (“WHEREFORE, Plaintiff prays for appropriate

equitable relief, attorney fees and costs which are more than $50,000.”), with Blair

II, Doc. 1-1 at 4 (same)). 

8

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 8 of 21
In its Dismissal Motion, MetLife maintains that due to Blair I and Blair II’s

interrelatedness and common nucleus of operative facts, either res judicata or

collateral estoppel flowing from the finality of Blair I operates to bar Ms. Blair’s

pursuit of her LTD Claim in Blair II. Ms. Blair counters that her second suit against

MetLife for “wrongful termination of LTD benefitsis not barred by [either doctrine].”

(Doc. 34 at 1 ¶ 3; id. at 16-20; id. at 23-25). Although following Ms. Blair’srambling

arguments in opposition to MetLife’s Dismissal Motion is an arduous endeavor,5the

gist of her position appears to be that res judicata and/or collateral estoppel cannot

apply because MetLife never has considered, much less issued a decision directly

addressing the impact of the additional evidence that she submitted in support of her

LTD Claim and Blair I does not foreclose her from pursuing a second cause of action

under ERISA premised upon such newand differing disability-related documentation

5 Sloppily sandwiched between Ms. Blair’s res judicata/collateral estoppel contentions is a

section about how judicial estoppel should operate to prevent MetLife from taking inconsistent

positions in Blair II versus Blair I. (Doc. 34 at 20-23). Ms. Blair has not cited to a single case in

which judicial estoppel has ever been applied in an ERISA lawsuit. Instead, Ms. Blair references

New Hampshire v. Maine, 532 U.S. 742, 121 S. Ct. 1808, 149 L. Ed. 2d 968 (2001), a state-boundary

dispute, and Burnes v. Pemco Aeroplex, Inc., 291 F.3d 1282 (11th Cir. 2002), an employment

discrimination lawsuit, as her supportive authorities. (Doc. 34 at 21-22). To the extent that judicial

estoppel is even a permissible equitable concept in this benefits-driven ERISA action, see infra at

15-16 n.10 and the court’s discussion of Varity and other cases infra at 16-18, the court rejects Ms.

Blair’s reliance upon the doctrine as she has not demonstrated that MetLife has taken a position in

Blair II that is “clearly” incompatible (Doc. 34 at 22) with any of its stances in Blair I. Instead,

MetLife’s twofold theme throughout Blair I and Blair II consistently has been that: (i) Ms. Blair has

no right to a “second appeal” under ERISA, and (ii) she cannot create cognizable liability based upon

MetLife’s subsequent voluntary acceptance of documents related to her otherwise administratively

exhausted LTD Claim.

9

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 9 of 21
at issue in Blair II. 

Assuming without deciding that defending on the grounds of res judicata or

collateral estoppel is an overreach given the current status of this record,

6

the court,

6 Ms. Blair points out that MetLife, the party invoking res judicata and collateral estoppel,

has not cited to a case in which either doctrine has been applied in an ERISA action procedurally

comparable to hers. (Doc. 34 at 24-25). Conversely, Ms. Blair has not referred to a decision which

suggests that reliance upon such a defense is somehow inappropriate in this instance. Id.

The Eleventh Circuit’s ERISA opinion in Ogden, discussed infra at 16-18, commented that

while the district court’s application of res judicata was not challenged on appeal, it “was

undoubtedly correct.” 348 F.3d at 1286 n.2. More specifically, the record in Ogden included a bench

trial in which “the district court found that the principles of res judicata barred the Ogdens’ claim

for legal relief” under Section 502(a)(1)(B) by virtue of an earlier state court proceeding. 348 F.3d

at 1286. The district court further determined that “the Ogdens were entitled to equitable relief under

ERISA Section 502(a)(3), even though they had never asked for an equitable remedy.” Id. The

Eleventh Circuit held “that an ERISA plaintiff has no cause of action under Section 502(a)(3) where

Congress provided for an adequate remedy elsewhere in the ERISA statutory framework, even if res

judicata now bars the adequate remedy provided.” Ogden, 348 F.3d at 1285.

