NOT FOR PUBLICATION

UNITED STATES DISTRICT COURT

DISTRICT OF NEW JERSEY

KEVIN GIBLIN, Civil Action No. 11-2603 (JLL)

Plaintiff,

OPINION

V.

SUN LIFE AND HEALTH INSURANCE

COMPANY, et a!.

Defendants.

LINARES, District Judge.

This matter comes before the Court by way of Defendant Sun Life and Health Insurance

Company (“Defendant”)’s motion for reconsideration of this Court’s August 20, 2012 Opinion

and Order denying Defendant’s motion for summary judgment. The Court has considered the

submissions made in support of and in opposition to the instant motion, and decides this matter

without oral argument pursuant to Fed. R. Civ. P. 78. For the reasons set forth below,

Defendant’s motion for reconsideration is denied.

I. BACKGROUND

The facts of this case are more fully detailed in this Court’s August 20, 2012 Opinion,

and are repeated here only to the extent they are relevant to the instant motion for

reconsideration.

This case arises from Plaintiff Kevin Giblin (“Plaintiff’)’s claim for recovery of disability

income benefits pursuant to § 502(a)( 1 )(B) of the Employee Retirement Income Security Act

(“ERISA”). See 29 U.S.C. § 1 132(a)(1)(B). Plaintiff was a full-time employee ofthe New York

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City District Council of Carpenters (“NYDCC”) until August 7, 2007 when he ceased working

as a result ofmedical conditions which he alleges include pulmonary dysfunction and

cardiovascular disease. (Compi. ¶ 8.) As an employee ofthe NYDCC, Plaintiff participated in

the Employee Welfare Benefit Plan (the “Plan”) which provided Group Long Term Disability

Benefits to employees of the NYDCC. (See id. ¶J 6-7.)

After ending his employment, Plaintiff made a claim for benefits under the Plan. (Id. ¶

9.) As the insurer and claims fiduciary of the Plan, Defendant initially accepted Plaintiff’s claim

and paid benefits through November 1, 2009, at which time it terminated Plaintiffs benefits.

(Id. ¶ 10.) Upon Defendant’s termination of benefits, Plaintiff filed an administrative appeal in

accordance with 29 U.S.C. § 1133. (Id. ¶ 12.) In support of his appeal, Plaintiffsubmitted

reports from his treating and examining physicians and other medical evidence in support of his

claim for disability benefits. (Id.) Additionally, Plaintiff was examined by Defendant’s

physician, Dr. Monroe Karetzky, who ultimately disputed the medical premise underlying

Plaintiffs disability claim. (CM/ECF No. 16-3 at ¶J 49-51.) Other physicians employed by

Defendant reviewed Plaintiffs medical records, and also disputed the medical premise upon

which Plaintiffs disability claim is based. (See, e.g., CM/ECF No. 16-3 at ¶J 17-18, 39-42, 49-

51.)

On April 13, 2012, the parties filed cross-motions for summary judgment. (See CM/ECF

Nos. 16, 17.) On August 30, 2012, this Court denied each party’s motion upon concluding that

conflicting medical evidence in the record created “issues of fact that prevent[edj the Court from

granting summary judgment.” (CMIECF No. 20 at 7.) Defendant filed the instant motion for

reconsideration on August 30, 2012.

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II. LEGAL STANDARD

“Reconsideration is an extraordinary remedy” and should be “granted ‘very sparingly’.”

See L. Civ. R. 7.1(i) cmt. 6(d); see also Fellenz v. Lombard Investment Corp., 400 F. Supp. 2d

681 (D.N.J. 2005). A motion for reconsideration “may not be used to re-litigate old matters” or

argue new matters that could have been raised before the original decision was reached. See,

e.g., F. Schoenfeld Asset Mgmt., LLCv. Cendant Corp., 161 F. Supp. 2d 349, 352 (D.N.J. 2001).

To prevail on a motion for reconsideration, the moving party must “set [] forth concisely

the matter or controlling decisions which the party believes the Judge or Magistrate Judge has

overlooked.” L. Civ. R. 7.1. When the assertion is that the Court overlooked something, the

Court must have overlooked “some dispositive factual or legal matter that was presented to it.”

McGovern v. City ofJersey City, No. 98-5 186, 2008 U.S. Dist. LEXIS 293, 2008 WL 58820, at

*2 (D.N.J. Jan. 2, 2008). The Court will reconsider a prior order only where a different outcome

is justified by: 1) an intervening change in law; 2) availability of new evidence not previously

available; or 3) a need to correct a clear error of law or manifest injustice. See N River Ins. Co.

v. CIGNA Reinsurance, Co., 52 F.3d 1194, 1218 (3d Cir. 1995).

