507 F.Supp.3d 384
D. Conn.2020Background
- Patricia Hughes, beneficiary under a long-term disability plan, had benefits terminated after Hartford concluded she failed to prove disability beyond October 5, 2016; she previously prevailed in Hughes I, which remanded for a full and fair review.
- On remand Hartford retained vendor Exam Coordinators Network (ECN) and doctors Eric Slattery and Arousiak Varpetian Maraian; Hartford issued an adverse appeal decision on August 30, 2019, just before the remand deadline.
- Hughes sued, then served discovery seeking: (1) completeness of Hartford’s administrative record; (2) evidence of Hartford’s financial conflict of interest; (3) bias of medical consultants; and (4) Hartford’s compliance with DOL claims-procedure regulations; she also sought in camera review of an email Hartford claimed privileged.
- The magistrate applied a "reasonable chance" standard for extra-record discovery: a plaintiff must show with specific facts (not conclusory allegations) a reasonable chance the requested discovery will produce "good cause" to expand the record.
- Rulings: limited extra-record discovery granted — drafts of the Aug. 30 letter; drafts and correspondence related to Dr. Slattery’s peer evaluation; DOL-regulation–responsive claims-procedure materials (29 C.F.R. § 2560.503‑1(j)(3) and (m)(8)) — and Hartford must submit the disputed privileged email for in camera review; Hartford’s motion for a protective order quashing duplicative non-party subpoenas was granted.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Proper standard for extra-record discovery in ERISA cases | Apply ordinary Rule 26 relevance/proportionality; allow broad discovery | Limit discovery; restrict extra-record evidence absent good cause to prevent burdens and preserve ERISA policy | Court adopts the "reasonable chance" standard: plaintiff must show specific facts (not conclusory) that the discovery has a reasonable chance to show "good cause" to expand the record |
| Completeness of administrative record (drafts of Aug. 30 decision and other files) | Drafts and other materials may show when Hartford decided and what it considered | Administrative record already contains what Hartford considered; drafts may be explainable and harmless | Ordered production of drafts/versions of the Aug. 30, 2019 letter (RFP No. 7); denied broader fishing requests about other missing ESI without specific factual basis |
| Discovery into Hartford’s structural conflict of interest (denial rates, internal statistics, disciplinary/regulatory history) | Conflict exists and Hartford acted on it; needs categorical discovery (denial rates, policies, disciplinary records) | Structural conflict alone is insufficient; statistics are unhelpful without context and are burdensome | Denied: mere existence of Glenn conflict insufficient; categorical "conflict" discovery (RFPs and interrogatories seeking denial rates, broad third‑party comparative data) not allowed without additional specific factual showing |
| Bias of medical reviewers (Dr. Slattery / ECN communications and report edits) | Slattery’s report edits and ECN interactions suggest bias and warrant discovery | Documents are either in the record already or irrelevant; subpoena procedural defect noted | Granted limited discovery: drafts of Dr. Slattery’s peer evaluation and correspondence between ECN/Hartford and Slattery about the evaluation (RFP No. 12, limited). Other broad requests denied |
| Documents under DOL claims-procedure regulation (29 C.F.R. § 2560.503‑1) | Claims manuals, policies and procedures relevant to whether Hughes received a full and fair review | Regulation does not alter Rule 26; many internal documents are confidential or not relevant | Ordered production, but only of documents that § 2560.503‑1(j)(3) and (m)(8) require or define as "relevant" (i.e., relied upon, considered, generated in course of decision, demonstrating compliance, or policy statements concerning the denied benefit); other requests denied |
| Privilege / fiduciary-exception (in-house counsel email) | Email concerned plan administration and is subject to ERISA fiduciary exception to attorney-client privilege; request in camera review | Hartford argues insurer-paid counsel is outside fiduciary exception (source-of-funds argument) | Ordered in camera review: Second Circuit fiduciary-exception precedent applies in ERISA context; Hartford must submit the email for the court’s review |
Key Cases Cited
- Halo v. Yale Health Plan, 819 F.3d 42 (2d Cir. 2016) (administrative‑record review principle and good‑cause framework)
- Locher v. UNUM Life Ins. Co. of Am., 389 F.3d 288 (2d Cir. 2004) (structural Glenn conflict alone does not establish good cause to expand the record)
- Metro. Life Ins. Co. v. Glenn, 554 U.S. 105 (2008) (recognition of administrator’s conflict when it both evaluates and pays claims)
- DeFelice v. Am. Int’l Life Assur. Co., 112 F.3d 61 (2d Cir. 1997) (discretionary extra-record evidence standard)
- Zervos v. Verizon N.Y., Inc., 277 F.3d 635 (2d Cir. 2002) (incompleteness of administrative record may be good cause)
- Muller v. First UNUM Life Ins. Co., 341 F.3d 119 (2d Cir. 2003) (presumption of review limited to administrative record)
- Pretty v. Prudential Life Ins. Co. of Am., 696 F. Supp. 2d 170 (D. Conn. 2010) (endorsing reasonable‑chance standard for discovery beyond the record)
- Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989) (discretionary review and conflict relevance)
- Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41 (1987) (ERISA purposes balancing litigation costs and claim fairness)
- In re Long Island Lighting Co., 129 F.3d 268 (2d Cir. 1997) (ERISA fiduciary exception to attorney-client privilege)
- Jicarilla Apache Nation v. United States, 564 U.S. 162 (2011) (fiduciary exception principles)