 

The record in this case is significantly less developed than the bench trial referenced in

Ogden. Additionally, in conducting its own research, the court has found at least one binding

authority that brings into question the procedural propriety of addressing res judicata and collateral

estoppel on a Rule 12(b)(6) record. As the Eleventh Circuit explained in Concordia v. Bendekovic,

693 F.2d 1073 (11th Cir. 1982):

In the case at bar, the defendants have raised the defense of res judicata [or

collateral estoppel as indicated by a footnote] in the form of a Rule 12(b)(6) motion

supported by the exhibits above mentioned. Res judicata, however, is not a defense

under 12(b); it is an affirmative defense that should be raised under Rule 8(c). Moch

v. East Baton Rouge Parish School Board, 548 F.2d at 596 n.3; Sherwood v. Pearl

River Valley Water Supply District, 427 F.2d 717 (5th Cir.) (Godbold, J., dissenting),

cert. denied, 400 U.S. 832, 91 S. Ct. 64, 27 L. Ed. 2d 63 (1970); Guam Investment

Co. v. Central Building, Inc., 288 F.2d 19, 24 (9th Cir. 1961). Nevertheless a party

may raise a res judicata defense bymotion rather than by answer where the defense’s

existence can be judged on the face of the complaint. Pearl River Valley, 427 F.2d

at 718 (Godbold, J., dissenting); Guam Investment Co., 288 F.2d at 24 (“It appears

to us that before an action may be summarily dismissed on the ground of res judicata

the ends of justice require as a minimum that the defense of res judicata appear from

the face of the complaint or that the record of the prior case be received in

10

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 10 of 21
nonetheless, concludes that the Dismissal Motion is due to be granted. In particular,

the court adopts as persuasive authority the Eleventh Circuit’s unpublished decision

in Blair I and applies it to Blair II. As Blair I instructs, once a final denial of an

ERISA claim has occurred and the claims administrator has advised the plaintiff that

she has exhausted her administrative remedies, a plaintiff’s subsequent submissions

in support of her finally-determined benefits claim, even if voluntarily accepted by

the administrator, do not expand the scope of the record for determining ERISA

liability. Instead, those records are meaningless non-events insofar as an

administrator’s exposure to ERISA liability is concerned. 

Here, there is no allegation that Ms. Blair ever filed a new application for longterm disability benefits under the Plan that includes both pre-January 2009 and postJanuary 2009 records that she contends confirm her still-disabled status. (See Doc.

36 at 3 ¶ 2 (“Blair has not filed a new application for benefits.”));7

(cf. Blair I, Doc.

evidence.”); Florasynth Laboratories,Inc. v. Goldberg, 191 F.2d 877 (7th Cir. 1951).

We must first address whether the record affords sufficient information from which

the district court could dismiss the complaint on the grounds of res judicata.

Concordia, 693 F.2d at 1075 (emphasis added). Here, the face of the complaint in Blair II expressly

disavows the presence of res judicata or collateral estoppel (Doc. 1-1 at 4 ¶ 16) and the record from

Blair I has not been received in Blair II. See Concordia, 693 F.2d at 1076 (“As a general rule, a court

in one case will not take judicial notice of its own records in another and distinct case even between

the same parties, unless the prior proceedings are introduced into evidence.” (internal quotation

marks omitted) (emphasis added) (quoting Guam, 288 F.2d at 23)).

7

 All page references to Doc. 36 correspond with the court’s CM/ECF numbering system.

11

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 11 of 21
35 at 42 n.17 (“The court expresses no opinion on whether Plaintiff might be entitled

to file another application for LTD benefits under the Plan or, if she were to do so,

how the additional evidence she submitted after the denial of her appeal might impact

a disability determination by MetLife.”)). Consequently, the universe of documents

that MetLife islegally obligated to consider under ERISA islimited to only those that

Ms. Blair submitted prior to January 30, 2009. See Blankenship v. Metro. Life Ins.