III. DISCUSSION

Defendant argues that in denying its motion for summary judgment, this Court

overlooked controlling precedent regarding the manner in which ERISA cases are decided. (See

CMIECF No. 21-1 at 3-7.) Defendant further argues that because the record establishes that its

decision to terminate Plaintiff’s benefits was not arbitrary and capricious, this Court should grant

summary judgment in its favor. (CM/ECF No. 21-1 at 7-8.) The Court will address each of

these arguments in turn.

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A. Whether this Court Overlooked Controlling Precedent

Defendant contends that in denying its motion for summary judgment based on the

conflicting medical evidence in the record, this Court ignored Third Circuit precedent which has

recognized “motions for summary judgment as the only appropriate way to bring the issue of

eligibility for benefits [under the arbitrary and capricious standard of review] before the court.”

(CM/ECF No. 21-1 at 6, emphasis in original.) In support ofits argument, Defendant relies on a

footnote in Lasser v. Reliance Std. Ins. Co., 344 F.3d 381 (3d Cir. 2003) which states that “de

novo fact finding is improper in reviewing a claims administrator’s decision under the arbitrary

and capricious standard ofreview.” Id. at 385 n.3.

Defendant’s reliance on Lasser is misplaced. Nothing in Lasser supports Plaintiffs

proposition that summary judgment is the only appropriate means by which a district court may

decide whether a plaintiffis eligible for benefits under the arbitrary and capricious standard of

review. As in this case, in Lasser the district court denied the parties’ cross-motions for

summary judgment because there was conflicting medical evidence in the record. Id. at 384 n.2.

It was only after the district court held a bench trial to determine whether the defendant

administrator had a conflict of interest that the court ruled on the plaintiffs claim.

This Court does not dispute that Lasser supports the proposition that this Court should

refrain from de novo fact finding in determining whether Defendant’s decision was arbitrary and

capricious. Nothing in Lasser, however, precludes this Court from considering evidence

presented during a bench trial to obtain a better understanding of the factual record upon which

Defendant relied in deciding to terminate Plaintiffs benefit, and make a determination as to

whether Defendant’s decision was arbitrary and capricious in light ofthat record.

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Indeed, there is ample authority within the Third Circuit recognizing the propriety of a

district court’s considering evidence that is not strictly within the administrative record for such

purposes. See, e.g., Kosiba v. Merck & Co., 384 F.3d 58, 69 (3d Cir. 2004) (“While the District

Court may take further evidence to aid in its understanding ofthe medical issues involved, it

must base its ultimate determination on the record before the plan administrator, not its own

judgment of whether [the plaintiff] was disabled.”) (emphasis added); see also Howley v. Mellon

Fin. Corp., 625 F.3d 788, 793 (3d Cir. 2004) (“A court may certainly consider evidence of

potential biases and conflicts of interest that is not found in the administrator’s record.”);

O’Sullivan v. Metropolitan Life Ins. Co., 114 F. Supp. 2d 303, 310 (D.N.J. 2000) (observing that

“evidence [outside the administrative recordj that assists the district court in understanding the

medical terminology or practice relating to a claim would be admissible, as such information

would not be beyond the scope of evidence before the administrator at the time of its decision.”).

Accordingly, this Court finds Defendant’s argument that summary judgment is the only

means by which this Court can adjudicate the instant case to be devoid of merit.

B. Whether Defendant’s Denial of Plaintiff’s Benefits was Arbitrary and Capricious

Defendant’s argument that its motion for summary judgment should have been granted

because its “decision was not arbitrary and capricious” is not an adequate basis upon which a

motion for reconsideration may be granted. In its original summary judgment motion, Defendant

devoted approximately seven pages to arguing that its decision to terminate Plaintiffs benefits

was not arbitrary and capricious. (See CM/ECF No. 16-2 at 18-25.) Defendant’s attempt to re

litigate this issue in its motion for reconsideration is improper. See, e.g., P. Schoenfrld, 161 F.

Supp. 2d at 352 (“Reconsideration motions. . . may not be used to re-litigate old matters.”).

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IV. CONCLUSION

For the foregoing reasons, Defendant’s motion for reconsideration ofthis Court’s August

20, 2012 Opinion and Order denying its motion for summary judgment is denied. An

appropriate order follows.

Date: October !, 2012

JØ L. Linares

Vjjitèd States District Judge

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