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United States District Court

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

LOUIS J. VELA,

Plaintiff,

 v.

AT&T UMBRELLA BENEFIT PLAN NO. 1,

Defendant

 /

No. C 08-1575

ORDER DENYING MOTIONS FOR

SUMMARY JUDGMENT WITHOUT

PREJUDICE; AFFORDING PLAINTIFF

OPPORTUNITY TO CONDUCT

DISCOVERY; DIRECTIONS TO PARTIES

Before the Court are (1) plaintiff Louis J. Vela’s motion for summary judgment, filed

February 24, 2009 and (2) defendant AT&T Umbrella Benefit Plan’s cross-motion for

summary judgment, filed March 20, 2009, each brought pursuant to Rule 56 of the Federal

Rules of Civil Procedure. Also before the Court are the parties’ supplemental briefings on

the issues raised by the Court as to (1) whether the term “Benefits Payable” under plaintiff’s

Disability Income Plan (“DIP”) refers to plaintiff’s gross or net benefits, (2) whether any

estoppel exists based on statements made by defendant to plaintiff’s wife, and (3) the

appropriate remedy if liability is established. Having considered the parties’ respective

submissions, the Court, as discussed below, will deny both motions without prejudice. 

In the course of the supplemental briefing, defendant sought to offer a declaration by

Tonya Warner (“Warner”) for the purpose of showing the claims administrator has

consistently interpreted the phrase “Benefits Payable” in the subject DIP to refer to gross

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 To the extent plaintiff may be arguing the Declaration is untimely, the Court finds to

the contrary. The Declaration was submitted solely in connection with the first of the

above-referenced three issues on which supplemental briefing was allowed, which issue

was not raised until the Court asked the parties to address it at the Case Management

Conference held on December 18, 2009. 

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benefits. (See Warner Decl. at ¶¶ 7-12.) Plaintiff objects to the Court’s consideration of the

Declaration on the grounds that it constitutes evidence outside the administrative record

and because discovery has closed.1

 

The scope of the evidence a district court may consider in reviewing a decision to

deny a claim under ERISA depends on whether the standard of review is abuse of

discretion or de novo. See Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 970 (9th Cir.

2006). In the instant case, the parties dispute the proper standard under which the

decision at issue should be reviewed, and further, if the standard is deemed to be abuse of

discretion, the degree of skepticism with which the Court should review said decision. (See

Pl.’s MSJ Reply at 2:17-21; see also Def.’s MSJ Reply at 7:5-10.) 

Under either standard of review, however, the Court finds, on the record before it,

the Declaration is relevant and admissible. See McDaniel v. Chevron Corp., 203 F.3d

1099, 1113 (9th Cir. 2000) (holding “consistent pattern of interpretation is significant

evidence” as to reasonableness of plan interpretation) (internal quotation and citation

omitted); Abatie, 458 F.3d at 968-70 (holding, under abuse of discretion standard, a “district

court may . . . consider evidence outside the administrative record to decide the nature,

extent, and effect on the decision-making process of any conflict of interest”; in determining

Court’s degree of skepticism “[a] Court may weigh a conflict more heavily if . . . the

administrator provides inconsistent reasons for denial . . . or has repeatedly denied benefits

to deserving participants by interpreting plan terms incorrectly”); Jebian v. Hewlett Packard,

349 F.3d 1098, 1110 (9th Cir. 2002) (holding, under de novo review, trial court may admit

additional evidence, beyond the record before the claims administrator, to “enable the full

exercise of informed and independent judgment”).

Nonetheless, as plaintiff points out, the documents on which Warner relies have not

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been submitted in connection with the Declaration and plaintiff has not had an opportunity

to conduct discovery with respect to any such additional evidence. Under the

circumstances, the Court will deny both motions for summary judgment without prejudice

and will afford plaintiff the opportunity to seek discovery with respect to defendant’s newly

proffered evidence. 

Accordingly, for the reasons stated above:

1. The parties’ pending motions for summary judgment are hereby DENIED

without prejudice.

2. Plaintiff may conduct limited discovery relevant to defendant’s additional

evidence; upon completion of such discovery, the parties shall renotice their motions for

summary judgment, and, if appropriate, submit in connection therewith a stipulated

schedule for additional supplemental briefing. 

IT IS SO ORDERED.

Dated: April 1, 2010 

MAXINE M. CHESNEY

United States District Judge

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