Co., 644 F.3d 1350, 1354 (11th Cir. 2011) (“Review of the plan administrator’s

denial of benefits is limited to consideration of the material available to the

administrator at the time it made its decision.” (citing Jett v. Blue Cross &Blue Shield

of Ala., Inc., 890 F.2d 1137, 1140 (11th Cir. 1989))).

Concomitantly, no ERISA liability in Blair II can lie for MetLife’s failure to

render a replacement disability decision factoring in those additional untimely

submitted records that it undertook to review only as a courtesy to Ms. Blair. As the

Eleventh Circuit explained in Blair I, MetLife cannot be ordered to “reconsider [Ms.

Blair’s] claim in light of the evidence she failed to timely submit and which MetLife

had no legal obligation to consider, under either the terms of the Plan or ERISA

itself.” Blair I, 569 F. App’x at 830; see Harvey v. Standard Ins. Co., 503 F. App’x

845, 849 (11th Cir. 2013) (“However, the district court correctly determined that

Standard did not unreasonably disregard these documents asthey were notsubmitted

12

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 12 of 21
to Standard until after it had rendered a final decision on her administrative appeal

on March 15, 2010[;] [i]nstead, Harvey submitted these documents as part of her

subsequent voluntary review . . . .”) (emphasis in original);8

id. (“Therefore only the

record before Standard during its consideration of Harvey’s initial claim or

administrative review thereon is relevant.”); cf. McCay v. Drummond Co., 509 F.

App’x 944, 949 (11th Cir. 2013) (rejecting plaintiff’s position that “there is a

continuing duty [to consider any new evidence], regardless of whether the final

determination has been reached on his claim, regardless of whether the plaintiff made

an effort to exhaust the administrative remedies available to him, and regardless of

whether the plaintiff is even employed or still a participant in the Plan”) (emphasis

added).9 Stated differently, because under Blair I MetLife had no ERISA-based

obligation to evaluate those late-submitted materials from Ms. Blair in an attempt to

resurrect her denied LTD Claim, MetLife similarly cannot be held liable in this case

for failing to follow through on thatsame voluntary process. Therefore, Blair I means

that Blair II seeks redress against MetLife that is implausible. 

The court rejects Ms. Blair’s efforts to create a plausible ERISA claim by

asserting waiver on the part of MetLife by virtue of its voluntary decision to undergo

8 Ms. Blair’s counsel in Blair I and Blair II, Myron Allenstein (“Mr. Allenstein”), is listed

as an attorney of record for the plaintiff in Harvey.

9

 Mr. Allenstein is also listed as an attorney of record for the plaintiff in McCay.

13

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 13 of 21
a second courtesy review of Ms. Blair’s LTD Claim. (Doc. 34 at 11-16). The Eleventh

Circuit has described waiver in the context of an ERISA case as “the voluntary,

intentional relinquishment of a known right.” Glass v. United of Omaha Life Ins. Co.,

33 F.3d 1341, 1348 (11th Cir. 1994) (citing Pitts by and through Pitts v. American

Security Life Ins. Co., 931 F.2d 351, 355 (5th Cir. 1991)). Ms. Blair suggests that

because the Eleventh Circuit has not completely foreclosed a plaintiff’sright to assert

waiver in an ERISA dispute, see Glass v. United of Omaha Life Ins. Co., 33 F.3d

1341, 1348 (11th Cir. 1994) (“declin[ing] to incorporate as part of the federal

common law of ERISA a ‘something-for-nothing’ waiver claim[,]” with respect to

mistakes made by the insurer in dealing with the eligibility of some enrollees, but

“leav[ing] open whether in other circumstances waiver principles might apply under

the federal common law in the ERISA context”), Blair II states a cognizable claim.

