N O T FO R PUB L ICAT IO N UNITED STATES C OUR T OF APPEALS FOR THE NINTH C IR C UIT
R OB ER T GOR

DON, Pla i ntiff-Appe lla

nt, v. M ETR OPOLITAN LIFE INSUR ANC E C OM PANY,

De fe nda n t-Appe l le e . No. 17-16821 D.C . No. 5:10-c v-05399-EJD M EM O R ANDUM *

Appe a l from

the Unite d

Stat e s Distric t C ourt for the Northe rn Distric t of C a lifornia Edwa rd J. Da vila , Distric t Judge , Pre s iding Subm itte d De c e m

be r 19, 2018 ** San Fran c isc o , C a lifornia B e fore : C ALLAHAN, N.R . SM ITH, a nd M UR GUIA, C irc uit Judge s. R obe rt Gordon brought suit a ga inst M e tropolita

n Life Insura

nc e C o m pa ny (M e tLife ) for its de nia l of longte rm disa bility be ne fits unde r a

pla n gove rne d by the E m ploy e e R e tire m e nt Inc om e Se c urity Ac t of 1974 (ER

ISA), 29 U.S.C
. 

# FIL ED JAN 04 2019 M OLLY C. DW Y ER, CLERK U
. S. CO URT O F APPEALS

* This disposition is not a ppropria te for public a t ion a

nd is not pre c e de nt e xc e pt a s provide d

by Ninth C irc uit R

ule 36-3.

* * The pa

ne l una nim ously c onc lude s this c a se is suita ble for de c ision without ora l a

rgum e nt. Se e Fe d. R . App. P. 34(a )(2).§§ 1001-1461. The distric t c ourt gra

nte d sum m ary judgm e nt in M e tLife ’ s favor, a pply ing a n a buse of disc re tion sta

nda rd. B e c a use the distric t c ourt a

pplie d the wrong sta nda rd, we re ve rse and re m and. The distric t c ourt re vie ws a de c ision to deny

be ne fits unde r an ERISA pla n de novo “unle ss the be n e fit pla n give s the a dm inistra

tor or fiduc ia

ry disc re tiona

ry a uthority to de te rm ine e ligibility

for be n e fits or to c o nstrue the te rm s of the pla n.” Gatti v . Re lianc e Standard Life Ins. C o. , 415 F.3d 978, 981 (9th C ir. 2005) (quoting Fire

stone Tire & Rubbe r C

o . v . Bruc h , 489 U.S. 101, 115 (1989)). “ W h e n the p la n give s the a dm i nistra

tor or fiduc ia

ry disc re tiona

ry a uthority to de te rm ine e ligibility for be n e fits, tha

t de te rm ination is re vie we d for a buse of disc re tion.” Id. Howe ve r, e ve n whe re a

pla n give s disc re tiona

ry a uthority to the a dm inistra

tor, 1 de novo re vie w (ra t

he r tha n a buse of disc re tion re vie w) a pplie s whe n

an a dm inistra

tor fa ils to a c tua lly

e xe rc i se its disc re tion in the de nia l of be ne fits or whe n a n a dm inistra

tor c om m its “ whole sa le and fla grant viola tions of theproc e dura l re quire m e nts of ER

ISA, an d . . . a c ts in utter disre ga rd of the unde rly ing purposeof the [be ne fit] pla

n[.] ” Abatie

v . Alta He alth &LifeIns. C o. , 458 F.3d 955, 971-72 (9th C ir. 2006) (e n ba

nc )
.

1 It is undispute d tha

t the be ne fit pla

n at issue gave M e tLife disc re tiona ry a uthority
. 2He re , M e tLife ’ s de nia l of be ne fits is subje c t to de novo re vie w, be c a use (1) M e t Life did not e xe rc ise its disc re tion whe n it fa i le d to issuea fina l de c ision on Gordon’ s a

ppe a l of its initia

l de nia l of be n e fits, e ve n y e ars a fte r the 90-da y de a dline to do so, a

n d (2) tha t fa ilure is a

whole sa le an d fla grant viola tion of the re quire m e nts of both ER

ISA an d the be ne fit pla

n. S e e Abatie , 458 F.3d a

t 971. De spite the distric t c ourt’ s c ha ra c te riz a tion tha

t M e tLife viola

te d only tim ing re quire m e nts, M e tLife ’ s fa ilure to issuea fina l de c ision on the

a ppe a l a fte r y e ars (and without e xp la

nation) is ne c e ssa

rily a viola tion of theproc e dura l re q uire m e nts for a p pe a ls se t forth in ER

ISA. Se e 29 C .F.R . § 2560.503–1(h)-(j). Suc h a c tion utte rly disre ga rds M e tLife ’ s obliga

tions a s a pla n a dm inistra

tor. Sum m a ry judgm e nt in a

n ERISA c a s e is only prope r whe re the re are no ge nuine d ispute s of m a te ria l fa c t, a nd the m ova

nt is e ntitle d to judgm e nt a s a m a tte r of la

w. Fe d . R . C iv. P. 56(a )
. B e c a use the pa rtie s have produc e d c onflic ting
m e dic a l opinions re ga

rding Gordon’ s disa

bility , those opinions c re a te a ge n uine dispute of m ate ria l fa c t. Ac c ordingly , we re ve rse the distric t c ourt’ s im prope r gran t of sum m a ry judgm e nt. RE V E RSE D and RE M A NDE D .

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