Opinion ID: 3028801
Heading Depth: 3
Heading Rank: 3

Heading: District Court Review

Text: Gambino and his wife, Danielle, brought suit in the District of New Jersey against 8 Liberty, alleging violations of ERISA that caused the loss of both STD and LTD benefits, and against Dr. Arnouk, claiming that his office’s failure to supply information caused Liberty to deny Gambino’s claim. Judge Hochberg presided over a bench trial at which she heard testimony from Gambino and his wife, Dr. Arnouk, and Harriett Michael, the case manager at Liberty who handled Gambino’s appeal. During theGambinos’ and Dr. Arnouk’s testimony, counsel for Liberty frequently objected that the witnesses were providing testimony as to facts that were not in the administrative record, upon which Liberty based its denial of STD benefits, and which were not otherwise permissibly relevant. At the conclusion of the bench trial, the District Court dismissed the suit against Dr. Arnouk, finding inconclusive proof of liability. Gambino v. Liberty Life Assurance Coompany of Boston, 2005 WL 4839146, at  (D.N.J. 2005). The District Court found Liberty’s denial of Gambino’s STD claim to be “arbitrary and capricious” and awarded Gambino STD benefits pursuant to 29 U.S.C. § 1132(a)(1)(B), in the amount of $22,749.13. Id. at . The District Court also found that Gambino “could not have been expected to have applied for” LTD benefits after being denied STD benefits, as it was “entirely foreseeable” that a denial of STD benefits “would likely cause a beneficiary to assume that an LTD claim would be futile.” Id. at . Because the District Court found that Liberty had violated the provisions of ERISA by denying Gambino’s STD claim in an arbitrary and capricious manner, the court determined that Gambino was also entitled to equitable relief with respect to his request for LTD benefits. Id. As an equitable remedy, the court ordered Liberty, 9 which had the authority to process claims for LTD benefits, to process Gambino’s claim for LTD benefits as if it had been timely filed and to make a recommendation to IKON following the usual and customary procedures for evaluating LTD claims. Id. The District Court did not explain what effect its ruling would have on IKON, a non-party to the suit, which serves as the insurer for the LTD plan and would be responsible for making any LTD benefit payments to Gambino.