However, merely leaving the door open for waiver to conceivably become viable

under ERISA-federal common law by no certainty means that waiver, if ever

expressly embraced in this circuit, would plausibly apply to this set of facts. See

Iqbal, 556 U.S. at 680, 129 S. Ct. at 1950-51 (instructing that merely conceivable

claims fall short of satisfying Rule 8’s line of plausibility); cf. Glass, 33 F.3d 1347

(“[N]ot all common law insurance principles automatically apply to ERISA-regulated

insurance policies.”); cf. also id. (“In the Eleventh Circuit we have created a very

14

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 14 of 21
narrow common law doctrine under ERISA for equitable estoppel . . . .”) (emphasis

added); id. at 1347 n.5 (“ERISA waiver principles, if they emerge in this circuit, may

be quite distinctfromstate waiver law, and partiesshould recognize this.”) (emphasis

added).

Moreover, in light of Blakenship’s binding guidance about the proper scope of

the administrative record and the persuasive insight gleaned fromBlairI, Harvey, and

McCay, the court strongly doubts that the Eleventh Circuit will ever apply waiver to

sustain an ERISA benefits claim premised upon an insurer’s willingness to undergo

a courtesy review of supplemental records, which non-mandatory process is then

circumvented by a plaintiff’s intervening appeal to federal court in a related action

the challenges the final denial of the same long-term disability claim. Indeed,

allowing waiver to apply to such a situation resembles the “something-for-nothing”

waiver claim squarely rejected by the Eleventh Circuit in Glass–MetLife has

equitably opened the door to ERISA benefits liability for initiating, but not

completing, the courtesy review or voluntary reconsideration of her LTD Claim even

though Ms. Blair was given all the review that she was contractually due to receive

from MetLife under the Plan.

10

10 Permitting such a waiver application would also seem to run afoul of the Supreme Court’s

decision in Varity and the Eleventh Circuit’s opinions in Ogden and Katz, discussed infra at 16-18,

as a plan participant would be invoking the equitable principle of waiver, presumably pursuant to

15

Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 15 of 21
Finally, to the extent that Ms. Blair is attempting to recast her LTD Claim in

Blair II as an equitable one arising under Section 502(a)(3),11 MetLife correctly

points out that, because she otherwise has an adequate remedy “elsewhere in the

ERISA’sstatutory framework[,]” see Ogden v. Blue BellCreameries U.S.A., Inc., 348

F.3d 1284, 1288 (11th Cir. 2003) (quoting Hembree v. Provident Life and Accident

Ins. Co., 127 F. Supp. 2d 1265, 1274 (N.D. Ga. 2000)), she is precluded from

pursuing relief under ERISA’s catchall equitable enforcement provision. 

As the Ogden court summarized the Supreme Court’s limitations placed upon

the availability of relief under Section 502(a)(3):

We explained inKatz v. Comprehensive Plan of Group Insurance,

197 F.3d 1084 (11th Cir. 1999), that an ERISA plaintiff who has an

adequate remedy under Section 502(a)(1)(B) cannot alternatively plead

and proceed underSection 502(a)(3). Id. at 1088-89. We also recognized

that an ERISA plaintiff that had an adequate remedy under Section

502(a)(1)(B) cannot assert a Section 502(a)(3) claim after his Section

502(a)(1)(B) claim has been lost. Id. at 1089.

Section 502(a)(3), to save an otherwise administratively exhausted or “lost” claim under Section

502(a)(1)(B).

11

It appears from certain portions of Ms. Blair’s opposition and sur reply that in Blair IIshe

exclusively seeks disability benefits under Section 502(a)(1)(B). (See, e.g., Doc. 34 at 26 (“Blair is

not making equitable claims.”)); (Doc. 36 at 4 ¶ 3 (indicating that “[c]ounsel for Blair routinely

requests equitable relief” under Section 502(a)(3), but clarifying that “[i]n this case she specifically

requests LTD benefits” under Section 502(a)(1)(B))); see also 29 U.S.C. § 1132(a)(1)(B) (allowing

participant to file suit “to recover benefits due to him under the terms of his plan”). However, these

statements are inconsistent with Ms. Blair’s attempts to invoke judicial estoppel and waiver in

opposition to MetLife’s Dismissal Motion, which concepts are founded in equity. See supra at 9 n.5

and 15-16 n.10.

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Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 16 of 21
In Katz, we affirmed a district court’s finding on summary

judgment that, pursuant to the Supreme Court’s holding in Varity Corp.

v. Howe, 516 U.S. 489, 116 S. Ct. 1065, 134 L. Ed. 2d 130 (1996), an

ERISA plaintiff could not state a valid claim for equitable relief when

Section 502(a)(1)(B) afforded her with an adequate remedy, even though

her Section 502(a)(1)(B) claim was subsequently lost on the merits.

Katz, 197 F.3d at 1089. In Varity, the Supreme Court held that a class of

ERISA beneficiaries had stated a claim for injunctive relief under

Section 502(a)(3) and reinstated themto theirformer employer’s welfare

benefit plan. Varity, 516 U.S. at 504-14, 116 S. Ct. at 1075-79. In so

holding, however,theSupreme Court emphasized that Section 502(a)(3)

is a “catchall” provision that provides relief only for injuriesthat are not

otherwise adequately provided for by ERISA. According to the Court,

“where Congress elsewhere provided adequate relief for a beneficiary’s

injury, there will likely be no need for further equitable relief, in which

case such relief would not be ‘appropriate.’” Id. at 515, 116 S. Ct. at

1079.

Following this instruction, we held in Katz that the plaintiff had

no Section 502(a)(3) cause of action because, at the time the district

court dismissed her Section 502(a)(3) claim, she had an adequate

remedy under Section 502(a)(1)(B). Katz, 197 F.3d at 1089; see also

Larocca v. Borden, Inc., 276 F.3d 22, 28 (1st Cir. 2002) (commenting

that “following [Varity], federal courts have uniformly concluded that,

if a plaintiff can pursue benefits under the plan pursuant to Section a(1),

there is an adequate remedy under the plan which bars a further remedy

under Section a(3)”). We further held that the availability of relief under

Section 502(a)(3) was in no way dependent on the success or failure of

the Section 502(a)(1)(B) claim because “the availability of an adequate

remedy under the law for Varity purposes, does not mean, nor does it

guarantee, an adjudication in one’s favor.” Katz, 197 F.3d at 1089;

accord Tolson v. Avondale Indus., Inc., 141 F.3d 604, 610 (5th Cir.

1998);see also Hembree ex rel. Hembree v. Provident Life and Accident

Ins. Co., 127 F. Supp. 2d 1265, 1273-74 (N.D. Ga. 2000) (holding that

a plaintiff could not assert a Section 502(a)(3) claim when the

contractual statute of limitations barred his Section 502(a)(1) claim).

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Ogden, 348 F.3d at 1287 (emphasis added). 

Consequently, because Section 502(a)(1)(B) adequately addresses Ms. Blair’s

benefits-related injury under ERISA, her LTD Claim cannot be salvaged by resorting

to ERISA’s conditional catchall provision by invoking waiver, judicial estoppel, or

any other equitable doctrine against MetLife. Thus, for all the foregoing reasons,

MetLife’s Dismissal Motion is due to be granted in terms of dismissing Blair II.

12

MetLife also has included a one-sentence tagalong request for attorney’s fees

and costs at the very end of its Dismissal Motion. (Doc. 29 at 15);13

(see also Doc. 35

at 8 n.7; id. at 9). Because MetLife has wholly failed to set out the appropriate

standard(s) for this court to apply, much less quantified and substantiated the

reasonableness of the attorney’sfees and coststhat itseeks to recover from Ms. Blair,

that portion of its Dismissal Motion is due to be denied.

B. Ms. Blair’s Amend Motion

The court hasstudied Ms. Blair’s proposed amended complaint (Doc. 28 at 3-7

¶¶ 1-17)

14

that she incorporated into her Amend Motion, as well as MetLife’s

12

 The court rejects as undeveloped and unpersuasive, see infra at 20-21, Ms. Blair’s onesentence statement about tolling and the accompanying non-contextualized block quote from 29

C.F.R. § 2560.503-1(c)(3), which she incorrectly identifies as “§ 2560.503-(c)(3).” (Doc. 34 at 25-

26).

13 All page references to Doc. 29 correspond with the court’s CM/ECF numbering system.

14 All page references to Doc. 28 correspond with the court’s CM/ECF numbering system.

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opposition. (Doc. 30). Because, with respect to those allegations pivotal to the court’s

Rule 12(b)(6) analysis, the amended assertions are essentially the same as those

included in her initial complaint (see, e.g., Doc. 28 at 3 ¶ 4 (“MetLife denied LTD

benefits and MetLife denied Blair’s administrative appeal on 1/30/09.”)), Ms. Blair

still has notstated a plausible ERISA claim. Consequently, her Amend Motion is due

to be denied as futile.

C. Ms. Blair’s Remaining Motions

Ms. Blair’s Compel and Sur Reply Motions are due to be termed as moot, as

nothing within either filing addressesthe key underpinnings of the court’sreasonsfor

granting MetLife’s Dismissal Motion. As explained above, the LTD Claim in Blair

II consists of disability records submitted by Ms. Blair after MetLife had finally

denied her benefits under the Plan. Seeking to impose liability upon MetLife in its

handling of these temporally deficient submissions is simply an implausibility under

ERISA, even if MetLife did, indeed, “do Ms. Blair wrong”

15

 in agreeing to conduct

a courtesy review, but never providing her with any results. More specifically, no

amount of discovery fromMetLife about “further reviews” or “second appeals” (Doc.

15 As set forth in § II.A, supra, Twiqbal’s plausibility standard “demands more than an

unadorned, the-defendant-unlawfully-harmed-me accusation.” Iqbal, 556 U.S. at 678, 129 S. Ct. at

1949. Ms. Blair’s complaint does not even clear the less demanding “the-defendant-unlawfullyharmed-me” hurdle. Instead, all she has are conclusory allegations that MetLife harmed her in a

manner that is not unlawful under ERISA.

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Case 4:13-cv-01789-VEH Document 42 Filed 03/02/16 Page 19 of 21
37 at 2) will legally transform Ms. Blair’s dispute into one protected under the Plan

or by ERISA. 

Similarly, nothing mentioned in Ms. Blair’s proposed sur reply (Doc. 36 at 3-4)

causes the court to alter its analysis of Blair II’s inherently implausible nature. Thus,

the court’s ruling on the Dismissal Motion remains favorable to MetLife with or

without regard to the discovery sought by Ms. Blair in her Compel Motion or the

points of clarification raised in her Sur Reply Motion’s proposed brief.

Alternatively, Ms. Blair’s Compel and Sur Reply Motions are due to be denied

as undeveloped. With the notable exceptions of motions that are either filed “jointly”

or as “unopposed,” this court rarely, if ever, grants a motion that is supported solely

by the moving party’s counsel’sipse dixit. Furthermore, as Ms. Blair ineffectively has

done here, offering only a one- or two-sentence statement that meagerly requests

relief while simultaneously omitting any on-point authorities (Doc. 36 at 1; Doc. 37

at 1) is a perfunctorily-made and, ultimately, an entirely unpersuasive, motion. Cf.

Flanigan’s Enters., Inc. v. Fulton Cty., 242 F.3d 976, 987 n.16 (11th Cir. 2001) (per

curiam), superseded by statute on other grounds as recognized in 596 F.3d 1265

(11th Cir. 2010) (holding that a party waives an argument if the party “fail[s] to

elaborate or provide any citation of authority in support” of the argument); Ordower

v. Feldman, 826 F.2d 1569, 1576 (7th Cir. 1987) (stating that an argument made

20

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without citation to authority is insufficient to raise an issue before the court).

IV. Conclusion

Therefore, MetLife’s Dismissal Motion is due to be granted in part and

otherwise denied. Further, Ms. Blair’s Amend Motion is due to be denied and her

Compel and Sur ReplyMotions are due to be termed as moot or, alternatively, denied.

The court will enter a separate order of dismissal consistent with this memorandum

opinion.

DONE and ORDERED this the 2nd day of March, 2016.

 

 VIRGINIA EMERSON HOPKINS

United States District Judge

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